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http://dx.doi.org/10.3233/NPM-210849 | DOI Listing |
Hypertens Res
January 2025
Department of Cardiovascular Medicine, Onga Nakama Medical Association Onga Hospital, Onga, Japan.
AJR Am J Roentgenol
January 2025
Assistant Professor, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School.
Transl Lung Cancer Res
December 2024
Department of Medical Oncology, BC Cancer Agency, Vancouver, Canada.
J Endocr Soc
January 2025
Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
Womens Health (Lond)
January 2025
Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale Campus, Glendale, AZ, USA.
In 2023, a breast cancer risk assessment and a subsequent positive test for the BRCA-2 genetic mutation brought me to the uncomfortable intersection of a longstanding career as an advocate for high-quality medical evidence to support shared patient-provider decision making and a new role as a high-risk patient. My search for studies of available risk-management options revealed that the most commonly recommended approach for women with a ⩾20% lifetime breast cancer risk, intensive screening including annual mammography and/or magnetic resonance imaging beginning at age 25-40 years, was supported only by cancer-detection statistics, with almost no evidence on patient-centered outcomes-mortality, physical and psychological morbidity, or quality of life-compared with standard screening or a surgical alternative, bilateral risk-reducing mastectomy. In this commentary, I explore parallels between the use of the intensive screening protocol and another longstanding women's health recommendation based on limited evidence, the use of hormone therapy (HT) for postmenopausal chronic disease prevention, which was sharply curtailed after the publication of the groundbreaking Women's Health Initiative trial in 2002.
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