The results of three recent studies demand that more attention be placed on defining the most-appropriate approach to population-based breast-cancer screening, in particular regarding the potential harms of increasing overdiagnosis. Two of these studies report that more-sensitive detection of breast neoplasms is possible by 3D tomography and by MRI, but the third paper raises the question of whether this increased sensitivity is desirable.
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References
Lång, K. et al. Performance of one-view breast tomosynthesis as a stand-alone breast cancer screening modality: results from the Malmö Breast Tomosynthesis Screening Trial, a population-based study. Eur. Radiol. http://dx.doi.org/10.1007/s00330-015-3803-3.
Harding, C. et al. Breast cancer screening, incidence, and mortality across US counties. JAMA Intern. Med. 175, 1483–1489 (2015).
Bleyer, A. & Welch, H. G. Effect of three decades of screening mammography on breast-cancer incidence. N. Engl. J. Med. 367, 1998–2005 (2012).
Narod, S. A., Iqbal, J. & Miller, A. B. Why have breast cancer mortality rates declined? J. Cancer Policy http://dx.doi.org/10.1016/j.jcpo.2015.03.002.
Mohammed, H. et al. Progesterone receptor modulates ERα action in breast cancer. Nature 523, 313–317 (2015).
Narod, S. A., Valentini, A., Nofech-Mozes, S., Sun, P. & Hanna, W. Tumour characteristics among women with very low-risk breast cancer. Breast Cancer Res. Treat. 134, 1241–1246 (2012).
Simos, D. et al. Imaging for distant metastases in women with early-stage breast cancer: a population-based cohort study. CMAJ 187, E387–E397 (2015).
Sopik, V. & Narod, S. A. Overdiagnosis in breast cancer chemoprevention trials. Curr. Oncol. 22, e6–e10 (2015).
Narod, S. A. Tamoxifen chemoprevention — end of the road? JAMA Oncol. http://dx.doi.org/10.1001/jamaoncol.2015.2247.
Narod, S. A., Giannakeas, V., Iqbal, J., Sopik, V. & Sun, P. Breast cancer mortality after a diagnosis of ductal carcinoma in situ (DCIS). JAMA Oncol. 1, 888–896 (2015).
Narod, S. A. Disappearing breast cancers. Curr. Oncol. 19, 59–60 (2012).
Saadatmand, S., Bretveld, R., Siesling, S. & Tilanus-Linthorst, M. M. Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173,797 patients. BMJ 351, h4901 (2015).
Miller, A. B. et al. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ 348, g366 (2014).
Kuhl, C. K. et al. Breast MRI screening of women at average risk of breast cancer: an observational cohort study [abstract]. J. Clin. Oncol. 33 (Suppl. 28S), a1 (2015).
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Narod, S. The importance of overdiagnosis in breast-cancer screening. Nat Rev Clin Oncol 13, 5–6 (2016). https://doi.org/10.1038/nrclinonc.2015.203
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DOI: https://doi.org/10.1038/nrclinonc.2015.203
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