【Clin Cancer Res】【NCCN-乳腺癌的筛查与诊断】之一

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【NCCN-乳腺癌的筛查与诊断】之一

Breast cancer screening and diagnosis

Breast screening considerations

Thorough clinical breast exam involves inspection and palpation of all breast tissue including lymph node basins.

Consider severe comorbid conditions limiting life expectancy and whether therapeutic interventions are planned.

Upper age limit for screening is not yet established.

Current evidence does not support the routine use of breast scintigraphy (eg, estamibi scan), or ductal lavage as screening procedures.

Current evidence does not support the routine use of breast MRI as a screening procedure, in average risk women.

Criteria for the use of breast MRI screening as an adjunct to mammography for high risk women include1:

Having a first-degree relative with a BRCA 1 or 2 mutation and are untested

Received radiation treatment to the chest between ages 10 and 30, such as for Hodgkin's Disease and Bannayan-Riley-Ruvalcaba syndromes).
There are several studies supporting the use of ultrasound for breast cancer screening as an adjunct to mammography for high risk women or women with dense breast tissue.2

A single study (DMIST) suggested benefit of digital mammography in young women and women with dense breasts. 3

RISK FACTORS USED IN THE MODIFIED GAIL MODEL 1

Current age

Age at menarche

Age at first live birth or nulliparity

Number of first-degree relatives with breast cancer

Number of previous benign breast biopsies

Atypical hyperplasia in a previous breast biopsy

Race 2

For calculation of risk, based on the modified Gail model, see www.nci.nih.gov.