Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement
Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement
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DOI：
10.7326/m15-2886
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发表时间：
2016-02-16
影响因子：
39.2
通讯作者：
LeFevre, Michael
中科院分区：
文献类型：
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作者：
Siu, Albert L.;Bibbins-Domingo, Kirsten;LeFevre, Michael
产品描述：2009年美国预防服务工作组（USPSTF）关于乳腺癌筛查建议的更新：USPSTF回顾了以下证据：乳腺癌筛查在降低乳腺癌特异性和全因死亡率方面的有效性，以及晚期乳腺癌和治疗相关发病率的发生率;乳腺癌筛查的危害;测试数字乳腺断层合成摄影作为主要筛查策略的性能特征;以及在乳腺密度增加的女性中进行连续筛查。此外，USPSTF还审查了以下方面的比较决策模型：乳腺X线筛查的最佳开始和停止年龄及间隔;乳腺密度、乳腺癌风险和合并症水平如何影响乳腺X线筛查的获益和危害的平衡;以及女性一生中与不同乳腺X线筛查策略相关的辐射诱发乳腺癌病例和死亡人数。这一建议适用于年龄在40岁或以上的无症状女性，这些女性既无乳腺癌病史，也无既往诊断的高风险乳腺病变，并且由于已知的潜在基因突变而不存在乳腺癌的高风险。（如BRCA 1或BRCA 2基因突变或其他家族性乳腺癌综合征）或年轻时胸部放射史。USPSTF建议50至74岁的女性每两年进行一次筛查性乳房X光检查。（B建议）在50岁之前开始筛查乳腺X线摄影的女性应该是个人的决定。妇女谁把潜在的好处比潜在的危害更高的价值可能会选择开始两年一次的筛选之间的40和49岁。（C建议）USPSTF的结论是，目前的证据不足以评估75岁或以上女性筛查乳房X光检查的益处和危害的平衡。USPSTF得出结论，目前的证据不足以评估数字乳腺断层合成摄影（DBT）作为乳腺癌主要筛查方法的益处和危害。（I声明）USPSTF的结论是，目前的证据不足以评估使用乳腺超声检查、磁共振成像（MRI）、DBT或其他方法对乳腺癌进行连续筛查的益处和危害的平衡，这些方法适用于在其他筛查乳房X线片上发现乳腺致密的女性。（一声明）
Description: Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for breast cancer.Methods: The USPSTF reviewed the evidence on the following: effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced breast cancer and treatment-related morbidity; harms of breast cancer screening; test performance characteristics of digital breast tomosynthesis as a primary screening strategy; and adjunctive screening in women with increased breast density. In addition, the USPSTF reviewed comparative decision models on optimal starting and stopping ages and intervals for screening mammography; how breast density, breast cancer risk, and comorbidity level affect the balance of benefit and harms of screening mammography; and the number of radiation-induced breast cancer cases and deaths associated with different screening mammography strategies over the course of a woman's lifetime.Population: This recommendation applies to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age.Recommendations: The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. (B recommendation)The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. (C recommendation)The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older. (I statement)The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer. (I statement)The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging (MRI), DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement)