By J. Michael Dixon
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Additional resources for ABC of Breast Diseases, 3rd edition (ABC Series)
Lancet 2003;361:296–300. ● Jordan VC, Glusman JE, Eckert S, et al. Raloxifene reduces incident primary breast cancers: integrated data from multicenter double blind placebo controlled, randomised trials in postmenopausal women. Breast Cancer Res Treat 1998;50:227. ● Key TJ, Allen NE, Spencer EA. Nutrition and breast cancer. Breast 2003;12:412–16. ● Lahmann PH, Hoffmann K, Allen N, van Gils CH, Khaw KT, Tehard B, et al. Body size and breast cancer risk: findings from a European Prospective Investigation into Cancer and Nutrition (EPIC).
Assessment should be by the triple approach, combining further imaging (mammography and ultrasonography) with clinical examination and proceeding to needle biopsy where indicated. A dedicated team should carry out assessments. The team should include radiologists, surgeons, and pathologists and be supported by specialist imaging and breast care nursing. About two thirds of screen detected abnormalities prove to be unimportant on further mammography or ultrasonography. When an important abnormality is thought to be present, diagnosis by needle biopsy should be attempted after clinical assessment.
There is no significantly increased risk 10 or more years after stopping. 95)). Duration of use, age at first use, dose, and type of hormone seem to have no significant effect on risk. Women who begin use before the age of 20 seem to have a higher risk than women who begin use at an older age, possibly because of higher rates of proliferation among nulliparous users. This higher risk “applies” at an age when the incidence of breast cancer is low. 13) Alcohol intake Several studies have shown a link between alcohol consumption and incidence of breast cancer, but the association may be with other dietary factors rather than with alcohol.