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乳腺癌筛查方式的进展及全球筛查项目的现状。

Advances in breast cancer screening modalities and status of global screening programs.

作者信息

Luo Chenyu, Wang Le, Zhang Yuhan, Lu Ming, Lu Bin, Cai Jie, Chen Hongda, Dai Min

机构信息

Medical Research Center, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.

Department of Cancer Prevention Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) Hangzhou Zhejiang China.

出版信息

Chronic Dis Transl Med. 2022 May 25;8(2):112-123. doi: 10.1002/cdt3.21. eCollection 2022 Jun.

Abstract

Breast cancer (BC) is the most prevalent malignancy worldwide, and a continued upward trend has been predicted in the coming decades. Screening in selected targeted populations, which is effective in reducing cancer-related mortality, has been widely implemented in many countries. This review summarizes the advances in BC screening techniques, organized or opportunistic BC screening programs across different countries, and screening modalities recommended by different academic authorities. Mammography is the most widely used and effective technique for BC screening. Other complementary techniques include ultrasound, clinical breast examination, and magnetic resonance imaging. Novel screening tests, including digital breast tomosynthesis and liquid biopsies, are still under development. Globally, the implementation status of BC screening programs is uneven, which is reflected by differences in screening modes, techniques, and population coverage. The recommended optimal screening strategies varied according to the authoritative guidelines. The effectiveness of current screening programs is influenced by several factors, including low detection rate, high false-positive rate, and unsatisfactory coverage and uptake rates. Exploration of accurate BC risk prediction models and the development of risk-stratified screening strategies are highly warranted in future research.

摘要

乳腺癌(BC)是全球最常见的恶性肿瘤,预计在未来几十年还将持续呈上升趋势。在选定的目标人群中进行筛查可有效降低癌症相关死亡率,许多国家已广泛实施。本综述总结了乳腺癌筛查技术的进展、不同国家有组织或机会性的乳腺癌筛查项目,以及不同学术权威推荐的筛查方式。乳腺钼靶摄影是乳腺癌筛查中使用最广泛且最有效的技术。其他辅助技术包括超声、临床乳腺检查和磁共振成像。新型筛查测试,包括数字乳腺断层合成和液体活检,仍在研发中。在全球范围内,乳腺癌筛查项目的实施情况不均衡,这体现在筛查模式、技术和人群覆盖范围的差异上。根据权威指南,推荐的最佳筛查策略各不相同。当前筛查项目的有效性受多种因素影响,包括低检出率、高假阳性率以及覆盖率和接受率不尽人意。在未来研究中,非常有必要探索准确的乳腺癌风险预测模型并制定风险分层筛查策略。

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