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JAMA Oncol:有乳腺癌家族史的女性进行乳腺癌筛查的起始年龄

2019-11-17 QQY MedSci原创

乳腺癌筛查指南认为有必要对高危妇女进行早期筛查,但对有乳腺癌家族史的妇女提供的指导有限。明确对乳腺癌患者家属进行风险适应性筛查的起始年龄或可助于补充目前的筛查指南。研究人员为了明确有家族史的女性进行乳腺癌筛查的起始年龄,开展了一项全国性的队列研究。纳入1932年后出生的、至少有一位直系亲属(FDR)记录的女性。收集1958年1月1日-2015年12月31日期间的数据。共纳入5 099 172位女性

乳腺癌筛查指南认为有必要对高危妇女进行早期筛查,但对有乳腺癌家族史的妇女提供的指导有限。明确对乳腺癌患者家属进行风险适应性筛查的起始年龄或可助于补充目前的筛查指南。

研究人员为了明确有家族史的女性进行乳腺癌筛查的起始年龄,开展了一项全国性的队列研究。纳入1932年后出生的、至少有一位直系亲属(FDR)记录的女性。收集1958年1月1日-2015年12月31日期间的数据。

共纳入5 099 172位女性,118 953位(2.3%)确诊原发性侵袭性乳腺癌。共102 751位女性(86.4%,确诊时平均55.9岁),在确诊乳腺癌时,无乳腺癌家族史(包括直系亲属[FDR]和旁系亲属[SDR])。风险适应性乳腺癌筛查的起始年龄因乳腺癌诊断时的FDRs和SDRs的数量以及FDRs诊断乳腺癌时的年龄而异。例如,一般人群推荐从50岁开始筛查(10年累积风险2.2%),有多位直系亲属罹患乳腺癌的女性,且其亲属罹患乳腺癌时的最小年龄小于50岁时,那她们在27岁时罹患乳腺癌的风险就已经达到基准风险水平(即普通人50岁时的风险)。当其亲属罹患乳腺癌时的最小年龄大于50岁时,那她们36岁时达到基准风险水平。

综上所述,有乳腺癌家族史的女性筛查乳腺癌的起始年龄应明显早于普通人群。本研究确定了风险适应性的乳腺癌筛查起始年龄,可作为补充目前乳腺癌患者亲属筛查指南的高质量证据。

原始出处:

Trasias Mukama, et al.Risk-Adapted Starting Age of Screening for Relatives of Patients With Breast Cancer.JAMA Oncol. Published online November 14, 2019. doi:https://doi.org/10.1001/jamaoncol.2019.3876

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    2020-05-23 minlingfeng
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    2019-11-17 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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    2019-11-17 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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    2019-11-17 一天没事干

    很好的学习机会

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