Ohuchi N, Yoshida K, Kimura M, Ouchi A, Shiiba K, Ohnuki K, Fukao A, Abe R, Matsuno S, Mori S
Second Department of Surgery, Tohoku University School of Medicine, Sendai.
Jpn J Cancer Res. 1995 May;86(5):501-6. doi: 10.1111/j.1349-7006.1995.tb03084.x.
False negative rates were compared in two screening modalities, physical examination with or without mammography, in an intervention study for women aged over 50 in Miyagi Prefecture. Thirty-five breast cancers were detected in 12,515 subjects who participated in the trial consisting of physical examination and mammography, whereas 44 breast cancers were detected in 50,105 subjects who received physical examination alone, so that the detection rates were 0.28% and 0.09%, respectively. Among 50,061 subjects who received physical examination alone, 8 women were diagnosed as having breast cancer within 12 months after the screening, while only one of 12,480 screenees receiving the combined modality was so diagnosed, implying false negative rates of 15.4% and 2.8%, respectively. When the screening sensitivity in the combined system was analyzed according to each single modality, the false negative rate provided by physical examination with mammography turned out to be 2.8%, significantly lower than that (33.3%) by the physical examination alone. Minimal breast cancers represented 25.7% of all screen-detected cancers in the combined modality, compared with 9.1% in the modality without mammography. The trial thus indicates that physical examination combined with mammography may be an appropriate modality for breast cancer screening in women aged over 50 on the basis of screening sensitivity.
在一项针对宫城县50岁以上女性的干预研究中，比较了两种筛查方式（单纯体格检查以及联合乳房X光检查的体格检查）的假阴性率。在12,515名参与了包括体格检查和乳房X光检查的试验的受试者中，检测出35例乳腺癌，而在仅接受体格检查的50,105名受试者中，检测出44例乳腺癌，因此检测率分别为0.28%和0.09%。在仅接受体格检查的50,061名受试者中，8名女性在筛查后12个月内被诊断为患有乳腺癌，而在接受联合检查方式的12,480名受检者中，只有1人被如此诊断，这意味着假阴性率分别为15.4%和2.8%。当根据每种单一方式分析联合系统中的筛查敏感性时，联合乳房X光检查的体格检查所提供的假阴性率为2.8%，显著低于单纯体格检查的假阴性率（33.3%）。在联合检查方式中，微小乳腺癌占所有筛查发现癌症的25.7%，而在未进行乳房X光检查的方式中这一比例为9.1%。因此，该试验表明，基于筛查敏感性，联合乳房X光检查的体格检查可能是50岁以上女性乳腺癌筛查的合适方式。
