Mammográfia: naprakész EUSOBI ajánlások a női lakosság tájékoztatására
Cikk címe: Mammográfia: naprakész EUSOBI ajánlások a női lakosság tájékoztatására
Szerzők: Francesco Sardanelli, Eva M. Fallenberg, Paola Clauser, Rubina M. Trimboli, Julia Camps-Herrero, Thomas H. Helbich, Forrai Gábor
Intézmények: Department of Biomedical Sciences for Health University of Milan, Milan Italy, Department of Radiology Charité-Universitätsmedizin Berlin Campus Virchow-Klinikum, Berlin Germany, Department of Biomedical Imaging and Image-guided Therapy Division of Molecular and Gender Imaging Medical University of Vienna Vienna Austria, Integrative Biomedical Research PhD Program Università degli Studi di Milano Milan Italy, Radiológiai Osztály Duna Medical Center Budapest Hungary
Évfolyam: XVII. évfolyam
Lapszám: 2018. / 06. lapszám
Oldal: 39-46
Rovat: KÉPALKOTÓ DIAGNOSZTIKA
Alrovat: SZŰRÉSEK
Absztrakt:
Cikkünk célja, hogy a mammográfiás vizsgálatról összefoglalja a legfontosabb tudnivalókat. Célközönségünk minden olyan hölgy, aki számára javasolt a vizsgálatok elvégzése, vagy bármilyen emlő-panasszal küzd. Összeszedtük a korai emlő daganat felismerésének előnyeit, továbbá elmagyarázzuk a meghívásos rendszer keretein belül történő mammográfiás emlőszűrés és a klinikai emlődiagnosztika közötti különbséget. Rávilágítunk arra is, hogy miért szükséges a korábban készült mammográfiás képeket és eredményeket magával hoznia mindenkinek a vizsgálatra (ez vonatkozik minden korábbi emlő képalkotó eljárásra). Összefoglaljuk a mammográfia technikai és kivitelezési részleteit és érintjük a vizsgálat kellemetlenségéről, a fájdalomról szóló tapasztalatokat is. Ezek a vizsgálaton átesett pácienseink kis részét érintik, erről ők személyesen számoltak be. Fel vázoljuk továbbá a szűrési program keretein belül történő visszahívási folyamatot és a klinikai emlődiagnosztika után szükséges teendőket. Bemutatjuk a mammográfiás lelet részleteit és a besorolási rendszereket, mint az R1-R5 és a BI-RADS. Segítünk eligazodni a diagnosztikus eljárás folyamatában, és beszélünk azokról a daganatokról is, amelyek hagyományos mammográfiával nem mutathatók ki. Szó esik továbbá az alkalmazott sugár dózisról, amely kapcsán az esetleg okozott emlőrák rizikóját szembe állítjuk a szűrővizsgálatnak köszönhetően egyértelműen csökkenthető halálozási arány- nyal. Kitérünk a túldiagnosztizálás kérdésére, mértékének reális megítélésére. Foglalkozunk az új mammográfiás eljárásokkal (tomoszintézis és kontrasztanyagos spektrális mammográfia) és végül igyekszünk a gyakran feltett kérdéseket megválaszolni.
Abstract:
This article summarises the information to be offered to women about mammography. After a delineation of the aim of early diagnosis of breast cancer, the difference bet- ween screening mammography and diagnostic mammography is explained. The need to bring images and reports from the previous mammogram (and from other recent breast imaging examinations) is high lighted. Mammography technique and procedure are described with parti- cular attention to discomfort and pain experienced by a small number of women who undergo the test. Information is given on the recall during a screening programme and on the request for further work-up after a diagnostic mam- mography. The logic of the mammography report and of classification systems such as R1-R5 and BI-RADS is illustrated, and brief but clear information is given about the diagnostic performance of the test, with particular refe- rence to interval cancers, i.e., those cancers that are mis- sed at screening mammography. Moreover, the breast can- cer risk due to radiation exposure from mammography is compared to the reduction in mortality obtained with the test, and the concept of overdiagnosis is presented with a reliable estimation of its extent. Information about new mammographic technologies (tomosynthesis and cont- rast-enhanced spectral mammography) is also given. Finally, frequently asked questions are answered.
XVII. évfolyam
2018. / 06. lapszám / Július
| Szerző | Intézmény |
|---|---|
| Francesco Sardanelli | Department of Biomedical Sciences for Health University of Milan, Milan Italy |
| Eva M. Fallenberg | Department of Radiology Charité-Universitätsmedizin Berlin Campus Virchow-Klinikum, Berlin Germany |
| Paola Clauser | Department of Biomedical Imaging and Image-guided Therapy Division of Molecular and Gender Imaging Medical University of Vienna Vienna Austria |
| Rubina M. Trimboli | Integrative Biomedical Research PhD Program Università degli Studi di Milano Milan Italy |
| Julia Camps-Herrero | Integrative Biomedical Research PhD Program Università degli Studi di Milano Milan Italy |
| Thomas H. Helbich | Department of Biomedical Imaging and Image-guided Therapy Division of Molecular and Gender Imaging Medical University of Vienna Vienna Austria |
| Forrai Gábor | Radiológiai Osztály Duna Medical Center Budapest Hungary |
[1] Sardanelli F, Helbich TH, European Society of Breast Imaging: Mammography: EUSOBI recommendations for women’s information, Insights Imaging, 2012, 3:7–10
[2] Sardanelli F, Aase H, Álvarez M et al: Position paper on screening for breast cancer by the European Society of Breast Imaging and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bul ga ria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland, and Turkey, Eur Radiol, 2017, 27(7): 2737–2743. 3] Feig SA: Screening mammography benefit controversies: sorting the evidence, Radiol Clin N Am, 2014, 52:455–480
[4] Lauby-Secretan B, Scoccianti C, Loomis D, International Agency for Research on Cancer Handbook Working Group et al: Breast Cancer Screening – viewpoint of the IARC Working Group, N Engl J Med, 2015, 372:2353–2358 5] Saadatmand S, Bretveld R, Siesling S, Tilanus-Linthorst MMA: Influence of tumour stage at breast cancer detection on survival in modern times: population-based study in 173,797 patients, BMJ, 2015, 351:h4901
[6] Kaplan HG, Malmgren JA, AtwoodMK, Calip GS: Effect of treatment and mammography detection on breast cancer survival over time: 1990–2007, Cancer, 2015, 121:2553– 2561
[7] Prummel MV, Muradali D, Shumak R et al: Digital compa- red with screen-film mammography: measures of diagnos- tic accuracy among women screened in the Ontario breast screening program, Radiology, 2016, 278:365–373
[8] Perry N, Broeders M, de Wolf C et al: European guidelines for quality assurance in breast cancer screening and diagnosis, Fourth Edition, 2016, Available at: http://www. euref.org/europeanguidelines, Accessed on Sept 10, 2016
[9] Sardanelli F, Boetes C, Borisch B et al: Magnetic reso- nance imaging of the breast: recommendations from the EUSOMA working group, Eur J Cancer, 2010, 46:1296– 1316
[10] Mann RM, Balleyguier C, Baltzer PA: European Society of Breast Imaging (EUSOBI), with language review by Europa Donna – The European Breast Cancer Coalition et al: Breast MRI: EUSOBI recommendations for women’s infor- mation, EurRadiol, 2015, 25:3669–3678 11] Drossaert CHC, Boer H, Seydel ER: Monitoring women’s experiences during three rounds of breast cancer scree- ning: results from a longitudinal study, J Med Screen, 2002, 9:168–175 12] American College of Radiology (ACR) Breast Imaging Reporting and Data System Atlas (BI-RADS Atlas), Reston, Va, USA: American College of Radiology, 2013, At: http://www.acr. org/Quality-Safety/Resources/BIRADS, Accessed on 9 Sept 2016.
[13] Törnberg S, Kemetli L, Ascunce N et al: A pooled analysis of interval cancer rates in six European countries, Eur J Cancer Prev, 2010, 19:87–93
[14] Carbonaro LA, Azzarone A, Paskeh BB et al: Interval bre- ast cancers: absolute and proportional incidence and blin- ded review in a community mammographic screening program, Eur J Radiol, 2014, 83: e84–e91
[15] Yaffe MJ, Mainprize JG: Risk of radiation-induced breast cancer from mammographic screening, Radiology, 2011, 258:98–105
[16] Hauge IH, Pedersen K, Olerud HM, Hole EO, Hofvind S: The risk of radiation-induced breast cancers due to biennial mammographic screening in women aged 50–69 years is minimal, Acta Radiol, 2014, 55:1174–1179
[17] Biesheuvel C, Barratt A, Howard K et al: Effects of study methods and biases on estimates of invasive breast cancer over detection with mammography screening: a systematic review, Lancet Oncol, 2017, 8:1129–1138
[18] Paci E, Broeders M, Hofvind S, Puliti D, Duffy SW, EUROSCREEN Working Group: European breast cancer service screening outcomes: a first balance sheet of the benefits and harms, Cancer Epidemiol Biomarkers Prev, 2014, 23:1159–1163
[19] Semturs F, Sturm E, Gruber R, Helbich TH: Physical aspects of different tomosynthesis systems, Radiologe, 2010, 50:982–990
[20] Diekmann F, Bick U: Breast tomosynthesis, Semin Ultrasound CT MR, 2011, 32:281–287
[21] Kopans DB: Digital breast tomosynthesis from concept to clinical care, AJR Am J Roentgenol, 2014, 202:299–308
[22] Skaane P, Bandos AI, Eben EB et al: Two-view digital bre- ast tomosynthesis screening with synthetically re – constructed projection images: comparison with digital bre- ast tomosynthesis with fullfield digital mammographic ima- ges, Radiology, 2014, 271:655–663
[23] Svahn TM, Houssami N, Sechopoulos I, Mattsson S: Review of radiation dose estimates in digital breast tomosynthesis relative to those in two-view full field digital mammography, Breast, 2015, 24:93–99
[24] Skaane P, Bandos AI, Gullien R et al: Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program, Radiology, 2013, 267:47–56
[25] Skaane P, Bandos AI, Gullien R et al: Prospective trial com- paring full-field digital mammography (FFDM) versus com- bined FFDM and tomosynthesis in a population-based screening programme using independent double reading with arbitration, Eur Radiol, 2013, 23:2061–2071
[26] Ciatto S, Houssami N, Bernardi D et al: Integration of 3D digital mammography with tomosynthesis for population breast cancer screening (STORM): a prospective compa- rison study, Lancet Oncol, 2013, 14:583–589
[27] Lång K, Andersson I, Rosso A, Tingberg A, Timberg P, Zackrisson S: Performance of one-view breast tomosynt- hesis as a standalone breast cancer screening modality: results from the Malmö Breast Tomosynthesis Screening Trial, a population-based study, EurRadiol, 2016, 26:184– 190
[28] Houssami N: Digital breast tomosynthesis (3D mammog- raphy) screening: data and implications for population scre- ening, Expert Rev Med Devices, 2015, 12:377–379 29] McDonald ES, Oustimov A, Weinstein SP, Synnestvedt MB, Schnall M, Conant EF: Effectiveness of digital breast tomosynthesis compared with digital mammography: out- comes analysis from 3 years of breast cancer screening, JAMA Oncol, 2016, 2: 737–743 30] Fallenberg EM, Dromain C, Diekmann F et al: Contrast- enhanced spectral mammography: does mammography provide additional clinical benefits or can some radiation exposure be avoided? Breast Cancer Res Treat, 2014, 146:371–381
[31] Lobbes MBI, Lalji U, Houwers J et al: Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme, EurRadiol, 2014, 24:1668– 1676
[32] Knogler T, Homolka P, Hörnig M et al: Contrast-enhanced dual energy mammography with a novel anode/filter com- bination and artifact reduction: a feasibility study. EurRadiol 2016, 26:1575–1581
[33] Jeukens CRLPN, Lalji UC, Meijer E et al: Radiation expo- sure of contrast-enhanced spectral mammography compa- red with full-field digital mammography, Invest Radiol, 2014, 49:659–665
[34] Tagliafico AS, Bignotti B, Rossi F et al: Diagnostic perfor- mance of contrast-enhanced spectral mammography: systematic review and meta-analysis, Breast, 2016, 28:13– 19
[35] Tennant SL, James JJ, Cornford EJ et al: Contrast-enhan- ced spectral mammography improves diagnostic accuracy in the symptomatic setting, ClinRadiol, 2016, 71:1148–1155
[36] Tardivel AM, Balleyguier C, Dunant A et al: Added value of contrast-enhanced spectral mammography in post – screening assessment, Breast J, 2016, 22:520–528
[37] Jochelson MS, Dershaw DD, Sung JS et al: Bilateral cont- rast-enhanced dual-energy digital mammography: feasibi- lity and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma, Radiology, 2013, 266: 743–751 38] Fallenberg EM, Dromain C, Diekmann F et al: Contrast- enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size, Eur Radiol, 2014, 24:256–264
[39] Stacul F, van der Molen AJ, Reimer P, Contrast Media Safety Committee of European Society of Urogenital Radiology et al: Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines, EurRadiol, 2011, 21:2527–2541
[40] Morcos SK, Bellin MF, Thomsen HS, Contrast Media Safety Committee of European Society of Urogenital Radiology et al: Reducing the risk of iodine-based and MRI contrast media administration: recommendation for a questionnaire at the time of booking, Eur J Radiol, 2008, 66:225–229
[41] Simon MS, Wassertheil-Smoller S, Thomson CA et al: Mammography interval and breast cancer mortality in women over the age of 75, Breast Cancer Res Treat, 2014, 148:187–195
[42] Oeffinger KC, Fontham ET, Etzioni R et al: Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society, JAMA, 2015, 314:1599– 1614
[43] Sardanelli F, Fallenberg EM, Clauser P, Trimboli RM, Camps-Herrero J, Helbich TH, Forrai G: Mammography: an update of the EUSOBI recommendations on information for women, Insights Imaging, 2017, 8:11–18