Jatoi Ismail
General Surgery Service, US Army Hospital Heidelberg, Heidelberg, Germany 69126.
Surg Clin North Am. 2003 Aug;83(4):789-801. doi: 10.1016/S0039-6109(03)00028-8.
Evidence suggests that CBE detects most breast cancers found by mammograms, and also some that mammograms miss, particularly in younger women. Recent estimates suggest that screening CBE has a sensitivity of about 54% and a specificity of about 94%. Yet, the impact of screening CBE on breast cancer mortality is still not clear, as there are no trials that have reported results comparing screening CBE alone to no screening. In some countries, the costs of screening mammography are considered too high, and policy makers are considering implementing screening programs based on CBE rather than mammography. In those countries with screening mammography programs already in place, screening CBE should also be included, as this will increase the overall sensitivity of breast cancer screening. Studies have shown that community health workers can be trained to conduct screening CBE, and that trained nurses perform CBE as well as physicians. Physicians should take on the responsibility to ensure that screening CBE is performed properly, however, and that it remains an integral part of all screening mammography programs.
有证据表明，临床乳腺检查（CBE）能检测出大多数通过乳房X光检查发现的乳腺癌，也能检测出一些乳房X光检查遗漏的病例，尤其是在年轻女性中。最近的估计表明，筛查性CBE的敏感度约为54%，特异度约为94%。然而，筛查性CBE对乳腺癌死亡率的影响仍不明确，因为尚无试验报告将单独的筛查性CBE与不筛查进行比较的结果。在一些国家，乳房X光筛查的成本被认为过高，政策制定者正在考虑实施基于CBE而非乳房X光检查的筛查项目。在那些已经实施乳房X光筛查项目的国家，也应包括筛查性CBE，因为这将提高乳腺癌筛查的总体敏感度。研究表明，社区卫生工作者可以接受培训来进行筛查性CBE，而且经过培训的护士进行CBE的效果与医生一样好。然而，医生应承担起责任，确保筛查性CBE正确实施，并使其仍然是所有乳房X光筛查项目的一个组成部分。
