４９歳以下の乳癌検診における超音波検査の有用性について

DOI 被引用文献10件 参考文献18件

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  • Usefulness of Ultrasound Mass-Screening for Breast Cancer in Women Aged Under 50

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In 2000, the Japanese Ministry of Health and Welfare recommended mammographic mass-screening for breast cancer in women aged 50 or over every other year, whereas traditional physical examination by mass-screening alone was recommended for women aged under 50. We investigated whether ultrasound mass-screening for breast cancer was feasible and sufficiently reliable for women in both of these age groups, and also studied whether it was superior to physical examination alone by reviewing cases of non-palpable breast cancer.<BR>The overall data for ultrasound mass-screening over a period of 14 years showed that the rate of breast cancer detection in women aged under 50 and those aged 50 or more was O.11% and 0.13 %, the sensitivity was 92.9% and 94.9%, and the specificity was 93.5% and 96.1%, respectively, the differences being non-significant. However, we also confirmed that the positive predictive value for women aged under 50 was 1.7%, which was significantly (p<0.005) lower than the value of 3.3% for women aged 50 or over. Furthermore, the rate of recall for a second examination was 7.3 % for women aged under 50, which was significantly (p<0.001) higher than the value of 4.4% for women aged 50 or over.<BR>On the other hand, non-palpable breast cancer detected by ultrasound examination accounted tor 25% of all breast cancers in women aged under 50, all of them were very small tumors less than 10 mm in diameter, and 90% of them were invasive. These results show that mass-screening by physical examination alone overlooks one fourth of all breast cancers in women aged under 50, raising the possibility that these cases would continue to grow into advanced cases in women beyond 50 years of age. We conclude that ultrasound mass-screening is as effective for detection of breast cancer in women aged under 50 as it is for detection in women aged 50 or over, and is superior to mass-screening by physical examination alone.

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