Blamey R W, Locker A P, Mitchell A K, Caseldine J
Department of Surgery, City Hospital, Nottingham, England.
Acta Oncol. 1989;28(6):869-71. doi: 10.3109/02841868909092322.
The Nottingham breast self-examination (BSE) project forms a part of the British Trial of Early Detection of Breast Cancer which compares mammographic screening, BSE and control areas. Presented here is an analysis of the Nottingham figures. A total of 89,000 women aged 40-64 were invited for lectures in BSE and 28,000 attended (42%); the corrected attendance allowing for register inaccuracies is around 55%. In women invited for education since the scheme began in 1979 (study) 751 cancers have been diagnosed. The 751 cancers occurring in the same health district and age group, working chronologically backwards from 1979 have been identified (control). Prognostic factors (size, node involvement and grade) are improved in the study group; however, at the present time of follow-up the case survival curves do not separate. A case control study shows that women aged 50-65 who attended for education have a relative risk of death from breast cancer of 0.66 (0.45-0.97) in comparison with those who did not attend (p = 0.025). The figure for women aged 40-49 is 0.85 (0.50-1.46). A programme of BSE is cheap to run, may give a survival advantage and should be added to mammographic screening programmes, especially when the interval is beyond 18 months.
诺丁汉乳房自我检查（BSE）项目是英国乳腺癌早期检测试验的一部分，该试验对乳房X光筛查、BSE和对照区域进行了比较。本文展示的是对诺丁汉数据的分析。共有89,000名40 - 64岁的女性被邀请参加BSE讲座，28,000人参加（42%）；考虑到登记不准确因素后的校正出席率约为55%。自1979年该计划启动以来被邀请参加教育的女性（研究组）中，已诊断出751例癌症。已确定了在同一健康区域和年龄组中，从1979年按时间顺序逆向发生的751例癌症（对照组）。研究组的预后因素（肿瘤大小、淋巴结受累情况和分级）有所改善；然而，在目前的随访阶段，病例生存曲线并未分开。一项病例对照研究表明，与未参加教育的女性相比，参加教育的50 - 65岁女性死于乳腺癌的相对风险为0.66（0.45 - 0.97）（p = 0.025）。40 - 49岁女性的这一数字为0.85（0.50 - 1.46）。BSE项目实施成本低廉，可能具有生存优势，应添加到乳房X光筛查项目中，尤其是当筛查间隔超过18个月时。
