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Introduction The Predicting Risk of Cancer at Screening study in Manchester, UK, is a prospective study of breast cancer risk estimation. It was designed to assess whether mammographic density may help in refinement of breast cancer risk estimation using either the Gail model (Breast Cancer Risk Assessment Tool) or the Tyrer-Cuzick model (International Breast Intervention Study model). Methods Mammographic density was measured at entry as a percentage visual assessment, adjusted for age and body mass index. Tyrer-Cuzick and Gail 10-year risks were based on a questionnaire completed contemporaneously. Breast cancers were identified at the entry screen or shortly thereafter. The contribution of density to risk models was assessed using odds ratios (ORs) with profile likelihood confidence intervals (CIs) and area under the receiver operating characteristic curve (AUC). The calibration of predicted ORs was estimated as a percentage [(observed vs expected (O/E)] from logistic regression. Results The analysis included 50,628 women aged 47–73 years who were recruited between October 2009 and September 2013. Of these, 697 had breast cancer diagnosed after enrolment. Median follow-up was 3.2 years. Breast density [interquartile range odds ratio (IQR-OR) 1.48, 95 % CI 1.34–1.63, AUC 0.59] was a slightly stronger univariate risk factor than the Tyrer-Cuzick model [IQR-OR 1.36 (95 % CI 1.25–1.48), O/E 60 % (95 % CI 44–74), AUC 0.57] or the Gail model [IQR-OR 1.22 (95 % CI 1.12–1.33), O/E 46 % (95 % CI 26–65 %), AUC 0.55]. It continued to add information after allowing for Tyrer-Cuzick [IQR-OR 1.47 (95 % CI 1.33–1.62), combined AUC 0.61] or Gail [IQR-OR 1.45 (95 % CI 1.32–1.60), combined AUC 0.59]. Conclusions Breast density may be usefully combined with the Tyrer-Cuzick model or the Gail model.

Background High mammographic density is associated with both risk of cancers being missed at mammography, and increased risk of developing breast cancer. Stratification of breast cancer prevention and screening requires mammographic density measures predictive of cancer. This study compares five mammographic density measures to determine the association with subsequent diagnosis of breast cancer and the presence of breast cancer at screening. Methods Women participating in the “Predicting Risk Of Cancer At Screening” (PROCAS) study, a study of cancer risk, completed questionnaires to provide personal information to enable computation of the Tyrer-Cuzick risk score. Mammographic density was assessed by visual analogue scale (VAS), thresholding (Cumulus) and fully-automated methods (Densitas, Quantra, Volpara) in contralateral breasts of 366 women with unilateral breast cancer (cases) detected at screening on entry to the study (Cumulus 311/366) and in 338 women with cancer detected subsequently. Three controls per case were matched using age, body mass index category, hormone replacement therapy use and menopausal status. Odds ratios (OR) between the highest and lowest quintile, based on the density distribution in controls, for each density measure were estimated by conditional logistic regression, adjusting for classic risk factors. Results The strongest predictor of screen-detected cancer at study entry was VAS, OR 4.37 (95% CI 2.72–7.03) in the highest vs lowest quintile of percent density after adjustment for classical risk factors. Volpara, Densitas and Cumulus gave ORs for the highest vs lowest quintile of 2.42 (95% CI 1.56–3.78), 2.17 (95% CI 1.41–3.33) and 2.12 (95% CI 1.30–3.45), respectively. Quantra was not significantly associated with breast cancer (OR 1.02, 95% CI 0.67–1.54). Similar results were found for subsequent cancers, with ORs of 4.48 (95% CI 2.79–7.18), 2.87 (95% CI 1.77–4.64) and 2.34 (95% CI 1.50–3.68) in highest vs lowest quintiles of VAS, Volpara and Densitas, respectively. Quantra gave an OR in the highest vs lowest quintile of 1.32 (95% CI 0.85–2.05). Conclusions Visual density assessment demonstrated a strong relationship with cancer, despite known inter-observer variability; however, it is impractical for population-based screening. Percentage density measured by Volpara and Densitas also had a strong association with breast cancer risk, amongst the automated measures evaluated, providing practical automated methods for risk stratification.

This is the story of Janie Ryan and her Ma, Iris. Born in Aberdeen in the early 1980s, her Ma having \"been tae London and got herself preggers\", Janie is initiated early into the ways of the fishwife - fighting, falling out, and moving on.

Still, love stories also demand inauspicious beginnings and unlikely pairings. While [Addie] would have once considered a banker \"an even worse prospect than a serial killer\", she immediately knows this is the start of a romance, and the pair fall into an easy, fun-and-sex-filled love affair. Despite Bruno's bafflement at Addie's lack of interest in her country's history (\"I know it's historic, this river, I just can't remember why\"), they have a relaxed, unquestioning enjoyment of each other. Then Obama wins, and \"it was like the world had found a new lover\", and for a while Addie and Bruno are happy. But then it ends, in a way that, for all its foreshadowing, still shocks and devastates. Some significant time after reading, I still haven't quite come to terms with it.

The Bible is full of tales of the underdog defeating oppression through faith and wisdom, and nowhere more so than in the Book of Judith, where the heroine uses wily deceit to convince her countrymen that God would keep them safe. How Judith, the 10-year-old heroine of Grace McCleen's fascinating debut novel, must have loved that story. Growing up with her father as part of a fundamentalist sect, Judith is the fervent one of the family, a girl who loves to read the Bible aloud and sit at home to await the approaching Armageddon, when all non-believers will meet their end. It's the aftermath of this that fascinates Judith most, and in her bedroom she has created a miniature Land of Decoration, in homage to the land promised to the Israelites in her adored Word of God.

What's a young, well-to-do woman to do if she's abandoned by her fiance in mid-19th-century Liverpool, as said fiance continues to treat her to long letters detailing the extent of his marital bliss?

Oh, but the French do loneliness and desperation classily.

Josh meets Caroline in a shared student house in London. The time is the late 1970s, so everyone in the house looks hideous. That's everyone except for Caroline.\" Caroline is Australian, blonde, beautiful, incapable of putting a foot wrong. Josh, a South African, is short, with clownish curly hair, but he bags the good-looking girl and they marry.

Bloom's fiercely elegant, sly prose, so perfectly suited to the short story, her psychotherapist background that gives her writing such authority, the intelligence she assumes in her readers - it's the stuff of which readers' obsessions are made. And obsessive love is something Bloom knows about.