Breast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR
Breast Cancer Screening in Women at Higher-Than-Average Risk: Recommendations From the ACR
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DOI：
10.1016/j.jacr.2017.11.034
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发表时间：
2018-03-01
影响因子：
4.5
通讯作者：
Sickles, Edward A.
中科院分区：
文献类型：
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作者：
Monticciolo, Debra L.;Newell, Mary S.;Sickles, Edward A.
早期发现可降低乳腺癌死亡率。ACR建议从40岁开始每年对平均风险的妇女进行乳房X线检查。高危妇女应尽早开始乳房X线筛查，并可能受益于前沿补充筛查模式。对于基于遗传学的风险增加的女性（及其未经测试的一级亲属），计算出的终身风险为20%或更高，或在年轻时有胸部或外套放射治疗史，建议使用对比增强乳腺MRI进行补充筛查。乳腺MRI也推荐用于有乳腺癌和致密组织个人病史的女性，或50岁之前确诊的女性。其他有乳腺癌病史的患者和活检时有乳腺癌的患者应考虑额外的MRI监测，特别是如果存在其他风险因素。对于那些有资格但不能接受MRI的人，可以考虑进行超声检查。所有女性，特别是黑人女性和德系犹太人后裔，应在30岁之前进行乳腺癌风险评估，以便识别出风险较高的女性，并从补充筛查中获益。
Early detection decreases breast cancer mortality. The ACR recommends annual mammographic screening beginning at age 40 for women of average risk. Higher-risk women should start mammographic screening earlier and may benefit front supplemental screening modalities. For women with genetics-based increased risk (and their untested first-degree relatives), with a calculated lifetime risk of 20% or more or a history of chest or mantle radiation therapy at a young age, supplemental screening with contrast-enhanced breast MRI is recommended. Breast MRI is also recommended for women with personal histories of breast cancer and dense tissue, or those diagnosed by age 50. Others with histories of breast cancer and those with atypia at biopsy should consider additional surveillance with MRI, especially if other risk factors are present. Ultrasound can be considered for those who qualify for but cannot undergo MRI. All women, especially black women and those of Ashkenazi Jewish descent, should be evaluated for breast cancer risk no later than age 30, so that those at higher risk can be identified and can benefit from supplemental screening.