WISDOM ランダム化臨床試験 リスクベースの対年間乳がんスクリーニング
Laura J Esserman1, Allison S Fiscalini1, Arash Naeim2
1University of California, San Francisco.
JAMA
|December 12, 2025
まとめ
リスクベースの乳がんスクリーニングは,遺伝的リスクとスクリーニングの強度によって女性を階層化します. この方法は安全ですが 年間マモグラフィと比較して バイオプシーの割合は減少しませんでした
科学分野:
- 腫瘍学
- 遺伝学
- 予防 医療
背景:
- 個々の乳がんリスク評価はスクリーニング戦略を最適化することができます.
- 現在のスクリーニング方法では 高リスクの個人に 効率的にリソースを割り当てられないかもしれません
研究 の 目的:
- 年間マンモグラフィー検査の代替としてリスクベースの乳がんスクリーニングの実現可能性を評価する.
- リスクの階層化はスクリーニング結果を改善するかどうかを判断する.
主な方法:
- 40歳から74歳までの女性において,リスクベースのスクリーニングと年次マンモグラフィーを比較した,多センターランダム化臨床試験が行われました.
- リスク評価には遺伝子シーケンシング,多遺伝子リスクスコア,そして検証されたリスクモデルが含まれていました.
- スクリーニングの推奨は,計算された5年間のリスクと遺伝的要因によって異なる.
主要な成果:
- リスクベースのスクリーニングは,ステージ≥IIBのがんを検出するのに劣らなかったが,年間スクリーニングと比較してバイオプシーの割合を減少させなかった.
- リスクベースのグループではマモグラフィー検査が少ないが,生検の割合は有意に低下しなかった.
- 癌の発生率,生検,マンモグラフィ,MRIはリスクの高いカテゴリーで増加しました.
結論:
- リスクベースの乳がんスクリーニング 遺伝子検査 効果的な分層リスクとスクリーニングの強度
- このアプローチは生検率の減少につながらなかった.
- 不必要な生検を減らすためにリスクベースのスクリーニングプロトコルを最適化するためにさらなる研究が必要になる可能性があります.
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