Wiersma Tj, de Bock G H, Assendelft W J J
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschapsbeleid, Postbus 3231, 3502 GE Utrecht.
Ned Tijdschr Geneeskd. 2003 Mar 22;147(12):547-50.
The general practitioner should encourage women aged 50-75 who are eligible for the national screening program for the early detection of breast cancer to participate. When any abnormalities are seen on the mammogram, the general practitioner should refer the woman for further investigations and inform her about the procedure to be followed. In the case of a lump, a mammogram or ultrasound examination of the breasts is indicated, unless the abnormality disappears during a different phase of the woman's menstrual cycle. Local pain and brown or bloody discharge from the nipples also necessitate further investigation. Women with a greater than 20% risk of ever developing breast cancer during their life based on a positive family history for breast cancer have an indication for periodic examination of the breasts and a mammogram before they are 50. If the risk is greater than 30%, consultation with a clinical geneticist can be suggested.
全科医生应鼓励年龄在50至75岁、符合国家乳腺癌早期检测筛查计划条件的女性参与筛查。当乳房X光检查发现任何异常时，全科医生应将该女性转诊进行进一步检查，并告知其后续要遵循的程序。对于乳房肿块，除非该异常在女性月经周期的不同阶段消失，否则需进行乳房X光检查或超声检查。乳头局部疼痛以及棕色或血性乳头溢液也需要进一步检查。基于乳腺癌家族史呈阳性，一生中患乳腺癌风险超过20%的女性，有指征在50岁之前定期进行乳房检查和乳房X光检查。如果风险超过30%，可以建议咨询临床遗传学家。
