Fiche publication


Date publication

septembre 2016

Journal

Bulletin du cancer

Auteurs

Membres identifiés du Cancéropôle Est :
Dr COUDERT Bruno , Pr COUTANT Charles , Pr PETIT Thierry


Tous les auteurs :
Delaloge S, Bachelot T, Bidard FC, Espie M, Brain E, Bonnefoi H, Gligorov J, Dalenc F, Hardy-Bessard AC, Azria D, Jacquin JP, Lemonnier J, Jacot W, Goncalves A, Coutant C, Ganem G, Petit T, Penault-Lorca F, Debled M, Campone M, Levy C, Coudert B, Lortholary A, Venat-Bouvet L, Grenier J, Bourgeois H, Asselain B, Arvis J, Castro M, Tardivon A, Cox DG, Arveux P, Balleyguier C, André F, Rouzier R,

Résumé

Breast cancer remains a potentially lethal disease, which requires aggressive treatments and is associated with long-term consequences. Its prognosis is linked to both tumor biology and burden at diagnosis. Although treatments have allowed important improvements in prognosis over the past 20 years, breast cancer screening remains necessary. Mammographic screening allows earlier stage diagnoses and a decrease of breast cancer specific mortality. However, breast cancer screening modalities should be revised with the objective to address demonstrated limitations of mammographic screening (limited benefit, imperfect sensitivity and specificity, overdiagnoses, radiation-induced morbidity). Furthermore, both objective and perceived performances of screening procedures should be improved. Numerous large international efforts are ongoing, leading to scientific progresses that should have rapid clinical implications in this area. Among them is improvement of imaging techniques performance, development of real time diagnosis, and development of new non radiological screening techniques such as the search for circulating tumor DNA, development of biomarkers able to allow precise risk evaluation and stratified screening. As well, overtreatment is currently addressed by biomarker-based de-escalation clinical trials. These advances need to be associated with strong societal support, as well as major paradigm changes regarding the way health and cancer prevention is perceived by individuals.

Mots clés

Biomarkers, Tumor, analysis, Breast Neoplasms, diagnosis, Early Detection of Cancer, methods, Female, France, Humans, Mammography, Risk Assessment, Sensitivity and Specificity, Tumor Burden

Référence

Bull Cancer. 2016 Sep;103(9):753-63