Mass screening to reduce mortality from breast cancer.

It is generally agreed that the best and possibly the only means to reduce mortality in breast cancer is to detect the disease in its early, most curable stage. This usually means detection when nodes are negative and often when the lesion is nonpalpable. The best method with which to achieve this goal is periodic examination including clinical study and mammography when the woman is apparently well, as is done in mass screening. This applies today to all women over 40 yr old. A baseline examination at age 35 yr is helpful. Radiation risk is today considered to be minimal, if any, and probably is not even measurable. Cost is important. The dedication of the screening institution is most important in this regard. The chief stumbling block is a lack of motivation on the part of subjects to accept or even demand the examination. This needs to be stimulated through contacts with women directly and with their physicians.