Effect of mass screening mammography on staging of carcinoma of the breast in women.

In 1980, our institution began a screening mammography program. A retrospective review was done to document whether or not implementation of this program significantly changed the method of discovery of carcinoma of the breast and the stage of carcinoma of the breast at presentation in the patients we studied. Women diagnosed with carcinoma of the breast during a three year period, prior to the institution of the screening program (group 1) were compared with a similar set of patients diagnosed after establishment of the program (group 2). There were 165 patients in group 1 and 181 in group 2. The vast majority of cancers for those in group 1, 84.2 per cent, were discovered at self-examination, as compared with 46.3 per cent for those in group 2. Forty-eight per cent of the cancers for those in group 2 were first discovered by mammography as compared with 6.1 per cent in group 1. There was no statistical difference in the number of patients presenting with stage O, III and IV disease. The percentage of patients presenting with stage I disease rose significantly after the establishment of the mammography program (16.4 per cent in group 1 to 41.5 per cent in group 2). Findings from this study confirm that a mammographic screening program can have a marked effect on lowering the stage of carcinoma of the breast at presentation. The current recommendations for screening mammography should be implemented. Doing so will result in earlier detection and improved survival in this group of patients.