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40 岁以下乳腺癌患者诊断前的高危筛查率。

Rates of high-risk screening prior to a breast cancer diagnosis in patients under age 40.

机构信息

Department of General Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.

Duke Cancer Institute, Duke University, Durham, NC, USA.

出版信息

Am J Surg. 2024 Feb;228:218-221. doi: 10.1016/j.amjsurg.2023.09.048. Epub 2023 Oct 11.

Abstract

BACKGROUND

NCCN Guidelines recommend screening young women with an increased breast cancer risk (>20 ​% lifetime risk). We sought to evaluate our institutional rates of high-risk screening in young breast cancer patients prior to their diagnoses."

METHODS

A single-institution retrospective review (2013-2018) was performed investigating risk scores (Tyrer-Cuzick model) and characteristics of breast cancer patients (age <40 ​y) prior to diagnosis.

RESULTS

92 breast cancer patients age <40 ​y were identified (average age 34.5). Only 3.3 ​% (n ​= ​3) underwent appropriate screening, despite 35.8 ​% meeting high-risk criteria. Nearly all patients underwent genetic testing (98.9 ​%) with pathogenic mutations identified in 36.5 ​%, including 15.3 ​% with BRCA1/2 mutations.

CONCLUSIONS

This analysis highlights a significant discrepancy between those meeting criteria for high-risk screening and those who underwent appropriate screening. We identified that this cohort carries significant genetic burden. Future analysis should investigate these findings on a broader scale and strategies to improve screening.

摘要

背景

NCCN 指南建议对乳腺癌风险增加(>20%终身风险)的年轻女性进行筛查。我们旨在评估在年轻乳腺癌患者确诊前进行高风险筛查的机构比率。

方法

对 2013 年至 2018 年的单机构回顾性研究进行了调查,研究了风险评分(Tyrer-Cuzick 模型)和乳腺癌患者(<40 岁)在诊断前的特征。

结果

共确定了 92 名年龄<40 岁的乳腺癌患者(平均年龄 34.5 岁)。尽管 35.8%符合高风险标准,但仅有 3.3%(n=3)进行了适当的筛查。几乎所有患者都接受了基因检测(98.9%),其中 36.5%发现了致病性突变,包括 15.3%的 BRCA1/2 突变。

结论

本分析突出了符合高风险筛查标准和接受适当筛查的患者之间存在显著差异。我们发现该队列存在显著的遗传负担。未来的分析应在更广泛的范围内研究这些发现,并制定改善筛查的策略。

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