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Utility of mammography for chronic kidney disease patients undergoing kidney transplant evaluation.
Clin Transplant ; 30(4): 445-51, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26855387
ABSTRACT
UNLABELLED: Transplant centers typically require screening mammography (MMG) for women ≥40 during evaluation. American Cancer Society recommends starting annual MMG at 40, while USPSTF recommends biennial MMG at 50. We sought to determine the effect of age and other breast malignancy risk factors on screening MMG in the pre-transplant renal failure population undergoing transplant evaluation.

METHODS:

We retrospectively examined women ≥40 undergoing kidney transplant evaluation from 2006 to 2012 (n = 541).

RESULTS:

Patients aged 40.0-49.9 and ≥50 had similar rates of breast biopsy and breast malignancy. African Americans underwent a higher rate of biopsies (OR 2.391, 95%CI 1.111-5.019, p = 0.026), with a lower rate of biopsy in those already on dialysis at presentation (OR 0.434, 95%CI 0.212-0.888, p = 0.022). Higher breast density (>50% fibroglandular tissue) increased both rate of biopsy (OR 2.876, 95%CI 1.377-6.010, p = 0.005) and malignancy (OR 5.061, 95%CI 1.012-25.315, p = 0.048).

CONCLUSIONS:

As we found no independent differences in biopsy or malignancy between age groups, it is reasonable for transplant centers to use the same evaluation MMG screening policy for all women ≥40. However, as malignancy risk increased with higher breast density, a lower threshold for additional workup may be warranted in patients with dense breasts or an indeterminate lesion on MMG.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamografia / Transplante de Rim / Falência Renal Crônica Aspecto clínico: Diagnóstico / Etiologia / Prognóstico Limite: Adulto / Idoso / Feminino / Humanos / Meia-Idade Idioma: Inglês Revista: Clin Transplant Assunto da revista: Transplante Ano de publicação: 2016 Tipo de documento: Artigo País de afiliação: Estados Unidos