Goh Rachel Sze Jen, Chong Bryan, Yeo Selvie, Neo Shao Yun, Ng Qin Xiang, Goh Serene Si Ning
NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Breast Cancer (Dove Med Press). 2025 Jun 27;17:531-544. doi: 10.2147/BCTT.S532884. eCollection 2025.
Interval breast cancers (IBCs) are detected between regular mammographic screenings after an initially negative result. Studies have shown that the prognosis of IBCs is similar to that of unscreened symptomatic cancers and is hence a surrogate used to assess the effectiveness of screening programs. This systematic review consolidates the current literature available on strategies to reduce the rates of IBC.
Following PRISMA guidelines, three databases were searched from inception till October 29, 2023 to identify papers, which reported IBC rates. Key search terms included "interval breast cancer", "mammogram", "tomosynthesis" and "screening".
A total of 32 articles were included. Fourteen studies discussed the use of digital breast tomosynthesis (DBT) as an alternative screening modality to mammograms. Six studies discussed the use of artificial intelligence (AI) on mammograms, five studies discussed the use of supplemental modalities including ultrasonography (US) in addition to mammograms, five studies discussed varying screening intervals and two studies discussed tamoxifen use.
The trajectory of IBCs can be altered by early detection when they are more amenable to treatment, through advanced screening techniques, adjusting inter-screening intervals and modifiable risk factors. The goal is to create a screening protocol that is economically effective and accessible to various populations.
间期乳腺癌(IBC)是在最初的乳腺钼靶筛查结果为阴性后,在定期筛查之间被发现的。研究表明,IBC的预后与未筛查的有症状乳腺癌相似,因此是用于评估筛查项目有效性的一个替代指标。本系统评价整合了目前关于降低IBC发生率策略的现有文献。
按照PRISMA指南,检索了三个数据库从建库至2023年10月29日期间发表的报告IBC发生率的论文。主要检索词包括“间期乳腺癌”“乳房X光检查”“断层合成”和“筛查”。
共纳入32篇文章。14项研究讨论了使用数字乳腺断层合成(DBT)作为乳腺钼靶的替代筛查方式。6项研究讨论了在乳房X光检查中使用人工智能(AI),5项研究讨论了除乳房X光检查外使用包括超声检查(US)在内的补充检查方式,5项研究讨论了不同的筛查间隔,2项研究讨论了他莫昔芬的使用。
通过先进的筛查技术、调整筛查间隔和可改变的危险因素,在IBC更易于治疗时进行早期检测,可以改变其病程。目标是制定一种经济有效且各种人群均可采用的筛查方案。