A systematic review of recommendations on screening strategies for breast cancer due to hereditary predisposition: Who, When, and How?

Abstract

BackgroundBreast cancer is a global health problem that cannot be underestimated. Many studies have shown that breast cancer is related to pathogenic mutations in hereditary predisposition genes. Clinical practice guidelines play a vital role in guiding the selection of breast cancer screening. Little is known about the quality and consistency of guidelines’ recommendations and their changes over these years.MethodsWe reviewed the existing screening guidelines for genetic susceptibility to breast cancer and assessed the methodological quality, and summarized the recommendations to aid clinicians to make decisions. We conducted a systematic search in PubMed, Embase, Web of Science, and guideline‐specific databases, aiming to find the guidelines of breast cancer due to hereditary predisposition. The necessary information was exacted by Excel. We also summarized different evidence grading systems. The qualities of the guidelines were assessed by the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument.ResultsA total of 54 recommendations from 13 guidelines were extracted. Generally speaking, the recommendations were consistent, mainly focusing on mammography and MRI.ConclusionsThe recommendations differ in details. Moreover, different guidelines are based on different grading systems, and some guidelines are not divided for age limits, which may limit the promotion and implementation of the guidelines. It is suggested that improvement can be made in this regard in the future.

Global guidelines for breast cancer screening: A systematic review

“…To our knowledge, it is currently unknown how many countries have issued breast cancer screening guidelines and the differences among these issued guidelines. Additionally, previous systematic reviews of international breast cancer screening guidelines were limited by publication date and screening population and did not systematically review screening recommendations for the population with different breast cancer risks [ [10] , [11] , [12] ].…”

Comparison of prognosis among patients with colorectal cancer liver metastases treated by surgical resection, radiofrequency ablation and HIFU: A protocol for network meta-analysis

“…Most of the basis for clinical decision-making comes from guidelines or systematic reviews. [ 14 ] Network meta-analysis (NMA) is considered the best quality evidence to provide sufficient information for practice. [ 15 ] Clinical treatments for colorectal cancer liver metastases are not the same.…”

Obesity as a Risk Factor for Breast Cancer—The Role of miRNA

“…Many causes and risk factors lead to tumor development. Family history and inheritance of mutations of one of the most significant and common genes, BRCA1, BRCA2, or at least seven other genes, ATM, CDH1, CHEK2, NF1, PALB2, PTEN, and TP53, are proven risk factors for breast cancer initiation and development [ 17 , 18 ]. Among the environmental risk factors are obesity related to disrupted metabolism, higher production of prooncogenic estrogen, and chronic inflammation [ 19 ], which constitute the background of the oncogenesis of breast cancer.…”