Beyond mammography: new frontiers in breast cancer screening.
Beyond mammography: new frontiers in breast cancer screening.
复制标题
超越乳腺X线摄影：乳腺癌筛查的新领域。
DOI：
10.1016/j.amjmed.2012.11.025
复制
发表时间：
2013-06
影响因子：
5.9
通讯作者：
Gatenby, Robert A.
中科院分区：
文献类型：
--
作者：
Drukteinis, Jennifer S.;Mooney, Blaise P.;Flowers, Chris I.;Gatenby, Robert A.
关键词：
乳腺癌筛查仍然是一个激烈的话题，有时甚至是激烈的辩论。乳房X光检查长期以来一直是乳腺癌检测的支柱，也是唯一被证明可以降低死亡率的筛查方法。虽然它仍然是乳腺癌筛查的黄金标准，但人们越来越意识到乳房X线摄影对妇女亚群的敏感性降低。乳房X光检查也经历了越来越多的审查假阳性和过多的活检，这增加了辐射剂量，成本和病人的焦虑。为了应对这些挑战，开发了乳腺癌筛查的新技术，包括：低剂量乳房X线摄影术;对比增强乳房X线摄影术、断层合成、自动全乳房超声、分子成像和MRI。在这里，我们研究了一些当前的争议和有前途的新技术，这些技术可能会改善普通人群和高危人群（如乳腺致密的女性）中乳腺癌的检测。我们建议，最佳的乳腺癌筛查最终需要一种基于癌症风险指标的个性化方法，并选择性地应用最适合个人年龄、风险和乳腺密度的特定筛查技术。
Breast cancer screening remains a subject of intense and, at times, passionate debate. Mammography has long been the mainstay of breast cancer detection and is the only screening test proven to reduce mortality. Although it remains the gold standard of breast cancer screening, there is increasing awareness of subpopulations of women for whom mammography has reduced sensitivity. Mammography has also undergone increased scrutiny for false positives and excessive biopsies, which increase radiation dose, cost and patient anxiety. In response to these challenges, new technologies for breast cancer screening have been developed, including; low dose mammography; contrast enhanced mammography, tomosynthesis, automated whole breast ultrasound, molecular imaging and MRI. Here we examine some of the current controversies and promising new technologies that may improve detection of breast cancer both in the general population and in high-risk groups, such as women with dense breasts. We propose that optimal breast cancer screening will ultimately require a personalized approach based on metrics of cancer risk with selective application of specific screening technologies best suited to the individual’s age, risk, and breast density.
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