Pisano E D, McLelland R
University of North Carolina, Chapel Hill.
Curr Opin Radiol. 1991 Aug;3(4):579-87.
Mammography, breast physical examination, and breast self-examination are recommended for breast cancer screening. Although in randomized trials of screening, mammography demonstrated a reduction in breast cancer mortality for women over 50, such data are not available for breast physical or self-examination. The Canadian National Breast Screening Study should provide data regarding the efficacy of breast physical examination alone. The World Health Organization has established trials to evaluate self-examination in the USSR and Germany. There is still controversy regarding routine mammographic screening and the optimal screening interval for women under age 50. The costs of mammographic screening remain a concern, but these costs can be lessened considerably through efficiency of mammographic services and a reduction in the number of false-positive interpretations that prompt biopsy. Primary care physicians can help to reduce breast cancer mortality by referring their patients for screening mammography and by performing breast physical examinations.
推荐进行乳房X光检查、乳房体格检查和乳房自我检查以筛查乳腺癌。虽然在筛查的随机试验中，乳房X光检查显示可降低50岁以上女性的乳腺癌死亡率，但乳房体格检查或自我检查尚无此类数据。加拿大全国乳房筛查研究应能提供关于单纯乳房体格检查有效性的数据。世界卫生组织已在苏联和德国开展了评估自我检查的试验。对于50岁以下女性的常规乳房X光筛查及最佳筛查间隔仍存在争议。乳房X光筛查的费用仍是一个问题，但通过提高乳房X光检查服务的效率以及减少导致活检的假阳性解读数量，这些费用可大幅降低。初级保健医生可通过将患者转诊进行乳房X光筛查以及开展乳房体格检查，帮助降低乳腺癌死亡率。
