Results of mass screening for breast cancer in 50,000 examinations.

Detection of earlier breast cancer, especially in its preclinical stage, offers the only method available today for reducing mortality from this disease. The Health Insurance Plan study, conducted since 1963 under contract with the National Institutes of Health, has achieved a one-third reduction in death rate in a study group compared to a matched control which has persisted in 7 years of follow-up. The Guttman Institute, founded in 1968 to develop practical methods for large scale screening, is operating a tandem approach using interview, clinical examination, improved mammography, and thermography for greatest yield. Emphasis is placed on motivation to accept the examination, teaching and encouragement of breast self-examination, and emphasis on periodic reexaminations. At the present time, almost 300 women receive this complete examination per day at the Institute's fixed facility. Periodic examinations leads to marked increase in number of cancers detected free of axillary nodal involvement. The tandem approach emphasizes substantial percentage of cancers detected on only one modality, two-thirds of which are without nodal involvement. Breast self-examination is necessary to detect "interval" cancers in more localized stage.