September 2005
Annals of Internal Medicine tip sheet for Sept. 6, 2005
1. U.S. Group Does Not Recommend Routine Screening for Breast Cancer Gene
The U.S. Preventive Services Task Force does not recommend routine screening for mutations in breast cancer genes BRCA1 and BRCA2, which are associated with an increased risk for breast and ovarian cancer (Guidelines, p. 355.)
However, the Task Force says that genetic counseling is appropriate for women with specific family histories associated with an increased risk of mutations in the BRCA1 or BRCA2 genes.
Such histories include women with two first degree relatives (parent, sibling, child) with breast cancer, one of whom received the diagnosis at age 50 years or younger, and women of Ashkenazi Jewish descent.
An editorial writer says that the recommendations show the importance of knowing one's family medical histories and will help eligible women consider the testing, the timing, the best way to involve family members and "the tradeoffs and uncertainties involved in the different preventive strategies available" if they are found to have a BRCA mutation." (Editorial, p. 388.)
These guidelines are the subject of a video news release, part of the Internal Medicine Report series produces by the American College of Physicians, publisher of Annals of Internal Medicine. Call for coordinates.
2. Inhaled Drug Reduces COPD Flare-Ups, Hospitalizations Better than Placebo
In a six-month study of 1,829 patients with moderate to severe chronic obstructive pulmonary disease (COPD), a daily dose of an inhaled bronchodilator, tiotropium, reduced the percentage of patients experiencing one or more flare-ups from 32 percent to 28 percent compared with a dummy pill (Article, p. 317). Patients taking the tiotropium also had fewer hospitalizations.
COPD is a cigarette-associated lung condition in which airflow is obstructed.
An editorial writer says that tiotropium should be considered a first-line medication in therapy for COPD and is a welcome addition for "a disease for which effective therapies are greatly needed" (Editorial, p. 386.)
3. Diet Drugs: A History of a Half-Century of Federal Regulation
(History of Medicine, p. 380).