Hormone replacement therapy 施行中における乳房検診の方法 Adequate Screening of Breast Cancer in Patients Receiving Hormone Replacement Therapy

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Hormone replacement therapy (HRT) 中の乳癌検診法についてretrospectiveに検討した。<BR>方法 : 2001年3月から2004年3月までの間に開始されたHRT482例について定期乳癌検診を実施した。方法はHRT開始前に視診, 触診, ultrasonography (US), mammography (MMG) のmediolateral oblique (MLO) 一方向撮影, 開始後6カ月でUS検査および視・触診, 1年後にはMMG二方向撮影, US検査および視・触診を行った。<BR>結果 : 482例中5例に乳癌が発見され;診断後はHRTを中止した。全例stage Iの乳頭腺管癌で, いずれも乳房温存術が可能であり, 全例1年後検診で発見された。しかし, その中の2例はUSを含めた読影技術, 2例は撮影技術, また1例は穿刺細胞診技術向上によってはより早期に発見できた可能性が高いと思われた。<BR>結論 : MMG読影が未使用者に比し難しくなるといわれるHRT中の乳癌検診においては診断医と施設の技術向上がより一層望まれる。

Objective : Many reports have pointed out a significant risk of breast cancer in postmenopausal women undergoing hormone replacement therapy (HRT). We examined the incidence of breast cancer in such women and retrospectively evaluated the adequacy of diagnostic methods and follow-up intervals for early detection of breast cancer.<BR>Materials and Methods : Between March 2001 and March 2004, we prescribed HRT for 482 women. These women underwent physical examination, ultrasonography, and single-directional mammography (MMG) before and every 6 months after the start of HRT. Bidirectional MMG was added after 12 months.<BR>Results : Of the 482 women, stage I ductal adenocarcinoma of the breast was found in 5 patients with an average age of 54 years (51-58y). All 5 patients underwent breast preservation surgery with axillary lymph node dissection. Review of the pretherapeutic single-directional MMG demonstrated that an abnormal shadow, suggesting an early lesion, had been present in 2 of the 5 women. Therefore, cancer might have been detected in these women if we had possessed suitable instruments and achieved quality control of mammographic screening.<BR>Conclusion : The present results suggest that for women receiving HRT, ultrasonography and bidirectional MMG is desirable for earlier detection of breast cancer, and that quality control is essential.

収録刊行物

  • 日本乳癌検診学会誌 = Journal of Japan Association of Breast Cancer Screening

    日本乳癌検診学会誌 = Journal of Japan Association of Breast Cancer Screening 13(3), 305-311, 2004-09-30

    Japan Association of Breast Cancer Screening

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各種コード

  • NII論文ID(NAID)
    10013661351
  • NII書誌ID(NCID)
    AN10398771
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09180729
  • データ提供元
    CJP書誌  J-STAGE 
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