Assessment and management of predisposition to specific diseases is currently a very hot dimension of medicine. Once purely the realm of epidemiologists, the emergence of molecular genetic testing and other highly sophisticated diagnostic and prognostic techniques has made risk assessment and care a part of the work of many clinicians--from GPs to the super-specialist. Nowhere has the study of "prognostic factors" been more high-profile (and more clinically fruitful) than in breast cancer. Breakthroughs in the identification of genes associated with breast carcinoma, particularly BRCA1 and 2, as well as other risk factors, influence not only how patients are screened, but also how they are treated. With one in nine women likely to contract breast cancer in her lifetime, the significance of identifying and managing the high-risk patient is evident.
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Victor G. Vogel, MD is Director of the Comprehensive Breast Cancer Program at the University of Pittsburgh Cancer Institute, Professor of Medicine and Epidemiology, University of Pittsburgh School of Medicine and Professor of Epidemiology, University of Pittsburgh Graduate School of Public Health.
This book is the first to identify women who are at increased risk for developing breast cancer as a large and increasingly important population in need of special health-care attention. By examining the factors that contribute to their risk and using quantitative risk models, Management of patients at High Risk offers practical, authoritative guidance in the management of these patients, both healthy and ill. The book covers the spectrum of issues clinicians face in providing expert counsel and effective, human care-including the many diagnostic and therapeutic options available. Chapters summarize the most recent thinking on generics, epidemiology, and the role of mammography, pharmacologic and surgical prevention and treatment. The authors review both the benefits and disadvantages of various management options and discusses important considerations such as costs, psychological management, and the associated legal and ethical issues. A practical model for organizing a risk assessment clinic is also presented.
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