6a) 📌In women receiving dialysis, risk of #BreastCancer may not be ⬆️ 📌But #prognosis in them is poor 📌Data from Australia & New Zealand Dialysis and Transplant Registry: Standardized mortality ratio for breast cancer in ♀️ on dialysis was 2.3 compared to general population
7a) 📌Comparative data on benefits of routine mammographic screening in ♀️ treated with maintenance dialysis are lacking. 📜In this tweetorial, we discuss #Breast_Cancer#Screening, #Incidence & #Mortality in ♀️ on Maintenance Dialysis: A Population-Based Cohort Study in Ontario pic.twitter.com/zcInCx7NXd
9a) Final cohort included 8373 ♀️ Based on their participation in mammographic screening, patients were divided into 2 states: screening “up-to-date” and screening “not-up-to-date” states.
13b) In ♀️ on maintenance dialysis, benefits of routine screening are uncertain due to: ⚡lower life expectancy related to non cancer-related deaths ⚡False + mammographic results: soft tissue calcification secondary to kidney disease & hyperparathyroidism, may mimic malignancy
14b) ⚡Breast cancer deaths may be uncommon in ♀️ on dialysis ⚡But, important factors to consider when discussing screening include: age, transplant listing status & genetic factors
16a) Strength of this analysis: ⚡Large population-based cohort of > 8000 ♀️ aged 50-74y treated with dialysis ⚡Using state-transition techniques, participants followed-up w/minimal attrition rates ⚡Outcomes defined by validated algorithm ➡️misclassified outcomes are unlikely
17) Learning points: ♀️ who remained in the screening “up-to-date” states may be: 📌 Healthier 📌More likely to be listed on the transplant waiting list 📌Policymakers to consider a personalized & risk-based approach to breast🦀 screening in ♀️ on maintenance dialysis
18b) The answer is d, similar. Moving on, the postulated pathogenic mechanisms leading to increased cancer development with kidney dysfunction include: a. Alteration in DNA repair b. Reduction in antioxidant defence c. Chronic inflammation d. All of the above
