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Historically, clinical breast examination (CBE) was a used as a diagnostic tool both to recognize and to diagnose breast cancer. CBE is no longer used to diagnose breast cancer, but rather is currently used as a screening test that can identify areas that might be breast cancer. Many of the observations that students are taught regarding CBE are more appropriate to advanced cancers that were common...
Mammography is one of an array of breast imaging modalities used to evaluate women with clinical breast symptoms, and its utility for this is well established. However, it is as a screening tool that mammography makes its unique contribution to the detection and treatment of early breast cancer, and it is in this role that it has received the most visibility and, sometimes, controversy. Despite its...
In this communication, we explore the current status and future prospects of positron emission tomography (PET) imaging in breast carcinoma. While the use of FDG-PET in the evaluation and management of cancer patients continues to increase, its precise role in the management of breast carcinoma is not yet clearly defined. Currently the most useful applications are in monitoring response to therapy...
Breast MRI has become one of the most useful breast imaging modalities. It is the most sensitive modality for detection of invasive ductal carcinoma. It will likely play an increasing role in screening women at high risk for developing breast cancer. Although there remains significant variability in specificity of MRI interpretation, as practice patterns become more established and standardized, variability...
Imaging gene expression non-invasively, with high sensitivity and specificity, would provide a more powerful diagnostic tool than any currently available. Although CT, MRI, and ultrasound have made great strides, none of the current modalities can image oncogene expression directly. No other reliable method is currently available to measure levels of specific receptors or mRNAs in vivo. In contrast...
Over 40,000 women in the United States will die this year of breast cancer. Current generally accepted techniques to detect breast cancer are limited to breast examination and imaging studies (mammography supplemented with ultrasound, and magnetic resonance imaging [MRI] for certain indications). Abnormalities found by these techniques require an invasive needle or surgical biopsy to determine if...
Ductoscopy and ductal lavage have evolved over several decades of interest by researchers in the early identification of breast cancer and its precursor lesions. Lavage has a history that spans back to George Papanicolau but has been limited dramatically in its clinical usefulness because of the great overlap of bland malignant cytology with true benign cytology. When sub-millimeter endoscopes first...
Breast cancer is a complex and heterogeneous disease and this diversity, especially at the molecular level, makes it challenging to develop blood-based tests to detect the disease, in its early stages. Although several biochemical markers aid in diagnosis, no existing test is sufficiently sensitive and specific for early detection. Currently there is justifiable optimism that the “omics” technologies...
The presence of disseminated tumor cells (DTCs) in the bone marrow has been shown to predict poor clinical outcome in early stage breast cancer. However, peripheral blood is easier to obtain and allows for real time monitoring of minimal residual disease (MRD). Towards this end, circulating tumor cells (CTCs) in the blood are detected using either direct methods, mainly antibody-based assays (immunocytochemistry,...
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