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BookDOI

European guidelines for quality assurance in breast cancer screening and diagnosis

TL;DR: The present supplements to the fourth edition of the European guidelines for quality assurance in breast cancer screening and diagnosis lay a cornerstone for a new, completely revised fifth editions of the guidelines.
Abstract: The fourth edition of the European guidelines for quality assurance in breast cancer screening and diagnosis was published by the European Commission in 2006. The present supplements to the fourth edition have been produced by the same groups of experts originally established under the Europe Against Cancer programme that have developed and updated the guidelines since the early 1990s. Over the years, the scope and the depth of the multidisciplinary guidelines have expanded, and recommendations and protocols have been updated to keep pace with developments in the field. The present supplements lay a cornerstone for a new, completely revised fifth edition of the guidelines

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Journal ArticleDOI
TL;DR: This work presents the results of a meta-analysis conducted at the 2016 European Oncology and Radiotherapy Guidelines Working Group (ESMO) workshop on breast cancer diagnosis and prognosis of women with atypical central giant cell granuloma (CGM) who have previously had surgery.

2,274 citations

Journal ArticleDOI
TL;DR: The use of mammography plus tomosynthesis in a screening environment resulted in a significantly higher cancer detection rate and enabled the detection of more invasive cancers.
Abstract: We found a significant increase in cancer detection rates, particularly for invasive cancers, and a simultaneous decrease in false-positive rates with use of mammography plus tomosynthesis compared with mammography alone.

890 citations

Journal ArticleDOI
TL;DR: The European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis (EQAQD) as mentioned in this paper have been developed as a global standard for quality assurance in breast cancer screening and diagnosis.

639 citations

Journal ArticleDOI
TL;DR: The availability of screening mammography was associated with a reduction in the rate of death from breast cancer, but the screening itself accounted for only about a third of the total reduction.
Abstract: Background A challenge in quantifying the effect of screening mammography on breast-cancer mortality is to provide valid comparison groups. The use of historical control subjects does not take into account chronologic trends associated with advances in breastcancer awareness and treatment. Methods The Norwegian breast-cancer screening program was started in 1996 and expanded geographically during the subsequent 9 years. Women between the ages of 50 and 69 years were offered screening mammography every 2 years. We compared the incidence-based rates of death from breast cancer in four groups: two groups of women who from 1996 through 2005 were living in counties with screening (screening group) or without screening (nonscreening group); and two historical-comparison groups that from 1986 through 1995 mirrored the current groups. Results We analyzed data from 40,075 women with breast cancer. The rate of death was reduced by 7.2 deaths per 100,000 person-years in the screening group as compared with the historical screening group (rate ratio, 0.72; 95% confidence interval [CI], 0.63 to 0.81) and by 4.8 deaths per 100,000 person-years in the nonscreening group as compared with the historical nonscreening group (rate ratio, 0.82; 95% CI, 0.71 to 0.93; P<0.001 for both comparisons), for a relative reduction in mortality of 10% in the screening group (P = 0.13). Thus, the difference in the reduction in mortality between the current and historical groups that could be attributed to screening alone was 2.4 deaths per 100,000 person-years, or a third of the total reduction of 7.2 deaths. Conclusions The availability of screening mammography was associated with a reduction in the rate of death from breast cancer, but the screening itself accounted for only about a third of the total reduction. (Funded by the Cancer Registry of Norway and the Research Council of Norway.)

504 citations

Journal ArticleDOI
L. von Karsa1, Julietta Patnick2, Julietta Patnick3, Nereo Segnan1, Wendy Atkin4, Stephen P Halloran5, Stephen P Halloran6, Iris Lansdorp-Vogelaar7, N. Malila, Silvia Minozzi, Sue Moss, Philip Quirke8, Robert Steele9, Michael Vieth, Lars Aabakken10, Lutz Altenhofen, R. Ancelle-Park, N. Antoljak11, A. Anttila, Paola Armaroli, S. Arrossi, Joan Austoker2, Rita Banzi12, Cristina Bellisario, J. Blom13, Hermann Brenner14, Michael Bretthauer15, M. Camargo Cancela1, Guido Costamagna, Jack Cuzick16, M. Dai17, Jill Daniel1, Jill Daniel18, Evelien Dekker19, N. Delicata, S. Ducarroz1, H. Erfkamp20, J. A. Espinàs, J. Faivre21, L. Faulds Wood, Anath Flugelman, S. Frkovic-Grazio22, Berta M. Geller23, Livia Giordano, Grazia Grazzini, Jane Green2, C. Hamashima24, C. Herrmann1, Paul Hewitson2, Geir Hoff, Holten Iw, R. Jover, Michal F. Kaminski, E. J. Kuipers7, Juozas Kurtinaitis, René Lambert1, Guy Launoy25, W. Lee26, R. Leicester27, Marcis Leja28, David A. Lieberman29, T Lignini1, Eric Lucas1, Elsebeth Lynge30, S. Mádai, J. Marinho, J. Maučec Zakotnik, G. Minoli, C. Monk31, António Pedro Delgado Morais, Richard Muwonge1, Marion R. Nadel32, L. Neamtiu, M. Peris Tuser, Michael Pignone33, Christian Pox34, M. Primic-Zakelj35, J. Psaila, Linda Rabeneck36, David F. Ransohoff33, M. Rasmussen30, Jaroslaw Regula, J. Ren1, Gad Rennert, J. F. Rey, Robert H. Riddell37, Mauro Risio, Vitor Rodrigues38, H. Saito24, Catherine Sauvaget1, Astrid Scharpantgen, Wolff Schmiegel34, Carlo Senore, Maqsood Siddiqi, D. Sighoko1, D. Sighoko39, Richard D. Smith18, Steve Smith40, Stepan Suchanek41, Eero Suonio1, W. Tong17, Sven Törnberg, E. Van Cutsem42, Luca Vignatelli, P. Villain2, Lydia Voti1, Lydia Voti43, Hidemi Watanabe44, Joanna Watson2, Sidney J. Winawer45, G. Young46, V. Zaksas, Marco Zappa, Roland Valori 
TL;DR: An overview of the principles, recommendations and standards in the guidelines for quality assurance in CRC screening and diagnosis are presented in journal format in an open-access Supplement of Endoscopy.
Abstract: Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010. They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines.

440 citations

References
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BookDOI
01 Jan 1987
TL;DR: Head and Neck Tumours.- Lip and Oral Cavity.- Pharynx.- Larynx.' Maxillary Sinus.- Salivary Glands.- Thyroid Gland.- Digestive System Tumour .
Abstract: Head and Neck Tumours.- Lip and Oral Cavity.- Pharynx.- Larynx.- Maxillary Sinus.- Salivary Glands.- Thyroid Gland.- Digestive System Tumours.- Oesophagus.- Stomach.- Colon and Rectum.- Anal Canal.- Liver.- Gall Bladder.- Extrahepatic Bile Ducts.- Ampulla of Vater.- Pancreas.- Lung Tumours.- Tumours of Bone and Soft Tissues.- Bone.- Soft Tissue.- Skin Tumours.- Carcinoma of Skin.- Melanoma of Skin.- Breast Tumours.- Gynaecological Tumours.- Cervix Uteri.- Corpus Uteri.- Ovary.- Vagina.- Vulva.- Urological Tumours.- Prostate.- Testis.- Penis.- Urinary Bladder.- Kidney.- Renal Pelvis and Ureter.- Urethra.- Ophthalmic Tumours.- Carcinoma of Eyelid.- Malignant Melanoma of Eyelid.- Carcinoma of Conjunctiva.- Malignant Melanoma of Conjunctiva.- Malignant Melanoma of Uvea.- Retinoblastoma.- Sarcoma of Orbit.- Carcinoma of Lacrimal Gland.- Brain Tumours.- Hodgkin's Disease.- Non-Hodgkin's Lymphoma.- Paediatric Tumours.- Nephroblastoma (Wilms' Tumour).- Neuroblastoma.- Soft Tissue Sarcomas - Paediatric.

15,624 citations

Book
01 Jan 1979
TL;DR: The principles of biomedical and Islamic medical ethics and an interfaith perspective on end-of-life issues and three cases to exemplify some of the conflicts in ethical decision-making are discussed.
Abstract: Morality and ethical theory types of ethical theory the principle of respect for autonomy the principle of nonmaleficence the principle of beneficence the principle of justice professional-patient relationships ideals, virtues and conscientiousness.

13,200 citations

Journal ArticleDOI
TL;DR: The results demonstrate that this method for histological grading provides important prognostic information and, if the grading protocol is followed consistently, reproducible results can be obtained.
Abstract: Morphological assessment of the degree of differentiation has been shown in numerous studies to provide useful prognostic information in breast cancer, but until recently histological grading has not been accepted as a routine procedure, mainly because of perceived problems with reproducibility and consistency. In the Nottingham/Tenovus Primary Breast Cancer Study the most commonly used method, described by Bloom & Richardson, has been modified in order to make the criteria more objective. The revised technique involves semiquantitative evaluation of three morphological features--the percentage of tubule formation, the degree of nuclear pleomorphism and an accurate mitotic count using a defined field area. A numerical scoring system is used and the overall grade is derived from a summation of individual scores for the three variables: three grades of differentiation are used. Since 1973, over 2200 patients with primary operable breast cancer have been entered into a study of multiple prognostic factors. Histological grade, assessed in 1831 patients, shows a very strong correlation with prognosis; patients with grade I tumours have a significantly better survival than those with grade II and III tumours (P less than 0.0001). These results demonstrate that this method for histological grading provides important prognostic information and, if the grading protocol is followed consistently, reproducible results can be obtained. Histological grade forms part of the multifactorial Nottingham prognostic index, together with tumour size and lymph node stage, which is used to stratify individual patients for appropriate therapy.

5,575 citations

Journal ArticleDOI
TL;DR: Preoperative chemotherapy is as effective as postoperative chemotherapy, permits more lumpectomies, is appropriate for the treatment of certain patients with stages I and II disease, and can be used to study breast cancer biology.
Abstract: PURPOSETo determine, in women with primary operable breast cancer, if preoperative doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan; AC) therapy yields a better outcome than postoperative AC therapy, if a relationship exists between outcome and tumor response to preoperative chemotherapy, and if such therapy results in the performance of more lumpectomies.PATIENTS AND METHODSWomen (1,523) enrolled onto National Surgical Adjuvant Breast and Bowel Project (NSABP) B-18 were randomly assigned to preoperative or postoperative AC therapy. Clinical tumor response to preoperative therapy was graded as complete (cCR), partial (cPR), or no response (cNR). Tumors with a cCR were further categorized as either pathologic complete response (pCR) or invasive cells (pINV). Disease-free survival (DFS), distant disease-free survival (DDFS), and survival were estimated through 5 years and compared between treatment groups. In the preoperative arm, proportional-hazards models were used to investigate the relationship b...

2,057 citations