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Suggested Citation:"Glossary." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer: A Non-Technical Summary. Washington, DC: The National Academies Press. doi: 10.17226/10107.
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GLOSSARY

Bias: a process at any stage of inference tending to produce results that depart systematically from the true values.

Biopsy: excision of a small piece of tissue for diagnostic examination; can be done surgically or with needles.

BRCA1: a gene located on the short arm of chromosome 17; when this gene is mutated, a woman is at greater risk of developing breast or ovarian cancer, or both, than women who do not have the mutation.

BRCA2: a gene located on chromosome 13; a germ-line mutation in this gene is associated with increased risk of breast cancer.

Breast self-examination: monthly physical examination of the breasts with the intent of finding lumps that could be an early indication of cancer.

Cell culture: the growth of cells in vitro for experimental purposes.

Clinical breast examination: a physical examination of the breasts, performed by a doctor. or nurse, with the intent of finding lumps that could be an early indication of cancer.

Clinical outcome: the end result of a medical intervention, e.g., survival or improved health.

Clinical trial: a formal study carried out according to a prospectively defined protocol that is intended to discover or verify the safety and effectiveness of procedures or interventions in humans. The term may refer to a controlled or uncontrolled trial.

Computer-aided detection: use of sophisticated computer programs designed to recognize patterns in images.

Contrast agent: a substance that enhances the image produced by medical diagnostic equipment such as ultrasound, X ray, magnetic resonance imaging, or nuclear medicine or and imaging-sensitive substance that is ingested or injected intravenously to enhance or increase contrast between anatomical structures.

Cost-effectiveness analysis: methods for comparing the economic efficiencies of different therapies or programs that produce health.

Detection: finding disease. Early detection means that the disease is found at an early stage, before it has grown large or spread to other sites.

Diagnosis: confirmation of a specific diseaseusually by imaging procedures and from the use of laboratory findings.

Diagnostic mammography: X-ray-based breast imaging undertaken for the purpose of diagnosing an abnormality discovered by physical exam or screening mammography.

Digital mammography: see full-field digital mammography.

DNA: abbreviation for deoxyribonucleic acid. DNA holds genetic information for cell growth, division, and function.

Duct: a hollow passage for gland secretions. In the breast, a passage through which milk passes from the lobule (which makes the milk) to the nipple.

Ductal carcinoma in situ: a lesion in which there is proliferation of abnormal cells within the ducts of the breast, but no visible evidence of invasion into the duct walls or surrounding tissues; sometimes referred to as “precancer” or “preinvasive cancer.”

Suggested Citation:"Glossary." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer: A Non-Technical Summary. Washington, DC: The National Academies Press. doi: 10.17226/10107.
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Page 28

Ductal lavage: a procedure in which a small catheter is inserted into the nipple and the breast ducts are flushed with fluid to collect breast cells.

Effectiveness: the extent to which a specific test or intervention, when used under ordinary circumstances, does what it is intended to do.

Epidemiology: science concerned with defining and explaining the interrelationships of factors that determine disease frequency and distribution.

False-negative result: a test result that indicates that the abnormality or disease being investigated is not present when in fact it is.

False-positive result: a test result that indicates that the abnormality or disease being investigated is present when in fact it is not.

Fine-needle aspiration: a procedure by which a thin needle is used to draw up (aspirate) samples for examination under a microscope.

Full-field digital mammography: similar to conventional mammography (film-screen mammography) except that a dedicated electronic detector system is used to computerize and display the X-ray information.

Gene: a functional unit of heredity that occupies a specific place or locus on a chromosome.

Invasive cancer: cancers capable of growing beyond their site of origin and invading neighboring tissue.

Invasive ductal carcinoma: a cancer that starts in the ducts of the breast and then breaks through the duct wall, where it invades the surrounding tissue; it is the most common type of breast cancer and accounts for about 80 percent of breast malignancies.

Invasive lobular carcinoma: a cancer that starts in the milk-producing glands (lobules) of the breast and then breaks through the lobule walls to involve the surrounding tissue; accounts for about 15 percent of invasive breast cancers.

Lead-time bias: the assumption that identifying and treating tumors at an earlier point in the progression of the disease will necessarily alter the rate of progression and the eventual outcome.

Length bias: the assumption that screening tests are more likely to identify slowly growing tumors than those with a fast growth rate.

Lobular carcinoma in situ: abnormal cells within a breast lobule that have not invaded surrounding tissue; can serve as a marker of future cancer risk.

Magnetic resonance imaging: method by which images are created by recording signals generated from the excitation (the gain and loss of energy) of elements such as the hydrogen of water in tissue in a magnetic field.

Malignant: a tumor that has the potential to become lethal through destructive growth or by having the ability to invade surrounding tissue and metastasize.

Mammogram: X-ray image of the breast.

Mammography: technique for imaging breast tissues with X rays.

Medicaid: jointly funded federal-state health insurance program for certain low-income and needy people. It covers approximately 36 million individuals including children; aged, blind, and/or disabled people; and people who are eligible to receive federally assisted income maintenance payments.

Medicare: a program that provides health insurance to people age 65 and over, those who have permanent kidney failure, and people with certain disabilities.

Suggested Citation:"Glossary." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer: A Non-Technical Summary. Washington, DC: The National Academies Press. doi: 10.17226/10107.
×

Page 29

Microcalcifications: tiny calcium deposits within the breast, singly or in clusters; often found by mammography. They may be a sign of cancer.

Molecular markers: changes in cells, at the molecular level, that are indicative of cancer or malignant potential.

Mortality: the death rate; ratio of number of deaths to a given population.

Overdiagnosis: labeling an abnormality as cancer when it in fact is not likely to become a lethal cancer.

Palpable tumor: a tumor that can be felt during a physical examination.

Positron emission tomography: use of radioactive tracers such as labeled glucose to identify regions in the body with altered metabolic activity.

Premalignant: changes in cells that may, but that do not always, become cancer. Also called “precancer.”

Prognosis: prediction of the course and end of disease and the estimate of chance for recovery.

Prophylactic bilateral mastectomy: surgical removal of both breasts with the intent of reducing the risk of developing breast cancer later in life.

Randomization: a method that uses chance to assign participants to comparison groups in a trial by using a random-numbers table or a computer-generated random sequence. Random allocation implies that each individual being entered into a trial has the same chance of receiving each of the possible interventions.

Risk: a quantitative measure of the probability of developing or dying from a particular disease such as cancer.

Scintimammography: use of radioactive tracers to produce an image of the breast.

Screen-film mammography: conventional mammography in which the X rays are recorded on film.

Screening: systematic testing of an asymptomatic population to determine the presence of a particular disease or certain risk factors known to be associated with the disease.

Screening mammography: X-ray-based breast imaging in an asymptomatic population with the goal of detecting breast tumors at an early stage.

Sensitivity: a measure of how often a test correctly identifies women with breast cancer.

Specificity: a measure of how often a test correctly identifies a woman as not having breast cancer.

Specimen bank: stored patient tissue samples that are used for biomedical research (also tumor or tissue banks).

Tomography: any of several techniques for making X-ray pictures of a predetermined plane section of a solid object by blurring out the images of other planes.

Tumor marker: any substance or characteristic that indicates the presence of a malignancy.

Ultrasound: use of inaudible, high-frequency sound waves to create an image of the body.

Suggested Citation:"Glossary." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer: A Non-Technical Summary. Washington, DC: The National Academies Press. doi: 10.17226/10107.
×
Page 27
Suggested Citation:"Glossary." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer: A Non-Technical Summary. Washington, DC: The National Academies Press. doi: 10.17226/10107.
×
Page 28
Suggested Citation:"Glossary." Institute of Medicine and National Research Council. 2001. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer: A Non-Technical Summary. Washington, DC: The National Academies Press. doi: 10.17226/10107.
×
Page 29
Next: Committee on Technologies for the Early Detection of Breast Cancer »
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X-ray mammography screening is the current mainstay for early breast cancer detection. It has been proven to detect breast cancer at an earlier stage and to reduce the number of women dying from the disease. However, it has a number of limitations.

These current limitations in early breast cancer detection technology are driving a surge of new technological developments, from modifications of x-ray mammography such as computer programs that can indicate suspicious areas, to newer methods of detection such as magnetic resonance imaging (MRI) or biochemical tests on breast fluids. To explore the merits and drawbacks of these new breast cancer detection techniques, the Institute of Medicine of the National Academy of Sciences convened a committee of experts. During its year of operation, the committee examined the peer-reviewed literature, consulted with other experts in the field, and held two public workshops.

In addition to identifying promising new technologies for early detection, the committee explored potential barriers that might prevent the development of new detection methods and their common usage. Such barriers could include lack of funding from agencies that support research and lack of investment in the commercial sector; complicated, inconsistent, or unpredictable federal regulations; inadequate insurance reimbursement; and limited access to or unacceptability of breast cancer detection technology for women and their doctors. Based on the findings of their study, the committee prepared a report entitled Mammography and Beyond: Developing Technology for Early Detection of Breast Cancer, which was published in the spring of 2001. This is a non-technical summary of that report.

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