乳腺癌筛查能降低死亡率吗？来自雅芳地区第一年筛查的证据。
Will screening for breast cancer reduce mortality? Evidence from the first year of screening in Avon.
作者信息
Nicholson S, Webb A J, Coghlan B, Farndon J R, Armstrong J S, Davies J D
机构信息
Regional Breast Screening Pathology Unit, Southmead Hospital, Bristol.
出版信息
Ann R Coll Surg Engl. 1993 Jan;75(1):8-11; discussion 12.
In the first year of screening in Avon, 93 malignant lesions were detected of which one-half were impalpable. Of the impalpable lesions, one-half were in situ or showed areas of microinvasion only. One-fifth of the malignant lesions were invasive tumours of special histological type which are known to carry a good prognosis even when not detected by screening. One-quarter of the lesions had clinical or pathological features which would be expected to confer a poor prognosis. Only 16 invasive ductal carcinomas measuring 1 cm or less in diameter were detected--a small proportion of the total number of malignant lesions. Although these early figures suggest that the effect of screening on mortality from breast cancer may be small, continued high-quality screening and careful detailed analysis are essential to determine the effect of screening on the mortality from breast cancer and the effect on the population as a whole.
在雅芳进行筛查的第一年，检测出93个恶性病变，其中一半触诊不到。在触诊不到的病变中，一半是原位癌或仅显示微浸润区域。五分之一的恶性病变是特殊组织学类型的浸润性肿瘤，即使未通过筛查发现，其预后也较好。四分之一的病变具有预期预后不良的临床或病理特征。仅检测到16例直径1厘米或更小的浸润性导管癌，占恶性病变总数的一小部分。尽管这些早期数据表明筛查对乳腺癌死亡率的影响可能较小，但持续进行高质量筛查和仔细详细分析对于确定筛查对乳腺癌死亡率的影响以及对整个人口的影响至关重要。
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