Screening

CAT scans and radiation exposure – pro

Any unecessary exposure that is not supported by credible literature is inappropiate and should be avoided. Several articles comment on radiation exposure from CT scans. Trigaux and Lacrosse recognize that computed tomography is a diagnostic procedure that involves relatively high radiation doses. Crawley et al confirm that as a diagnostic imaging modality, CT gives higher patient radiation dose in comparison with other imaging modalities. In the

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MRI for breast cancer – pro

Lay Summary: MRI is becoming widely accepted for breast cancer screening. For evaluation of suspected cancer, there must be a mammographic or ultrasound quandary that MRI can elucidate. Diagnostic:For evaluation of suspected cancer, according to 2008 European guidelines, there must be mammographic of ultrasound findings that MRI can clarify. Most guidelines do not recommend MRI for dense breasts alone but one lukewarmly endorses this idea. BC Guideline

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PET and CAT to stage stage II breast cancer – pro

Lay Summary: More extensive staging that is recommended by guidelines is commonly performed for stage II breast cancer but it can be avoided. Stage II is divided into stage IIA and stage IIB based on tumor size and whether it has spread to the axillary lymph nodes (the lymph nodes under the arm). In stage IIA, the cancer is either not larger than 2 centimeters and has spread to the axillary lymph nodes, or between 2 and 5 centimeters but has not

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Atypical hyperplasia: preventing development of breast cancer – pro

Atypical ductal hyperplasia is a condition which raises a risk of cancer but is not in itself cancer. As such, it does not fit the guidelines criteria to approve BRCA testing on the basis of the personal history of breast cacner. In fact, this condition is known to be prophylaxed by the use of tamoxifen, which is also an option for BRCA carriers. However, other BRCA options, such as prophylactic mastectomy and oophorectomy are not routinely performed

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Screening for hereditary pancreatic cancer – pro

The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening for pancreatic cancer in asymptomatic adults using abdominal palpation, ultrasonography, or serologic markers. The USPSTF found no evidence that screening for pancreatic cancer is effective in reducing mortality. There is a potential for significant harm due to the very low prevalence of pancreatic cancer, limited accuracy of available screening tests, the invasive

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Followup in lung cancer – pro

Gudelines for folowup of cancer patients are sparse. Among the few cancer types is lung. (The following is from the article by Colice et al: In lung cancer patients who have been treated with curative-intent therapy, the follow-up for complications related to the curative-intent therapy should be managed by the appropriate specialist and should probably last 3 to 6 months. At that point, the patient should be reevaluated by the multidisciplinary

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Thermography for breast cancer detection – pro

Thermography, when used in a clinical setting, is a diagnostic imaging procedure that detects, records, and produces an image (thermogram) of a patient's skin surface temperatures and/or thermal patterns. The procedure uses equipment that can provide both qualitative and quantitative representations of these temperature patterns. Standardized interpretation guidelines in thermal breast imaging have been utilized since the adoption of the 20 point

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BRCA testing without personal history – pro

Lay Summary: I discuss the guidelines for BRCA testing. There are two approaches to determining necessity for BRCA testing, one that focuses on specific family history and another that focuses on global risk. The USPSTF recommends against routine referral for genetic counseling or routine breast cancer susceptibility genes (BRCA) testing for women whose family history is not associated with an increased risk for deleterious mutations in breast cancer

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Breast Cancer Follow-UP – pro

It has now been well established that routine scans are not useful in follow-up care of breast cancer survivors. Guidelines recommend that all patients who have completed primary treatment for breast cancer should have regular follow-up surveillance consisting of medical history, physical examination and annual mammograms. It was also recommended that the frequency of visits be adjusted according to the individual patient's needs, that patients be

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Followup of Resected Gastric Cancer – pro

Patients with early gastric cancer have an excellent prognosis after appropriate treatment, with a high survival rate and a low rate of recurrence.There are no guidelines as to how to follow gastric cancer. A recent review concluded: " Early detection of asymptomatic gastric cancer recurrence did not improve overall survival of patients with recurrence after curative resection. Until development of more effective treatment for this disease, close

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