Nurs Womens Health. 2023 Jun;27(3):220-230. doi: 10.1016/j.nwh.2022.12.006. Epub 2023 May 5.
Breast cancer is well recognized as a leading type of cancer affecting women in the United States. Although breast cancer screening is well supported in the literature, there is a lack of clear agreement regarding which breast cancer risk calculating tools should be used to develop personalized screening regimens. In this review of 11 primary articles published from 2017 through 2022, we assess current evidence on breast cancer risk assessment in outpatient clinic and mammography settings and the pivotal role of health care providers in influencing patients' choices regarding individualized screenings. Risk assessment is strongly recommended by multiple clinical practice guidelines, yet there is inadequate evidence to endorse one risk assessment tool as best practice. Further research is needed to integrate risk assessment within the clinic workflow and screening encounters. Patient-centered communication and shared decision-making are critical components for managing each woman's perceived risk and objective risk for breast cancer.
乳腺癌是一种在美国女性中发病率较高的癌症。尽管文献中广泛支持乳腺癌筛查,但对于应该使用哪种乳腺癌风险计算工具来制定个性化的筛查方案,尚无明确共识。在对 2017 年至 2022 年期间发表的 11 篇主要文章的综述中,我们评估了当前关于门诊和乳房 X 线照相术环境中乳腺癌风险评估的证据,以及医疗保健提供者在影响患者对个体化筛查的选择方面的关键作用。多项临床实践指南强烈建议进行风险评估,但没有足够的证据支持将一种风险评估工具作为最佳实践。需要进一步的研究来整合风险评估与临床工作流程和筛查接触。以患者为中心的沟通和共同决策是管理每位女性对乳腺癌的感知风险和客观风险的关键组成部分。