Аврора wrote:bulochka wrote:На данный момент и ВОЗ, и American Cancer Society рассматривают маммографию как золотой стандарт для диагностики рака груди. Ультразвуковое скринирование никто не рекомендует само по себе (но его с удовольствием сделают, если необходимо, для дифференциальной диагностики уплотнений, обнаруженных на маммограмме). Один из недостатков ультразвука - в два раза выше процент ложно-положительных результатов по сравнению с маммографией.
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WHO wrote:Breast cancer is the most common cancer among women worldwide, and there are several possible methods for screening.
If facilities are available, screening by mammography alone, with or without physical examination of the breasts, plus follow-up of individuals with positive or suspicious findings, will reduce mortality from breast cancer by up to one-third among women aged 50–69 years (IARC, In press).
ACS Guidelines wrote: Recommendation
Women at average risk should begin annual mammography at age 40. Women should have an opportunity to become informed about the benefits, limitations, and potential harms associated with regular screening.
Rationale and Evidence
Since 1997, there have been updates in the evidence from RCTs of breast cancer screenings. Several other reports have challenged the value of screening for breast cancer with mammography, leading to a surge of new literature reexamining the underlying evidence related to breast cancer screening. The updated clinical trial results from individual studies and meta-analyses continue to show a significant mortality reduction from mammo-graphy screening, and this finding is further supported by evidence from organized screening programs.
Journal of American Medical Association, 2005;293:1245-1256 wrote:Ultrasound, frequently used as a targeted diagnostic examination focusing on a specific area of concern, may help distinguish between cyst and solid masses and also between benign and malignant masses. Breast ultrasound data are available from diagnostic populations, with screening studies limited to women with dense breasts on mammography or at increased risk for breast cancer. Although ultrasound may detect 3 to 4 additional breast cancers per 1000 women in these increased-risk populations, there are no data on the use of screening ultrasound in the general population. Breast ultrasound has limitations as a potential screening tool because it requires a well-trained skilled operator. Examination techniques are not standardized, interpretation criteria are variable, and breast ultrasound does not consistently detect microcalcifications. Preliminary data suggest a higher rate of false-positive examination results with ultrasound than with mammography alone. For example, the false-positive rate (based on solid lesion for ultrasound) ranged from 2.4% to 12.9% for ultrasound and 0.7% to 6% for mammography.