programas cribado cancer

Nota bibliográfica cribado c mama 2014-05

Gunsoy NB, Garcia-Closas M, Moss SM. Estimating breast cancer mortality reduction and overdiagnosis due to screening for different strategies in the United Kingdom. Br J Cancer. 2014;110(10):2412–9. Available from:

Conclusions: Estimates of mortality reduction and overdiagnosis were highly dependent on screening frequency, age range, and uptake, which may explain differences between some previous estimates obtained from randomised trials and from service screening.

Dent T, Jbilou J, Rafi I, Segnan N, Törnberg S, Chowdhury S, et al. Stratified Cancer Screening: The Practicalities of Implementation. Public Health Genomics. Basel; 2013;16(3):94–9. Available from: doi:

Conclusion: Stratified screening based on genetic testing is a radically new approach to prevention. Various organisational issues would need to be considered before it could be introduced, and a number of questions require further research.

Stout NK, Lee SJ, Schechter CB, Kerlikowske K, Alagoz O, Berry D, et al. Benefits, Harms, and Costs for Breast Cancer Screening After US Implementation of Digital Mammography. J Natl Cancer Inst. 2014;106(6):dju092.
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Conclusions The transition to digital breast cancer screening in the United States increased total costs for small added health benefits. The value of digital mammography screening among women aged 40 to 49 years depends on women’s preferences regarding false positives.

Smith RA. Counterpoint: Overdiagnosis in Breast Cancer Screening. J Am Coll Radiol. 2014;(0). Available from:
Berlin L. Point: Mammography, Breast Cancer, and Overdiagnosis: The Truth Versus the Whole Truth Versus Nothing but the Truth. J Am Coll Radiol. 2014;(0). Available from:

American College of Obstetricians and Gynecologists. Management of women with dense breasts diagnosed by mammography. Committee Opinion No. 593. American College of Obstetricians and Gynecologists. Obs Gynecol. 2014;123(593):910–1.

Helvie MA, Chang JT, Hendrick RE, Banerjee M. Reduction in late-stage breast cancer incidence in the mammography era: Implications for overdiagnosis of invasive cancer. Cancer. 2014;n/a–n/a. Available from: PMID: 24840597.

BACKGROUND Mammographic screening is expected to decrease the incidence of late-stage breast cancer. In the current study, the authors determined the decrease in late-stage cancer incidence and the changes in invasive cancer incidence that occurred in the mammographic era after adjusting for prescreening temporal trends. METHODS Breast cancer incidence and stage data were obtained from the Surveillance, Epidemiology, and End Results program. The premammography period (1977-1979) was compared with the mammographic screening period (2007-2009) for women aged ≥ 40 years. The authors estimated prescreening temporal trends using 5 measures of annual percentage change (APC). Stage-specific incidence values from 1977 through 1979 (baseline) were adjusted using APC values of 0.5%, 1.0%, 1.3%, and 2.0% and then compared with observed stage-specific incidence in 2007 through 2009. RESULTS Prescreening APC temporal trend estimates ranged from 0.8% to 2.3%. The joinpoint estimate of 1.3% for women aged ≥ 40 years approximated the 4-decade long APC trend of 1.2% noted in the Connecticut Tumor Registry. At an APC of 1.3%, late-stage breast cancer incidence decreased by 37% (56 cases per 100,000 women) with a reciprocal increase in early-stage rates noted from 1977 through 1979 to 2007 through 2009. Resulting late-stage cancer incidence decreased from 21% at an APC of 0.5% to 48% at an APC of 2.0%. Total invasive breast cancer incidence decreased by 9% (27 cases per 100,000 women) at an APC of 1.3%. CONCLUSIONS There is evidence that a substantial reduction in late-stage breast cancer has occurred in the mammography era when appropriate adjustments are made for prescreening temporal trends. At background APC estimates of ≥ 1%, the total invasive breast cancer incidence also decreased. Cancer 2014. © 2014 American Cancer Society.

Feig SA. Screening Mammography Benefit Controversies: Sorting the Evidence. Radiol Clin North Am. 2014;52(3):455–80. Available from: doi:
 KEY POINTS  Numerous clinical studies have confirmed that screening women age 40 years and older reduces breast cancer mortality by 30% to 50%. Several factors including faster breast cancer growth rates and lower breast cancer incidence among younger women, as well as shorter life expectancy and more comorbid conditions among older women, should also be considered in screening guidelines. Annual screening beginning at age 40 years and continuing with no upper age limit, as long as a woman has a life expectancy of at least 5 years and no significant comorbid conditions, is currently recommended by the American Cancer Society, the American College of Radiology, and the Society of Breast Imaging.
Bernardi D, Caumo F, Macaskill P, Ciatto S, Pellegrini M, Brunelli S, et al. Effect of integrating 3D-mammography (digital breast tomosynthesis) with 2D-mammography on radiologists’ true-positive and false-positive detection in a population breast screening trial. Eur J Cancer. 2014;50(7):1232–8. Available from: doi: 10.1016/j.ejca.2014.02.004. PMID: 24582915.

CONCLUSION: There was broad variability in radiologist-specific TP detection at 2D-mammography and hence in the additional TP detection and incremental CDR attributable to integrated 2D/3D-mammography; more consistent (less variable) TP-detection estimates were observed for the integrated screen-read. Integrating 3D-mammography with 2D-mammography improves radiologists’ screen-reading through improved cancer detection and/or reduced FPR, with most readers achieving both using integrated 2D/3D mammography.

Conant EF. Clinical Implementation of Digital Breast Tomosynthesis. Radiol Clin North Am. 2014;52(3):499–518. Available from: doi: 10.1016/j.rcl.2013.11.013. PMID: 24792652.

Digital breast tomosynthesis is rapidly being implemented in breast imaging clinics across the world as early clinical data demonstrate that this innovative technology may address some of the long-standing limitations of conventional mammography. This article reviews the recent clinical data supporting digital breast tomosynthesis implementation, the basics of digital breast tomosynthesis image interpretation using case-based illustrations, and potential issues to consider as this new technology is integrated into daily clinical use
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