Authors' objectives:

Over 170,000 women are diagnosed with breast cancer yearly in the United States, incurring enormous individual and societal costs. The objective of this systematic review is to assess the quantity and quality of published evidence regarding specific current issues of diagnosis and management of women with breast disease.

Authors' recommendations: The best available evidence suggests that breast symptoms are evaluated initially by clinical breast exam and imaging study, with supplemental studies when the diagnosis is unclear. There is no evidence to support modifying the work-up of breast symptoms or mammographic abnormalities based on risk factors other than age. Strong evidence supports the necessity of performing excisional biopsy following stereotactic core needle biopsy (SCBX) diagnosis of atypical ductal hyperplasias (ADHs), as excisional biopsy often leads to a change in diagnosis. Preliminary evidence strongly suggests that Tamoxifen therapy markedly decreases the incidence of cancer following a diagnosis of lobular carcinoma in situ (LCIS) or atypical hyperplasia (AH), but it is associated with increased risk of endometrial cancer, thromboembolic disease, and other complications. While studies to date strongly suggest that sentinel node biopsy is successful in most breast cancer patients, long-term cancer outcomes and survival data are required before sentinel node biopsy could be considered the standard of care.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/epcsums/abnorsum.htm

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)