Page 17 - Delaware Medical Journal - March 2018
P. 17

SCIENTIFIC ARTICLE
1. Physical activity: 30 minutes of moderate physical activity 5x/week can 23
2. Smoking cessation: The risk of breast

than among non-smokers.24
3. Weight control: Being overweight

the risk of breast cancer as much as 25,26
4. Reducing alcohol intake: Alcohol increases the risk of breast cancer, and the risk is proportional to intake. Keep alcohol intake down to no more than one alcoholic beverage a day on average.27
IN SUMMARY
Breast density is not a strong independent risk factor for breast cancer, and most women with even  from screening MRI and/or ultrasound, as long as their annual mammogram is tomosynthesis.
Whether a woman does or does not have dense breasts on mammography, each woman should gather a detailed three generation family history and meet with her PCP to discuss breast cancer risk assessment and, most importantly, RISK REDUCTION. Prevention is better than early detection.
CONTRIBUTING AUTHORS
■ DIANA DICKSON-WITMER, MD, FACS is a Breast Surgical Oncologist and the Medical Director of the Breast Center and the Breast Program at Helen F. Graham Cancer Center and Research Institute in Newark, Del.
■ ARVIND SABESAN, MD is a Chief General Surgery Resident at Christiana Care Health System who will be attending Moffitt Cancer Center to complete a surgical oncology fellowship.
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3. Sprague BL, Gangnon RE, Burt V, et al. Prevalence of Mammographically Dense Breasts in the United
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4. Redondo A, Comas M, Macia F, et al. Inter- and intraradiologist variability in the BI-RADS assessment and breast density categories for screening mammograms. The British journal of Radiology 2012; 85(1019):1465-70.
5. Gard CC, Aiello Bowles EJ, Miglioretti DL, et al. Misclassification of Breast Imaging Reporting and Data System (BI-RADS) Mammographic Density and Implications for Breast Density Reporting Legislation. The Breast Journal 2015; 21(5):481-9.
6. Checka, CM; AJR. 2012, 198, W292-W295
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10. Hughes K; presentation at 33rd Annual Miami Breast Cancer Conference, March 10-13, Miami, Florida 11. Natinger AB, Ann Intern Med, June 2016
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13. Siu AL, Annals of Internal Medicine; 16 February 2016; 164(4); P 279-296
14. Oeffinger KC, Fontham ETH, Herzig A; Breast Cancer Screening for Women at Average Risk 2015 Guideline Update from the American Cancer Society. JAMA; 2015;314(15):p1599-1614
15. Perlman M, Jeudy M, Chelmow D; Breast Cancer Risk Assessment and Screening in Average –Risk Women. Practice Bulletin No. 179. Am College of Obstetricians and Gynecol 2017;130:el-16
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17. https://www.aafp.org/afp/2016/0415/p711.html. Accessed 1/20/2018
18. Freer PE; Breast Cancer Res Treat; 2015;153(2):p455-64
19. Throckmorton AD, Rhodes DJ, Huges KS, Degnim AC, Dickson-Witmer, D; Dense Breasts: what Do Our Patients Need to Be Told and Why?; Ann Surg Oncol; October 2016; DOI 10.1245/s10434-016-5400-3
20. Rhodes DJ, Hruska CB, Conners AL, et al. Journal club: molecular breast imaging at reduced radiation dose for supplemental screening in mammographically dense breasts. AJR. American Journal of Roentgenology 2015; 204(2):241-51.
21. Fisher B,Tamoxifen for prevention of breast cancer: current status of the NSABP-1 study. J Natl Cancer Inst; 2005; 97; p1652-62
22. Hartmann LC, et a; Efficacy of Bilateral Prophylactic Mastectomy in Women with a Family History of Breast Cancer. NEJM 1999; 340(2); p77-84
23. Dallal CM; Long-term recreational physical activity and risk of invasive and in situ breast cancer: the California teachers study. Arch Intern Med. 2007 Feb 26; 167(4); p408-15
24. American Cancer Society’s Cancer Prevention Study II (CPS-II), Journal of the Natl Cancer Institute; Feb 28, 2013
25. Reeves GK,. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ. 335(7630):1134, 2007.
26. Eliassen AH, Adult weight change and risk of postmenopausal breast cancer. JAMA; 296(2):193-201, 2006.
27. Smith-Warner SA, Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA; 1998;279:535-40
28. Melnikov J, Ann Intern Med; Jan 2016,164; p268-278
29. Aujero, M., MD, Holt, JS, MD Clinical Performance of Synthesized Two-dimensional Mammography
Combined with Tomosynthesis in a Large Screening Population Radiology; April 2017,283(1) 70-76
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