Department of Surgery, Fukui Saiseikai Hospital, 7-1 Funabashi, Wadanakacyou, Fukui, Fukui, 918-8503, Japan.
Breast Cancer. 2013 Oct;20(4):310-5. doi: 10.1007/s12282-012-0333-6. Epub 2012 Jan 27.
The US Preventative Services Task Force assesses the efficacy of breast cancer screening by the sum of its benefits and harms, and recommends against routine screening mammography because of its relatively great harms for women aged 40-49 years. Assessment of the efficacy of screening mammography should take into consideration not only its benefits but also its harms, but data regarding those harms are lacking for Japanese women.
In 2008 we collected screening mammography data from 144,848 participants from five Japanese prefectures by age bracket to assess the harms [false-positive results, performance of unnecessary additional imaging, fine-needle aspiration cytology (FNA), and biopsy and its procedures].
The rate of cancer detected in women aged 40-49 years was 0.28%. The false-positive rate (9.6%) and rates of additional imaging by mammography (5.8%) and ultrasound (7.3%) were higher in women aged 40-49 years than in the other age brackets. The rates of FNA (1.6%) and biopsy (0.7%) were also highest in women aged 40-49 years. However, they seemed to be lower than the rates reported by the Breast Cancer Surveillance Consortium (BCSC) and other studies in the US.
The results, although preliminary, indicate the possibility that the harms of screening mammography for Japanese women are less than those for American women.
美国预防服务工作组通过权衡乳腺癌筛查的益处和危害来评估其效果，并建议对 40-49 岁女性不进行常规筛查性乳房 X 光检查，因为其对女性的危害相对较大。评估筛查性乳房 X 光检查的效果不仅应考虑其益处，还应考虑其危害，但缺乏针对日本女性的这些危害的数据。
我们于 2008 年通过年龄组收集了来自日本五个县的 144848 名参与者的筛查性乳房 X 光检查数据，以评估危害（假阳性结果、进行不必要的额外影像学检查、细针抽吸细胞学检查（FNA）、活检及其程序）。
40-49 岁女性中癌症检出率为 0.28%。40-49 岁女性的假阳性率（9.6%）和额外乳房 X 光检查（5.8%）和超声检查（7.3%）的比例高于其他年龄组。FNA（1.6%）和活检（0.7%）的比例也在 40-49 岁女性中最高。然而，这些比率似乎低于乳腺癌监测联盟（BCSC）和美国其他研究报告的比率。
尽管结果初步表明，日本女性筛查性乳房 X 光检查的危害可能小于美国女性，但仍需进一步研究。
