Pamilo M, Lönnqvist J, Halttunen A, Soiva M, Suramo I
Mammography Screening Centre, Cancer Society of Finland, Helsinki.
J Epidemiol Community Health. 1991 Dec;45(4):321-4. doi: 10.1136/jech.45.4.321.
The aim was to find out if it is possible, by classifying screening mammograms according to the likelihood of malignancy, to divide the recalled women to a group in which there is high suspicion of malignancy, most having breast cancers, and a group with more obscure findings.
Screening mammograms of recalled women were classified according to the likelihood of malignancy. 0 = technically insufficient, 1 = normal, 2 = benign tumour, 3 = malignancy cannot be excluded, 4 = strongly suspicious for malignancy, 5 = malignant.
This study was a population based survey of mammography screening in Helsinki and surroundings in Finland.
21,417 women (aged 50-59 years) were invited to be screened, 18,012 (84.10%) participated. Of these 579 (3.21% of those screened) were recalled for further studies; 124 of these were referred for surgical biopsy and 82 had breast cancer.
All cases classified as 5, 60% of the cases classified as 4, 6.5% of the cases classified as 3, 0% of the cases classified as 2 or 1, and 1.2% of the cases classified as 0 proved to have breast cancers. However classification 5 represented 5.9% of all recalled women and 41.5% of all screening detected breast cancers; classification 4, 6.0% of all recalled women and 25.6% of all screening detected breast cancers; classification 3, 68.9% of all recalled women and 31.7% of all screening detected breast cancers; classification 2, 11.7% and classification 1, 2.9% of all recalled women. No breast cancers were detected with these classifications. Classification 0 represented 4.5% of all recalled women and 1.2% of all screening detected breast cancers. Classifications 5 and 4 represented only 11.9% of all recalled women but 67.1% of all screening detected breast cancers.
By classifying screening mammograms according to the likelihood of malignancy, recalled women can be divided into two groups: (1) a quite small subgroup in which everyone or almost everyone will be shown to have breast cancer; and (2) a much larger subgroup in which only a few will be proven to have breast cancer. The invitation procedure for the further studies should be improved on this basis of minimising anxiety among recalled women.
旨在查明是否有可能通过根据恶性可能性对乳腺钼靶筛查图像进行分类，将召回的女性分为两组，一组是高度怀疑恶性、多数患有乳腺癌的女性，另一组是检查结果较为模糊的女性。
根据恶性可能性对召回女性的乳腺钼靶筛查图像进行分类。0 = 技术上不充分，1 = 正常，2 = 良性肿瘤，3 = 不能排除恶性，4 = 高度怀疑恶性，5 = 恶性。
本研究是一项基于芬兰赫尔辛基及周边地区乳腺钼靶筛查的人群调查。
邀请了21417名年龄在50至59岁之间的女性进行筛查，其中18012名（84.10%）参与。在这些参与者中，579名（占筛查人数的3.21%）被召回进一步检查；其中124名被转诊进行手术活检，82名患有乳腺癌。
所有分类为5的病例、60%分类为4的病例、6.5%分类为3的病例、0%分类为2或1的病例以及1.2%分类为0的病例被证实患有乳腺癌。然而，分类为5的病例占所有召回女性的5.9%，占所有筛查发现乳腺癌的41.5%；分类为4的病例占所有召回女性的6.0%，占所有筛查发现乳腺癌的25.6%；分类为3的病例占所有召回女性的68.9%，占所有筛查发现乳腺癌的31.7%；分类为2的病例占所有召回女性的11.7%，分类为1的病例占所有召回女性的2.9%。这些分类中未检测到乳腺癌。分类为0的病例占所有召回女性的4.5%，占所有筛查发现乳腺癌的1.2%。分类为5和4的病例仅占所有召回女性的11.9%，但占所有筛查发现乳腺癌的67.1%。
通过根据恶性可能性对乳腺钼靶筛查图像进行分类，召回的女性可以分为两组：（1）一个非常小的亚组，其中每个人或几乎每个人都将被证明患有乳腺癌；（2）一个大得多的亚组，其中只有少数人将被证明患有乳腺癌。应在此基础上改进进一步检查的邀请程序，以尽量减少召回女性的焦虑。
