Mittra I
Department of Surgery, Tata Memorial Hospital, Bombay, India.
Lancet. 1994 Feb 5;343(8893):342-4. doi: 10.1016/s0140-6736(94)91170-3.
Many studies have shown that screening for breast cancer can reduce mortality from the disease. Mammography has come to be regarded as the screening method of choice, but evidence suggests that physical examination (PE) is at least as effective in reducing mortality. Mammography detects many non-infiltrating and small, non-palpable tumours, but we do not know whether these would ever cause symptoms or threaten the woman's life. It is doubtful whether the time gained by early mammographic detection confers any survival benefit over PE detection. PE has substantial advantages over mammography in terms of human and economic costs. The question we should be asking is not how to refine mammographic screening but whether we need it at all.
许多研究表明，乳腺癌筛查可降低该病的死亡率。乳房X线摄影术已被视为首选的筛查方法，但有证据表明，体格检查（PE）在降低死亡率方面至少同样有效。乳房X线摄影术能检测出许多非浸润性且不可触及的小肿瘤，但我们不知道这些肿瘤是否会引发症状或威胁女性生命。早期通过乳房X线摄影术检测所争取的时间是否比通过体格检查检测能带来更多生存益处，这一点尚不确定。在人力和经济成本方面，体格检查比乳房X线摄影术具有显著优势。我们应该问的问题不是如何改进乳房X线摄影筛查，而是我们究竟是否需要它。
