Department of Surgery, University of Cape Town Faculty of Health Sciences and Groote Schuur Hospital, Observatory, 7925 Cape Town, South Africa.
Best Pract Res Clin Obstet Gynaecol. 2012 Apr;26(2):283-90. doi: 10.1016/j.bpobgyn.2011.11.007. Epub 2012 Jan 4.
Diagnosing breast cancer early and efficiently is a critical component of any strategy aimed at decreasing breast cancer mortality in developing countries. In this chapter, I evaluate the evidence behind screening strategies and its controversies. The effect of breast-cancer screening has never been formally evaluated in developing countries, and data from the major screening trials need to be viewed in this context. Screening asymptomatic women by means of breast self-examination, clinical examination or mammography can play a significant role in decreasing breast-cancer mortality in developing countries. Major programmes should not be implemented, however, until adequate diagnostic and therapeutic facilities are in place. The most fundamental interventions in early detection, diagnosis, surgery, radiation therapy, and drug therapy must be integrated, organised and resourced appropriately within existing healthcare structures.
早期、高效地诊断乳腺癌是降低发展中国家乳腺癌死亡率策略的重要组成部分。在本章中，我评估了筛查策略背后的证据及其争议。乳腺癌筛查在发展中国家从未得到正式评估，需要从这一角度来看待主要筛查试验的数据。通过自我检查、临床检查或乳房 X 线摄影对无症状妇女进行筛查，可以在降低发展中国家乳腺癌死亡率方面发挥重要作用。然而，在具备适当的诊断和治疗设施之前，不应实施主要计划。在现有医疗保健结构内，必须将早期检测、诊断、手术、放射治疗和药物治疗方面最基本的干预措施进行适当的整合、组织和配置资源。
