Abstract

A substantial short-term reduction in mortality from breast cancer h as been obtained in a study group of 31000 women following the mammography project of the Health Insurance Plan of Greater New York. 1/3 of cancers found would have been undetected by clinical examination. The study included an initial and 3 subsequent annual examinations. Cancers were detected after 1 year of previous negative findings. The mammography was carried out with special portable X-ray e quipment using 70 mm film. The X-ray technicians have developed skill as prescreeners in reading mammograms. Paramedical personnel have been trained to do clinical examinations of the breasts while others have been trained in thermography. The entire examination can be completed in 10 minutes. It consists of an interview a clinical examination mammography and thermography. These methods are considered complementary. X-ray is omitted in patients under age 35. 6604 initial examinations were made the 1st year. 494 biopsies were performed. 55 cancers (8.3 per 1000) were found. Of these 19 were found on clinical examination 10 by mammography alone and 26 by 2 or more methods. This high detection rate was thought to be due to self-selection factors by the self-referred women. Follow-up care was provided by hospitals in the city. Papanicolaou cervical screening and chest X-rays were added at 1 center. A mobile van has been developed for use in many communities. To develop motivation and acceptance by women of each area a corps of health aids canvassed the community on a person-to-person basis.

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