Abstract:
OBJECTIVE:To find out how women with breast or ovarian cancer rate their chances of carrying hereditary factors for these cancers and to determine the extent to which they overestimate their risk. SUMMARY BACKGROUND DATA:BRCA1 and BRCA2 are genes that cause breast and ovarian cancer when they are inherited in families. Testing for disease-associated mutations in these genes is now available commercially. Previous studies have shown that women overestimate their chances of carrying mutations. However, women's perceptions of risk have not been compared to objective estimates or to actual BRCA1 and BRCA2 testing results. METHODS:This study examines estimates of carrying BRCA1 and BRCA2 mutations among women participating in a randomized trial comparing alternative precounseling educational materials. Estimates were provided by participants in a baseline mailed survey. Estimates given by participants were compared to those given by an expert panel and by a statistical model. Testing was offered free of charge and was done in an academic laboratory using standard techniques. Baseline estimates of participating women were compared to the estimates of the expert panel, to the carrier probability provided by the statistical model, and to actual testing results. RESULTS:Women who have a personal history of breast or ovarian cancer significantly overestimate their risk of carrying hereditary factors for breast and ovarian cancer. Self-estimates exceeded the estimates of experts and a statistical model. One hundred women completed testing, and 21 mutations in BRCA1 or BRCA2 were found. Many test-negative women also overestimated their hereditary risk. Some women with a high carrier probability were negative for BRCA1 and BRCA2 mutations. CONCLUSIONS:Overestimation of hereditary factors is common among affected women with a family history of cancer. Pretest education and counseling should reduce these high-risk perceptions. Better estimates of carrier probability will direct more intensive clinical services and research.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Iglehart JD,Miron A,Rimer BK,Winer EP,Berry D,Shildkraut MJdoi
10.1097/00000658-199809000-00010subject
Has Abstractpub_date
1998-09-01 00:00:00pages
375-84issue
3eissn
0003-4932issn
1528-1140journal_volume
228pub_type
杂志文章abstract::The clinical, pathological, surgical, postoperative findings and survivorship of 58 patients younger and 513 patients older than 21 years at the time of diagnosis with thyroid neoplasms are reported. The younger patients have a predominance of well differentiated carcinomas which are more likely to be follicular. The ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00018
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:This study investigated the pathogenesis of water and sodium metabolism derangements in obstructive jaundice. SUMMARY BACKGROUND DATA:Obstructive jaundice is associated with hypodipsia, depletion of extracellular water, alterations of the water and sodium regulating hormones, and an increased incidence of re...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199401000-00012
更新日期:1994-01-01 00:00:00
abstract::The induction of donor-specific tolerance could prevent the side effects of immunosuppression while improving allograft survival. Male adult Buffalo (RT1b) rats underwent an intrathymic (IT), portal venous (PV), intrasplenic (IS), or subcutaneous (SQ) injection of 25 x 10(6) major histocompatibility complex (MHC) mism...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199210000-00003
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001796
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31817b65f2
更新日期:2008-07-01 00:00:00
abstract::A study was done of 144 patients undergoing Billroth I partial gastrectomy for benign gastric ulcer. At a mean follow-up of 9.4 years, 95 patients were alive. Of 79 patients reviewed, 84% had an excellent or good result on clinical (Visick) grading. Five cases of proven recurrent ulceration were found; two of these pa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198202000-00012
更新日期:1982-02-01 00:00:00
abstract:OBJECTIVE:To document the decreased incidence of surgical complications after pancreas transplantation in recent times. SUMMARY BACKGROUND DATA:Compared with other abdominal transplants, pancreas transplants have historically had the highest incidence of surgical complications. However, over the past few years, the au...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200002000-00017
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months. SUMMARY BACKGROUND DATA:The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative complications. A laparoscopic appro...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200010000-00007
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:We sought to test whether postconditioning, a series of brief mechanical interruptions of reperfusion applied during the onset of reperfusion, can prevent neurologic injury of the spinal cord after transient ischemia. SUMMARY BACKGROUND DATA:Ischemia-reperfusion injury of the spinal cord is the principal mec...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000217608.08582.35
更新日期:2006-07-01 00:00:00
abstract::A retrospective analysis was made of the complications from pelvic exenterations performed over the past 30 years for colorectal adenocarcinoma at the Roswell Park Cancer Institute. Seventy-five patients underwent exenteration, 51 for primary disease (PD) and 24 for recurrent disease (RD). Both total and posterior exe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199201000-00009
更新日期:1992-01-01 00:00:00
abstract::Twenty-two patients developed one or more aortoenteric fistulae following aortic reconstruction with a dacron graft. Endoscopy was performed on 11 of these patients on 17 occasions and a preoperative diagnosis was made in eight patients. Fistulous communication was most common between the aorta and duodenum (60%), and...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198203000-00011
更新日期:1982-03-01 00:00:00
abstract:OBJECTIVE:To determine prospectively the immunologic response and adverse clinical events in surgical patients exposed to bovine thrombin during cardiac surgical procedures. SUMMARY BACKGROUND DATA:Topical bovine thrombin is used extensively as a hemostatic agent during cardiovascular surgery. Antibodies developing af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200101000-00014
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVES:To investigate the effect of preoperative chemoradiotherapy on surgical complications in patients after pancreatic resection for (borderline-)resectable pancreatic cancer. SUMMARY OF BACKGROUND DATA:Preoperative chemoradiotherapy is increasingly used in patients with (borderline-)resectable pancreatic cance...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004313
更新日期:2020-11-12 00:00:00
abstract:OBJECTIVE:The authors examined the natural history of choledochal cysts in adults treated surgically. BACKGROUND:An initial diagnosis of choledochal cyst is uncommon in adults. The recommended treatment is excision, rather than bypass, to achieve effective biliary drainage and because of the risk of cancer. METHODS:A...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199508000-00004
更新日期:1995-08-01 00:00:00
abstract::Two hundred thirty-four patients with extensive ulcerative colitis from the city of Göteborg, Sweden have been followed up and the cumulative risk of development of cancer of the large bowel was estimated. These patients constitute all persons in this region who developed an extensive ulcerative colitis between 1951 a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197812000-00018
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVE:In Western populations, long-term survival rates after curative resection of gastric cancer remain extremely poor. The lack of effective adjuvant therapy has prompted the evaluation of neoadjuvant approaches. Since 1988, we have conducted three separate phase II trials using neoadjuvant chemotherapy to treat ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199903000-00001
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To compare surgical safety and efficiency of 2 image guidance modalities, perfect augmented reality (AR) and side-by-side unregistered image guidance (IG), against a no guidance control (NG), when performing a simulated laparoscopic cholecystectomy (LC). BACKGROUND:Image guidance using AR offers the potentia...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002793
更新日期:2019-02-01 00:00:00
abstract::Forty-seven consecutively presenting myasthenia gravis (MG) patients with generalized weakness were treated according to a standardized prospective protocol. All patients underwent a sternal splitting "total" thymectomy. Medical status before surgery was optimized by plasmapheresis without immunosuppression. Medicatio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198208000-00001
更新日期:1982-08-01 00:00:00
abstract:OBJECTIVE:To determine whether the rates of death and complications of carotid endarterectomy (CE) were different in the octogenarian population than in patients younger than age 80. SUMMARY BACKGROUND DATA:The utility of CE depends on the ability of the surgeon and hospital to attain low rates of death and complicati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200006000-00001
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:The study's primary aim was to evaluate the effectiveness of thermal imaging (TI) and its secondary aim was to compare TI and indocyanine green (ICG) fluorescence angiography, with respect to the evaluation of the viability of the gastric conduit. SUMMARY BACKGROUND DATA:The optimal method for evaluating per...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003169
更新日期:2020-06-01 00:00:00
abstract::The efficacy of supplemental fresh frozen plasma (FFP) therapy after massive packed red cell (PRBC) replacement for hemorrhagic shock was studied in 22 conditioned dogs. Ten dogs were randomized to received FFP, balanced electrolyte solution (BES), and PRBC, while 12 dogs received BES and PRBC. Coagulation factor acti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198510000-00010
更新日期:1985-10-01 00:00:00
abstract::A randomized clinical trial was undertaken to compare early and delayed cholecystectomy for acute cholecystitis. Patients entering early (n = 83) or delayed (n = 82) surgery groups were comparable with regard to prerandomization data. One patient in the early group and five in the delayed group refused surgery (p < 0....
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198004000-00018
更新日期:1980-04-01 00:00:00
abstract:OBJECTIVE:We hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. BACKGROUND:Surgical readmissions have few known modifiable predictors. Pain experienced by patients may reflect surgical complications and/or inadequate or dif...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002372
更新日期:2017-09-01 00:00:00
abstract::The role of surgery in the treatment of gastrinoma is unclear. The purpose of this study was to determine prospectively the surgical cure rate using a controlled clinical trial. Eleven patients who fit the entry criteria underwent abdominal exploration and attempted tumor resection for cure. A historical control group...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199001000-00002
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To assess a new bloodless technique using radiofrequency energy for segmental liver resection of hepatic tumors. SUMMARY BACKGROUND DATA:Liver resection remains a formidable surgical procedure; safe performance requires a high level of training and skill. Intraoperative blood loss during liver resection rema...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200211000-00004
更新日期:2002-11-01 00:00:00
abstract::1016 Women were placed on estrogen support following hysterectomy and have been followed for a total of 14,318 patient/years. Support was principally conjugated estrogen with the customary dose 1.5 mg/day. The follow-up studies in this group of women shows a marked drop in deaths from all causes over those which might...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197705000-00010
更新日期:1977-05-01 00:00:00
abstract:OBJECTIVES:We aimed to examine the association between total number of resected nodes and survival in patients after esophagectomy with and without nCRT. BACKGROUND:Most studies concerning the potentially positive effect of extended lymphadenectomy on survival have been performed in patients who underwent surgery alon...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000965
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:This study aims at improving diagnosis of intestinal ischemia, by measuring plasma and urinary fatty acid binding protein (FABP) levels. METHODS:Fifty consecutive patients suspected of intestinal ischemia were included and blood and urine were sampled at time of suspicion. Plasma and urinary concentrations o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318207a767
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the minimum amount of weight loss required to see a reduction in major adverse cardiovascular events (MACE). BACKGROUND:Although obesity is an established risk factor for morbidity and mortality, the minimum amount of weight loss to have a meaningful impact on cardiovas...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004369
更新日期:2020-10-01 00:00:00
abstract::We investigated the clinical posttransplant effect of allopurinol on preserved kidneys. Thirty-four paired kidneys from brain-dead cadavers were preserved by hypothermic pulsatile perfusion with silica gel fraction in separate cassettes. Allopurinol was added to one perfusate and omitted from the other in a randomized...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-197701000-00021
更新日期:1977-01-01 00:00:00