programas cribado cancer
INICIO / CÁNCER DE MAMA / ACTUALIZACIÓN BIBLIOGRÁFICA / NOTA BIBLIOGRáFICA CRIBADO C MAMA 2013-10

Nota bibliográfica cribado c mama 2013-10

Apesteguía Ciriza L, Pina Insausti LJ. Cribado poblacional de cáncer de mama. Certezas, controversias y perspectivas de futuro. Radiologia. (0). Available from: http://www.sciencedirect.com/science/article/pii/S0033833813001471. doi:http://dx.doi.org/10.1016/j.rx.2013.05.008.

Resumen Los programas poblacionales de detección precoz del cáncer de mama basados en la mamografía deben mantener un alto nivel de calidad y sus resultados han de ser permanentemente monitorizados. Aunque la mayoría de autores consideran que estos programas han disminuido la mortalidad por cáncer de mama aproximadamente un 30%, no faltan voces críticas. Algunos autores sostienen que la reducción de la mortalidad es inferior, aproximadamente del 12%, por errores en la aleatorización de pacientes, porque la tasa de tumores avanzados apenas ha disminuido y porque los tratamientos adyuvantes también mejoran la supervivencia. Otras críticas se centran también en el sobrediagnóstico y el sobretratamiento. Creemos que a pesar del indudable valor del cribado mamográfico, debemos estar abiertos a ciertos cambios, como la estratificación de las pacientes por nivel de riesgo y la introducción de técnicas complementarias a la mamografía, como la tomosíntesis, la ecografía y la resonancia magnética en casos seleccionados

Nederend J, Duijm LEM, Louwman MWJ, Coebergh JW, Roumen RMH, Lohle PN, et al. Impact of the transition from screen-film to digital screening mammography on interval cancer characteristics and treatment – A population based study from the Netherlands. Eur J Cancer. 2013;
Available from: http://www.ejcancer.com/article/S0959-8049(13)00893-9/abstract. doi: 10.1016/j.ejca.2013.09.018.

Ozanne EM. Overdiagnosis and Overtreatment of Breast Cancer: How Can We Promote Informed Patient Choice? Curr Breast Cancer Rep. 2013; Available from: http://link.springer.com/10.1007/s12609-013-0128-6. doi: 10.1007/s12609-013-0128-6.

Gur D, Sumkin JH. Screening for Early Detection of Breast Cancer: Overdiagnosis versus Suboptimal Patient Management. Radiology. 2013;268(2):327–8. Available from: http://pubs.rsna.org/doi/abs/10.1148/radiol.13122721. doi: 10.1148/radiol.13122721.     PMID: 23882095.

Wickerham DL, Julian TB. Ductal Carcinoma In Situ: A Rose by Any Other Name. J Natl Cancer Inst. 2013;
Available from:http://jnci.oxfordjournals.org/content/early/2013/09/24/jnci.djt268.short.
doi: 10.1093/jnci/djt268.

Punglia RS, Schnitt SJ, Weeks JC. Treatment of Ductal Carcinoma In Situ After Excision: Would a Prophylactic Paradigm Be More Appropriate? J Natl Cancer Inst. 2013; Available from: http://jnci.oxfordjournals.org/content/early/2013/09/24/jnci.djt256.abstract. doi: 10.1093/jnci/djt256.

Corresponding to the increased use of mammography, the incidence of ductal carcinoma in situ (DCIS) has risen dramatically in the past 30 years. Despite its growing incidence, the treatment of DCIS remains highly variable and controversial. Although DCIS itself does not metastasize and is never lethal, it may be a precursor of invasive breast cancer and is a marker of increased breast cancer risk. Confusing a precursor lesion with cancer, many clinicians apply an invasive breast cancer treatment paradigm to DCIS patients, offering adjuvant radiation therapy and tamoxifen after diagnosis. In this commentary, we outline the issues associated with DCIS management—is DCIS a cancer, a precursor of cancer, or a marker of invasive carcinoma risk? Specifically, we argue that consideration be given to removing the term “carcinoma” from DCIS, using cancer “occurrence” to mean the diagnosis of invasive cancer after DCIS instead of “recurrence,” and make the argument that a prophylactic paradigm of treatment after excision may be more appropriate.
Marmot MG, Altman DG, Cameron D a, Dewar J a, Thompson SG, Wilcox M. The benefits and harms of breast cancer screening: an independent review. Br J Cancer. 2013;108(11):2205–40. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3693450&tool=pmcentrez&rendertype=abstract. doi: 10.1038/bjc.2013.177. PMID: 23744281.

Ripping TM, Verbeek a LM, van der Waal D, Otten JDM, den Heeten GJ, Fracheboud J, et al. Immediate and delayed effects of mammographic screening on breast cancer mortality and incidence in birth cohorts. Br J Cancer. 2013;(October):1–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24113141.
doi: 10.1038/bjc.2013.627.  PMID: 24113141.

Conclusion:When applying a trend study to estimate the impact of mammographic screening, we recommend using a birth cohort approach.British Journal of Cancer advance online publication, 10 October 2013; doi:10.1038/bjc.2013.627 www.bjcancer.com.

Duffy SW, Chen TH, Smith RA. Real and artificial controversies in breast cancer screening. Breast Cancer Manag. 2013;2(6):519–28.
Available from: http://www.futuremedicine.com/doi/pdf/10.2217/bmt.13.53.
doi: 10.2217/bmt.13.53.

SUMMARY We review the apparent disparities between different reviews of the effects of mammographic screening on mortality from breast cancer and overdiagnosis. When results of each review are expressed with respect to a common population and a common baseline, all find a substantial mortality benefit and variation among estimates is minor. There are genuine disagreements about overdiagnosis, but methods that take account of lead time and underlying incidence trends yield estimates of overdiagnosis that are modest and are outweighed by the mortality benefit. There is potential for individualized screening regimens, particularly with respect to breast density
 
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