In the past 30 years, there has been a small but significant increase in the incidence of advanced breast cancer in American women 25 to 39 years of age, according to a study published in the February 27 issue of JAMA.

During the same period, there was no increase in advanced disease in older women, according to the researchers, led by Rebecca H. Johnson, MD, from the Seattle Children’s Hospital and the University of Washington.

In the young women, the incidence of breast cancer with distant involvement at diagnosis increased from 1.53 per 100,000 women in 1976 to 2.90 per 100,000 women in 2009. This is an absolute difference of 1.37 per 100,000, and is an average compounded increase of 2.07% per year (P < .001) over a 34-year interval.

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Approximately 10 million individuals in the United States are affected by temporomandibular joint (TMJ) abnormalities (National Institutes of Health data, National Institute of Dental and Craniofacial Research). ¹

The highest prevalence of temporomandibular disorders (TMD) is in women aged 20 to 40 years, with women representing 80% of patients being treated for TMD. ^2,3 Magnetic resonance imaging (MRI) plays an important role in the evaluation of TMD, as it allows for a noninvasive depiction of the joint that is not otherwise available. Moreover, clinical diagnosis of TMJ abnormalities can be challenging, particularly given the psychosocial factors that can be involved in pain disorders. The diagnostic accuracy of the clinical examination is variable, ranging from 54% to 90%. ⁴

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Twenty-seven percent of mTBI patients with a normal CT scan showed evidence of abnormalities on brain MRI.

MRI may be better than CT scans at predicting whether patients with mild traumatic brain injuries (mTBI) are likely to have persistent neurologic problems, according to the results of a clinical trial published in the December 2012 Annals of Neurology.

Approximately 15% of patients with mTBI have measurable neurologic deficits at one year after injury, but clinicians have no definitive method of predicting patient outcomes.

To address this clinical need, Esther Yuh, MD, PhD, Assistant Professor in Residence at the University of California, San Francisco, School of Medicine, and her colleagues examined the potential of MRI to predict patient outcome three months after mTBI. The researchers prospectively followed 135 patients who were evaluated for acute head injury in the emergency departments of three level I trauma centers—San Francisco General Hospital and Trauma Center, the University of Pittsburgh Medical Center, and the University Medical Center Brackenridge in Austin, Texas. These centers were part of the Transforming Research and Clinical Knowledge in Traumatic Brain Injury study (TRACK-TBI).

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Researchers estimated Wednesday that mammograms caused more than 1 million American women over the past three decades to be diagnosed with early-stage breast cancers that would not have proved fatal if left undetected and untreated — a controversial finding sure to provoke more heated debate over the benefits of the screenings.

The study, published in the New England Journal of Medicine, concluded that these women were “overdiagnosed” and “overtreated” because there was not a corresponding decline in the diagnosis of tough-to-cure breast cancers that have already spread. The authors said mammography has saved few lives.

“There’s been a dramatic increase in early-stage breast cancers that coincides with an increased use of mammograms,” said study co-author Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute of Health Policy and Clinical Practice in Hanover, N.H. “But it’s not enough to find early-stage breast cancer; it must translate into fewer women being diagnosed at a later stage, and we found this decrease to be remarkably small.”

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Lourenco AP; Chung MT; Mainiero MB
Alpert Medical School, Brown University, Providence, Rhode Island, USA. alourenco@lifespan.org

OBJECTIVES: The purpose of this study was to determine the utility of targeted sonography in the management of probably benign breast lesions detected on magnetic resonance imaging (MRI).

METHODS: A total of 4370 consecutive contrast-enhanced breast MRI examinations from March 1, 2004, to March 1, 2009, were retrospectively reviewed. The study was Health Insurance Portability and Accountability Act compliant and Institutional Review Board approved. When targeted sonography was recommended for a Breast Imaging Reporting and Data System (BI-RADS) category 3 examination, results of the sonography and any subsequent breast pathologic examinations were recorded. The frequency of identifying the MRI-detected lesions and the rate at which the BI-RADS category was changed by sonography were calculated for mass and non-mass-like lesions.

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Now researchers are about to take an even closer look at Bunnell, a retired engineer from Madison, Connecticut.

Working with $2 million in new grants to be announced this week, the researchers for the Alzheimer’s Disease Neuroimaging Initiative will, for the first time, start mapping the DNA of 800 participants in a study attempting to find the root causes of memory loss. The goal is to see if physical changes from Alzheimer’s can be matched to genetic disparities, which can then be compared with findings from healthy people like Bunnell.

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Children undergoing computed tomography (CT) scans with cumulative radiation doses of about 50 mGy had about triple the risk for leukemia, and those who received doses of about 60 mGy had nearly triple the risk for brain cancer, according to the results of a retrospective cohort study published online June 7 in the Lancet.

“We’ve been doing this particular study for about 8 years, and it’s been about 20 years of research at Newcastle on radiation effects,” lead author Mark Pearce, PhD, from Newcastle University and Royal Victoria Infirmary, United Kingdom, said in a news conference. “We found that radiation exposure from CT scans in childhood could triple the risk of leukemia and brain cancer.”

The study authors note that CT scans are very useful diagnostically, but that children are more radiosensitive than adults and may therefore have additional potential risks for cancer from ionizing radiation. The study goal was to determine the excess risk for leukemia and brain tumors after CT scanning in a cohort of children and young adults.

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