gt;gt; the jama network. gt;gt; Kevin Oeffinger, MD: Hello, I’m Kevin Oeffinger. I am a family physician, and cochaired the guideline development group for the American Cancer Society, in developing our new, updated guideline for breast cancer screening, for women that are at average risk for breast cancer, and living in the United States.
I’m at memorial sloan kettering cancer center. And I serve as the Director of the Cancer Survivorship Center. We spent over 18 months reviewing hundreds of studies on breast cancer screening. And working with the Duke Evidence Synthesis Group, who conducted a systematic review. Most importantly, we know emphatically that breast cancer screening, with screening mammography saves lives.
It is the single, best tool that a woman has for preventing a premature death from breast cancer. There is a consistent reduction in mortality across most study designs for women between the ages of 40 and 69. And there’s strong, inferential evidence that women age 70 and older benefit from that. And the American Cancer Society recommends that women around the age of 40 begin starting their discussion with their healthcare professional.
And make a shared decision on whether or not to start screening annually between the ages of 40 and 44. We think that the evidence clearly shows that benefit outweighs harm, starting at age 45. And recommend strongly that women start mammography at age 45 and continue it annually until age 54. Then beyond that, we recommend transitioning to everyotheryear.
Recognizing that as women get older, the benefit of annual diminishes compared to every other year. Although it never goes down to zero, there is always some benefit from annual. We recommend that as long as a woman has a reasonable likelihood of another 10 years of healthy life, that they continue screening. We no long recommend having a al breast examination,.
And rather prefer that healthcare professionals use that time to devote to discussing the potential benefits and the potential downsides of mammography with a woman. Or using that time for other preventative measures. When we talk about balancing, or weighing harms and benefits, on the benefits we’re talking about the lives saved. On the harm we’re talking about a false positive, which might result in a biopsy.
Or we’re talking about overdiagnosis. The only way to 100% prevent overdiagnosis is not to be screened. That’s something none of us no guideline group would recommend. About 60% of women over a 10year period would have a false positive finding. Most of those requiring just additional images. About 7% to 8% of them will need a biopsy.
To determine what was the abnormality on the mammogram. And then there is also the concept of overdiagnosis. Which the evidence review, and we concurred with, still have such widely disparate estimates, that we really can’t place an estimate. Though we think it’s around the magnitude of 2% to maybe 3% of the women that are diagnosed with cancer.
CPC 2016 Denervation and Neurolysis in Resistant Hypertension
ladies and gentlemen, i think we’re ready to start. This is a very special session, and I hope more members of the audience will arrive. It’s sort of strange start because it overlaps with sessions. Sorry for this. This is a session funded by American Heart Association.
On behalf of our journal hypertension. And the idea is that two teams, and this time these are home teams from here, from South Korea will present very interesting cases and we’re going to have very good and very informed discussion.
Both during presentation and after presentation. This is an interactive session. Now the good things about this for both the presenters and the audience are that you are being filmed so you’re now film stars. But also that the authors and the discussants.
Will have a paper in hypertension if everything goes well. The vigorous discussion is essential and on my right there, there is Denise Kuo. Denise, stand up and wave, yeah. And the Denise will take your names afterwards as you contributed vigorously to discussion of both cases.
You’re both film stars and the authors in hypertension just after being here for an hour and a half, I think that’s a good deal. So, without any further ado, I’ll pass the sharing of the first case to Professor Rhian Touyz, the president of ISH.
Rhian. So Anna. Yeah. Anna, it’s really such a pleasure to have the American Heart Association participate in this session at the International Society of Hypertension. Certainly the first of such an association.
And hopefully not the last. With that, I would like to welcome our presenters for the first case and that is entitled A Case of Refractory Hypertension Controlled by Repeated Renal Denervation and Celiac Plexus Block:.
A case of refractory sympathetic overload. And this presentation is going to be given by s Lee, Woo, Kim, Yoon, Lee and Park from here in Korea. So, thank you so much for your contributions. Thank you, chairman.