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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

BACKGROUND: Women's health, traditionally defined, emphasises reproductive and maternal conditions without consideration of social contexts. Advocates urge a broader conceptualisation. The medical literature influences the definitions and delivery of women's health care. We compared how women's health was represented in leading general medical (GM) versus women's health specialty (WS) journals. METHODS: Original investigations published between January 1 - June 30, 1999 in leading GM (n = 514) and WS (n = 82) journals were compared. Data were collected from 99 GM and 82 WS articles on women's health. Independent reviewers conducted content analyses of sample characteristics, study design, and health topic. Each article was classified as "Traditional" (e.g. menstruation, breast cancer), "Non-traditional" (e.g. abuse, osteoporosis), or "Both." RESULTS: Of the GM articles, 53 (53.5%) focused solely on a traditional women's health topic; half were reproductive and half female cancers. In contrast, 22 (26.8%) WS articles were traditionally focused. A non-traditional topic was the sole focus of 27 (27.3%) GM articles versus 34 (41.5%) WS articles. One-fifth of GM and one-third of WS articles addressed both. RCTs dominated the GM articles, while 40% of WS articles used qualitative or mixed study designs. Leading sources of women's death and disability were not well covered in either type of journal. CONCLUSIONS: Most GM articles drew on a narrow definition of women's health. WS journals provided more balanced coverage, addressing social concerns in addition to "navel-to-knees" women's health. Since GM journals have wide impact, editorial decisions and peer review processes should promote a broader conceptualisation of women's health.
BMC Womens Health 2002 Jun 20
PMID:Representation of women's health in general medical versus women's health specialty journals: a content analysis. 1208 93

BACKGROUND: The aim of this study was first, to investigate whether women starting oral contraceptive (OC) use at a young age and before first birth have an increased risk for breast cancer and second, to report difficulties encountered in studying long-term health impacts of medical technologies. METHODS: Breast cancers occurring up until 1997 among 37153 Helsinki students born between 1946 and 1960 were identified by record linkage from the Finnish Cancer Registry; for each cancer case, five age-matched random controls were picked from the same student population. Those who had used the Helsinki Student Health Service (HSHS) at least three times (150 cases and 316 controls) form the final study subjects. Data on OC use and background characteristics were collected from patient records, and data on live births were derived from the population register. Odds ratios (OR) were adjusted for number of births, smoking and sports activity. RESULTS: Compared to the few non-users, OC users had a higher risk of breast cancer: the adjusted OR was 2.1 (95% confidence interval 1.1-4.2). Among OC users, no statistically significant differences in risk of breast cancer were found in regard to starting age or first birth, but small numbers made confidence intervals wide. Even though we had chosen students to be our study group, the population turned out to be unsuitable to answer our research question: most women had started their OC use old (at the age of 20 or later) and there were very few unexposed (almost all had used OC and before their first birth). CONCLUSIONS: Because adoption of the modern pattern of OC use was not common among students, it is unlikely that the impact of early and extended OC use can be studied before 2010, when women born in the 1960s are 40 to 50 years old.
BMC Womens Health 2002 Aug 05
PMID:Oral contraceptive use before first birth and risk of breast cancer: a case control study. 1216 Apr 67

BACKGROUND: A cross sectional study was conducted in Tehran Iran to examine the extent of patient delay and associated factors in the presentation of breast cancer. METHODS: A group of newly diagnosed breast cancer patients were interviewed and were asked about the period from first onset of symptoms to first medical consultation to indicate patient delay. This was studied in relation to patients' age, educational level, marital status, family history of breast cancer, history of benign breast disease, number of children and the nature of the first symptom seen. RESULTS: In all, 190 breast cancer patients were interviewed. Of these, 75% presented to physician within 3 months. Forty-two patients (25%) delayed more than 3 months. In multivariate regression analysis it was found that there was a risk for longer delay in widowed or divorced women (OR 3.7, 95% CI 1.5-9.7), women with a positive family history of breast cancer (OR 2.8, 95% CI 1.1-7.7), and less educated patients (illiterate: OR 5.2, 95% CI 1.5-17.7; primary schooling: OR 4.6, 95% CI 1.4-14.7). Significant associations also were found between delay presentation and the late stage disease (P = 0.01) and bigger tumor size (P = 0.004). CONCLUSION: The findings suggest that one in four women with breast cancer present late and this has significant effect on their disease prognosis. To reduce patient delay health education programs regarding breast cancer should be implemented and target women who are at higher risk of delay.
BMC Womens Health 2003 Jul 07
PMID:Delayed presentation in breast cancer: a study in Iranian women. 1284 32

HEALTH ISSUE: The sex differences in mortality, life expectancy, and, to a lesser extent, health expectancy, are well recognized in Canada and internationally. However, the factors explaining these differences between women and men are not well understood. This chapter explores the contribution of various causes of death (such as preventable, and sex-specific deaths) on these differences between women and men. KEY FINDINGS: "External" preventable causes of death (e.g. smoking-related, injuries, etc.) were responsible for a large portion of the sex gap in mortality and life expectancy. When excluding these causes from the calculations, the sex gap in life expectancies were largely reduced, decreasing from approximately 5.5 years (life expectancy being 81.4, years in women, and 75.9 years in men) to approximately 2.2 years (84.9 in women and 82.7 in men). Sex gaps in corresponding health expectancies entirely disappeared when these preventable causes of death were excluded. Moreover, a larger death burden was observed among women than men for sex-specific causes of death (eg. excess breast cancer, gynaecological cancers, maternal mortality). Significant disparities were also observed in the mortality rates of various subgroups of women by geographic regions of Canada. DATA GAPS AND RECOMMENDATIONS: These results indicate that women do not appear to have a large biological survival advantage but, rather, are at lower risk of preventable deaths. They also provide additional information needed for the development of policies aimed at reducing disparities in life and health expectancies in Canada and other developed countries.
BMC Womens Health 2004 Aug 25
PMID:Mortality: life and health expectancy of Canadian women. 1534 72

HEALTH ISSUE: Although lung cancer is the leading cause of cancer deaths for Canadian women, breast cancer is the most frequently diagnosed. About 5400 women are expected to die from this disease in 2003. In 1998, a woman's lifetime risk of breast cancer was about one in nine. KEY FINDINGS: A number of risk factors for breast cancer have been identified. These include advancing age, hormonal factors (eg. early menarche, late menopause and late age at first full-term pregnancy), familial risk, BRCA-1 and BRCA-2 gene mutations, diet and postmenopausal obesity.Several interventions have been introduced to assist women at high risk for breast cancer, including genetic counseling and testing for women who have strong family histories of breast cancer; selective estrogen receptor modifiers, such as tamoxifen, that has been shown to reduce breast cancer rates; prophylactic mastectomy and screening. DATA GAPS AND RECOMMENDATIONS: Guidelines are unclear in several areas, particularly in screening. Where clinical guidelines are available, health services research or ongoing monitoring (by provincial/territorial cancer agencies) is needed to assess compliance with the guidelines and to ensure equity of access within the provinces/territories.Key components of organized screening programs need to be established, in part to ensure that screening is carried out in high-quality, co-ordinated programs. There is also a need to develop ways to involve women fully in informed decision-making and to address several policy issues to prevent disparities in access to high-quality services. Patenting issues associated with genetic tests also need to be clarified.
BMC Womens Health 2004 Aug 25
PMID:Breast Cancer in Canadian Women. 1534 75

HEALTH ISSUE: The average age of natural menopause in Western societies is estimated to be 51 years; women in Canada can therefore expect to live, on average, a third of their lives in post-menopausal years. During these years women are at increased risk of chronic diseases such as osteoporosis and cardiovascular disease. KEY FINDINGS: Clinical and epidemiological data on women in perimenopause are limited. There are no adequate Canadian data on symptom severity and prevalence among perimenopausal and postmenopausal women. Scientific evidence is lacking to support or refute claims that commonly used botanical products can offer therapeutic relief of menopausal symptoms.Recent data from the Women's Health Initiative suggest that combined estrogen plus therapy increases the risk of stroke, coronary artery disease and breast cancer. Hormone therapy is no longer recommended for the prevention of chronic diseases for asymptomatic women. Stroke is an important issue for perimenopausal and postmenopausal women and sex differences may exist in the progestin treatment of stroke. Osteoporosis affects an estimated one in six women over the age of 50. DATA GAPS AND RECOMMENDATIONS: There is a need to conduct clinical and epidemiological research aimed at better understanding the menopausal transition and defining its clinical phases. Investigations aimed at alternative combinations and doses of hormone therapy and non-pharmaceutical alternatives in light of known risks and benefits are also necessary. Health care practitioners and women need to be educated on the risks and effective treatment related to cardiovascular disease so they can present for treatment more quickly and receive the most effective therapies.
BMC Womens Health 2004 Aug 25
PMID:Perimenopausal and Postmenopausal Health. 1534 86

BACKGROUND: Elevated pregnancy estrogen levels are associated with increased risk of developing breast cancer in mothers. We studied whether pregnancy weight gain that has been linked to high circulating estrogen levels, affects a mother's breast cancer risk. METHODS: Our cohort consisted of women who were pregnant between 1954-1963 in Helsinki, Finland, 2,089 of which were eligible for the study. Pregnancy data were collected from patient records of maternity centers. 123 subsequent breast cancer cases were identified through a record linkage to the Finnish Cancer Registry, and the mean age at diagnosis was 56 years (range 35 - 74). A sample of 979 women (123 cases, 856 controls) from the cohort was linked to the Hospital Inpatient Registry to obtain information on the women's stay in hospitals. RESULTS: Mothers in the upper tertile of pregnancy weight gain (>15 kg) had a 1.62-fold (95% CI 1.03-2.53) higher breast cancer risk than mothers who gained the recommended amount (the middle tertile, mean: 12.9 kg, range 11-15 kg), after adjusting for mother's age at menarche, age at first birth, age at index pregnancy, parity at the index birth, and body mass index (BMI) before the index pregnancy. In a separate nested case-control study (n = 65 cases and 431 controls), adjustment for BMI at the time of breast cancer diagnosis did not modify the findings. CONCLUSIONS: Our study suggests that high pregnancy weight gain increases later breast cancer risk, independently from body weight at the time of diagnosis.
BMC Womens Health 2004 Oct 21
PMID:Pregnancy weight gain and breast cancer risk. 1549 3

BACKGROUND: Several researchers have claimed that classification of tumours on the basis of HER-2/neu overexpression or amplification may define a subset of breast cancer in which the net effect of a risk factor could be rather more obvious and its impact on breast cancer development more clear. We decided to investigate, in a group of patients from a geographical area with a low incidence of breast cancer, whether HER-2/neu positive tumours are correlated with established or suspected risk factors for breast cancer and thus to identify distinct subgroups of high risk women. METHODS: This study analysed data from patients who attended the Breast Unit at the University Hospital of Heraklion, Crete, Greece between 1996 and 2002. 384 women with primary invasive breast cancer were compared with 566 screened women who were referred to the Unit and had not developed breast neoplasm by the time the data were analysed. Risk factor data were obtained from each subject by personal interviews using a structured questionnaire. The detection and scoring of the HER-2/neu protein, estrogen and progesterone receptor expression were performed using immunochemistry. Odds ratios and 95% confidence intervals were determined by chi-square test and logistic regression analysis. Case-case odds ratios were calculated in order to measure the risk heterogeneity between HER-2/neu+ and HER-2/neu-tumours. Separate analyses were performed for premenopausal and postmenopausal women and according to estrogen receptor status. RESULTS: In multivariate analysis without HER-2/neu stratification, an increased breast cancer risk was associated with only four of the factors examined: use of oral contraceptives (OR = 4.40, 95%C.I: 1.46-13.28), use of HRT (OR = 7.34, 95%C.I: 2.03-26.53), an age at first full pregnancy more than 23 years (OR = 1.91, 95%C.I: 1.29-2.83) and body mass index more than 29 kg/m2 (OR = 3.13, 95%C.I: 2.02-4.84). Additionally, a history of abortion or miscarriage (OR = 0.56, 95%C.I: 0.38-0.82) was correlated with a decreased risk of breast cancer. In the case to case comparison only BMI >29 kg/m2 revealed a relative connection that was stronger with positive than with negative HER-2/neu tumours (ratio of OR's = 2.23, 95%C.I: 1.20-4.15, p = 0.011). This may indicate evidence of heterogeneity of a rather significant degree for this factor. In the ER negative group an age at first full pregnancy >23 years and a BMI >29 kg/m2 were associated with an increased risk in both HER-2/neu groups, but the association was significantly stronger for the latter factor in the positive HER-2/neu tumours (ratio of OR's = 2.46, 95%CI: 0.97-6.21). CONCLUSIONS: Our study did not confirm that the established or putative hormonal breast cancer risk factors differ regarding their relations with HER-2/neu+ versus HER-2/neu-breast tumours, with the exception of increased BMI. Further innovative studies with larger sample sizes are needed to examine how the status of these potentially modifiable breast cancer risk factors interacts with biological markers such as HER-2/neu oncoprotein.
BMC Womens Health 2005 Feb 04
PMID:Correlation of breast cancer risk factors with HER-2/neu protein overexpression according to menopausal and estrogen receptor status. 1569

Pregnancy is infrequently complicated by the diagnosis of a concurrent breast cancer. This presents a particularly complicated clinical problem. The treatment of breast cancer in young women involves a number of difficult decisions regarding therapy. These decisions become even more complex when the concerns of the safety of an unborn child are added to the equation. For breast cancers diagnosed late in the third trimester, it is relatively straight forward to delay therapy until after delivery. For women diagnosed earlier in pregnancy, there are legitimate concerns that delays in therapy may adversely affect outcomes. While there are no randomized trials addressing the optimal treatment of women in this situation, there are case reports, case series, and cohort experiences that provide some insight. There are recommendations available from an international working group and from the National Comprehensive Cancer Network that address the treatment of women in this situation. There is general consensus that both surgery and chemotherapy are relatively safe after the first trimester of pregnancy. It is generally agreed that therapeutic radiation, if necessary, should be delayed until completion of pregnancy.
BMC Cancer 2007 May 30
PMID:"I'm pregnant and I have breast cancer". 1753 41

We present a mixture model-based analysis for identifying differences in the distribution of RNA polymerase II (Pol II) in transcribed regions, measured using ChIP-seq (chromatin immunoprecipitation following massively parallel sequencing technology). The statistical model assumes that the number of Pol II-targeted sequences contained within each genomic region follows a Poisson distribution. A Poisson mixture model was then developed to distinguish Pol II binding changes in transcribed region using an empirical approach and an expectation-maximization (EM) algorithm developed for estimation and inference. In order to achieve a global maximum in the M-step, a particle swarm optimization (PSO) was implemented. We applied this model to Pol II binding data generated from hormone-dependent MCF7 breast cancer cells and antiestrogen-resistant MCF7 breast cancer cells before and after treatment with 17beta-estradiol (E2). We determined that in the hormone-dependent cells, approximately 9.9% (2527) genes showed significant changes in Pol II binding after E2 treatment. However, only approximately 0.7% (172) genes displayed significant Pol II binding changes in E2-treated antiestrogen-resistant cells. These results show that a Poisson mixture model can be used to analyze ChIP-seq data.
BMC Genomics 2008 Sep 16
PMID:A Poisson mixture model to identify changes in RNA polymerase II binding quantity using high-throughput sequencing technology. 1883 89


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