Screening for breast cancer: some clinical aspects

Abstract

There is little doubt that screening by palpation and mammography will reduce the mortality from breast cancer. Most of the studies have been designed to test survival difference and, following diagnosis, patients were treated by a variety of surgeons and methods. We present clinical and pathological data on 32 asymptomatic patients who were screened and found to have breast cancer. Investigation and treatment was performed by one surgeon according to a defined protocol. We confirm that mammography is a more sensitive diagnostic tool than palpation and describe how a review of the patient with the suspicious mammogram will increase the incidence of palpable tumours. We stress the importance of fine-needle aspiration cytology as a diagnostic and localization method. The low incidence of axillary node metastasis in patients with invasive carcinoma is described. More importantly, no patient in this series required treatment by mastectomy. In our experience patients with breast cancer detected by screening are eminently suitable for treatment by breast conservation.

The Operative Management of Screen‐detected Breast Cancers

“…It has been suggested that 70–88% of mammographically detected breast cancers are suitable for breast conservation, compared with only 50–60% of those detected clinically. 9,10 Despite the high potential for breast conservation among women with screen‐detected breast cancers, few if any centres are realizing the suggested rates. 9,11–14 …”