VALUE OF MAMMOGRAPHY IN REDUCTION OF MORTALITY FROM BREAST CANCER IN MASS SCREENING

¹ Clinical Associate Professor, Department of Community and Preventive Medicine, New York Medical College; and Director of Radiology, La Guardia Hospital, New York.
² Director of Surgery, Jewish Memorial Hospital, New York; and Associate Clinical Professor of Surgery, New York Medical College, New York.
³ Director of Research and Statistics, Health Insurance Plan.

A randomized mass screening program using mammography as well as clinical examination in women aged 40 to 64 years resulted in a higher proportion of breast cancer detected with no axillary lymph node involvement and subsequently a substantial reduction in mortality in a study group as compared to a matched control. Both clinical examination and mammography contributed independently to the yield. However, in women under 50 in this study, mammography led to detection of only a small proportion of additional cases, while at age 50 years and over omission of either modality would have led to substantially lower cancer detection rates. The particularly substantial contribution of mammography is underscored by a case fatality rate of only 2 per cent in cancers detected in mammography alone.

It would be reasonable to conclude that further follow-up to determine long-term effect of the screening procedures is indicated.

It would also seem useful to evaluate the contribution of newer improved methods of mammography and introduction of other modalities such as thermography in improving results in women under 50 years of age.

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