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The surgeon's role in breast screening

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Abstract

The early detection of breast cancer by mammographic screening reduces the mortality of the disease. In the United Kingdom, a national screening service is being established for women 50–64 years of age by single mediolateral oblique mammography every 3 years.

It is stressed that the basic mammograph is only the first stage in the screening procedure. The multidisciplinary assessment of mammographic abnormalities is a second critical step by which the need for biopsy is determined. The surgeons involved in screening programs must also appreciate the significance of the methods of assessment used. They must also be knowledgeable of the methods for biopsy of impalpable lesions and of the treatment of the noninvasive and small-invasive cancers. Ideally, they should be full members of the multidisciplinary team responsible for the program. These roles are reviewed.

Résumé

La détection précoce du cancer du sein par mammographie de dépistage réduit la mortalité due à cette maladie. Au Royaune Uni, on a établi un bureau national de dépistage qui étudie chez les femmes de 50 à 64 ans les résultats d'un seul cliché (latéral interne oblique) réalisé tous les trois ans.

Ce cliché n'est que la première étape du dépistage. Ensuite, par évaluation multidisciplinaire, on détermine quelles pateintes doivent subir une biopsie. Les chirurgiens participant à ce programme doivent également apprécier la valeur des critères de ce choix. Ils doivent connaître les méthodes de biopsie des lésions impalpables et les différents traitements des cancers non invasifs et des petits cancers invasifs. Idéalement, ils font partie de l'équipe multidisciplinaire qui conduit ce programme. Les rôles de chacun des participants sont définis.

Resumen

La detección temprana del cáncer mamario mediante tamizaje por mamografía reduce la mortalidad asociada con esta enfermedad. En el Reino Unido está en proceso de ser establecido un servicio nacional de tamizaje para mujeres entre los 50 y los 64 años de edad, utilizando mamografía de imagen mediolateral única tomada cada 3 años.

Se hace énfasis en que la mamografía de base es sólo la primera etapa del procedimiento de tamizaje. La valoración multidisciplinaria de las anormalidades mamográficas es un segundo paso crucial, sobre el cual se determina la necesidad de realizar biopsia. Los cirujanos involucrados en los programas de tamizaje deben también entender con claridad la significación de los métodos de valoración utilizados, asf como estar familiarizados con los métodos de biopsia de las lesiones no palpables y con las modalidades de tratamiento de los cánceres mfnimos y no invasivos. Idealmente, estos cirujanos deben ser miembros del equipo multidisciplinario responsable del programa. El artículo revisa sus respectivas responsabilidades.

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Correspondence to Professor Sir A. P. M. Forrest M.D., F.R.C.S..

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Forrest, A.P.M. The surgeon's role in breast screening. World J. Surg. 13, 19–24 (1989). https://doi.org/10.1007/BF01671149

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Keywords

  • Breast Cancer
  • Como
  • Cancer Invasifs
  • Multidisciplinary Team
  • Critical Step