Division of General Surgery, Department of Surgery, 66984American University of Beirut Medical Center, Beirut, Lebanon.
Division of Hematology and Oncology, Department of Internal Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.
Cancer Control. 2021 Jan-Dec;28:10732748211039443. doi: 10.1177/10732748211039443.
Breast cancer (BC) is the most common cancer in women and men combined, and it is the second cause of cancer deaths in women after lung cancer. In Lebanon, the same epidemiological profile applies where BC is the leading cancer among Lebanese females, representing 38.2% of all cancer cases. As per the Center for Disease Control, there was a decline in BC mortality rate from 2003 to 2012 reflecting the adoption of national mammographic screening as the gold standard for BC detection by Western countries. The aim of this review study is to summarize current recommendations for BC screening and the available modalities for detecting BC in different countries, particularly in Lebanon. It also aims at exploring the impact of screening campaigns on BC early stage diagnosis in Lebanon. Despite the considerable debates whether screening mammograms provides more harm than benefits, screening awareness should be stressed since its benefits far outweigh its risks. In fact, the majority of BC mortality cases in Western countries are non-preventable by the use of screening mammograms alone. As such, Lebanon adopted a public focus on education and awareness campaigns encouraging early BC screening. Several studies showed the impact of early detection that is reflected by an increase in early stage disease and a decrease in more aggressive stages. Further studies should shed the light on the effect of awareness campaigns on early breast cancer diagnosis and clinical down staging at a national scope; therefore, having readily available data on pre- and post-adoption of screening campaigns is crucial for analyzing trends in mortality of breast cancer origin and reduction in advanced stages diseases. There is still room for future studies evaluating post-campaigns knowledge, attitudes, and practices of women having participated, emphasizing on the barriers refraining Lebanese women to contribute in BC screening campaigns.
乳腺癌(BC)是男性和女性中最常见的癌症,也是女性癌症死亡的第二大原因,仅次于肺癌。在黎巴嫩,同样的流行病学特征也适用,BC 是黎巴嫩女性中最主要的癌症,占所有癌症病例的 38.2%。根据疾病控制中心的数据,从 2003 年到 2012 年,BC 的死亡率有所下降,这反映了西方国家采用国家乳房 X 光筛查作为 BC 检测的金标准。本综述研究的目的是总结当前 BC 筛查的建议,以及不同国家(特别是黎巴嫩)用于检测 BC 的现有方法。它还旨在探讨筛查活动对黎巴嫩早期 BC 诊断的影响。尽管关于筛查乳房 X 光片是否弊大于利存在相当大的争议,但应强调筛查意识,因为其益处远远大于风险。事实上,在西方国家,大多数 BC 死亡病例不能仅通过使用筛查乳房 X 光片来预防。因此,黎巴嫩采取了以公众为中心的教育和宣传活动,鼓励早期 BC 筛查。多项研究表明,早期检测的影响反映在早期疾病的增加和更具侵袭性阶段的减少。进一步的研究应该阐明宣传活动对早期乳腺癌诊断和临床降期的影响,在国家范围内;因此,随时掌握筛查活动前后的数据对于分析乳腺癌起源的死亡率趋势和减少晚期疾病至关重要。未来仍有研究评估女性参与后的知识、态度和实践,强调阻碍黎巴嫩女性参与 BC 筛查活动的障碍。