RESUMO
BACKGROUND: Breast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic. METHODS: A time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student's t-test was employed to compare the prevalence rates between 2019 and 2023. RESULTS: Between 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests. CONCLUSIONS: Over the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.
Assuntos
Neoplasias da Mama , COVID-19 , Mamografia , Teste de Papanicolaou , Neoplasias do Colo do Útero , Humanos , Feminino , Teste de Papanicolaou/estatística & dados numéricos , COVID-19/epidemiologia , Brasil/epidemiologia , Mamografia/estatística & dados numéricos , Mamografia/tendências , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Detecção Precoce de Câncer/estatística & dados numéricos , Detecção Precoce de Câncer/tendências , Detecção Precoce de Câncer/métodos , Idoso , Adulto Jovem , Esfregaço Vaginal/estatística & dados numéricosRESUMO
The new recommendations of the European Council (December 2022) indicate to the Member States to implement mammography screening programs for women aged 45 to 74 and make explicit reference to the European guidelines produced by the ECIBC (European Commission Initiative on Breast Cancer) for operational indications. For women aged 70-74, the ECIBC suggests a three-year interval, rather than two years, and the process of adaptation and adoption of the guidelines in Italy has taken this recommendation as it is. Previous indications for Italian screening programs proposed a two-year interval for all women over 50 years of age. The intervention analyzes the rationale and interpretation of the evidence that led to the formulation of the different recommendations. It discusses whether the new recommendations fit into the perspective of risk-stratified screening that is under evaluation by several studies. it analyzes some of the critical issues of the methodology for developing recommendations in defining the characteristics of complex interventions, in particular the difficulties that the formulation of dichotomous questions finds in answering questions such as what is the best age to stop screening and what is the best interval at any age, which require an analysis of a continuous variable as age or interval duration. Finally, the opportunities and limitations in producing evidence regarding the best interval to adopt in mammography screening are discussed.
Assuntos
Neoplasias da Mama , Mamografia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer , Itália/epidemiologia , Mamografia/tendências , Programas de Rastreamento/métodosRESUMO
INTRODUCTION: Reported breast cancer screening among American Indian women is consistently below that of White women. The last claims-based trends were from 1991 to 2001. This study updates mammography trends for American Indian women and examines the impact of race, urbanicity, and income on long-term mammography use. METHODS: This was a multi-year (2005-2019), retrospective study of women aged 40-89 years using a 5% sample of Medicare fee-for-service beneficiaries residing in Arizona, California, New Mexico, Oklahoma, and Washington. This study used multivariable logistic regression to examine the impact of urbanicity and income on receiving mammography for American Indian women compared with that for White women. Analyses were conducted in 2022. RESULTS: Overall, annual age-adjusted mammography use declined from 205 per 1,000 in 2005 to 165 per 1,000 in 2019. The slope of these declines was significantly steeper (difference = -2.41, p<0.001) for White women (-3.06) than for American Indian women (-0.65). Mammography-use odds across all urbanicity categories were less for American Indian women than for White women compared with those of their respective metropolitan counterparts (e.g., rural: 0.96, 95% CI=0.77, 1.20 for American Indian women and 1.47, 99% CI=1.39, 1.57 for White women). Although residing in higher-income communities was not associated with mammography use for American Indian women, it was 31% higher for White women (OR=1.31, 99% CI=1.28, 1.34). CONCLUSIONS: The disparity in annual age-adjusted mammography use between American Indian and White women narrowed between 2005 and 2019. However, the association of urbanicity and community income on mammography use differs substantially between American Indian and White women. Policies to reduce disparities need to consider these differences.
Assuntos
Indígena Americano ou Nativo do Alasca , Neoplasias da Mama , Disparidades em Assistência à Saúde , Mamografia , Brancos , Idoso , Feminino , Humanos , Indígena Americano ou Nativo do Alasca/estatística & dados numéricos , Neoplasias da Mama/diagnóstico por imagem , Mamografia/economia , Mamografia/estatística & dados numéricos , Mamografia/tendências , Medicare , Estudos Retrospectivos , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Programas de Rastreamento/economia , Programas de Rastreamento/estatística & dados numéricos , Renda/estatística & dados numéricos , Fatores Raciais/economia , Fatores Raciais/estatística & dados numéricos , Fatores Raciais/tendências , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Brancos/estatística & dados numéricosRESUMO
OBJECTIVES: Since 2002, the Korean government has provided breast cancer screening as part of the National Cancer Screening Program. This study reported trends in the screening rate among Korean women from 2005 to 2020, including organized and opportunistic screening for breast cancer. METHODS: Data from the Korean National Cancer Screening Survey, an annual cross-sectional nationwide survey, were collected using a structured questionnaire between 2005 and 2020. The study population included 23,702 women aged 40-74 years with no history of cancer. We estimated the screening rate based on the current recommendation of biennial mammographic screening for breast cancer. In addition, a joinpoint trend analysis was performed for breast cancer screening rates among various subgroups. RESULTS: In 2020, the breast cancer screening rate was 63.5%, reflecting an annual increase of 7.72% (95% confidence interval 5.53 to 9.95) between 2005 and 2012, followed by non-significant trends thereafter. In particular, a significant decrease in the breast cancer screening rate was observed in the subgroups aged 50-59 years old, with 12-15 years of education, and living in rural areas. CONCLUSIONS: Although there has been substantial improvement in breast cancer screening rates in Korean women, the trend has flattened in recent years. Therefore, continual efforts are required to identify subgroups with unmet needs and solve barriers to the uptake of breast cancer screening.
Assuntos
Neoplasias da Mama , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Estudos Transversais , Detecção Precoce de Câncer , Mamografia/tendências , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , República da Coreia/epidemiologiaRESUMO
Importance: Following reductions in US ambulatory care early in the pandemic, it remains unclear whether care consistently returned to expected rates across insurance types and services. Objective: To assess whether patients with Medicaid or Medicare-Medicaid dual eligibility had significantly lower than expected return to use of ambulatory care rates than patients with commercial, Medicare Advantage, or Medicare fee-for-service insurance. Design, Setting, and Participants: In this retrospective cohort study examining ambulatory care service patterns from January 1, 2019, through February 28, 2021, claims data from multiple US payers were combined using the Milliman MedInsight research database. Using a difference-in-differences design, the extent to which utilization during the pandemic differed from expected rates had the pandemic not occurred was estimated. Changes in utilization rates between January and February 2020 and each subsequent 2-month time frame during the pandemic were compared with the changes in the corresponding months from the year prior. Age- and sex-adjusted Poisson regression models of monthly utilization counts were used, offsetting for total patient-months and stratifying by service and insurance type. Exposures: Patients with Medicaid or Medicare-Medicaid dual eligibility compared with patients with commercial, Medicare Advantage, or Medicare fee-for-service insurance, respectively. Main Outcomes and Measures: Utilization rates per 100 people for 6 services: emergency department, office and urgent care, behavioral health, screening colonoscopies, screening mammograms, and contraception counseling or HIV screening. Results: More than 14.5 million US adults were included (mean age, 52.7 years; 54.9% women). In the March-April 2020 time frame, the combined use of 6 ambulatory services declined to 67.0% (95% CI, 66.9%-67.1%) of expected rates, but returned to 96.7% (95% CI, 96.6%-96.8%) of expected rates by the November-December 2020 time frame. During the second COVID-19 wave in the January-February 2021 time frame, overall utilization again declined to 86.2% (95% CI, 86.1%-86.3%) of expected rates, with colonoscopy remaining at 65.0% (95% CI, 64.1%-65.9%) and mammography at 79.2% (95% CI, 78.5%-79.8%) of expected rates. By the January-February 2021 time frame, overall utilization returned to expected rates as follows: patients with Medicaid at 78.4% (95% CI, 78.2%-78.7%), Medicare-Medicaid dual eligibility at 73.3% (95% CI, 72.8%-73.8%), commercial at 90.7% (95% CI, 90.5%-90.9%), Medicare Advantage at 83.2% (95% CI, 81.7%-82.2%), and Medicare fee-for-service at 82.0% (95% CI, 81.7%-82.2%; P < .001; comparing return to expected utilization rates among patients with Medicaid and Medicare-Medicaid dual eligibility, respectively, with each of the other insurance types). Conclusions and Relevance: Between March 2020 and February 2021, aggregate use of 6 ambulatory care services increased after the preceding decrease in utilization that followed the onset of the COVID-19 pandemic. However, the rate of increase in use of these ambulatory care services was significantly lower for participants with Medicaid or Medicare-Medicaid dual eligibility than for those insured by commercial, Medicare Advantage, or Medicare fee-for-service.
Assuntos
Assistência Ambulatorial/tendências , COVID-19/epidemiologia , Pandemias , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/estatística & dados numéricos , Colonoscopia/estatística & dados numéricos , Colonoscopia/tendências , Bases de Dados Factuais , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Planos de Pagamento por Serviço Prestado/tendências , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Seguro Saúde/estatística & dados numéricos , Seguro Saúde/tendências , Masculino , Mamografia/estatística & dados numéricos , Mamografia/tendências , Medicaid/estatística & dados numéricos , Medicare/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Telemedicina/estatística & dados numéricos , Telemedicina/tendências , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto JovemRESUMO
The encouraging results of modern breast cancer care builds on tremendous improvements in diagnostics and therapy during the 20th century. Scandinavian countries have made important footprints in the development of breast diagnostics regarding technical development of imaging, cell and tissue sampling methods and, not least, population screening with mammography. The multimodality approach in combination with multidisciplinary clinical work in breast cancer serve as a role model for the management of many cancer types worldwide. The development of breast radiology is well represented in the research published in this journal and this historical review will describe the most important steps.
Assuntos
Neoplasias da Mama/história , Mama/diagnóstico por imagem , Mamografia/história , Publicações Periódicas como Assunto/história , Radiologia/história , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/radioterapia , Feminino , História do Século XX , História do Século XXI , Humanos , Imageamento por Ressonância Magnética/história , Mamografia/tendências , Doses de Radiação , Países Escandinavos e Nórdicos , Ultrassonografia Mamária/históriaRESUMO
Contrast-enhanced mammography (CEM) has emerged as a viable alternative to contrast-enhanced breast MRI, and it may increase access to vascular imaging while reducing examination cost. Intravenous iodinated contrast materials are used in CEM to enhance the visualization of tumor neovascularity. After injection, imaging is performed with dual-energy digital mammography, which helps provide a low-energy image and a recombined or iodine image that depict enhancing lesions in the breast. CEM has been demonstrated to help improve accuracy compared with digital mammography and US in women with abnormal screening mammographic findings or symptoms of breast cancer. It has also been demonstrated to approach the accuracy of breast MRI in preoperative staging of patients with breast cancer and in monitoring response after neoadjuvant chemotherapy. There are early encouraging results from trials evaluating CEM in the screening of women who are at an increased risk of breast cancer. Although CEM is a promising tool, it slightly increases radiation dose and carries a small risk of adverse reactions to contrast materials. This review details the CEM technique, diagnostic and screening uses, and future applications, including artificial intelligence and radiomics.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Mamografia/tendências , Inteligência Artificial , Detecção Precoce de Câncer , Feminino , Previsões , Humanos , Imageamento por Ressonância Magnética , Doses de RadiaçãoRESUMO
The COVID-19 pandemic has led to delays in cancer diagnosis, in part due to postponement of cancer screening. We used Google Trends data to assess public attention to cancer screening during the first peak of the COVID-19 pandemic. Search volume for terms related to established cancer screening tests ("colonoscopy," "mammogram," "lung cancer screening," and "pap smear") showed a marked decrease of up to 76% compared to the pre-pandemic period, a significantly greater drop than for search volume for terms denoting common chronic diseases. Maintaining awareness of cancer screening during future public health crises may decrease delays in cancer diagnosis.
Assuntos
COVID-19 , Detecção Precoce de Câncer , Comportamento de Busca de Informação , Armazenamento e Recuperação da Informação/tendências , Ferramenta de Busca/tendências , Neoplasias da Mama/diagnóstico por imagem , Colonoscopia/tendências , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Mamografia/tendências , Ferramenta de Busca/estatística & dados numéricos , Esfregaço Vaginal/tendênciasAssuntos
COVID-19 , Detecção Precoce de Câncer/tendências , Neoplasias/diagnóstico , Idoso , Colonoscopia/estatística & dados numéricos , Feminino , Humanos , Masculino , Mamografia/tendências , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Teste de Papanicolaou/tendências , Antígeno Prostático Específico/sangue , SARS-CoV-2 , Tomografia Computadorizada por Raios X/tendênciasRESUMO
Breast cancer remains a global challenge, causing over 600,000 deaths in 2018 (ref. 1). To achieve earlier cancer detection, health organizations worldwide recommend screening mammography, which is estimated to decrease breast cancer mortality by 20-40% (refs. 2,3). Despite the clear value of screening mammography, significant false positive and false negative rates along with non-uniformities in expert reader availability leave opportunities for improving quality and access4,5. To address these limitations, there has been much recent interest in applying deep learning to mammography6-18, and these efforts have highlighted two key difficulties: obtaining large amounts of annotated training data and ensuring generalization across populations, acquisition equipment and modalities. Here we present an annotation-efficient deep learning approach that (1) achieves state-of-the-art performance in mammogram classification, (2) successfully extends to digital breast tomosynthesis (DBT; '3D mammography'), (3) detects cancers in clinically negative prior mammograms of patients with cancer, (4) generalizes well to a population with low screening rates and (5) outperforms five out of five full-time breast-imaging specialists with an average increase in sensitivity of 14%. By creating new 'maximum suspicion projection' (MSP) images from DBT data, our progressively trained, multiple-instance learning approach effectively trains on DBT exams using only breast-level labels while maintaining localization-based interpretability. Altogether, our results demonstrate promise towards software that can improve the accuracy of and access to screening mammography worldwide.
Assuntos
Neoplasias da Mama/diagnóstico , Mama/diagnóstico por imagem , Aprendizado Profundo , Detecção Precoce de Câncer , Adulto , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Feminino , Humanos , Mamografia/tendências , Pessoa de Meia-IdadeRESUMO
BI-RADS is a communication and data tracking system that has evolved since its inception as a brief mammography lexicon and reporting guide into a robust structured reporting platform and comprehensive quality assurance tool for mammography, ultrasound, and MRI. Consistent and appropriate use of the BI-RADS lexicon terminology and assessment categories effectively communicates findings, estimates the risk of malignancy, and provides management recommendations to patients and referring clinicians. The impact of BI-RADS currently extends internationally through six language translations. A condensed version has been proposed to facilitate a phased implementation of BI-RADS in resource-constrained regions. The primary advance of the 5th edition of BI-RADS is harmonization of the lexicon terms across mammography, ultrasound, and MRI. Harmonization has also been achieved across these modalities for the reporting structure, assessment categories, management recommendations, and data tracking system. Areas for improvement relate to certain common findings that lack lexicon descriptors and a need for further clarification of proper use of category 3. BI-RADS is anticipated to continue to evolve for application to a range of emerging breast imaging modalities.
Assuntos
Mama/diagnóstico por imagem , Mamografia , Imagem Multimodal , Neoplasias da Mama/diagnóstico por imagem , Feminino , Previsões , Gestão da Informação em Saúde/métodos , Gestão da Informação em Saúde/tendências , Humanos , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/tendências , Mamografia/métodos , Mamografia/normas , Mamografia/tendências , Imagem Multimodal/métodos , Imagem Multimodal/tendências , Ultrassonografia Mamária/métodos , Ultrassonografia Mamária/tendênciasRESUMO
Although computers have had a role in interpretation of mammograms for at least two decades, their impact on performance has not lived up to expectations. However, in the last five years, the field of medical image analysis has undergone a revolution due to the introduction of deep learning convolutional neural networks - a form of artificial intelligence (AI). Because of their considerably higher performance compared to conventional computer aided detection methods, these AI algorithms have resulted in renewed interest in their potential for interpreting breast images in stand-alone mode. For this, first the actual capability of the algorithms, compared to breast radiologists, needs to be well understood. Although early studies have pointed to the comparable performance between AI systems and breast radiologists in interpreting mammograms, these comparisons have been performed in laboratory conditions with limited, enriched datasets. AI algorithms with performance comparable to breast radiologists could be used in a number of different ways, the most impactful being pre-selection, or triaging, of normal screening mammograms that would not need human interpretation. Initial studies evaluating this proposed use have shown very promising results, with the resulting accuracy of the complete screening process not being affected, but with a significant reduction in workload. There is a need to perform additional studies, especially prospective ones, with large screening data sets, to both gauge the actual stand-alone performance of these new algorithms, and the impact of the different implementation possibilities on screening programs.
Assuntos
Inteligência Artificial , Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer/tendências , Interpretação de Imagem Assistida por Computador/métodos , Mamografia/tendências , Mama/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Feminino , Previsões , Humanos , Mamografia/métodosRESUMO
BACKGROUND: Artificial intelligence (AI) is increasingly applied in the field of breast imaging. OBJECTIVES: What are the main areas where AI is applied in breast imaging and what AI and computer-aided diagnosis (CAD) systems are already available? MATERIALS AND METHODS: Basic literature and vendor-supplied information are screened for relevant information, which is then pooled, structured and discussed from the perspective of breast imaging. RESULTS: Original CAD systems in mammography date almost 25 years back. They are much more widely applied in the United States than in Europe. The initial CAD systems exhibited limited diagnostic abilities and disproportionally high rates of false positive results. Since 2012, deep learning mechanisms have been applied and expand the application possibilities of AI. CONCLUSION: To date there is no algorithm that has beyond doubt been proven to outperform double reporting by two certified breast radiologists. AI could, however, in the foreseeable future, take over the following tasks: preselection of abnormal examinations to substantially reduce workload of the radiologists by either excluding normal findings from human review or by replacing the double reader in screening. Furthermore, the establishment of radio-patho-genomic correlations and their translation into clinical practice is hardly conceivable without AI.
Assuntos
Inteligência Artificial , Neoplasias da Mama/diagnóstico por imagem , Mamografia/métodos , Feminino , Humanos , Mamografia/tendênciasRESUMO
In this article, we explore the evidence around the relative benefits and harms of breast cancer screening using a single radiologist to examine each female's mammograms for signs of cancer (single reading), or two radiologists (double reading). First, we briefly explore the historical evidence using film-screen mammography, before providing an in-depth description of evidence using digital mammography. We classify studies according to which exact version of double reading they use, because the evidence suggests that effectiveness of double reading is contingent on whether the two radiologists are blinded to one another's decisions, and how the decisions of the two radiologists are integrated. Finally, we explore the implications for future mammography, including using artificial intelligence as the second reader, and applications to more complex three-dimensional imaging techniques such as tomosynthesis.
Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/métodos , Mamografia/métodos , Idoso , Idoso de 80 Anos ou mais , Detecção Precoce de Câncer/tendências , Feminino , Previsões , Humanos , Mamografia/tendências , Pessoa de Meia-IdadeRESUMO
Objective: This study examined screening mammograms in women aged 65 to 74 years and 75+ years before and after the Affordable Care Act (ACA) implementation. Method: This repeated cross-sectional study of community-dwelling women age 65+ years without a history of breast cancer or mastectomy utilized the Medicare Current Beneficiary Survey and Medicare fee-for-service claims data from 2001 to 2013. We used covariate-adjusted logistic regression with generalized estimating equations, stratified by age group. Results: The adjusted odds of screening mammograms in women aged 65-74 (n = 742) and 75+ years (n = 681) were lower in 2013 (odds ratio [OR]: 0.75, 95% confidence interval [CI]: [0.67, 0.83]; OR: 0.67, 95% CI: [0.60, 0.75], respectively) than the odds of screening mammograms in 2001. Discussion: Annual screening mammograms decreased in women aged 65 to 74 years and 75+ years, despite increased access from the ACA implementation. Future research as to why women are no longer receiving screening mammograms, such as changes in physician specialty guidelines, is warranted.
Assuntos
Mamografia/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Patient Protection and Affordable Care Act , Comitês Consultivos/legislação & jurisprudência , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Guias como Assunto , Humanos , Mamografia/tendências , Programas de Rastreamento/tendências , Medicare , Estados UnidosAssuntos
Humanos , Feminino , Mamografia/tendências , Técnicas de Apoio para a Decisão , Detecção Precoce de Câncer/tendências , Participação do Paciente/psicologia , Participação do Paciente/tendências , Neoplasias da Mama/diagnóstico por imagem , Literatura de Revisão como Assunto , Mamografia/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Tomada de Decisões , Detecção Precoce de Câncer/psicologia , Revisões Sistemáticas como AssuntoAssuntos
Tomada de Decisão Clínica , Aprendizado Profundo/tendências , Diagnóstico por Computador/métodos , Diagnóstico por Computador/tendências , Erros de Diagnóstico/legislação & jurisprudência , Radiologistas , Radiologia/tendências , Robótica/tendências , Viés , Neoplasias da Mama/diagnóstico por imagem , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico por imagem , Telefone Celular , Fatores de Confusão Epidemiológicos , Conjuntos de Dados como Assunto , Aprendizado Profundo/normas , Retinopatia Diabética/diagnóstico por imagem , Erros de Diagnóstico/ética , Feminino , Disparidades em Assistência à Saúde , Humanos , Mamografia/métodos , Mamografia/tendências , Guias de Prática Clínica como Assunto , Radiologistas/legislação & jurisprudência , Radiologistas/normas , Radiologia/métodos , Retina/diagnóstico por imagem , Retina/patologia , Robótica/legislação & jurisprudência , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , Triagem , Tuberculose/diagnóstico por imagem , Incerteza , Estados Unidos , United States Food and Drug Administration/legislação & jurisprudênciaRESUMO
Breast cancer imaging is always improving for the last 20 years in spite of digitalization and computer development. News tools in mammography (Digital Breast Tomosynthesis, Contrast enhanced mammography), sonography (elastography, Automated echography), MRI (Diffusion, abbreviated MRI) and Nuclear medicine has the great potential to be the future of breats imaging. But true revolution will be to use the huge volume of "hidden" imaging data, by Intelligence Artificial process or Biological progress (in genomics, proteiomics) to purpose to our patient a personalized imaging.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Angiografia/métodos , Inteligência Artificial/tendências , Neoplasias da Mama/irrigação sanguínea , Meios de Contraste , Diagnóstico por Imagem/tendências , Técnicas de Imagem por Elasticidade/métodos , Feminino , Genômica , Humanos , Imageamento por Ressonância Magnética/métodos , Mamografia/métodos , Mamografia/tendências , Tomografia por Emissão de Pósitrons/métodos , Proteômica , Linfonodo Sentinela/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler em Cores , Ultrassonografia Mamária/métodosRESUMO
Al igual en otras partes del mundo, en Argentina la mortalidad específica por cáncer mamario disminuyó de forma sostenida entre 1996 y 2017. Es probable que en la actualidad la mamografía sea la herramienta más importante para detectar precozmente, evaluar y llevar un seguimiento de las personas con esta patología. Sin embargo existe mucha controversia acerca de los beneficios del tamizaje poblacional y de la realización de diagnósticos precoces de cáncer de mama. El propósito de esta revisión narrativa es brindar una mirada contraintuitiva, cuestionadora de los beneficios de esta práctica,ponderando también sus riesgos, escasamente visibilizados por las estrategias comunicacionales concordantes con el modelo deprevenir es mejor que curar y la lucha contra la historia natural del cáncer. (AU)
As in other parts of the world, in Argentina, breast cancer specific mortality declined steadily between 1996 and 2017. Mammography is currently the most important tool for early detection, evaluation and follow-up of people suffering fromthis disease. However, there is a controversy about the benefits of population screening and early diagnosis of breastcancer. The aim of this narrative review is to provide a counterintuitive, questioning view of the benefits of this practice, also weighing its risks, poorly visible through communication strategies consistent with the model of prevention is betterthan cureand the fight against the natural history of cancer. (AU)