Mary E. Costanza (born February 21, 1937) is a retired doctor and professor at the University of Massachusetts Amherst medical school. She is known for her research in the field of cancer, cancer prevention, and leadership of the American Cancer Society in Massachusetts.
Costanza has a B.A. from Radcliffe College (1958), an M.A. from the University of California, Berkeley (1963), and an M.D. from the University of Rochester School of Medicine (1968). [1] [2] She did an internship and residency in medicine at Tufts- New England Medical Center where she continued on to be a clinical fellow. Starting in 1970 she volunteered at a health clinic in Somerville, Massachusetts, an activity she retained until 1980. [2] From 1980 until 1990 she was the director of oncology at the University of Massachusetts and its associated hospital. [2] Starting in 1990 she led the High Risk Breast Cancer Clinic. [2] [ where? ] She was a visiting scientist at the Dana-Farber Cancer Institute from 1989 to 1990.[ citation needed ] In 1995 she was named president of the Massachusetts American Cancer Society. [3]
Costanza's early research was on the carcinoembryonic antigen as a screening tool for cancer. [4] [5] Her subsequent research compared outcomes of patients receiving different chemotherapy drug regimes [6] [7] and toxic effects from cancer drugs. [8] Costanza has shared the pros and cons of different drug regimes used for breast cancer in The New York Times . [9] [10] Her later work centered on raising public awareness of breast cancer [11] and working to improve implementation of screening for breast cancer, [12] including large-scale studies on new drugs for prevention of breast cancer [13] and the connection between weight and prevalence of breast cancer in women. [14] She has researched the benefit of reminding women about the need for regular mammograms, [15] [16] and screening for colorectal cancer [17] and prostate cancer. [18]
In 1994 Costanza was diagnosed with breast cancer and spoke with The Boston Globe about her personal decisions while being a patient. [3]
Mammography is the process of using low-energy X-rays to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses or microcalcifications.
A tumor marker is a biomarker found in blood, urine, or body tissues that can be elevated by the presence of one or more types of cancer. There are many different tumor markers, each indicative of a particular disease process, and they are used in oncology to help detect the presence of cancer. An elevated level of a tumor marker can indicate cancer; however, there can also be other causes of the elevation.
Carcinoembryonic antigen (CEA) describes a set of highly-related glycoproteins involved in cell adhesion. CEA is normally produced in gastrointestinal tissue during fetal development, but the production stops before birth. Consequently, CEA is usually present at very low levels in the blood of healthy adults. However, the serum levels are raised in some types of cancer, which means that it can be used as a tumor marker in clinical tests. Serum levels can also be elevated in heavy smokers.
Phyllodes tumors, are a rare type of biphasic fibroepithelial mass that form from the periductal stromal and epithelial cells of the breast. They account for less than 1% of all breast neoplasms. They were previously termed cystosarcoma phyllodes, coined by Johannes Müller in 1838, before being renamed to phyllodes tumor by the World Health Organization in 2003. Phullon, which means 'leaf' in Greek, describes the unique papillary projections characteristic of phyllodes tumors on histology. Diagnosis is made via a core-needle biopsy and treatment is typically surgical resection with wide margins (>1 cm), due to their propensity to recur.
Philip Strax was an American radiologist who pioneered the use of mammography to screen for early breast cancer. With his co-investigators, the statistician Sam Shapiro and the surgeon Louis Venet, he conducted a randomized controlled trial comparing outcomes of over 60,000 women who received either mammogram and clinical breast exam or standard medical care. The first results of this study were published in the Journal of the American Medical Association (JAMA) in 1966. The study demonstrated that screening mammograms, which are routine periodic mammograms of asymptomatic women, could find breast cancer at an early enough stage to save lives. For this research Strax and Shapiro shared the Kettering Prize for outstanding contributions to cancer diagnosis or treatment in 1988.
A breast cyst is a cyst, a fluid-filled sac, within the breast. One breast can have one or more cysts. They are often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a soft grape or a water-filled balloon, but sometimes a breast cyst feels firm.
The United States Preventive Services Task Force (USPSTF) is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services". The task force, a volunteer panel of primary care clinicians with methodology experience including epidemiology, biostatistics, health services research, decision sciences, and health economics, is funded, staffed, and appointed by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.
Breast cancer screening is the medical screening of asymptomatic, apparently healthy women for breast cancer in an attempt to achieve an earlier diagnosis. The assumption is that early detection will improve outcomes. A number of screening tests have been employed, including clinical and self breast exams, mammography, genetic screening, ultrasound, and magnetic resonance imaging.
Molecular breast imaging (MBI), also known as scintimammography, is a type of breast imaging test that is used to detect cancer cells in breast tissue of individuals who have had abnormal mammograms, especially for those who have dense breast tissue, post-operative scar tissue or breast implants.
Daniel B. Kopans, MD, FACR is a radiologist specializing in mammography and other forms of breast imaging.
Invasive lobular carcinoma (ILC) is breast cancer arising from the lobules of the mammary glands. It accounts for 5–10% of invasive breast cancer. Rare cases of this carcinoma have been diagnosed in men.
The triple test score is a diagnostic tool for examining potentially cancerous breasts. Diagnostic accuracy of the triple test score is nearly 100%. Scoring includes using the procedures of physical examination, mammography and needle biopsy. If the results of a triple test score are greater than five, an excisional biopsy is indicated.
Dynamic angiothermography (DATG) is a technique for the diagnosis of breast cancer. This technique, though springing from the thermography of old conception, is based on a completely different principle. DATG records the temperature variations linked to the vascular changes in the breast due to angiogenesis. The presence, change, and growth of tumors and lesions in breast tissue change the vascular network in the breast. Consequently, measuring the vascular structure over time, DATG effectively monitors the change in breast tissue due to tumors and lesions. It is currently used in combination with other techniques for diagnosis of breast cancer. This diagnostic method is a low cost one compared with other techniques.
A well-woman examination is an exam offered to women to review elements of their reproductive health. The exam includes a breast examination, a pelvic examination and a Pap smear but may include other procedures. Hospitals employ strict policies relating to the provision of consent by the patient, the availability of chaperones at the examination, and the absence of other parties.
H. Gilbert Welch is an American academic physician and cancer researcher. He was an internist at the Veterans Administration Medical Center in White River Junction, Vermont, as well as a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice. In September 2018, Welch resigned from Dartmouth College after a 20-month long research misconduct investigation at Dartmouth concluded he had committed plagiarism.
In medicine, breast imaging is a sub-speciality of diagnostic radiology that involves imaging of the breasts for screening or diagnostic purposes. There are various methods of breast imaging using a variety of technologies as described in detail below. Traditional screening and diagnostic mammography uses x-ray technology and has been the mainstay of breast imaging for many decades. Breast tomosynthesis is a relatively new digital x-ray mammography technique that produces multiple image slices of the breast similar to, but distinct from, computed tomography (CT). Xeromammography and galactography are somewhat outdated technologies that also use x-ray technology and are now used infrequently in the detection of breast cancer. Breast ultrasound is another technology employed in diagnosis and screening that can help differentiate between fluid filled and solid lesions, an important factor to determine if a lesion may be cancerous. Breast MRI is a technology typically reserved for high-risk patients and patients recently diagnosed with breast cancer. Lastly, scintimammography is used in a subgroup of patients who have abnormal mammograms or whose screening is not reliable on the basis of using traditional mammography or ultrasound.
Kathleen I. Pritchard, is the head of oncology at Sunnybrook Health Sciences Centre in Toronto, Canada, specializing in breast cancer therapies, and leading the clinical trials division of the centre. She has authored numerous studies on women's health, breast cancer, hormone replacement therapy, public health, and research methodology. According to Thomson Reuters, Pritchard was one of the most cited researchers in the world in 2014 and 2015.
Fiona Jane Gilbert is a Scottish radiologist and academic.
HB 2102, also known as "Henda's Law", is a breast density (BD) notification law approved in 2011 by the FDA that mammography patients be provided educational materials on dense breast tissue can hide abnormalities, including breast cancer, from traditional screening. Henda's Law aims to promote patient doctor discussion as well as reduce the rate of false negatives, as mammography may not detect abnormalities in dense breasts.
Dense breast tissue, also known as dense breasts, is a condition of the breasts where a higher proportion of the breasts are made up of glandular tissue and fibrous tissue than fatty tissue. Around 40–50% of women have dense breast tissue and one of the main medical components of the condition is that mammograms are unable to differentiate tumorous tissue from the surrounding dense tissue. This increases the risk of late diagnosis of breast cancer in women with dense breast tissue. Additionally, women with such tissue have a higher likelihood of developing breast cancer in general, though the reasons for this are poorly understood.