Greenwald P, Nasca P C, Lawrence C E, Horton J, McGarrah R P, Gabriele T, Carlton K
N Engl J Med. 1978 Aug 10;299(6):271-3. doi: 10.1056/NEJM197808102990602.
We examined the effects of breast self-examination and breast examination by physicians on the stage of breast cancer at diagnosis. Clinical and pathological-staging information was compared to interview data on method of initial detection of 293 women. Tumors were detected in clinical Stage I 53.8% of the time when the detection method was routine physician examination, 37.7% when it was self-examination and only 27.0% when detection was accidental. Sixty-nine per cent of women practicing self-examination at the time of diagnosis discovered their tumor by this method. Differences were less apparent when pathological stage was considered. Tumors found during routine examination of the breast averaged 6.1 mm smaller in diameter than those discovered accidentally. We estimate that breast-cancer mortality might be reduced by 18.8% to 24.4% through self-examination or routine physician examination, respectively.
我们研究了乳房自我检查和医生乳房检查对乳腺癌诊断时分期的影响。将临床和病理分期信息与293名女性的初次检测方法访谈数据进行了比较。当检测方法为常规医生检查时，53.8%的肿瘤在临床I期被检测到；当检测方法为自我检查时，这一比例为37.7%；而当检测是偶然发现时，这一比例仅为27.0%。69%在诊断时进行自我检查的女性通过这种方法发现了她们的肿瘤。当考虑病理分期时，差异不太明显。在乳房常规检查中发现的肿瘤直径平均比偶然发现的肿瘤小6.1毫米。我们估计，通过自我检查或常规医生检查，乳腺癌死亡率可能分别降低18.8%至24.4%。
