Fri, 15 Nov This message describes the theories that breast cancer oncologists think about, and how new ones are evolving to account for exciting new data on a survival benefit for some persons for radiotherapy after even a mastectomy. Later ones will deal with those new data, and whether some oncologists are unaware of those data. Spread from One Source For 60 years, starting in or perhaps earlier , breast cancer was seen in medical literature to be a disease that arose in one location the breast and, if left untreated, spread through the lymphatic system first to nearby lymph nodes and subsequently to other organs in the body. This theory of "contiguous" development of metastases was articulated by Dr. Halsted, inventor of the Halsted radical mastectomy.
To parameterize the 1-year transition probabilities between different health status of the natural history of breast cancer based on the data of randomized controlled trial of X-ray mammography screening worldwide. Based on the breast cancer screening randomized controlled trials defined by a mammography screening review from the Cochrane and the International Agency for Research on Cancer, a systematic review was initiated in PubMed by searching names of the key investigators of the trials, combined with the diseases, screening intervention and outcome indicators. If applicable, all the original cumulative incidence rates were converted into one-year transition rate, using the life-table approach considering time length of follow-up. A total of 23 reports from 9 RCTs were included. The data on transition rate between the healthy status to precancerous lesions was absent. The 1-year transition rate from health to carcinoma in situ was Correspondingly, the 1-year transition rate from health to breast cancer including carcinoma in situ and invasive cancer were estimated as
Natural history models of breast cancer progression provide an opportunity to evaluate and identify optimal screening scenarios. This paper describes a detailed Markov model characterising breast cancer tumour progression. Breast cancer is modelled by a state continuous-time Markov model. The model differentiates between indolent and aggressive ductal carcinomas in situ tumours, and aggressive tumours of different sizes. We compared such aggressive cancers, that is, which are non-indolent, to those which are non-growing and regressing.
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