programas cribado cancer

Nota bibliográfica cribado c mama 2013-09

Njor SH, Garne JP, Lynge E. Over-diagnosis estimate from The Independent UK Panel on Breast Cancer Screening is based on unsuitable data. J Med Screen. 2013;20(2):104–5. Available from: doi: 10.1177/0969141313495190.

Paci E, Smith R, Broeders M, Duffy S. Complex statistical techniques cannot overcome weak methodology in the evaluation of breast cancer mortality trends. J R Soc Med. 2013;106(9):346.
Available from: doi: 10.1177/0141076813501807.

NICE.   Classification and care of people at risk of familial breast cancer and management of breast cancer and related risks in people with a family history of breast cancer. Manchester; 2013.

Mukhtar TK, Yeates DRG, Goldacre MJ. Breast cancer mortality trends in England and the assessment of the effectiveness of mammography screening: population-based study. J R Soc Med. 2013;106(6):234–42. Available from: doi: 10.1177/0141076813486779.
Conclusions Mortality statistics do not show an effect of mammographic screening on population-based breast cancer mortality in England.

Maxwell AJ, Beattie C, Lavelle J, Lyburn I, Sinnatamby R, Garnett S, et al. The effect of false positive breast screening examinations on subsequent attendance: retrospective cohort study. J Med Screen. 2013;20(2):91–8. Available from: doi: 10.1177/0969141313499147.
Conclusions The findings suggest that most women who undergo the breast screening assessment process retain confidence in breast screening. Needle sampling and open biopsy should be used judiciously in the assessment of screen-detected abnormalities in view of the reduced reattendance that results from their use after incident screening examinations.

Webb ML, Cady B, Michaelson JS, Bush DM, Calvillo KZ, Kopans DB, et al. A failure analysis of invasive breast cancer. Cancer. 2013;n/a–n/a. Available from: 10.1002/cncr.28199.
CONCLUSIONS Most deaths from breast cancer occur in unscreened women. To maximize mortality reduction and life-years gained, initiation of regular screening before age 50 years should be encouraged.

 Kerlikowske K, Zhu W, Hubbard RA, Geller B, Dittus K, Braithwaite D, et al. Outcomes of screening mammography by frequency, breast density, and postmenopausal hormone therapy. JAMA Intern Med. 2013;173(9):807–16. doi: 10.1001/jamainternmed.2013.307; 10.1001/jamainternmed.2013.307.
CONCLUSIONS AND RELEVANCE: Women aged 50 to 74 years, even those with high breast density or HT use, who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of false-positive results than those who undergo annual mammography. When deciding whether to undergo mammography, women aged 40 to 49 years who have extremely dense breasts should be informed that annual mammography may minimize their risk of advanced-stage disease but the cumulative risk of false-positive results is h…

Omer ZB  Esserman LJ, Howe R,Ozanne EM HE. IMpact of ductal carcinoma in situ terminology on patient treatment preferences. JAMA Intern Med. 2013;-. Available from: doi: 10.1001/jamainternmed.2013.8405.
 Ductal carcinoma in situ (DCIS) is a preinvasive malignancy of the breast and is diagnosed in more than 50?000 women a year in the United States. It is treated with either mastectomy or lumpectomy, often combined with radiation therapy.1 In cases of low-grade DCIS, studies suggest that if progression occurs, it does so within a time frame of 5 to 40 years2 and possibly in only 20% of DCIS cases.3 This raises the possibility that some cases of DCIS will follow an indolent course that will not attain clinical significance during the patient's lifetime. Accordingly, watchful waiting has been proposed as a reasonable option for DCIS,4 akin to what is currently offered for patients with early stage prostate cancer; however, how to implement such a strategy is unclear.

Njor SH, von Euler-Chelpin M. Information to women invited to mammography screening. Ann Oncol. 2013;24(10):2467–8.
Available from: doi: 10.1093/annonc/mdt373.

Berry DA. Breast cancer screening: Controversy of impact. St Gall 2013 Proc B. 2013;22, Supple(0):S73–S76.
Available from: doi:
 Abstract Few medical issues have been as controversial or as political, at least in the United States as the role of mammographic screening for breast cancer. The advantages of finding a cancer early seem obvious. Indeed, randomized trials evaluating screening mammography demonstrate a reduction in breast cancer mortality, but the benefits are less than one would hope. Moreover, the randomized trials are themselves subject to criticism, including that they are irrelevant in the modern era because most were conducted before chemotherapy and hormonal therapy became widely used. In this article I chronicle the evidence and controversies regarding mammographic screening, including attempts to assess the relative contributions of screening and therapy in the substantial decreases in breast cancer mortality that have been observed in many countries over the last 20-25 years. I emphasize the trade-off between harms and benefits depending on the woman’s age and other risk factors. I also discuss ways for communicating the associated risks to women who have to decide whether screening (and what screening strategy) is right for them.

Lynge E, Ponti A, James T, Mojek O, von Euler-Chelpin M, Anttila A, et al. Variation in detection of ductal carcinoma in situ during screening mammography: A survey within the International Cancer Screening Network. Eur J Cancer. (0).
Available from: doi:
Conclusions Considerable international variation was found in DCIS detection. This variation could not be fully explained by variation in incidence nor in breast cancer detection rates. It suggests the potential for wide discrepancies in management of DCIS resulting in overtreatment of indolent DCIS or undertreatment of potentially curable disease. Comprehensive cancer registration is needed to monitor DCIS detection. Efforts to understand discrepancies and standardise management may improve care.
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