Women's Health and Education Center (WHEC)

Gynecologic Oncology

List of Articles

  • Breast Cancer Risk Assessment
    Breast cancer biology is a topic of intensive research, and there have been huge breakthroughs in recent years. Scientific insight into estrogen-receptor biology has led to major advances in estrogen-targeted prevention and chemotherapy. Increased breast density has emerged as a dominant, detectable, and modifiable risk factor for subsequent development of breast cancer in women. The purpose of this document is to discuss clinical application of the various tools available to assess a woman's risk for breast cancer and apply in clinical practice. This review also provides a comprehensive examination of the importance of breast density as a dominant risk factor for the development of breast cancer, highlighting the role that genetics and hormones play in maintaining breast density in postmenopausal women. Future research can be directed toward the detection of preexisting conditions (such as gene mutations) that put women at risk for highly aggressive cancers. Recommendations for genetic testing are reviewed here, with a particular focus on the components of genetic counseling, identifying individuals for testing, and interpreting test results.

  • Breast Cancer: Early Detection
    It is estimated that 217,640 new cases of breast cancer will be diagnosed in United States this year; more than 99% of these breast cancers occur in women. Breast cancer is the most common malignancy among U.S. women and it is the second leading cause of death from cancer among American women (lung cancer is first). A woman's lifetime risk (80-year life-span) of developing breast cancer is 12.5%, or 1 in 8. Early detection of breast cancer has been shown to decrease the mortality rate. Technology continues to evolve to improve the accuracy of detection. The review also focuses on mammography and other detection techniques as screening tools to identify non-palpable lesions. This information is designed to aid practitioners in making decisions about appropriate care. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institutions or type of practices.

  • Assessment & Prognostic Factors In Breast Cancer
    Few breast cancer risk factors are prevalent in more than 10% to 15% of the population, although some associated with very large relative risks (e.g., mutated genes, cellular atypia). Estimates of the summary population attributable risk for breast cancer range from only 21% to 55%, leaving most of the population attributable risk for the disease unexplained. Age is one of the most important risk factors for breast cancer. Although age-adjusted incidence rates continue to rise, breast cancer mortality has fallen in the past decade in the United States. It is useful for determining the extent of the disease, predicting overall survival, and providing guidance for therapy. Clinically established prognostic factors in breast cancer and concepts and mechanisms of breast cancer metastasis are also discussed. We hope our forums help the clinicians’ better understanding of the disease process and the patient management.

  • Evolution Of Surgical Management Of Breast Cancer
    The surgeon has become an integral part of a multidisciplinary team who manages patients with breast carcinoma. This team includes the diagnostic radiologist, radiation oncologist, medical oncologist, and pathologist. Our resolute purpose must always be to promote the best interest of each individual patient, and not those of surgery, radiotherapy or chemotherapy. The significant contributions of investigators for breast cancer management in the 20th century established the outcome results for conservative surgical techniques to be equivalent to those of radical approaches with regard to disease-free and overall survival. Preservation of the nipple-areolar complex (NAC) while performing a mastectomy is not a new concept for the treatment of breast disease. Historically, the subcutaneous mastectomy was performed in the setting of prophylaxis for high-risk patients or to reduce breast pain, but often left much breast tissue within the skin flaps and at the base of the NAC.

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