Meme Kanserinde Tarama Yöntemleri ve Önemi
Özet
Meme kanseri, dünya genelinde ve Türkiye’de kadınlarda en sık görülen kanser türüdür ve kansere bağlı ölümlerin başlıca nedenlerinden biridir. Tarama programları, hastalığın asemptomatik döneminde tespit edilmesini sağlayarak erken tanı ve tedaviye olanak tanır. Organize taramalar, sistematik bir planla belirli yaş ve risk gruplarını hedef alırken; fırsatçı taramalar bireysel başvuruya dayalıdır. Türkiye’de, 40–69 yaş arası kadınlara 2 yılda bir mamografi taraması, Kanser Erken Teşhis, Tarama ve Eğitim Merkezleri (KETEM) ve mobil birimler aracılığıyla ücretsiz sunulmaktadır. Amerikan ve Avrupa rehberlerinde tarama yaşı ve sıklığı farklılık göstermektedir; American Cancer Society (ACS) ve Amerikan Radyoloji Koleji (ACR) 40 yaşında başlamayı önerirken, US Preventive Services Task Force (USPSTF) 40–74 yaş arası için 2 yılda bir taramayı önermektedir. Yüksek riskli bireylerde (ör. BRCA1/2 mutasyon taşıyıcıları), tarama daha erken yaşta başlamakta ve genellikle yıllık MRG ile desteklenmektedir. Mamografi, taramada temel yöntem olmakla birlikte, meme yoğunluğu fazla olan bireylerde MRG ve ultrasonografi gibi tamamlayıcı yöntemler önerilmektedir. Tarama programlarının bireyselleştirilmesi, yaşam boyu risk değerlendirmesi ve teknolojik gelişmelerle birlikte, erken tanı ve mortaliteyi azaltmada önemli katkılar sunmaktadır.
Referanslar
Xu Y, Gong M, Wang Y, et al. Global trends and forecasts of breast cancer incidence and deaths. Sci Data; 2023;10(1):334. doi: 10.1038/s41597-023-02253-5.
Sung, H., Ferlay, J., Siegel, R. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians; 2021; 71(3), 209-249. https://doi.org/10.3322/caac.21660
World Health Organization (WHO). Cancer Fact Sheets – Breast Cancer.
Smith RA, Duffy SW, Gabe R, et al. The randomized trials of breast cancer screening: what have we learned? Radiol Clin North Am; 2004; 42: 793-806.
Nyström L, Bjurstam N, Jonsson H, et al. Reduced breast cancer mortality after 20+ years of follow-up in the Swedish randomized controlled mammography trials in Malmö, Stockholm, and Göteborg. J Med Screen; 2017; 24(1):34-42. doi: 10.1177/0969141316648987.
Fletcher SW, Black W, Harris R, et al. Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst; 1993; 20;85(20):1644-56. doi: 10.1093/jnci/85.20.1644.
American Cancer Society Recommendations for the Early Detection of Breast Cancer; 2023.
Nicholson WK, Silverstein M, Wong JB, et al. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA; 2024;11;331(22):1918-1930. doi: 10.1001/jama.2024.5534.
T.C. Sağlık Bakanlığı KETEM Mobil Tarama Raporları; 2023.
TRD Yeterlilik Kurulu, Rehber ve Standartlar Komitesi-Meme Kanseri Tarama Rehberi; 2021.
New ACR Breast Cancer Screening Guidelines; 2023.
Baker J, Noguchi N, Marinovich ML, et al. Atypical ductal or lobular hyperplasia, lobular carcinoma in-situ, flat epithelial atypia, and future risk of developing breast cancer: Systematic review and meta-analysis. Breast; 2024; 78:103807. doi: 10.1016/j.breast.2024.103807.
NCCN Guidelines Version- Breast Cancer Screening and Diagnosis; 2025.
EUSOBI Recommendations on Breast Cancer Screening; 2022.
Marcon M, Fuchsjäger MH, Clauser P, et al. Essentials: screening for breast cancer - general recommendations by EUSOBI. Eur Radiol; 2024; 34(10):6348-6357. doi: 10.1007/s00330-024-10740-5.
Mann RM, Athanasiou A, Baltzer PAT,et al; European Society of Breast Imaging (EUSOBI). Breast cancer screening in women with extremely dense breasts recommendations of the European Society of Breast Imaging (EUSOBI). Eur Radiol; 2022; 32(6):4036-4045. doi: 10.1007/s00330-022-08617-6.
Daly MB, Pal T, Maxwell KN, NCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2024. J Natl Compr Canc Netw. 2023; 21(10):1000-1010. doi: 10.6004/jnccn.2023.0051.
Warner E. Screening. BRCA1 and BRCA2 Mutation Carriers for Breast Cancer. Cancers (Basel). 2018; 30;10(12):477. doi: 10.3390/cancers10120477.
Calderon-Margalit R, Paltiel O. Prevention of breast cancer in women who carry BRCA1 or BRCA2 mutations: a critical review of the literature. Int J Cancer; 2004;10;112(3):357-64. doi: 10.1002/ijc.20429.
Manna EDF, Serrano D, Cazzaniga L, et al. Hereditary Breast Cancer: Comprehensive Risk Assessment and Prevention Strategies. Genes (Basel). 2025;13;16(1):82. doi: 10.3390/genes16010082.
ESMO Essentials For Clinicians Breast Cancer 2nd Edition;2024.
Phi XA, Tagliafico A, Houssami N, et al. Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis. BMC Cancer; 2018; 3;18(1):380. doi: 10.1186/s12885-018-4263-3.
Sung JS, Lebron L, Keating D, et al. Performance of Dual-Energy Contrast-enhanced Digital Mammography for Screening Women at Increased Risk of Breast Cancer. Radiology; 2019;293:81-8. doi: 10.1148/radiol.2019182660.
Jochelson MS, Pinker K, Dershaw DD, et al. Comparison of screening CEDM and MRI for women at increased risk for breast cancer: A pilot study. Eur J Radiol; 2017;97:37-43. doi: 10.1016/j.ejrad.2017.10.001.
Start Mammograms at 40, Not 50, USPSTF Suggests. Cancer Discov. 2023;7;13(7):1506. doi: 10.1158/2159-8290.CD-NB2023-0040.
Xu Y, Gong M, Wang Y, et al. Global trends and forecasts of breast cancer incidence and deaths. Sci Data; 2023;10(1):334. doi: 10.1038/s41597-023-02253-5.
Sung, H., Ferlay, J., Siegel, R. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians; 2021; 71(3), 209-249. https://doi.org/10.3322/caac.21660
World Health Organization (WHO). Cancer Fact Sheets – Breast Cancer.
Smith RA, Duffy SW, Gabe R, et al. The randomized trials of breast cancer screening: what have we learned? Radiol Clin North Am; 2004; 42: 793-806.
Nyström L, Bjurstam N, Jonsson H, et al. Reduced breast cancer mortality after 20+ years of follow-up in the Swedish randomized controlled mammography trials in Malmö, Stockholm, and Göteborg. J Med Screen; 2017; 24(1):34-42. doi: 10.1177/0969141316648987.
Fletcher SW, Black W, Harris R, et al. Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst; 1993; 20;85(20):1644-56. doi: 10.1093/jnci/85.20.1644.
American Cancer Society Recommendations for the Early Detection of Breast Cancer; 2023.
Nicholson WK, Silverstein M, Wong JB, et al. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA; 2024;11;331(22):1918-1930. doi: 10.1001/jama.2024.5534.
T.C. Sağlık Bakanlığı KETEM Mobil Tarama Raporları; 2023.
TRD Yeterlilik Kurulu, Rehber ve Standartlar Komitesi-Meme Kanseri Tarama Rehberi; 2021.
New ACR Breast Cancer Screening Guidelines; 2023.
Baker J, Noguchi N, Marinovich ML, et al. Atypical ductal or lobular hyperplasia, lobular carcinoma in-situ, flat epithelial atypia, and future risk of developing breast cancer: Systematic review and meta-analysis. Breast; 2024; 78:103807. doi: 10.1016/j.breast.2024.103807.
NCCN Guidelines Version- Breast Cancer Screening and Diagnosis; 2025.
EUSOBI Recommendations on Breast Cancer Screening; 2022.
Marcon M, Fuchsjäger MH, Clauser P, et al. Essentials: screening for breast cancer - general recommendations by EUSOBI. Eur Radiol; 2024; 34(10):6348-6357. doi: 10.1007/s00330-024-10740-5.
Mann RM, Athanasiou A, Baltzer PAT,et al; European Society of Breast Imaging (EUSOBI). Breast cancer screening in women with extremely dense breasts recommendations of the European Society of Breast Imaging (EUSOBI). Eur Radiol; 2022; 32(6):4036-4045. doi: 10.1007/s00330-022-08617-6.
Daly MB, Pal T, Maxwell KN, NCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2024. J Natl Compr Canc Netw. 2023; 21(10):1000-1010. doi: 10.6004/jnccn.2023.0051.
Warner E. Screening. BRCA1 and BRCA2 Mutation Carriers for Breast Cancer. Cancers (Basel). 2018; 30;10(12):477. doi: 10.3390/cancers10120477.
Calderon-Margalit R, Paltiel O. Prevention of breast cancer in women who carry BRCA1 or BRCA2 mutations: a critical review of the literature. Int J Cancer; 2004;10;112(3):357-64. doi: 10.1002/ijc.20429.
Manna EDF, Serrano D, Cazzaniga L, et al. Hereditary Breast Cancer: Comprehensive Risk Assessment and Prevention Strategies. Genes (Basel). 2025;13;16(1):82. doi: 10.3390/genes16010082.
ESMO Essentials For Clinicians Breast Cancer 2nd Edition;2024.
Phi XA, Tagliafico A, Houssami N, et al. Digital breast tomosynthesis for breast cancer screening and diagnosis in women with dense breasts - a systematic review and meta-analysis. BMC Cancer; 2018; 3;18(1):380. doi: 10.1186/s12885-018-4263-3.
Sung JS, Lebron L, Keating D, et al. Performance of Dual-Energy Contrast-enhanced Digital Mammography for Screening Women at Increased Risk of Breast Cancer. Radiology; 2019;293:81-8. doi: 10.1148/radiol.2019182660.
Jochelson MS, Pinker K, Dershaw DD, et al. Comparison of screening CEDM and MRI for women at increased risk for breast cancer: A pilot study. Eur J Radiol; 2017;97:37-43. doi: 10.1016/j.ejrad.2017.10.001.
Start Mammograms at 40, Not 50, USPSTF Suggests. Cancer Discov. 2023;7;13(7):1506. doi: 10.1158/2159-8290.CD-NB2023-0040.
