Trotz teils jahrzehntelangem Mammografie-Screening ist Brustkrebs unverändert die
häufigste Krebs-Todesursache bei Frauen. In diesem Beitrag werden die Zielsetzungen
von
Präventionsprogrammen vorgestellt, die Anfänge des Mammografie-Screenings beschrieben
und
die aktuellen Konzepte kritisch diskutiert. Darüber hinaus wird ein Konzept für ein
effektiveres Früherkennungsprogramm präsentiert und eine Vision für zukünftige Modelle
gewagt.
Abstract
Breast cancer is the most common malignant disease in women in the western world.
The
prognosis of this disease depends to a large extent on the time of diagnosis. With
the
development and introduction of imaging techniques examination concepts for the early
detection of breast cancer were developed. The focus of these concepts was primarily
X-ray
mammography, which has been used in population-based screening programs since the
mid-seventies of the last century. Prospective randomized studies have shown that
women
whose breast cancer was diagnosed by mammography screening have a 30% lower risk of
dying
from this breast cancer as than women with a clinically diagnosis. In many European
countries organized mammography screening programs were therefore initiated in the
1970s
and 1980 s; in Germany, the mammography screening program was introduced in 2007.
However,
despite decades of mammography screening in some cases, little has changed in terms
of the
actual problem, even in European countries with high participation rates: Breast cancer
remains by far the most common cause of cancer death and the leading cause of years
of
life lost in women. This manuscript describes the objectives of prevention programs,
presents the beginnings of mammography screening in Europe and especially in Germany,
and
outlines and critically discusses the main advantages and limitations of current concepts.
In addition, a concept for a more effective breast cancer screening program in the
near
future is presented and a vision for future models is ventured.
Schlüsselwörter
Mammografie - Mamma-MRT - Prävention
Key words
mammography - breast MRI - prevention
