Clinicopathological Analysis of Mass Screening for Breast Cancer

• Published in: Journal of Japan Association of Breast Cancer Screening Vol. 5; no. 1; pp. 41 - 46
• Main Authors: Akiyama, Futoshi, Suzuki, Koichi, Sakamoto, Goi
• Format: Journal Article
• Language: Japanese
• Published: Japan Association of Breast Cancer Screening 1996
• Subjects: advanced cancer; breast cancer; mass screening; microcalcification; pathology
• ISSN: 0918-0729; 1882-6873
• DOI: 10.3804/jjabcs.5.41

The endpoint of mass screening for breast cancer is to detect the cancer when it is still at an early stage and/or only a small mass. It seems that mammography is most useful for detecting breast cancer at an early stage, especially when it is a non-palpable mass. Clinicopathological studies on the natural history of breast cancer have indicated that almost all latent breast cancers found as areas of microcalcification develop to clinical-stage breast cancer within a 20-year period. About 30% of breast cancers are found by wedge resection examination for cases of microcalcification. This indicates that the remaining 70% of patients undergo excessive surgery. Lesions found as areas of microcalcification are very small and mainly papillary lesions, which are the most difficult to diagnose pathologically. Therefore, it is very important to establish a reliable pathological diagnostic procedure for microcalcification cases. Twelve (11%) of 114 patients with stage III breast cancer treated at the Cancer Institute Hospital between 1992 and 1993 had been diagnosed as having benign lesions at other hospitals. Under the present circumstances, the most efficient approach is to educate women about self-examination in order to find breast cancers less than 2 cm in diameter to reduce the incidence of breast cancer death, since the10-year survival rate for this group is 90%. We would save more than 4, 000 women's lives a year if all breast cancer patients in Japan could be treated when their tumors were less than 2 cm in diameter.