Ohuchi N, Yoshida K, Kimura M, Ouchi A, Kamioki S, Shiiba K, Matoba N, Kojima S, Takahashi K, Matsuno S
Second Department of Surgery, Tohoku University School of Medicine, Sendai.
Jpn J Cancer Res. 1993 Jul;84(7):807-12. doi: 10.1111/j.1349-7006.1993.tb02048.x.
A cohort study to compare mass screening with and without mammography was conducted in Miyagi Prefecture, Japan in order to establish whether the effectiveness of breast cancer screening would be improved when mammography was combined with physical examination. A trial of mass screening combined with mammography was carried out in 9634 women aged over 50. Lateral imaging of the breast using single-view film mammography was performed at the first stage of mass screening in addition to physical examination of the breast. Results in the trial were compared with those obtained in 35511 age-matched subjects without mammography. Thirty breast cancers were found in the trial with a detection rate of 0.31%, which was much higher than that (0.08%) obtained by physical examination without mammography. In 15 of the 30 patients the breast tumor was not palpated at the first screening, but abnormal findings were detected in the mammography. A higher rate (73%) of early breast cancer was obtained in the screening trial with mammography than that (39%) obtained in the screening with physical examination alone. Mass screening combined with mammography is superior to that without mammography for breast cancer screening, especially for the detection of non-palpable, early breast cancer.
为确定乳腺钼靶检查与体格检查相结合时乳腺癌筛查的效果是否会得到改善，日本宫城县开展了一项队列研究，比较了有乳腺钼靶检查和无乳腺钼靶检查的大规模筛查情况。对9634名50岁以上女性进行了乳腺钼靶检查联合大规模筛查的试验。在大规模筛查的第一阶段，除了对乳房进行体格检查外，还使用单视图乳腺钼靶摄影对乳房进行侧位成像。将试验结果与35511名年龄匹配的未进行乳腺钼靶检查的受试者的结果进行比较。试验中发现了30例乳腺癌，检出率为0.31%，远高于未进行乳腺钼靶检查时体格检查的检出率（0.08%）。在这30例患者中，有15例在首次筛查时未触及乳腺肿瘤，但在乳腺钼靶检查中发现了异常结果。乳腺钼靶检查筛查试验中早期乳腺癌的检出率（73%）高于单纯体格检查筛查的检出率（39%）。乳腺钼靶检查联合大规模筛查在乳腺癌筛查方面优于无乳腺钼靶检查的筛查，特别是对于不可触及的早期乳腺癌的检测。
