Recent information regarding the early diagnosis possibilities of the precancerous breast pathology

R. Stănculescu, C. Coroleucă, C. Coroleucă, D.E. Comandașu, V. Bausic

Rezumat: The primary objective of mammography as a screening method is decreasing breast cancer mortality. In Europe, breast cancer mortality rates have declined significantly in the last 20 years. In Romania there is a discrepancy between the low incidence and the high mortality rate of breast cancer. For this reason, the effectiveness of mammography as screening method should be reassessed. Worldwide there are conflicting data regarding the appropriate age range for screening and the time interval it should be done. This paper aims to establish a review on current opportunities for early diagnosis of breast lesions and breast screening peculiarities in order to update the therapeutic management according to the latest standards. The ultimate goal is the development of a protocol of investigations according to every stage in patients assigned to high-risk group. Presentation of results of meta-analysis published in prestigious scientific journals with identifying the indicators that measure the efficiency of screening methods. The effectiveness of breast screening by mammography is difficult to assess because of the large amount of time needed to assess the results. The literature is controversial on the benefits of mammography as a screening method. Breast screening performed annually brings no additional benefit compared to clinical examination regarding the decrease of mortality for patients in the age group 40-49 years. Mammography has low sensitivity for screening premenopausal patients. For this reason, laboratory investigations (mammography, breast ultrasound and MRI) have combined to stratify risk in this age group. We recommend genetic screening (gene mutations BRCA1, BRCA2) for patients who have an increased risk of inherited predisposition. Clinical examination of the breast remains of significant value in the early diagnosis of precancerous lesions, in large part equaling mammographic examination. Breast screening should be performed differentiated by age. Drawing up a national registry is needed to fit patients into risk groups because efficient screening depends on effective organization.
Cuvinte cheie: precancerous breast pathology, screening, mammography.