Cases of Breast Cancer Undetected by Physical Examination, Ultrasonography and Mammography
10.2185/jjrm.55.65
- Author:
Juji TSUCHIYA
;
Masayoshi ASANO
;
Susumu TACHIBANA
;
Iwao KUMAZAWA
;
Hajime KAWAGOE
;
Masato NAWA
- Publication Type:Journal Article
- MeSH:
cisplatin/etoposide protocol;
Malignant neoplasm of breast;
Clinical examination;
Mammography;
Cases
- From:Journal of the Japanese Association of Rural Medicine
2006;55(2):65-75
- CountryJapan
- Language:Japanese
-
Abstract:
We reviewed the cases of breast cancer that had not been detected by physical examination (PE), ultrasound (US) and mammography (MMG). Of 90 cases that were diagnosed as breast cancer definitely on pathological assay, 13 cases had gone unnoticed by PE, seven by US, and 15 by MMG. Thus, the detection rate worked out at 85.6%, 92.2% and 83.3%, respectively. When the diagnoses wee made by any combination of one with another, the detection rate for joint PE/US, PE/MMG and US/MMG came to95.6%, 97.8% and 98.9%, indicating that the combined use of US and MMG was most efficient.Tumors that had been undetected by PE and MMG were significantly smaller in size than those that had been detected, but this was not the case for tumors that had gone unnoticed by US. Therefore, we considered that oversight during US examination is more likely due to difficulty making diagnostic differentiation between cancer and fatty tissue or cyst, etc. than tumor size. We found that those cases which had gotten pass PE had a significantly lower histological grade malignancy and a lower grade of invasiveness than the other cases of breast cancer, even though the former tended to show lymphatic metastasis frequently. Furthermore, all of these metastatic breast cancers had a smaller diameter ranging from 0.8cm to 0.9cm. This suggested hat we cannot afford to let them pass because they are non-palpable. At present, the Japanese Ministry of Health, Labor and Welfare are recommending the breast cancer mass-screening by use of PE in combinationwith MMG. However, because MMG is not always omnipotent and lets many breast cancer cases pass, we should conduct the mass screening with US and MMG but without PE.
