Long term absence of invasive breast cancer diagnosis in 2,402,672 pre and postmenopausal women: A systematic review and meta-analysis.

BACKGROUND: Invasive Breast Cancer (IBC) risk estimates continue to be based on data collated from cancer registries, i.e., retrospective research that excludes disease-free women. For women without a prior diagnosis, these estimates inflate both risk and screening frequency recommendations and inadvertently increase recently recognized harms from overdiagnosis and overtreatment. OBJECTIVE: To estimate the likelihood that pre or postmenopausal women with no prior diagnosis will remain free of IBC in order to enable evidence-based screening recommendations. METHODS: Prospective data from 21 studies of 2,402,672 women were analyzed, updating our previously published systematic search of 19 studies. This second systematic search included PubMed and The Cochrane Library from 2012 through April 2019. Inclusion criteria: only studies reporting the number of women enrolled, length of follow-up, and number of women diagnosed with IBC. Linear regression was used to estimate the percentage of women expected to remain free from an IBC diagnosis based on follow-up duration. To minimize non-response bias and selective outcome bias, only studies reporting outcomes for all enrolled women followed for similar, specific lengths of time were included. Sensitivity analyses confirm that the overall findings were unchanged by age at enrollment, menopausal status, screened women, variation in sample size, duration of follow-up, and heteroskedasticity. RESULTS: The calculated percentage of women remaining IBC-free after follow-ups of 5, 10, 15, 20 and 25 years decreases uniformly by about one-fourth of one percent per year, i.e., 0.255% (95% CI: -0.29, -0.22; p < .0001). At 25 years, the expected percentage of women with no invasive breast cancer is 93.41% (95% CI: 92.75, 94.07). CONCLUSIONS: Over 99.7% of pre/postmenopausal women with no prior diagnosis continued with no IBC each year, with 93.41% still free after 25 years. Our study supports the medical justification for reducing the frequency of mammograms for menopausal women with no prior IBC diagnosis.

THE LINK BETWEEN DEPRESSION AND SCHADENFREUDE: FURTHER EVIDENCE.

This replication examined the link between schadenfreude (i.e., pleasure from another's misfortune), freudenfreude (i.e., pleasure from another's success), and self-rated depression. Using the Freudenfreude and Schadenfreude Test (FAST), moderately depressed students reported more schadenfreude and less freudenfreude than their mildly depressed peers. The limitations of this study and further research directions are discussed.

Invasive Breast Cancer Incidence in 2,305,427 Screened Asymptomatic Women: Estimated Long Term Outcomes during Menopause Using a Systematic Review.

BACKGROUND: Earlier studies of breast cancer, screening mammography, and mortality reduction may have inflated lifetime and long-term risk estimates for invasive breast cancer due to limitations in their data collection methods and interpretation. OBJECTIVE: To estimate the percentage of asymptomatic peri/postmenopausal women who will be diagnosed with a first invasive breast cancer over their next 25 years of life. METHODS: A systematic review identified peer-reviewed published studies that: 1) enrolled no study participants with a history of invasive breast cancer; 2) specified the number of women enrolled; 3) reported the number of women diagnosed with a first invasive breast cancer; 4) did not overcount [count a woman multiple times]; and, 5) defined the length of follow-up. Data sources included PubMed, Cochrane Library, and an annotated library of 4,409 full-text menopause-related papers collected and reviewed by the first author from 1974 through 2008. Linear regression predicted incidence of first invasive breast cancer, based on follow-up duration in all studies that met the our inclusion criteria, and in a subset of these studies that included only women who were 1) at least 50 years old and 2) either at least 50 or less than 50 but surgically menopausal at enrollment. RESULTS: Nineteen studies met the inclusion criteria. They included a total of 2,305,427 peri/postmenopasual women. The mean cumulative incidence rate of first invasive breast cancer increased by 0.20% for each year of age (95% CI: 0.17, 0.23; p < 0.01; R2 = 0.90). Over 25 years of follow-up, an estimated 94.55% of women will remain breast cancer-free (95% CI: 93.97, 95.13). In the 12 studies (n = 1,711,178) that enrolled only postmenopausal women, an estimated 0.23% of women will be diagnosed with a first invasive breast cancer each year (95% CI: 0.18, 0.28; p < 0.01, R2 = 0.88). CONCLUSION: The vast majority (99.75%) of screened asymptomatic peri/postmenopasual women will not be diagnosed with invasive breast cancer each year. Approximately 95% will not be diagnosed with invasive breast cancer during 25 years of follow-up. Women who receive clinical examinations, but do not have mammograms, will have higher cancer-free rates because innocuous positives (comprising 30-50% of mammography diagnoses) will remain undetected. Informed consent to asymptomatic women should include these results and consideration of the benefits of avoiding mammograms.

Freudenfreude and Schadenfreude Test (FAST) scores of depressed and non-depressed undergraduates.

The Freudenfreude and Schadenfreude Test (FAST) had moderate test-retest reliability in an undergraduate sample. Freudenfreude scores were lower and Schadenfreude scores were higher among mildly depressed than nondepressed students. Distinctive reactions to personal success and failure were associated with depression. Responses to others' success and failure may also be related to depression.

Relationship between a history of consistent maternal employment and depression in young adults.

Research on the correlates of maternal employment has yielded inconsistent results. In this study, 79 male and 120 female undergraduates with mothers who had been employed from the students' infancy through their adolescence scored higher on the Beck Depression Inventory-II than those whose mothers had not been employed. This relationship between children's depressive symptoms and mothers' employment history was not evident among young adults whose mothers' employment was perceived to be financially unnecessary.

High school, college, and professional school faculty members' perceptions of students who are current smokers, former smokers, and nonsmokers.

A questionnaire rating the descriptions of a hypothetical student smoker, a former smoker, and a nonsmoker, as well as personal smoking habits, was administered to 35 high school, 34 college, and 24 professional school faculty members. Respondents rated smokers more negatively than nonsmokers or former smokers. Paired-sample t tests indicated that smokers were rated as less intelligent, independent, conscientious, and ambitious and as having poorer judgment and being more hostile than the nonsmoking student. In addition, paired-sample t tests identified only one significant difference out of seven between the ratings of the former smoker and the nonsmoker; the former smoker was rated less artistically creative than one who had never smoked. High school teachers' ratings of students who smoked relative to nonsmokers were more negative than those of college and professional school faculty, suggesting that high school student smokers might be especially socially penalized for their decision to smoke.

High school and college students' perceptions of current smokers, former smokers, and nonsmokers.

A questionnaire assessing perceptions of hypothetical male and female current smokers, a former smoker, and a nonsmoker, as well as personal smoking habits, was administered to 108 suburban high school and 115 college students. Both smokers and nonsmokers held a more negative view of smokers than nonsmokers; mean character ratings of former smokers fell in between. Paired-sample t tests indicated that smokers were viewed as less intelligent, creative, independent, conscientious, ambitious, and considerate, as having poorer judgment, and as more hostile than their nonsmoking counterparts. Respondents who currently smoke rated hypothetical smokers less negatively than respondents who did not smoke. In addition, paired-sample t tests identified no significant differences between the overall ratings of the female and male target smokers. No mean differences emerged on the ratings of targets; however, the high school students were more likely than the college students to report believing that the majority of students at their school smoke and that teachers discriminate against students who smoke.