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Following the Japanese government's change of policy in 1999, financing for cancer screening is no longer subsidised by the state, and local authority-led breast cancer screening faces a turning point with the introduction of mammography (MMG). We reviewed the effectiveness of breast cancer screening in Yokohama City in 1997 in order to obtain basic data for future policy making.<BR>Subjects : A total of 1, 380 subjects had been screened as positive for cancer. Detailed data were obtained in 67 out of 70 cases by reviewing the hospital charts. In our study these 67 subjects were matched by age with 67 controls who had received treatment during the same period. Results : The rates of occurrence where a detailed examination (exam.) was recommended in Gynecology (G), Internal Medicine (M), and Surgery (S) were 3.7% in 17, 938 cases at 68 institutions, 3. 1% in 2, 252 cases at 28, and 7.0% in 9, 195 cases at 65, respectively. Of the subjects, 59.6% in G, 84.1% in M and 81.4% in S were clinically diagnosed at the exam. The referral rates to other institutions were 76.5% in G, 82.6% in M, and 18.5% in S. The exam. was carried out in 229 cases at 16 institutions (G), 32 cases at four (M), and 1, 115 cases at 80 (S), and results without detailed information were only obtained in four cases. Ultrasonography (US) alone was used as a diagnostic method at the exam. in 75% of cases in G, 100% of cases in M, and 17% of cases in S whilst 60% in S were detected using combined mammography (MMG) /US, cytology, biopsy, MM, and other methods. The final diagnosis was benign in nine cases out of 79, who were diagnosed as having cancer at the exam. In the case control study, more than 85% of the screening group (Group S) had subjective symptoms and this was the same in the control group (Group C). The rate and number of cases of stage I cancer or lower were not significantly different between the two groups. Conclusion : Upon investigation, the present screening is far from ideal and is not contributing to the early detection of cancer. An MMG screening method should be introduced with guidelines.
- 日本乳癌検診学会の論文
日本乳癌検診学会 | 論文
- Characteristics of Patients with Interval Breast Carcinomas.
- Evaluation of Mass Screening for Breast Cancer Conducted under the Health and Medical Service Law for the Elderly and the Actual Conditions of Health Insurance Administration in Zentsuji City.
- Two Cases of Mucinous Carcinoma of the Breast Manifested as Interval Cancer.
- Breast-Conserving Therapy for Breast Cancer Patients Showing Mammographic Evidence of Calcification.
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