McMaster University, Hamilton, Ontario, Canada (H.J.S.).
European Commission, Joint Research Centre, Ispra, Italy (D.L., E.P., Z.S.).
Ann Intern Med. 2020 Jan 7;172(1):46-56. doi: 10.7326/M19-2125. Epub 2019 Nov 26.
The European Commission Initiative for Breast Cancer Screening and Diagnosis guidelines (European Breast Guidelines) are coordinated by the European Commission's Joint Research Centre. The target audience for the guidelines includes women, health professionals, and policymakers.
An international guideline panel of 28 multidisciplinary members, including patients, developed questions and corresponding recommendations that were informed by systematic reviews of the evidence conducted between March 2016 and December 2018. GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision frameworks were used to structure the process and minimize the influence of competing interests by enhancing transparency. Questions and recommendations, expressed as strong or conditional, focused on outcomes that matter to women and provided a rating of the certainty of evidence.
This synopsis of the European Breast Guidelines provides recommendations regarding organized screening programs for women aged 40 to 75 years who are at average risk. The recommendations address digital mammography screening and the addition of hand-held ultrasonography, automated breast ultrasonography, or magnetic resonance imaging compared with mammography alone. The recommendations also discuss the frequency of screening and inform decision making for women at average risk who are recalled for suspicious lesions or who have high breast density.
欧洲委员会乳腺癌筛查和诊断指南倡议（欧洲乳腺指南）由欧盟委员会联合研究中心协调。指南的目标受众包括女性、卫生专业人员和政策制定者。
一个由 28 名多学科成员组成的国际指南小组，包括患者，制定了问题和相应的建议，这些问题和建议是基于 2016 年 3 月至 2018 年 12 月期间进行的系统评价证据。使用 GRADE（推荐评估、制定和评估分级）证据决策框架来构建流程，通过提高透明度来最小化利益冲突的影响。问题和建议以强烈或有条件的形式表达，侧重于对女性重要的结果，并对证据的确定性进行评级。
本欧洲乳腺指南概要提供了针对平均风险的 40 至 75 岁女性的有组织筛查计划的建议。这些建议涉及数字乳房 X 线摄影筛查以及与单独乳房 X 线摄影相比，增加手持式超声、自动乳房超声或磁共振成像。建议还讨论了筛查频率，并为因可疑病变或乳腺密度高而被召回的平均风险女性做出决策。
