Kopans D B, Moore R H, McCarthy K A, Hall D A, Hulka C A, Whitman G J, Slanetz P J, Halpern E F
Department of Radiology, Massachusetts General Hospital, Boston, USA.
AJR Am J Roentgenol. 1997 Jan;168(1):29-31. doi: 10.2214/ajr.168.1.8976914.
Our objective was to determine whether it is scientifically justified to require that women with implants or a history of treatment for breast cancer be screened in a diagnostic mammography setting and that they be excluded from mammography screening programs.
The recall rates for women with breast implants or a history of treatment for breast cancer who were screened in a dedicated mammography screening program were compared with those of other women in the screening program. The computerized records for the breast screening program of the Department of Radiology at our institution for January 1, 1990, through December 31, 1995, were reviewed. The recall rates for women who had breast implants and those for women with a history of treatment for breast cancer were compared with the recall rates for the other women who underwent screening. Each recall rate included women who were called back for additional evaluation in addition to those for whom a biopsy was recommended on the basis of the screening study.
Of 45,134 screening examinations done during the review period, 43,454 (96%) were for women who had no history of breast cancer or of breast implants; 590 (1%) were for women who had undergone mastectomy; 991 (2%) were for women who had been treated with lumpectomy and irradiation for breast cancer; and 99 (0.2%) were for women with breast implants. Among the 43,454 examinations of women with no history of breast cancer or implants, 3081 examinations (7%) led to interpretations that produced requests for the patient to return for additional evaluation. Thirty-six women who had been treated for breast cancer by mastectomy were recalled (6%). Seventy-five women who had undergone lumpectomy and irradiation for breast cancer were recalled (8%). Five women with breast implants were recalled (5%). Statistically, these rates were not significantly different.
We find no scientific reason to exclude women who have been treated for breast cancer or who have breast implants from dedicated screening programs.
我们的目的是确定要求患有植入物或有乳腺癌治疗史的女性在诊断性乳腺摄影环境中进行筛查，并将她们排除在乳腺摄影筛查项目之外是否具有科学依据。
将在专门的乳腺摄影筛查项目中接受筛查的患有乳房植入物或有乳腺癌治疗史的女性的召回率与筛查项目中的其他女性的召回率进行比较。回顾了我们机构放射科1990年1月1日至1995年12月31日的乳腺筛查项目的计算机记录。将有乳房植入物的女性和有乳腺癌治疗史的女性的召回率与接受筛查的其他女性的召回率进行比较。每个召回率包括被召回进行进一步评估的女性，以及那些根据筛查研究建议进行活检的女性。
在审查期间进行的45134次筛查检查中，43454次（96%）是针对没有乳腺癌或乳房植入物病史的女性；590次（1%）是针对接受过乳房切除术的女性；991次（2%）是针对接受过乳腺癌保乳手术和放疗的女性；99次（0.2%）是针对有乳房植入物的女性。在43454次没有乳腺癌或植入物病史的女性检查中，3081次检查（7%）的解读结果要求患者返回进行进一步评估。36名接受过乳房切除术治疗乳腺癌的女性被召回（6%）。75名接受过乳腺癌保乳手术和放疗的女性被召回（8%）。5名有乳房植入物的女性被召回（5%）。从统计学上看，这些比率没有显著差异。
我们没有发现科学依据将接受过乳腺癌治疗或有乳房植入物的女性排除在专门的筛查项目之外。
