Via Christi Women's Connection: Breast Cancer Management in 2012

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Breast Cancer Management through therapies and other treatments in 2012

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Via Christi Women's Connection: Breast Cancer Management in 2012

  1. 1. * Jackie Osland, MD, FACS October 9, 2012
  2. 2. *100 Rate Per 100,000 80 60 Lung & bronchus 40 Uterus Breast Colon & rectum 20 Stomach Ovary Pancreas 0 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 *Age-adjusted to the 2000 US standard population. Source: US Mortality Data 1960-2005, US Mortality Volumes 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2008.
  3. 3. *Risk*Early Detection*Advances in Therapy
  4. 4. * Most common cancer in women* Nearly 300,000 women diagnosed per year in the US* One in 3 women in the US will get cancer* One in 8 women in the US will get breast cancer* Survival rates have increased over the past decade *
  5. 5. Age-specific Risk of DevelopingInvasive Cancer in Next 10 YearsCurrent Age Women (general population)20 years…………………..1 in 2,00030 years………………….. 1 in 25640 years………………….. 1 in 6750 years………………….. 1 in 3960 years………………….. 1 in 2985 years………………….. 1 in 8
  6. 6. * Most women who get breast cancer don’t have a family history of breast cancer* 5-10% of breast cancer is related to a genetic syndrome* Most common genetic syndromes are related to a BRCA 1 or BRCA 2 mutation* Lifetime risk of breast cancer with a genetic syndrome is 60-85% *
  7. 7. *BRCA mutations *Risk factors *Early onset breast cancer < 50 years of age *Multiple family members with breast cancer *Ovarian cancer*NCCN guidelines *
  8. 8. *Age*Family History*Not deodorant, under-wire bras or mammograms*Obesity *
  9. 9. *By 2030, obesity may replacesmoking as the leading causativeagent of cancer *
  10. 10. * US Preventive Services Task Force November 2009 * Screening 1,339 women in their 50’s to save one life makes screening worthwhile * Screening 1904 women in their 40’s to save one life is not worthwhile * Screening women in their 40’s would reduce their risk of death by 15% *
  11. 11. * Acknowledges the limitations of mammography * False alarms, missed cancers, unnecessary biopsies * Effectiveness of mammography does increase with age * In fact, the technology used today is better that the technology used in the studies for this review* ACS continues to recommend annual screening beginning at age 40 *
  12. 12. “We have learned nothing, we arewhere the Greeks were. “ Francis Wood Carter 1914
  13. 13. *
  14. 14. *
  15. 15. * Sentinel Node Biopsy * Drastically reduces risk of lymphedema for the node negative patient * Many women are now saved a full axillary node dissection*
  16. 16. 2000 1990 1970 1980 1950 1960 Tumor HumanDNA Sequencing Suppressor Genome PCR Genes Project
  17. 17. * Completed in 2003* 13 year project* Coordinated by the US Department of Energy and the NIH with international contributors* Analysis of the data will continue for many years *
  18. 18. * Exponential growth in information for treatment * Increase in molecular alterations associated with disease * Scientific Explosion*
  19. 19. *
  20. 20. *
  21. 21. *100 Rate Per 100,000 80 60 Lung & bronchus 40 Uterus Breast Colon & rectum 20 Stomach Ovary Pancreas 0 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 *Age-adjusted to the 2000 US standard population. Source: US Mortality Data 1960-2005, US Mortality Volumes 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2008.
  22. 22. * While breast conservation provides excellent cancer control, there are some cases that require mastectomy * BRCA mutations * Extensive disease through the breast * Prior radiation treatment* Dr. Vanessa Voge –Plastic Surgical Specialists *
  23. 23. *Pulitzer Prize 2010 for General Nonfiction *Described by TIME as one of the 100 most influential books of the last 100 years*

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