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The early diagnosis rate of breast cancer among women in my country is significantly lower than that in European and American countries. One of the reasons is that the screening of breast cancer is weak. Therefore, it is urgent to strengthen and standardize the screening of breast cancer in my country. The release of the “Guidelines for Breast Cancer Screening in Chinese Women (2022 Edition)” will help standardize the current breast cancer screening work in my country, and is applicable to medical institutions at all levels, especially medical workers who carry out breast cancer screening in grass-roots hospitals.
Age for breast cancer screeningBreast cancer screening in general risk populations The starting age is 40 years old; education about breast cancer related knowledge and breast examination should be carried out from the age of 18 (recommendation strength: strong, GRADE evidence level: intermediate). For high-risk women, imaging screening is required in advance according to the risk of cancer: it is recommended that healthy women with high penetrance deleterious mutations should start screening earlier to 25 years of age; Women with a history of lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH), starting at the age of diagnosis of LCIS, ADH, or ALH; for high-risk women with a family history of breast cancer, starting Screening age should be 10 years younger than the youngest family member at the time of breast cancer diagnosis, but ≥25 years old (Strength of recommendation: strong, GRADE evidence: intermediate). 
High-risk groups➤Definition of high-risk groups for breast cancer< /strong>Crowds carrying breast cancer susceptibility genes or those with one of the following conditions: (1) family history of breast cancer in immediate family members (parents, children, brothers, sisters); (2) breast cancer history Female; (3) A history of thoracic radiotherapy (cumulative radiotherapy dose ≥10 Gy before age 30); (4) ADH, ALH or LCIS diagnosed before age 40. ➤Breast cancer screening guidelines for high-risk groups1. Healthy women with breast cancer susceptibility genes:< /span>(1) Healthy women who carry high penetrance susceptibility genes (BRCA1, BRCA2, CDH1, PALB2, PTEN and TP53) Recommended: ① Self-conscious regular BSE on the breast from the age of 18; ② 25-29 age, on the basis of breast self-examination (BSE) and clinical breast examination (CBE) (1 time/6-12 months), breast ultrasound examination once a year; ③30-75 years old, at BSE and CBE (1 time/6-12 months) On the basis of every 6-12 months), breast ultrasound examination once every 6 months, mammography X-ray (except for TP53 deleterious mutation) or breast MRI (alternating X-ray and MRI) once a year; ④ over 75 years old The population considers individualized screening protocols. (2) Other susceptibility genes other than high penetrance genes need to be considered in combination with genotype and family history. The intensity of screening is between those carrying high penetrance susceptibility genes and other high-risk groups. between. 2. Other high-risk groups who do not carry breast cancer susceptibility genes: (1) Regular breast self-examination with self-awareness starting at the age of 18; (2) CBE once every 6 to 12 months on the basis of self-examination, starting from the identification of high risk; High-risk starting, but ≥25 years old, on the basis of BSE and CBE (1 time/6 to 12 months), 1 time/year breast ultrasound examination. After the age of 50, mammography examinations should be performed once a year, and breast MR examinations should be added if necessary. ➤Indications for breast cancer susceptibility gene testing1. Breast cancer onset age≤45 years old. 2. The age at onset of breast cancer is between 46 and 50 years old and meets one of the following conditions: (1) Unknown or limited family history; (2) Multiple primary breast cancer at any age (3) have close relatives who have breast cancer, ovarian cancer, pancreatic cancer, and prostate cancer at any age. 3. Breast cancer onset age ≥51 years old and one of the following conditions. (1) Close relatives with blood relationship meet the following conditions: ① Breast cancer onset age ≤ 50 years old or male breast cancer onset at any age; ② Ovarian cancer onset at any age; ③ Pancreatic cancer onset at any age; ④ Metastasis at any age Sexual prostate cancer or high-risk prostate cancer. (2) A total of ≥3 breast cancer patients including probands and close relatives. (3) ≥2 cases of breast cancer or prostate cancer in close relatives. 4. Breast cancer at any age: (1) triple negative breast cancer; (2) lobular breast cancer patients, same asHave a history of diffuse gastric cancer in yourself or in your family at the time. General risk population➤Definition of breast cancer general risk population< /strong>: The general risk group for breast cancer is all women of school age except those at high risk of breast cancer. ➤Guidelines for Breast Cancer Screening in General Risk Populations (Strength of Recommendation: Strong, GRADE Evidence: Moderate-Low ): (1) Females aged 18 to 25, ① carry out breast cancer prevention and treatment knowledge education; ② 1 time/month BSE. (2) For women aged 26 to 40, ① conduct education on breast cancer prevention and treatment; ② BSE once a month; ③ CBE once a year. (3) For women aged 41 to 70, ① carry out breast cancer prevention and treatment knowledge education; ② BSE once a month; ③ CBE once a year; ④ breast imaging examination once a year. Breast ultrasound is the first choice for examination, and auxiliary mammography can be considered if necessary. (4) For women over 70 years old, ① conduct education on breast cancer prevention and treatment; ② BSE once a month; ③ CBE once a year; ④ opportunistic screening (perform when there are symptoms or suspicious signs Film degree exam). 
The above content is excerpted from: Chinese Women’s Breast Cancer Screening Guidelines Development Expert Group of China Association of Research Hospitals Breast Professional Committee. )[J]. China Research Hospital, 2022, 09(2): 6-13.Download link: https://guide.medlive.cn/guideline/25596