The global authoritative mammography survey shows that 2% to 4% of the normal population has non-palpable breast lesions, of which 20% to 30% are malignant, and these lesions usually require pathological examination for a definitive diagnosis. How can we detect early breast lesions and prevent them before they happen is the current focus of breast cancer prevention and treatment! Early stage breast cancer is curable! Therefore, breast cancer screening for the general population and screening for high-risk groups is particularly important.
I. Guidelines for breast cancer screening in general population
1. Breast screening for non-high risk groups is not recommended for 20-39 years old.
2. 40-49 years of age
(1) Suitable for opportunistic screening.
(2) 1 mammogram per year.
(3) Recommended in conjunction with clinical physical examination.
(4) Combined with ultrasound examination is recommended for dense breast.
3.50-69 years old
(1) Suitable for opportunistic screening and population screening.
(2) Mammography once every 1-2 years.
(3) Recommended in combination with clinical physical examination.
(4) Combination with ultrasound is recommended for dense mammary glands.
4. 70 years old or above
(1)Suitable for opportunistic screening.
(2) Mammography once every 2 years.
(3) Combination with clinical physical examination is recommended.
(4) Combined with ultrasound examination is recommended for dense breast.
II. Screening advice for people with high risk of breast cancer
Early screening is recommended (before the age of 40);
Screening interval is recommended once every six months;
In addition to clinical examination, B-ultrasound and mammogram, new imaging methods such as MRI can be used.
Definition of high risk group for breast cancer
1. Those who have obvious genetic predisposition to breast cancer.
Genetic testing criteria for hereditary breast cancer-ovarian cancer syndrome.
(1) Carriers of BRCA1/BRCA2 gene mutation in blood-related relatives.
(2) Patients with breast cancer who meet 1 or more of the following conditions.
(1) Age of onset ≤ 45 years.
(2) Breast cancer patients with age of onset ≤ 50 years and 1 consanguineous relative who is also a breast cancer patient with age of onset ≤ 50 years and/or 1 or more consanguineous relatives with ovarian epithelial cancer/fallopian tube cancer/primary peritoneal cancer of any age.
(iii) A single individual with 2 primary breast cancers and age of first presentation ≤ 50 years.
④Any age of onset and 2 or more consanguineous close relatives with breast cancer and/or ovarian epithelial/fallopian tube/primary peritoneal cancer of any age of onset.
⑤ A consanguineous male relative with breast cancer.
(6) Combined past history of ovarian epithelial cancer/fallopian tube cancer/primary peritoneal cancer.
(3) Patients with ovarian epithelial cancer/ fallopian tube cancer/ primary peritoneal cancer.
(4) Male patients with breast cancer.
(5)Family history of the following.
(①Any of the above conditions in a consanguineous first or second degree relative.
(2) Two or more related third-degree relatives with breast cancer (at least one with age of onset ≤ 50 years) and/or ovarian epithelial cancer/fallopian tube cancer/primary peritoneal cancer.
2.Patients with previous moderate to severe atypical hyperplasia or lobular carcinoma in situ in the ducts or lobules of the breast.
3. Patients with lymphoma who have previously undergone chest radiotherapy.