Mammography as a screening method for the examination of large populations

Abstract

The technical and scientific information is presently available which, if properly utilized, could facilitate the early diagnosis of breast cancer. Hopefully, it could likewise reduce the high mortality rate of breast cancer. Due to the lack of adequately trained professional and allied health personnel, a massive screening program on a national scale is unwarranted and would be unproductive at this time. Based upon our experience in the U.C.L.A. Center for Health Sciences, the establishment of screening clinics for women 40 years of age and over in conjunction with a cervical cancer detection clinic in a number of large medical centers is indicated. Thermography as a prescreening modality should be investigated further.

A Note on the Cost-Benefit Problem in Screening for Breast Cancer

“…[27] we take the information that the percentage of patients with axillary nodes is 30 in the screening and 54 in the control group. Similar figures (27 versus 60) are reported by DOWDY et al [8]. Adopting the H.I.P.…”

“…2.) Equally important is the fact that the cost differential would even become larger if s were taken three times [23] or even five times [8] as high as our value of s = 5. Since s is contained in each term of C l , one would have to add simply the difference in 's to our C l value of 10 to obtain C l as 20 or 30.…”

“…A number of comments on the results just stated are in order, before proceeding to matters of benefit: OJ A rate as high as 13 per 1000 is reported from a cervical cancer detection clinic which offers breast examination as an additional service [8]. oOJ This, of course, implies a P value of 14/7214, about two per thousand, that is half the value just adopted.…”

“…DOWDY et al [8] have stated that »late care of a breast cancer patient is considered to cost $ 4707 more than for a patient with early breast cancer«. This statement appears to be the result of a misreading of a fairly complicated table in the document just quoted [26].…”

Breast cancer screening: Preliminary report of 207 biopsies performed in 4,128 volunteer screenees

“…We base this decision on the fact that a frequently reported positive biopsy rate in surgical series based on physical examination alone hovers around the 20% level. 2*16*' 3 As can be seen from our results, the anticipated 10% positive biopsy rate was exceeded by 70%, 17% of the 207 biopsies examined being malignant. Only 28% of the carcinomas detected were invasive and later than Stage I.…”