４０歳代乳癌検診における存在診断と質的診断

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  • What is the Most Effective Method of Breast Cancer Screening for Women in Their 40s ?

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We set out to determine the most effective method of breast cancer screening for women in their 40s by comparing the sensitivities of physical examination (PhE), mammography (MMG) and ultrasound (US) in patients with primary breast cancer. One hundred and seventy-three patients aged 30-59y were enrolled in the study and allocated among 3 groups : 30-39y (group A : n = 20); 40-49y (group B : n = 84) and 50-59y (group C : n = 69). The diagnoses tested by each modality were cancer, suspicious cancer, benign and normal. Cancer and suspicious cancer were considered positive. There were no significant differences in T-factor, stage and histologic type among the 3 groups. The sensitivity of PhE alone was 85% in A, 87% in B and 88% in C. The sensitivity of MMG alone was 85% in A, 69% in B and 88% in C. The number of category 1 diagnoses (no abnormal findings) with mammography alone in group B was 25% : higher than in A (15%) and C (4%). In contrast, the sensitivity of US was 94% in A, 91% in B and 92% in C : these results were superior to those with MMG alone in all age groups. The combination of PhE and MMG was most effective in group C. The combination of PhE and US gave a higher sensitivity than the PhE-MMG combination in groups A and B, while in group C the sensitivity of the PhE-MMG combination was the same as that of PhE and US.

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