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01-12-2020 | Breast Cancer | Critical Review

Do we still need breast cancer screening in the era of targeted therapies and precision medicine?

Authors: Rubina Manuela Trimboli, Paolo Giorgi Rossi, Nicolò Matteo Luca Battisti, Andrea Cozzi, Veronica Magni, Moreno Zanardo, Francesco Sardanelli

Published in: Insights into Imaging | Issue 1/2020

Abstract

Breast cancer (BC) is the most common female cancer and the second cause of death among women worldwide. The 5-year relative survival rate recently improved up to 90% due to increased population coverage and women’s attendance to organised mammography screening as well as to advances in therapies, especially systemic treatments. Screening attendance is associated with a mortality reduction of at least 30% and a 40% lower risk of advanced disease. The stage at diagnosis remains the strongest predictor of recurrences. Systemic treatments evolved dramatically over the last 20 years: aromatase inhibitors improved the treatment of early-stage luminal BC; targeted monoclonal antibodies changed the natural history of anti-human epidermal growth factor receptor 2-positive (HER2) disease; immunotherapy is currently investigated in patients with triple-negative BC; gene expression profiling is now used with the aim of personalising systemic treatments. In the era of precision medicine, it is a challenging task to define the relative contribution of early diagnosis by screening mammography and systemic treatments in determining BC survival. Estimated contributions before 2000 were 46% for screening and 54% for treatment advances and after 2000, 37% and 63%, respectively. A model showed that the 10-year recurrence rate would be 30% and 25% using respectively chemotherapy or novel treatments in the absence of screening, but would drop to 19% and 15% respectively if associated with mammography screening. Early detection per se has not a curative intent and systemic treatment has limited benefit on advanced stages. Both screening mammography and systemic therapies continue to positively contribute to BC prognosis.

Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69:7–34. https://doi.org/10.3322/caac.21551CrossRefPubMed

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424. https://doi.org/10.3322/caac.21492

Hendrick RE, Baker JA, Helvie MA (2019) Breast cancer deaths averted over 3 decades. Cancer 125:1482–1488. https://doi.org/10.1002/cncr.31954CrossRefPubMed

Howlader N, Noone AM, Krapcho M et al. (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute, Bethesda, MD. https://seer.cancer.gov/csr/1975_2017/. Accessed 31 August 2020

Coviello V, Buzzoni C, Fusco M et al (2017) Survival of cancer patients in Italy. Epidemiol Prev 41:1–244. https://doi.org/10.19191/EP17.2S1.P001.017CrossRefPubMed

Plevritis SK, Munoz D, Kurian AW et al (2018) Association of screening and treatment with breast cancer mortality by molecular subtype in US women, 2000-2012. JAMA 319:154–164. https://doi.org/10.1001/jama.2017.19130CrossRefPubMedPubMedCentral

Basu P, Ponti A, Anttila A et al (2018) Status of implementation and organization of cancer screening in the European Union member states-summary results from the second European screening report. Int J Cancer 142:44–56. https://doi.org/10.1002/ijc.31043CrossRefPubMed

Mangone L, Mancuso P, Tagliabue G et al (2019) Neoadjuvant therapy for breast cancer. Tumori 105:488–493. https://doi.org/10.1177/0300891619869505CrossRefPubMed

Miller KD, Nogueira L, Mariotto AB et al (2019) Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin 69:363–385. https://doi.org/10.3322/caac.21565CrossRefPubMed

10.

Curigliano G, Burstein HJ, Winer EP et al (2017) De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen international expert consensus conference on the primary therapy of early breast cancer 2017. Ann Oncol 28:1700–1712. https://doi.org/10.1093/annonc/mdx308CrossRefPubMedPubMedCentral

11.

Cohen JG, Ingleby H, Moore L (1956) Can mass x-ray surveys be used in detection of early cancer of the breast? J Am Med Assoc 161:1069–1071. https://doi.org/10.1001/jama.1956.62970110003010aCrossRef

12.

Frigerio A, Sardanelli F, Podo F (2017) Radiological screening of breast cancer: evolution. In: Veronesi U, Goldhirsch A, Veronesi P et al (eds) Breast Cancer. Springer International Publishing, Cham, pp 171–203CrossRef

13.

Schünemann HJ, Lerda D, Quinn C et al (2020) Breast cancer screening and diagnosis: a synopsis of the European breast guidelines. Ann Intern Med 172:46–56. https://doi.org/10.7326/M19-2125CrossRefPubMed

14.

Nelson HD, Pappas M, Cantor A et al (2016) Harms of breast cancer screening: systematic review to update the 2009 U.S. Preventive Services Task Force recommendation. Ann Intern Med 164:256–267. https://doi.org/10.7326/M15-0970CrossRefPubMed

15.

Nelson HD, Fu R, Cantor A et al (2016) Effectiveness of breast cancer screening: systematic review and meta-analysis to update the 2009 U.S. Preventive Services Task Force recommendation. Ann Intern Med 164:244–255. https://doi.org/10.7326/M15-0969CrossRefPubMed

16.

Klarenbach S, Sims-Jones N, Lewin G et al (2018) Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer. CMAJ 190:E1441–E1451. https://doi.org/10.1503/cmaj.180463CrossRefPubMedPubMedCentral

17.

Pisano ED, Gatsonis C, Hendrick E et al (2005) Diagnostic performance of digital versus film mammography for breast-cancer screening. N Engl J Med 353:1773–1783. https://doi.org/10.1056/NEJMoa052911CrossRefPubMed

18.

Sardanelli F, Fallenberg EM, Clauser P et al (2017) Mammography: an update of the EUSOBI recommendations on information for women. Insights Imaging 8:11–18. https://doi.org/10.1007/s13244-016-0531-4CrossRefPubMed

19.

Sardanelli F, Aase HS, Álvarez M et al (2017) Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey. Eur Radiol 27:2737–2743. https://doi.org/10.1007/s00330-016-4612-zCrossRefPubMed

20.

Hendrick RE, Ikeda DM, Miyake KK (2017) Mammography acquisition. In: Ikeda DM, Miyake KK (eds) Breast imaging: the requisites, 3rd edn. Elsevier, St. Louis, pp 30–75

21.

Puliti D, Bucchi L, Mancini S et al (2017) Advanced breast cancer rates in the epoch of service screening: The 400,000 women cohort study from Italy. Eur J Cancer 75:109–116. https://doi.org/10.1016/j.ejca.2016.12.030CrossRefPubMed

22.

Zorzi M, Puliti D, Vettorazzi M et al (2006) Mastectomy rates are decreasing in the era of service screening: a population-based study in Italy (1997–2001). Br J Cancer 95:1265–1268. https://doi.org/10.1038/sj.bjc.6603405CrossRefPubMedPubMedCentral

23.

Duffy SW, Tabár L, Yen AM et al (2020) Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women. Cancer 126:2971–2979. https://doi.org/10.1002/cncr.32859CrossRefPubMed

24.

Mariotto AB, Zou Z, Zhang F et al (2018) Can we use survival data from cancer registries to learn about disease recurrence? the case of breast cancer. Cancer Epidemiol Biomarkers Prev 27:1332–1341. https://doi.org/10.1158/1055-9965.EPI-17-1129CrossRefPubMedPubMedCentral

25.

Bonadonna G, Brusamolino E, Valagussa P et al (1976) Combination chemotherapy as an adjuvant treatment in operable breast cancer. N Engl J Med 294:405–410. https://doi.org/10.1056/NEJM197602192940801CrossRefPubMed

26.

Fisher B, Carbone P, Economou SG et al (1975) L-phenylalanine mustard (L-PAM) in the management of primary breast cancer. N Engl J Med 292:117–122. https://doi.org/10.1056/NEJM197501162920301CrossRefPubMed

27.

Munzone E, Curigliano G, Burstein HJ et al (2012) CMF revisited in the 21st century. Ann Oncol 23:305–311. https://doi.org/10.1093/annonc/mdr309CrossRefPubMed

28.

(1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet 351:1451–1467. https://doi.org/10.1016/S0140-6736(97)11423-4

29.

Andre F, Pusztai L (2006) Molecular classification of breast cancer: implications for selection of adjuvant chemotherapy. Nat Clin Pract Oncol 3:621–632. https://doi.org/10.1038/ncponc0636CrossRefPubMed

30.

Loibl S, Gianni L (2017) HER2-positive breast cancer. Lancet 389:2415–2429. https://doi.org/10.1016/S0140-6736(16)32417-5CrossRefPubMed

31.

Francis PA, Pagani O, Fleming GF et al (2018) Tailoring adjuvant endocrine therapy for premenopausal breast cancer. N Engl J Med 379:122–137. https://doi.org/10.1056/NEJMoa1803164CrossRefPubMedPubMedCentral

32.

Davies C, Pan H, Godwin J et al (2013) Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 381:805–816. https://doi.org/10.1016/S0140-6736(12)61963-1CrossRefPubMedPubMedCentral

33.

Gray RG, Rea D, Handley K et al (2013) ATTom: Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer. J Clin Oncol 31:5–5. https://doi.org/10.1200/jco.2013.31.18_suppl.5CrossRef

34.

Goss PE, Ingle JN, Martino S et al (2005) randomised trial of letrozole following tamoxifen as extended adjuvant therapy in receptor-positive breast cancer: updated findings from NCIC CTG MA.17. JNCI J Natl Cancer Inst 97:1262–1271. https://doi.org/10.1093/jnci/dji250CrossRefPubMed

35.

Mamounas EP, Jeong J-H, Wickerham DL et al (2008) Benefit from exemestane as extended adjuvant therapy after 5 years of adjuvant tamoxifen: intention-to-treat analysis of the National Surgical Adjuvant Breast and Bowel Project B-33 trial. J Clin Oncol 26:1965–1971. https://doi.org/10.1200/JCO.2007.14.0228CrossRefPubMed

36.

Goss PE, Ingle JN, Pritchard KI et al (2016) Extending aromatase-inhibitor adjuvant therapy to 10 years. N Engl J Med 375:209–219. https://doi.org/10.1056/NEJMoa1604700CrossRefPubMedPubMedCentral

37.

Tjan-Heijnen VCG, van Hellemond IEG, Peer PGM et al (2017) Extended adjuvant aromatase inhibition after sequential endocrine therapy (DATA): a randomised, phase 3 trial. Lancet Oncol 18:1502–1511. https://doi.org/10.1016/S1470-2045(17)30600-9CrossRefPubMed

38.

Blok EJ, Kroep JR, Meershoek-Klein Kranenbarg E et al (2018) Optimal duration of extended adjuvant endocrine therapy for early breast cancer; results of the IDEAL trial (BOOG 2006-05). JNCI J Natl Cancer Inst 110:40–48. https://doi.org/10.1093/jnci/djx134CrossRef

39.

Mamounas EP, Bandos H, Lembersky BC et al (2019) Use of letrozole after aromatase inhibitor-based therapy in postmenopausal breast cancer (NRG Oncology/NSABP B-42): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 20:88–99. https://doi.org/10.1016/S1470-2045(18)30621-1CrossRefPubMed

40.

Pan H, Gray R, Braybrooke J et al (2017) 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years. N Engl J Med 377:1836–1846. https://doi.org/10.1056/NEJMoa1701830CrossRefPubMedPubMedCentral

41.

Diéras V, Rugo HS, Schnell P et al (2019) Long-term pooled safety analysis of palbociclib in combination with endocrine therapy for HR+/HER2- advanced breast cancer. JNCI J Natl Cancer Inst 111:419–430. https://doi.org/10.1093/jnci/djy109CrossRefPubMed

42.

A study of palbociclib in addition to standard endocrine treatment in hormone receptor positive HER2 normal patients with residual disease after neoadjuvant chemotherapy and surgery (PENELOPE-B). https://clinicaltrials.gov/ct2/show/study/NCT01864746. Accessed 31 August 2020

43.

Endocrine therapy with or without abemaciclib (LY2835219) following surgery in participants with breast cancer (monarchE). https://clinicaltrials.gov/show/NCT03155997. Accessed 31 August 2020

44.

A trial to evaluate efficacy and safety of ribociclib with endocrine therapy as adjuvant treatment in patients With HR+/HER2- early breast cancer (NATALEE). https://clinicaltrials.gov/show/NCT03701334. Accessed 31 August 2020

45.

Moja L, Tagliabue L, Balduzzi S et al (2012) Trastuzumab containing regimens for early breast cancer. Cochrane Database Syst Rev 2012:CD006243. https://doi.org/10.1002/14651858.CD006243.pub2CrossRefPubMedCentral

46.

von Minckwitz G, Procter M, de Azambuja E et al (2017) Adjuvant pertuzumab and trastuzumab in early HER2-positive breast cancer. N Engl J Med 377:122–131. https://doi.org/10.1056/NEJMoa1703643CrossRef

47.

Martin M, Holmes FA, Ejlertsen B et al (2017) Neratinib after trastuzumab-based adjuvant therapy in HER2-positive breast cancer (ExteNET): 5-year analysis of a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 18:1688–1700. https://doi.org/10.1016/S1470-2045(17)30717-9CrossRefPubMed

48.

Tolaney SM, Guo H, Pernas S et al (2019) Seven-year follow-up analysis of adjuvant paclitaxel and trastuzumab trial for node-negative, human epidermal growth factor receptor 2–positive breast cancer. J Clin Oncol 37:1868–1875. https://doi.org/10.1200/JCO.19.00066CrossRefPubMedPubMedCentral

49.

Cortazar P, Zhang L, Untch M et al (2014) Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 384:164–172. https://doi.org/10.1016/S0140-6736(13)62422-8CrossRefPubMed

50.

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2018) Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials. Lancet Oncol 19:27–39. https://doi.org/10.1016/S1470-2045(17)30777-5

51.

Gianni L, Pienkowski T, Im Y-H et al (2016) 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol 17:791–800. https://doi.org/10.1016/S1470-2045(16)00163-7CrossRefPubMed

52.

Schneeweiss A, Chia S, Hickish T et al (2013) Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomised phase II cardiac safety study (TRYPHAENA). Ann Oncol 24:2278–2284. https://doi.org/10.1093/annonc/mdt182CrossRefPubMed

53.

Burstein HJ, Curigliano G, Loibl S et al (2019) Estimating the benefits of therapy for early-stage breast cancer: the St. Gallen international consensus guidelines for the primary therapy of early breast cancer 2019. Ann Oncol 30:1541–1557. https://doi.org/10.1093/annonc/mdz235CrossRefPubMed

54.

Nanda R, Liu MC, Yau C et al (2017) Pembrolizumab plus standard neoadjuvant therapy for high-risk breast cancer (BC): Results from I-SPY 2. J Clin Oncol 35:506–506. https://doi.org/10.1200/JCO.2017.35.15_suppl.506CrossRef

55.

Schmid P, Cortes J, Pusztai L et al (2020) Pembrolizumab for early triple-negative breast cancer. N Engl J Med 382:810–821. https://doi.org/10.1056/NEJMoa1910549CrossRefPubMed

56.

Gianni L, Huang C-S, Egle D et al (2020) Abstract GS3-04: Pathologic complete response (pCR) to neoadjuvant treatment with or without atezolizumab in triple negative, early high-risk and locally advanced breast cancer. NeoTRIPaPDL1 Michelangelo randomised study. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10–14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr GS3-04. http://www.cancerres.aacrjournals.org/content/80/4_Supplement/GS3-04.

57.

Hennigs A, Riedel F, Marmé F et al (2016) Changes in chemotherapy usage and outcome of early breast cancer patients in the last decade. Breast Cancer Res Treat 160:491–499. https://doi.org/10.1007/s10549-016-4016-4CrossRefPubMedPubMedCentral

58.

Cardoso F, van’t Veer LJ, Bogaerts J et al (2016) 70-gene signature as an aid to treatment decisions in early-stage breast cancer. N Engl J Med 375:717–729. https://doi.org/10.1056/NEJMoa1602253CrossRefPubMed

59.

Filipits M, Rudas M, Jakesz R et al (2011) A new molecular predictor of distant recurrence in ER-positive, HER2-negative breast cancer adds independent information to conventional clinical risk factors. Clin Cancer Res 17:6012–6020. https://doi.org/10.1158/1078-0432.CCR-11-0926CrossRefPubMed

60.

Dubsky P, Brase JC, Jakesz R et al (2013) The EndoPredict score provides prognostic information on late distant metastases in ER+/HER2− breast cancer patients. Br J Cancer 109:2959–2964. https://doi.org/10.1038/bjc.2013.671CrossRefPubMedPubMedCentral

61.

Sgroi DC, Carney E, Zarrella E et al (2013) Prediction of late disease recurrence and extended adjuvant letrozole benefit by the HOXB13/IL17BR biomarker. JNCI J Natl Cancer Inst 105:1036–1042. https://doi.org/10.1093/jnci/djt146CrossRefPubMed

62.

Dowsett M, Sestak I, Lopez-Knowles E et al (2013) Comparison of PAM50 risk of recurrence score with Oncotype DX and IHC4 for predicting risk of distant recurrence after endocrine therapy. J Clin Oncol 31:2783–2790. https://doi.org/10.1200/JCO.2012.46.1558CrossRefPubMed

63.

Gnant M, Filipits M, Greil R et al (2014) Predicting distant recurrence in receptor-positive breast cancer patients with limited clinicopathological risk: using the PAM50 risk of recurrence score in 1478 postmenopausal patients of the ABCSG-8 trial treated with adjuvant endocrine therapy alone. Ann Oncol 25:339–345. https://doi.org/10.1093/annonc/mdt494CrossRefPubMed

64.

Paik S, Tang G, Shak S et al (2006) Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor–positive breast cancer. J Clin Oncol 24:3726–3734. https://doi.org/10.1200/JCO.2005.04.7985CrossRefPubMed

65.

Sparano JA, Gray RJ, Makower DF et al (2018) Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med 379:111–121. https://doi.org/10.1056/NEJMoa1804710CrossRefPubMedPubMedCentral

66.

Gluz O, Nitz UA, Christgen M et al (2016) West German study group phase III planb trial: first prospective outcome data for the 21-gene recurrence score assay and concordance of prognostic markers by central and local pathology assessment. J Clin Oncol 34:2341–2349. https://doi.org/10.1200/JCO.2015.63.5383CrossRefPubMed

67.

Gonzalez-Angulo AM, Barlow WE, Gralow J et al (2011) SWOG S1007: A phase III, randomised clinical trial of standard adjuvant endocrine therapy with or without chemotherapy in patients with one to three positive nodes, hormone receptor (HR)-positive, and HER2-negative breast cancer with recurrence score (RS). J Clin Oncol 29:TPS104–TPS104. https://doi.org/10.1200/jco.2011.29.15_suppl.tps104CrossRef

68.

Berry DA, Cronin KA, Plevritis SK et al (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792. https://doi.org/10.1056/NEJMoa050518CrossRefPubMed

69.

Saadatmand S, Bretveld R, Siesling S, Tilanus-Linthorst MMA (2015) Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173 797 patients. BMJ 351:h4901. https://doi.org/10.1136/bmj.h4901CrossRefPubMedPubMedCentral

70.

Alabousi M, Zha N, Salameh J et al (2020) Digital breast tomosynthesis for breast cancer detection: a diagnostic test accuracy systematic review and meta-analysis. Eur Radiol 30:2058–2071. https://doi.org/10.1007/s00330-019-06549-2CrossRefPubMed

71.

Hovda T, Holen ÅS, Lång K et al (2020) Interval and consecutive round breast cancer after digital breast tomosynthesis and synthetic 2D mammography versus standard 2D digital mammography in BreastScreen Norway. Radiology 294:256–264. https://doi.org/10.1148/radiol.2019191337CrossRefPubMed

72.

Bernardi D, Gentilini MA, De Nisi M et al (2020) Effect of implementing digital breast tomosynthesis (DBT) instead of mammography on population screening outcomes including interval cancer rates: Results of the Trento DBT pilot evaluation. Breast 50:135–140. https://doi.org/10.1016/j.breast.2019.09.012CrossRefPubMed

73.

Conant EF, Barlow WE, Herschorn SD et al (2019) Association of digital breast tomosynthesis vs digital mammography with cancer detection and recall rates by age and breast density. JAMA Oncol 5:635–642. https://doi.org/10.1001/jamaoncol.2018.7078CrossRefPubMedPubMedCentral

74.

Bakker MF, de Lange SV, Pijnappel RM et al (2019) Supplemental MRI screening for women with extremely dense breast tissue. N Engl J Med 381:2091–2102. https://doi.org/10.1056/NEJMoa1903986CrossRefPubMed

75.

Zanardo M, Cozzi A, Trimboli RM et al (2019) Technique, protocols and adverse reactions for contrast-enhanced spectral mammography (CESM): a systematic review. Insights Imaging 10:76. https://doi.org/10.1186/s13244-019-0756-0CrossRefPubMedPubMedCentral

76.

Cozzi A, Schiaffino S, Sardanelli F (2019) The emerging role of contrast-enhanced mammography. Quant Imaging Med Surg 9:2012–2018. https://doi.org/10.21037/qims.2019.11.09CrossRefPubMedPubMedCentral

77.

Ghaderi KF, Phillips J, Perry H et al (2019) Contrast-enhanced mammography: current applications and future directions. Radiographics 39:1907–1920. https://doi.org/10.1148/rg.2019190079CrossRefPubMed

78.

European Society of Radiology (ESR) (2019) Impact of artificial intelligence on radiology: a EuroAIM survey among members of the European Society of Radiology. Insights Imaging 10:105. https://doi.org/10.1186/s13244-019-0798-3

79.

McKinney SM, Sieniek M, Godbole V et al (2020) International evaluation of an AI system for breast cancer screening. Nature 577:89–94. https://doi.org/10.1038/s41586-019-1799-6CrossRefPubMed

80.

Pisano ED (2020) AI shows promise for breast cancer screening. Nature 577:35–36. https://doi.org/10.1038/d41586-019-03822-8CrossRefPubMed

81.

Sardanelli F (2017) Trends in radiology and experimental research. Eur Radiol Exp 1:1. https://doi.org/10.1186/s41747-017-0006-5CrossRefPubMedPubMedCentral

82.

Neri E, Del Re M, Paiar F et al (2018) Radiomics and liquid biopsy in oncology: the holons of systems medicine. Insights Imaging 9:915–924. https://doi.org/10.1007/s13244-018-0657-7CrossRefPubMedPubMedCentral

83.

Underwood JJ, Quadri RS, Kalva SP et al (2020) Liquid biopsy for cancer: review and implications for the radiologist. Radiology 294:5–17. https://doi.org/10.1148/radiol.2019182584CrossRefPubMed

Title: Do we still need breast cancer screening in the era of targeted therapies and precision medicine?
Authors: Rubina Manuela Trimboli
Paolo Giorgi Rossi
Nicolò Matteo Luca Battisti
Andrea Cozzi
Veronica Magni
Moreno Zanardo
Francesco Sardanelli
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Breast Cancer
Mammography
Breast Cancer
Mammography
Cytostatic Therapy
Published in: Insights into Imaging / Issue 1/2020
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-020-00905-3

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Do we still need breast cancer screening in the era of targeted therapies and precision medicine?

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