Newcomb P A, Weiss N S, Storer B E, Scholes D, Young B E, Voigt L F
Fred Hutchinson Cancer Research Center, Seattle, Wash.
J Natl Cancer Inst. 1991 Feb 20;83(4):260-5. doi: 10.1093/jnci/83.4.260.
Two hundred nine female enrollees of the Group Health Cooperative of Puget Sound who developed advanced-stage breast cancer during the period 1982-1988 were interviewed about their practice of breast self-examination (BSE), use of other breast cancer screening modalities, and medical and reproductive histories. Each subject's description of how she performed the examination was scored according to her mention of up to 10 recommended BSE techniques. A random sample of 433 women without advanced-stage breast cancer from the same population was interviewed for comparison. Relative to women not practicing BSE, the risk of advanced-stage breast cancer among BSE users was 1.15 (95% confidence interval, 0.73-1.81). Frequency of BSE did not differ between women with advanced-stage breast cancer and control subjects, whether in all subjects or in subgroups defined by age, use of mammography, or frequency of clinical breast examinations. While self-described proficiency in BSE was generally low in both case and control subjects, the small percentage of women reporting more thorough self-examinations, regardless of frequency, had about a 35% decrease in the occurrence of advanced-stage breast cancer compared to women who did not perform BSE. These results suggest that, while carefully performed BSE may avoid the development of some advanced-stage breast cancers, BSE as practiced by most Seattle-area women is of little or no benefit.
对普吉特海湾集团健康合作社的209名女性入组者进行了访谈，她们在1982年至1988年期间患了晚期乳腺癌，内容涉及她们的乳房自我检查（BSE）做法、其他乳腺癌筛查方式的使用情况以及医疗和生育史。根据每位受试者对多达10种推荐的BSE技术的提及情况，对她描述的检查执行方式进行评分。从同一人群中随机抽取433名无晚期乳腺癌的女性进行访谈作为对照。与不进行BSE的女性相比，进行BSE的女性患晚期乳腺癌的风险为1.15（95%置信区间，0.73 - 1.81）。晚期乳腺癌女性与对照受试者之间的BSE频率没有差异，无论是在所有受试者中，还是在按年龄、乳房X线摄影使用情况或临床乳房检查频率定义的亚组中。虽然病例组和对照组受试者自我描述的BSE熟练程度普遍较低，但报告进行更彻底自我检查的女性比例较小，无论频率如何，与未进行BSE的女性相比，晚期乳腺癌的发生率约降低了35%。这些结果表明，虽然仔细进行BSE可能避免一些晚期乳腺癌的发生，但大多数西雅图地区女性所进行的BSE益处很小或没有益处。
