title: [Breast cancer screening: On our way to the future].
abstract: Breast cancer remains a potentially lethal disease, which requires aggressive treatments and is associated with long-term consequences. Its prognosis is linked to both tumor biology and burden at diagnosis. Although treatments have allowed important improvements in prognosis over the past 20 years, breast cancer screening remains necessary. Mammographic screening allows earlier stage diagnoses and a decrease of breast cancer specific mortality. However, breast cancer screening modalities should be revised with the objective to address demonstrated limitations of mammographic screening (limited benefit, imperfect sensitivity and specificity, overdiagnoses, radiation-induced morbidity). Furthermore, both objective and perceived performances of screening procedures should be improved. Numerous large international efforts are ongoing, leading to scientific progresses that should have rapid clinical implications in this area. Among them is improvement of imaging techniques performance, development of real time diagnosis, and development of new non radiological screening techniques such as the search for circulating tumor DNA, development of biomarkers able to allow precise risk evaluation and stratified screening. As well, overtreatment is currently addressed by biomarker-based de-escalation clinical trials. These advances need to be associated with strong societal support, as well as major paradigm changes regarding the way health and cancer prevention is perceived by individuals.
authors.affiliation: Université Paris Saclay, institut Gustave-Roussy, département de médecine oncologique, Inserm U981, 114, rue Edouard-Vaillant, 94800 Villejuif, France. Electronic address: suzette.delaloge@gustaveroussy.fr.
authors.forename: Suzette
authors.initials: S
authors.lastname: Delaloge
authors.affiliation: Centre Léon-Bérard, département de cancérologie médicale, 28, rue Laënnec, 69008 Lyon cedex 08, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bachelot
authors.affiliation: Université de recherche Paris, sciences et lettres, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: François-Clément
authors.initials: FC
authors.lastname: Bidard
authors.affiliation: Hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Espie
authors.affiliation: Institut Curie, Saint-Cloud, 35, rue Dailly, 92210 Saint-Cloud, France; Université Versailles-Saint-Quentin, 78180 Montigny-le-Bretonneux, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Brain
authors.affiliation: Université de Bordeaux, institut Bergonie, 229, cours de l'Argonne, 33000 Bordeaux, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Bonnefoi
authors.affiliation: Hôpital Tenon, université Paris-Sorbonne, Inserm U938, 4, rue de la Chine, 75020 Paris, France.
authors.forename: Joseph
authors.initials: J
authors.lastname: Gligorov
authors.affiliation: Institut universitaire du cancer-Toulouse oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Dalenc
authors.affiliation: Centre Armoricain d'oncologie, Cario, 21, rue du Vieux-Séminaire, 22000 Saint-Brieuc, France.
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Hardy-Bessard
authors.affiliation: Université de Montpellier, institut du cancer, IRCM U1194, 34298 Montpellier, France.
authors.forename: David
authors.initials: D
authors.lastname: Azria
authors.affiliation: Institut de cancérologie de la Loire, 108 B, avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jacquin
authors.affiliation: R&D Unicancer, 101, rue de Tolbiac, 75013 Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Lemonnier
authors.affiliation: Université de Montpellier, institut du cancer, IRCM U1194, 34298 Montpellier, France.
authors.forename: William
authors.initials: W
authors.lastname: Jacot
authors.affiliation: Université Aix-Marseille, institut Paoli-Calmettes, Inserm U1068, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Goncalves
authors.affiliation: Université de Bourgogne, centre Georges-François-Leclerc, 1, rue du Pr-Marion, 21000 Dijon, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Coutant
authors.affiliation: Centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Ganem
authors.affiliation: Université de Strasbourg, centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67000 Strasbourg, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Petit
authors.affiliation: Université d'Auvergne, centre Jean-Perrin, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Penault-Llorca
authors.affiliation: Université de Bordeaux, institut Bergonie, 229, cours de l'Argonne, 33000 Bordeaux, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Debled
authors.affiliation: Institut d'oncologie de l'Ouest, Inserm U892, IRT-UN, 8, quai Moncousu, 44007 Nantes cedex, France.
authors.forename: Mario
authors.initials: M
authors.lastname: Campone
authors.affiliation: Centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Levy
authors.affiliation: Université de Bourgogne, centre Georges-François-Leclerc, 1, rue du Pr-Marion, 21000 Dijon, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Coudert
authors.affiliation: Centre Catherine-de-Sienne, 2, rue Éric-Tabarly, 44202 Nantes, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Lortholary
authors.affiliation: CHU de Limoges, service d'oncologie médicale, 22, avenue Martin-Luther-King, 87000 Limoges, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Venat-Bouvet
authors.affiliation: Institut Sainte-Catherine, 250, chemin de Baignes-Pieds, 84918 Avignon cedex 9, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Grenier
authors.affiliation: Centre Jean-Bernard, 9, rue Beauverger, 72000 Le Mans, France.
authors.forename: Hugues
authors.initials: H
authors.lastname: Bourgeois
authors.affiliation: R&D Unicancer, 101, rue de Tolbiac, 75013 Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Asselain
authors.affiliation: Ligue nationale contre le cancer, comité du Lot, 28, boulevard Gambetta, 46000 Cahors, France.
authors.forename: Johanna
authors.initials: J
authors.lastname: Arvis
authors.affiliation: Europadonna France, 14, rue Corvisart, 75013 Paris, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Castro
authors.affiliation: Université de recherche Paris, sciences et lettres, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Tardivon
authors.affiliation: Université de Lyon, 69000 Lyon, France; Université Lyon 1, 69100 Villeurbanne, France; Centre de recherche en cancérologie de Lyon, Inserm U1052, CNRS UMR5286, 69000 Lyon, France; Centre Léon-Bérard, 69008 Lyon, France.
authors.forename: David G
authors.initials: DG
authors.lastname: Cox
authors.affiliation: Registre de Côte d'Or, centre Georges-François-Leclerc, 1, rue du Pr-Marion, 21000 Dijon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
authors.affiliation: Institut Gustave-Roussy, département d'imagerie médicale, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Balleyguier
authors.affiliation: Université Paris Saclay, institut Gustave-Roussy, département de médecine oncologique, Inserm U981, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: André
authors.affiliation: Université de recherche Paris, sciences et lettres, institut Curie, 26, rue d'Ulm, 75005 Paris, France; Institut Curie, Saint-Cloud, 35, rue Dailly, 92210 Saint-Cloud, France; Université Versailles-Saint-Quentin, 78180 Montigny-le-Bretonneux, France.
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005602:France; D006801:Humans; D008327:Mammography; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor
keywords: Biomarkers; Biomarqueurs; Breast cancer; Cancer du sein; Dépistage; Personalized; Personnalisé; Risk; Risque; Screening