乳癌診断における超音波検査の有用性と検診導入への問題点

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  • Usefulness of Ultrasound in the Diagnosis of Breast Cancer and Problems with its Use in Screening

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While ultrasound may be useful in health screening for identifying early-stage breast cancer that cannot be detected by mammography (MMG), it can potentially increase the number of patients with benign disease requiring further testing. In order to ascertain the usefulness of breast ultrasound and its associated problems, MMG and ultrasound were performed at our institution from April 1, 2000 to April 30, 2005. The subjects were 4, 383 women in whom diagnosis was made by either cytological or histological analysis.<BR>Women in whom lesions were identified by ultrasound but not by MMG were extracted, and their age and clinical diagnosis were ascertained. Of 1, 072 subjects with breast cancer, the malignant lesions were detected by ultrasound but not by MMG in 129 patients. Of these patients, the most common age group was 40-49 years (n = 57, p< 0. 0001) and the most common histologic type was ductal carcinoma in situ (DCIS) (n = 47, p< 0. 0001). Of 3, 311 subjects with benign disease, the lesions were detected by ultrasound but not by MMG in 1, 356 patients. The most common benign lesion was fibroadenoma (n = 367).<BR>These results suggest that breast ultrasound is useful for early detection of breast cancer especially for women in their 40s or younger. Moreover, in order to use ultrasound practically for health screening, it will be necessary to improve diagnostic performance and facilitate categorization.

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