Evans D G, Thomas S, Caunt J, Roberts L, Howell A, Wilson M, Fox R, Sibbering D M, Moss S, Wallis M G, Eccles D M, Duffy S
Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Trust, Wythenshawe, Manchester, M23 9LT, UK,
Fam Cancer. 2014 Mar;13(1):13-21. doi: 10.1007/s10689-013-9661-8.
Although there have been encouraging recent studies showing a potential benefit from annual mammography in women aged 40-49 years of age with an elevated breast cancer risk due to family history there is little evidence of efficacy in women aged <40 years of age. A prospective study (FH02) has been developed to assess the efficacy of mammography screening in women aged 35-39 years of age with a lifetime breast cancer risk of ≥ 17 % who are not receiving MRI screening. Retrospective analyses from five centres with robust recall systems identified 47 breast cancers (n = 12 in situ) with an interval cancer rate of 15/47 (32%). Invasive tumour size, lymph node status and current vital status were all significantly better than in two control groups of unscreened women (including those with a family history) recruited to the POSH study. Further evaluation of the prospective arm of FH02 is required to assess the potential added value of digital mammography and the cancer incidence rates in moderate and high risk women in order to inform cost effectiveness analyses.
尽管近期有一些令人鼓舞的研究表明，对于因家族病史而乳腺癌风险升高的40至49岁女性，每年进行乳腺钼靶检查可能有益，但几乎没有证据表明其对40岁以下女性有效。一项前瞻性研究（FH02）已开展，以评估乳腺钼靶筛查对35至39岁、终生患乳腺癌风险≥17%且未接受MRI筛查的女性的效果。来自五个拥有完善召回系统的中心的回顾性分析发现了47例乳腺癌（12例原位癌），间期癌发生率为15/47（32%）。浸润性肿瘤大小、淋巴结状态和当前生存状态均显著优于招募到POSH研究中的两个未筛查女性对照组（包括有家族病史的女性）。需要对FH02的前瞻性研究部分进行进一步评估，以评估数字乳腺钼靶的潜在附加价值以及中高风险女性的癌症发病率，从而为成本效益分析提供依据。
