Early Diagnosis of Breast Cancer: Public Health and Mammographic Screening
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Malignant breast tumors are the leading oncological pathology (after skin cancer) in the female population all over the world (more than 20%). According to American Cancer Society, breast cancer is expected to account for 30% of all new cancer cases among women in 2017 (Simon, 2017). The research in the sphere of the timely diagnosis of malignant neoplasms led to the development and further widespread implementation of screening programs, which help to reveal the disease before the onset of symptoms or signs of illness. The paper discusses different scientific approaches to mass screening, various opinions concerning the real impact of screening and contemporary treatment into breast cancer mortality decrease, and presents the results of a breast screening program in the Republic of Tatarstan (Russian Federation). The results showed the effectiveness of this diagnostic method: in 59,000 women aged 50–69 years in total, there were revealed 373 cases of breast cancer (0.63%), in which breast cancer of the I–II stage was 80%. Of the histological forms, 45.4% in the detected malignant neoplasms were presented by invasive ductal cancer, 24.8%—by invasive lobular carcinoma, and the proportion of non-invasive cancer was 4%. Cancer without metastatic involvement of lymphatic nodes (T1–4N0) occurred in 63% of cases. The paper discusses such negative factors of mass mammographic screening as overdiagnosis, false-positive results, and overtreatment. The analyses of existing research all over the world show that since the problem has been actively studied all over the world, the approach to the analysis of screening results has changed to the prevalence of individual approach to each case, the number of cases connected with overdiagnosis is constantly reduced, and the quality of visualization is rapidly improving due to the success of interdisciplinary research and rapid technical progress.
KeywordsPublic health Breast cancer Mammography Mass screening Cancer screening Early diagnosis of cancer Invasive ductal cancer Invasive lobular carcinoma
This work was supported by the Targeted Sectoral Program “Reducing Mortality from Breast Cancer” in the Republic of Tatarstan (Order No. 405, 13.05.2008) (for Rinat Gamirov) and by the program of competitive growth of Kazan Federal University (for Regina Gamirova).
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