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Variation exists in the current evidence base with regard to the optimum RMI I threshold that should be applied in secondary care. The cut-off levels used will have implications for both the management options considered and the number of women who will be referred for specialist treatment. Therefore it is important to establish the relative sensitivities and specificities at the different levels. The research should be a prospective observational cohort study evaluating women referred with suspected ovarian cancer. Diagnostic accuracy, sensitivity, specificity and cost effectiveness should be examined at the different RMI I thresholds. . | Breast Cancer What is cancer The body is made up of trillions of living cells. Normal body cells grow divide into new cells and die in an orderly fashion. During the early years of a person s life normal cells divide faster to allow the person to grow. After the person becomes an adult most cells divide only to replace worn-out or dying cells or to repair injuries. Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer but they all start because of out-of-control growth of abnormal cells. Cancer cell growth is different from normal cell growth. Instead of dying cancer cells continue to grow and form new abnormal cells. Cancer cells can also invade grow into other tissues something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell. Cells become cancer cells because of damage to DNA. DNA is in every cell and directs all its actions. In a normal cell when DNA gets damaged the cell either repairs the damage or the cell dies. In cancer cells the damaged DNA is not repaired but the cell doesn t die like it should. Instead this cell goes on making new cells that the body does not need. These new cells will all have the same damaged DNA as the first cell does. People can inherit damaged DNA but most DNA damage is caused by mistakes that happen while the normal cell is reproducing or by something in our environment. Sometimes the cause of the DNA damage is something obvious like cigarette smoking. But often no clear cause is found. In most cases the cancer cells form a tumor. Some cancers like leukemia rarely form tumors. Instead these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow. Cancer cells often travel to other parts of the body where they begin to grow and form new tumors that replace normal tissue. This process is called metastasis. It happens when the cancer cells get into the bloodstream
