文章：

有效预防乳腺癌的关键步骤

Key steps for effective breast cancer prevention

原文发布日期：2020-06-11

DOI: 10.1038/s41568-020-0266-x

类型: Review Article

开放获取: 否

英文摘要：

Despite decades of laboratory, epidemiological and clinical research, breast cancer incidence continues to rise. Breast cancer remains the leading cancer-related cause of disease burden for women, affecting one in 20 globally and as many as one in eight in high-income countries. Reducing breast cancer incidence will likely require both a population-based approach of reducing exposure to modifiable risk factors and a precision-prevention approach of identifying women at increased risk and targeting them for specific interventions, such as risk-reducing medication. We already have the capacity to estimate an individual woman’s breast cancer risk using validated risk assessment models, and the accuracy of these models is likely to continue to improve over time, particularly with inclusion of newer risk factors, such as polygenic risk and mammographic density. Evidence-based risk-reducing medications are cheap, widely available and recommended by professional health bodies; however, widespread implementation of these has proven challenging. The barriers to uptake of, and adherence to, current medications will need to be considered as we deepen our understanding of breast cancer initiation and begin developing and testing novel preventives.

摘要翻译： 

尽管已有数十年的实验室、流行病学和临床研究，乳腺癌的发病率仍在持续上升。乳腺癌仍是导致女性疾病负担的首要癌症相关原因，全球每20名女性中就有1人患病，在高收入国家这一比例高达每8人中就有1人。要降低乳腺癌发病率，很可能需要采取双重策略：一方面从人群层面减少可改变危险因素的暴露，另一方面实施精准预防，识别高风险女性并针对她们采取特定干预措施，如降低风险的药物治疗。我们已具备使用经验证的风险评估模型来估算个体女性乳腺癌风险的能力，且这些模型的准确性有望随时间推移继续提高，特别是在纳入多基因风险和乳腺密度等较新危险因素后。有循证医学证据支持的风险降低药物价格低廉、易于获取，并得到专业健康机构的推荐；然而，这些药物的广泛实施已被证明颇具挑战性。在我们不断深化对乳腺癌始发机制的理解并开始开发和测试新型预防手段的同时，也必须考虑当前药物在采纳和依从性方面所面临的障碍。

原文链接：

Key steps for effective breast cancer prevention