2) Our returning faculty is Subashri @happiedoc (#nephrologist from Chennai 🇮🇳)
— @CKD_ce (@ckd_ce) March 12, 2024
Our topic: Breast Cancer Screening, Incidence, and Mortality in Women Treated With Maintenance Dialysis: A Population-Based Cohort Study in Ontario 🇨🇦#MedTwitter #nephtwitter @ISNkidneycare pic.twitter.com/akbk0nQYPk
4) 🦀Cancer & cancer-related mortality incidence is ~ 1.5 times ⬆️ in #KidneyFailure compared to the age & sex-matched general population
— @CKD_ce (@ckd_ce) March 12, 2024
⬆️ 🦀 cancer incidence is dependent on the type of cancerhttps://t.co/qkL0TNnF2w pic.twitter.com/QZaiQwr1o2
6a)
— @CKD_ce (@ckd_ce) March 12, 2024
📌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)
— @CKD_ce (@ckd_ce) March 12, 2024
📌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
8)
— @CKD_ce (@ckd_ce) March 12, 2024
🔍Retrospective population-based cohort study
🗓️July 1, 2002 to December 31, 2018
♀️ aged 50- 74 years with kidney failure on maintenance dialysis
📜Used various administrative databases held @ Institute for Clinical Evaluative Sciences @ICESOntario
9b) During the observation period, ♀️ transitioned between these 2 screening states, and to the other states, such as the state of breast cancer diagnosis, breast cancer and non breast cancer death, & kidney transplantation 👇 pic.twitter.com/6lTp6h3sfI
— @CKD_ce (@ckd_ce) March 12, 2024
11)
— @CKD_ce (@ckd_ce) March 12, 2024
📌Incidence rate (per 1000 pt-year [95% CI]), all ages:
🦀Breast cancer: 2.84 (2.25-3.60)
🦀☠️Breast cancer deaths: 0.70 (0.43–1.12)
☠️Non-breast cancer deaths: 149.08 (144.31–153.99)
📊Differences b/w Screening “Up-To-Date” & “Not Up-To-Date” screening states are shown👇: pic.twitter.com/L5HKuBPmFB
13a)
— @CKD_ce (@ckd_ce) March 12, 2024
📌In general population: trial-based evidence has shown ⬇️ relative risk in breast 🦀cancer mortality by almost 20% with screening vs no screening among ♀️ (age: 50-69y)
📌 On avg, it may take up to 10 yrs for 1 in 1000 women (0.1%) screened to avoid 1 breast cancer death
14a) Hence, current guidelines recommend a #shared-decision approach to cancer screening, considering individuals’ risk, life expectancy, potential harms, values, & preferences.
— @CKD_ce (@ckd_ce) March 12, 2024
15)
— @CKD_ce (@ckd_ce) March 12, 2024
🌟Current study suggests a “one-size-fits all” approach to cancer screening may be inappropriate for ♀️ on dialysis
🌟Requires careful evaluation of accuracy of screening tools, frequency, pts’ choices, cost-benefit & benefits-to-harm ratio & consequences of diagnosis & Rx
16b) Limitations:
— @CKD_ce (@ckd_ce) March 12, 2024
⚡Retrospective observational data
⚡Statistical inferences could not be made given the low event rates for both breast cancer incidences and deaths across the entire cohort
18a) Now, let me ask you a couple questions:
— @CKD_ce (@ckd_ce) March 12, 2024
Incidence of breast cancer in women on dialysis, in comparison with general population is:
18c) The answer is d. All of the above. Great job! pic.twitter.com/0Oa8vVw0o7
— @CKD_ce (@ckd_ce) March 12, 2024
19) You just earned 0.5hr 🆓CE/#CME! Claim your certificate now at https://t.co/GEJu23ImRd and share this #tweetorial with your followers and friends! Thanks to @happiedoc for authoring & @sophia_kidney for managing!#FOAMed #nephtwitter @ISNkidneycare @KIReports @goKDIGO
— @CKD_ce (@ckd_ce) March 12, 2024