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乳腺癌补充筛查方式的必要性:日本基于人群的乳腺癌筛查项目视角

The need for supplemental breast cancer screening modalities: a perspective of population-based breast cancer screening programs in Japan.

作者信息

Uematsu Takayoshi

机构信息

Breast Imaging and Breast Intervention Section, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.

出版信息

Breast Cancer. 2017 Jan;24(1):26-31. doi: 10.1007/s12282-016-0707-2. Epub 2016 Jun 3.

Abstract

PURPOSE

This article discusses possible supplemental breast cancer screening modalities for younger women with dense breasts from a perspective of population-based breast cancer screening program in Japan.

CONCLUSION

Supplemental breast cancer screening modalities have been proposed to increase the sensitivity and detection rates of early stage breast cancer in women with dense breasts; however, there are no global guidelines that recommend the use of supplemental breast cancer screening modalities in such women. Also, no criterion standard exists for breast density assessment. Based on the current situation of breast imaging in Japan, the possible supplemental breast cancer screening modalities are ultrasonography, digital breast tomosynthesis, and breast magnetic resonance imaging. An appropriate population-based breast cancer screening program based on the balance between cost and benefit should be a high priority. Further research based on evidence-based medicine is encouraged. It is very important that the ethnicity, workforce, workflow, and resources for breast cancer screening in each country should be considered when considering supplemental breast cancer screening modalities for women with dense breasts.

摘要

目的

本文从日本基于人群的乳腺癌筛查项目的角度,探讨针对乳腺致密的年轻女性可能的补充性乳腺癌筛查方式。

结论

已提出补充性乳腺癌筛查方式以提高乳腺致密女性早期乳腺癌的敏感性和检出率;然而,尚无全球指南推荐在此类女性中使用补充性乳腺癌筛查方式。此外,乳腺密度评估也不存在标准规范。基于日本乳腺成像的现状,可能的补充性乳腺癌筛查方式为超声检查、数字乳腺断层合成以及乳腺磁共振成像。基于成本效益平衡制定合适的基于人群的乳腺癌筛查项目应是重中之重。鼓励开展基于循证医学的进一步研究。在考虑针对乳腺致密女性的补充性乳腺癌筛查方式时,考虑每个国家乳腺癌筛查的种族、劳动力、工作流程和资源非常重要。

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