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Breast Cancer Screening and Diagnosis Clinical Practice Guidelines in Oncology

The key to a continued reduction in mortality from breast cancer is early detection and accurate diagnosis made in a cost-effective manner. These practice guidelines are designed to facilitate clinical decision making on the important issues in screening for breast cancer.

For the most recent version of the guidelines, please visit NCCN.org

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Cervical Cancer Screening

Edward E. Partridge, Nadeem R. Abu-Rustum, Susan M. Campos, Patrick J. Fahey, Michael Farmer, Rochelle L. Garcia, Anna Giuliano, Howard W. Jones III, Subodh M. Lele, Richard W. Lieberman, Stewart L. Massad, Mark A. Morgan, R. Kevin Reynolds, Helen E. Rhodes, Diljeet K. Singh, Karen Smith-McCune, Nelson Teng, Cornelia Liu Trimble, Fidel Valea, and Sharon Wilczynski

women without access to health care and those who have immigrated to the United States from countries where cervical cancer screening is not routinely performed. 2 Because cervical cytology screening is the current method for early detection of this

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Breast Cancer: Noninvasive and Special Situations

Robert W. Carlson, D. Craig Allred, Benjamin O. Anderson, Harold J. Burstein, W. Bradford Carter, Stephen B. Edge, John K. Erban, William B. Farrar, Andres Forero, Sharon Hermes Giordano, Lori J. Goldstein, William J. Gradishar, Daniel F. Hayes, Clifford A. Hudis, Britt-Marie Ljung, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Lori J. Pierce, Elizabeth C. Reed, Mary Lou Smith, George Somlo, Neal S. Topham, John H. Ward, Eric P. Winer, and Antonio C. Wolff

to be declining, 1 , 2 suggesting a benefit from early detection and more effective treatment. The origin of most breast cancer cases is unknown. However, numerous risk factors for the disease have been established, including female gender

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Invasive Breast Cancer

Robert W. Carlson, D. Craig Allred, Benjamin O. Anderson, Harold J. Burstein, W. Bradford Carter, Stephen B. Edge, John K. Erban, William B. Farrar, Andres Forero, Sharon Hermes Giordano, Lori J. Goldstein, William J. Gradishar, Daniel F. Hayes, Clifford A. Hudis, Britt-Marie Ljung, David A. Mankoff, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Lori J. Pierce, Elizabeth C. Reed, Jasgit Sachdev, Mary Lou Smith, George Somlo, John H. Ward, Antonio C. Wolff, and Richard Zellars

death. The incidence of breast cancer has increased steadily in the United States over the past few decades, but breast cancer mortality seems to be declining, 1 , 2 suggesting a benefit from early detection and more effective treatment. The cause

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Cervical Cancer Screening Clinical Practice Guidelines in Oncology

Despite a significant decrease in the incidence and mortality of cervical carcinoma in the United States, 10,520 women are expected to develop the disease in 2004, with 3,900 expected deaths. Because cervical cytology screening is the current method for early detection of this neoplasm, the purpose of the NCCN Cervical Cancer Screening Guidelines is to provide direction for the evaluation and management of cervical cytology.

For the most recent version of the guidelines, please visit NCCN.org

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Management of Recurrent or Metastatic Cervical Cancer

Presented by: Nadeem R. Abu-Rustum

Cervical cancer often affects individuals aged <50 years, with the main cause being a long-lasting infection with certain types of human papillomavirus (HPV). Prevention of cervical cancer includes screening tests and the HPV vaccine and, if found early, it can be treatable. Metastatic disease, however, is more lethal and is a significant problem worldwide due to screening and treatment limitations. Clinicians should discuss early detection options and treatment modalities with patients with cervical cancer for informed decision-making.

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Breast Cancer Clinical Practice Guidelines in Oncology

The American Cancer Society estimates that approximately 217,440 new cases of breast cancer will have been diagnosed in the United States in the year 2004 and approximately 40,580 patients will die of this disease. Breast cancer is the most common malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. The incidence of breast cancer has increased steadily in the United States over the past few decades, but breast cancer mortality appears to be declining. This suggests a benefit from early detection and more effective treatment.

For the most recent version of the guidelines, please visit NCCN.org

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Breast Cancer Screening and Diagnosis Clinical Practice Guidelines

The University of Alabama at Birmingham Comprehensive Cancer Center

The lifetime risk of a woman developing breast cancer has increased over the past 5 years in the United States: of every 7 women, 1 is at risk based on a life expectancy of 85 years. An estimated 214,640 new cases (212,920 women and 1,720 men) of breast cancer and 41,430 deaths (40,970 women and 460 men) from this disease will occur in the United States in 2006. However, mortality from breast cancer has decreased slightly, attributed partly to mammographic screening. Early detection and accurate diagnosis made in a cost-effective manner are critical to a continued reduction in mortality. These practice guidelines are designed to facilitate clinical decision making.

For the most recent version of the guidelines, please visit NCCN.org

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NCCN Invasive Breast Cancer Clinical Practice Guidelines in Oncology

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

The American Cancer Society estimates that 214,640 new cases of breast cancer will be diagnosed and 41,430 will die of the disease in the United States in 2006. Breast cancer is the most common malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. The incidence of breast cancer has steadily increased in the United States over the past few decades, but breast cancer mortality appears to be declining, suggesting a benefit from early detection and more effective treatment. These guidelines discuss diagnosis, treatment, and follow up for invasive breast cancer.

For the most recent version of the guidelines, please visit NCCN.org

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Treatment Options for Merkel Cell Carcinoma

Samuel W. Beenken and Marshall M. Urist

Merkel cell carcinoma (MCC) or neuroendocrine carcinoma of the skin is uncommon, often aggressive, and has a poor prognosis. Complete surgical excision with histologic documentation of clear resection margins is recommended for the primary cancer. Retrospective analysis of clinical data strongly suggests that adjuvant radiotherapy improves local control of MCC, but no evidence has been published that it prolongs survival. Sentinel lymph node biopsy is a useful method of determining the need for regional lymph node dissection in stage I patients. Chemotherapy regimens similar to those employed for small cell carcinoma of the lung have been recommended for advanced MCC. Patients often show an initial response to therapy, but it is usually short-lived. The three-year overall survival for patients with MCC is 31%. Before an improvement in long-term survival can be realized, early detection, appropriate use of surgery and radiation therapy, and the development of effective systemic chemotherapy are required.