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Dépistage du cancer du sein : en route vers le futur

Suzette Delaloge 1, 2, 3, * Thomas Bachelot 4 François-Clément Bidard 5 Marc Espie 6 Etienne Brain 7, 8 Hervé Bonnefoi 9 Joseph Gligorov 10 Florence Dalenc 11 Anne-Claire Hardy-Bessard 12 David Azria 13 Jean-Philippe Jacquin 14 Jérôme Lemonnier 15 William Jacot 13 Anthony Gonçalvès 16 Gérard Ganem 17 Charles Coutant 18 Thierry Petit 19 Frédérique Penault-Lorca 20 Marc Debled 9 Mario Campone 21, 22 Christelle Levy 23 Benoit Coudert 18 Alain Lortholary 24 Laurence Venat-Bouvet 25 Julien Grenier 26 Hugues Bourgeois 17 Bernard Asselain 15 Johanna Arvis 27 Martine Castro 28 Anne Tardivon 5 David G Cox 29 Patrick Arveux 30 Corinne Balleyguier 31 Fabrice André 1, 2, 3 Roman Rouzier 5 
* Corresponding author
2 Pathologie mammaire
Département de médecine oncologique [Gustave Roussy]
Abstract : 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
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Suzette Delaloge, Thomas Bachelot, François-Clément Bidard, Marc Espie, Etienne Brain, et al.. Dépistage du cancer du sein : en route vers le futur. Bulletin du Cancer, John Libbey Eurotext, 2016, 103 (9), pp.753 - 763. ⟨10.1016/j.bulcan.2016.06.005⟩. ⟨inserm-01822723⟩



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