Division of Medical Oncology and Hematology, Princess Margaret Hospital, 610 University Ave 5-124, Toronto, ON M5G 2M9, Canada.
J Natl Cancer Inst. 2012 Oct 17;104(20):1542-7. doi: 10.1093/jnci/djs394. Epub 2012 Sep 17.
Over the last few decades there has been an increase in the use of strategies to detect clinically occult breast cancer with the aim of achieving diagnosis at an earlier stage when prognosis may be improved. Such strategies include screening mammography in healthy women, diagnostic imaging and axillary staging in those diagnosed with breast cancer, and the use of follow-up imaging for the early detection of recurrent or metastatic disease. Some of these strategies are established, whereas for others there are inconsistent supportive data. Although the potential benefit of early detection of clinically occult breast cancer seems intuitive, use of such strategies can also be associated with harm. In this commentary, we provide an extended discussion on the potential benefits and harms of the routine and frequent use of screening interventions to detect clinically occult breast cancer and question whether we may be causing more harm than good.
在过去几十年中，人们越来越多地使用各种策略来检测临床上隐匿性乳腺癌，以期在预后可能改善的早期阶段做出诊断。这些策略包括对健康女性进行筛查性乳房 X 线摄影，对诊断为乳腺癌的女性进行诊断性影像学检查和腋窝分期，以及使用随访影像学检查来早期发现复发或转移性疾病。其中一些策略已经确立，而对于其他策略则存在不一致的支持数据。尽管早期发现临床上隐匿性乳腺癌的潜在益处似乎是直观的，但这些策略的使用也可能带来危害。在这篇评论中，我们对常规和频繁使用筛查干预措施来检测临床上隐匿性乳腺癌的潜在益处和危害进行了扩展讨论，并质疑我们是否可能弊大于利。
