Supplemental Breast Cancer Screening in Women With Dense Breasts Should Be Offered With Simultaneous Collection of Outcomes Data
Ce dossier, consacré au dépistage des cancers du sein, présente les controverses associées à la mammographie, des évaluations de son efficacité, de son coût et de son rapport bénéfices/risques ainsi que des recommandations
Although mammographic screening reduces breast cancer mortality, all women do not share this benefit equally. Just as inadequate patient preparation for colonoscopy can hide colon cancer, dense breast tissue on mammography can hide breast cancer, especially if the cancer lacks calcifications. Women with heterogeneously or extremely dense breasts who have cancer detected soon after a normal mammogram because of clinical symptoms are said to have “interval cancer.” Interval cancers tend to be more aggressive and larger and have a worse prognosis than screen-detected cancers. Because a negative screening mammography result cannot reliably rule out cancer in women with dense breasts, experts and advocates have promoted breast density notification laws in the hopes that knowledge of having dense breasts will empower women to push for adequate screening that includes supplemental tests.
Annals of Internal Medicine , éditorial en libre accès, 2015