Abstract
Abstract Objective: To present the current recommendations for breast cancer screening in Brazil, as devised by the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Breast Disease Society, and the Brazilian Federation of Gynecological and Obstetrical Associations. Materials and methods: We analyzed scientific studies available in the Medline and Lilacs databases. In the absence of evidence, the recommendations reflected the consensus of a panel of experts. Recommendations: Annual mammography screening is recommended for women 40-74 years of age. Among women ≥ 75 years of age, annual mammography screening should be reserved for those with an expected survival > 7 years. Complementary ultrasound should be considered for women with dense breasts. Complementary magnetic resonance imaging is recommended for women at high risk. When available, an advanced form of mammography known as tomosynthesis can be considered as a means of screening for breast cancer.
Highlights
INTRODUCTIONOrganized screening programs have led to a reduction in breast cancer mortality in several countries.[1,2] In Brazil, despite all efforts, an increase in both breast cancer incidence and mortality rates has been noticed.[3,4,5] One peculiarity of breast cancer in Brazil and in other developing countries is that its incidence among women aged 40-50 years is proportionally higher than that reported in developed countries.[6,7,8]
Organized screening programs have led to a reduction in breast cancer mortality in several countries.[1,2] In Brazil, despite all efforts, an increase in both breast cancer incidence and mortality rates has been noticed.[3,4,5] One peculiarity of breast cancer in Brazil and in other developing countries is that its incidence among women aged 40-50 years is proportionally higher than that reported in developed countries.[6,7,8]Programs that aim at standardizing breast cancer screening guidelines – as well as educating the population regarding the importance of such tests – should be promoted
We analyzed studies available in Medline and Lilacs databases to answer the following clinical question: “What impact do mammography, ultrasonography, magnetic resonance and tomosynthesis have on breast cancer screening according to age bracket and personal and family risk?” Our assessment was based on the levels of scientific evidence established by the Oxford Centre for Evidence-based Medicine[10] and on the criteria employed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.[11]
Summary
Organized screening programs have led to a reduction in breast cancer mortality in several countries.[1,2] In Brazil, despite all efforts, an increase in both breast cancer incidence and mortality rates has been noticed.[3,4,5] One peculiarity of breast cancer in Brazil and in other developing countries is that its incidence among women aged 40-50 years is proportionally higher than that reported in developed countries.[6,7,8]. Programs that aim at standardizing breast cancer screening guidelines – as well as educating the population regarding the importance of such tests – should be promoted. In 2012, the Brazilian College of Radiology and Diagnostic Imaging (CBR), the Brazilian Society for Breast Disease (SBM) and the Brazilian Federation of Gynecological and Obstetrical Associations (FEBR ASGO), via the Brazilian National Mammography Commission, published their joint recommendations for breast cancer screening in Brazil.[9]. The purpose of this article is to present an update of those recommendations, based on the most recent and relevant scientific data on the subject
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