The use of an expert system of composite risk factors in breast cancer screening.

Mass Screening seems to be the only promising way to discover breast cancer patients at an early and more curable stage and a positive method improving the cost-effectiveness and compliance of mass screening is the use of prognostic factors, to identify the high-risk group, who alone then would be screened. In a 200 women sample, who had undergone screening for breast cancer with clinical examination and bilateral mammography, we calculated the Composite Risk Factors of six Characteristics (C6RF), which are family history for breast cancer, pregnancy history, menstrual history, history of cystic breast disease, history of regular breast clinical or self-examination and presence or not of breast lump, using an expert system in IBM-compatible personal computer. In these cases the average C6RF was 0.18 (SD +/- 0.19) in low-risk group and 2.61 (SD +/- 4.76) in high-risk group and all cases with C6RF values higher than 0.56 were put in the high-risk group. Under these conditions, the sensitivity of the C6RF method, in discovering breast cancer, was 90% and the specificity 81.5% and the C6RF method was proved to be clinically valuable in identifying the high-risk group and controlling breast cancer.