Ultrasound is a more suitable method for breast cancer screening in China

  Author: Cui Xingyi, our reporter, Fu Tanping, our correspondent

  "Guangming Daily" (April 23, 2022 Edition 07)

  Breast cancer is the malignant tumor with the highest incidence in women in the world. At present, the prevalence of breast cancer in China is 59/100,000, and the peak age of incidence is 40 to 50 years old.

Relevant data show that compared with Western countries, Chinese female breast cancer presents three characteristics: First, the prevalence rate increases rapidly. In the past 30 years, the prevalence of Chinese female breast cancer has increased significantly at a rate of 3% to 5%; Second, the incidence is younger, with an average of more than 10 years younger than Western women; third, the prevalence and fatality rates vary greatly among different regions, and the early diagnosis rate and survival rate are relatively low.

  Experts said that active and effective breast cancer screening can improve the early diagnosis rate and reduce the mortality rate, but there is still a lack of norms and guidelines suitable for Chinese women.

The main point of contention is whether to recommend breast ultrasound or mammography (X-ray examination) as the main means.

It is reported that X-rays are generally used for breast cancer screening in European and American countries, and the guidelines of European and American countries also mainly recommend X-rays as a screening method.

  For more than 10 years, the team of Professor Sun Qiang from the Department of Breast Surgery of Peking Union Medical College Hospital has carried out research on the appropriate screening model for breast cancer in Chinese women, and led the formulation of the "Guidelines for Breast Cancer Screening in Chinese Women". preferred and primary means.

This guideline is based on evidence-based medicine for breast cancer screening in Chinese women, and is formulated for the clinical characteristics of early onset and high breast density in Chinese women. Overall patient survival will play a positive role.

  According to reports, the characteristics of breast cancer among Chinese women are very different from those of European and American women: the physiological characteristics of Chinese women's breasts are higher density and smaller volume; the peak age of the disease is younger, and the proportion of dense breasts is higher.

These factors lead to the poor sensitivity of X-ray examination, and X-ray examination is not suitable for breast cancer screening in Chinese women.

In recent years, more and more multidisciplinary clinical expert opinions such as breast surgery, internal medicine, ultrasonography, and imaging tend to support the application of breast ultrasound in screening.

  Sun Qiang's team led a national prospective, multi-center randomized controlled study of 13,000 high-risk women, randomly using X-ray examination, breast ultrasound, and X-ray combined ultrasound examination. Significantly better than X-ray examination.

For Chinese women, breast ultrasound has obvious advantages in breast cancer screening in terms of breast cancer age, breast density, health economics, radiation and comfort of examination.

  According to Sun Qiang, the key to improving the overall survival rate of breast cancer in Chinese women is early detection, and the key to early detection is screening and popular science.

Chinese women enter the peak age of disease from the age of 40. It is recommended that everyone begin to receive breast cancer prevention knowledge education from the age of adulthood, regular breast self-examination, clinical breast examination, and annual breast ultrasound examination from the age of 40.

For women at high risk of breast cancer, regular breast ultrasounds can be brought forward as early as age 30.

  (Our reporter Cui Xingyi, our correspondent Fu Tanping)