Breast cancer (BC) is the most common female cancer and the second cause of death among women worldwide. The 5-year relative survival rate recently improved up to 90% due to increased population coverage and women’s attendance to organised mammography screening as well as to advances in therapies, especially systemic treatments. Screening attendance is associated with a mortality reduction of at least 30% and a 40% lower risk of advanced disease. The stage at diagnosis remains the strongest predictor of recurrences. Systemic treatments evolved dramatically over the last 20 years: aromatase inhibitors improved the treatment of early-stage luminal BC; targeted monoclonal antibodies changed the natural history of anti-human epidermal growth factor receptor 2-positive (HER2) disease; immunotherapy is currently investigated in patients with triple-negative BC; gene expression profiling is now used with the aim of personalising systemic treatments. In the era of precision medicine, it is a challenging task to define the relative contribution of early diagnosis by screening mammography and systemic treatments in determining BC survival. Estimated contributions before 2000 were 46% for screening and 54% for treatment advances and after 2000, 37% and 63%, respectively. A model showed that the 10-year recurrence rate would be 30% and 25% using respectively chemotherapy or novel treatments in the absence of screening, but would drop to 19% and 15% respectively if associated with mammography screening. Early detection per se has not a curative intent and systemic treatment has limited benefit on advanced stages. Both screening mammography and systemic therapies continue to positively contribute to BC prognosis.

Do we still need breast cancer screening in the era of targeted therapies and precision medicine? / R.M. Trimboli, P. Giorgi Rossi, N.M.L. Battisti, A. Cozzi, V. Magni, M. Zanardo, F. Sardanelli. - In: INSIGHTS INTO IMAGING. - ISSN 1869-4101. - 11:1(2020), pp. 105.1-105.10. [10.1186/s13244-020-00905-3]

Do we still need breast cancer screening in the era of targeted therapies and precision medicine?

R.M. Trimboli
Primo
;
N.M.L. Battisti;A. Cozzi;V. Magni;M. Zanardo
Penultimo
;
F. Sardanelli
Ultimo
2020

Abstract

Breast cancer (BC) is the most common female cancer and the second cause of death among women worldwide. The 5-year relative survival rate recently improved up to 90% due to increased population coverage and women’s attendance to organised mammography screening as well as to advances in therapies, especially systemic treatments. Screening attendance is associated with a mortality reduction of at least 30% and a 40% lower risk of advanced disease. The stage at diagnosis remains the strongest predictor of recurrences. Systemic treatments evolved dramatically over the last 20 years: aromatase inhibitors improved the treatment of early-stage luminal BC; targeted monoclonal antibodies changed the natural history of anti-human epidermal growth factor receptor 2-positive (HER2) disease; immunotherapy is currently investigated in patients with triple-negative BC; gene expression profiling is now used with the aim of personalising systemic treatments. In the era of precision medicine, it is a challenging task to define the relative contribution of early diagnosis by screening mammography and systemic treatments in determining BC survival. Estimated contributions before 2000 were 46% for screening and 54% for treatment advances and after 2000, 37% and 63%, respectively. A model showed that the 10-year recurrence rate would be 30% and 25% using respectively chemotherapy or novel treatments in the absence of screening, but would drop to 19% and 15% respectively if associated with mammography screening. Early detection per se has not a curative intent and systemic treatment has limited benefit on advanced stages. Both screening mammography and systemic therapies continue to positively contribute to BC prognosis.
Breast neoplasms; Cancer screening; Mammography; Precision medicine; Prognosis
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Settore MED/06 - Oncologia Medica
Settore MED/42 - Igiene Generale e Applicata
Article (author)
File in questo prodotto:
File Dimensione Formato  
Trimboli et al. - 2020 - Do we still need breast cancer screening in the era of targeted therapies and precision medicine.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 958.53 kB
Formato Adobe PDF
958.53 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/773032
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 13
  • ???jsp.display-item.citation.isi??? 14
social impact