{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390001288118897408.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.3804/jjabcs.24.132"}},{"identifier":{"@type":"URI","@value":"https://www.jstage.jst.go.jp/article/jjabcs/24/1/24_132/_pdf"}},{"identifier":{"@type":"NAID","@value":"130007396925"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2015206391"}}],"dc:title":[{"@language":"ja","@value":"検診発見乳癌の視触診・マンモグラフィ・乳房超音波での検出特徴と 視触診省略についての検討"},{"@language":"en","@value":"Search for an Effective Combination of Examination Methods for Detection of Breast Cancers at Screening"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"Clinical breast examination（CBE）including inspection and palpation, mammography（MMG） and ultrasonography（US）have mainly been used for breast cancer screening, and each have different rates of cancer detection or undetectability according to their specific characteristics. We tried to search for a combination of examination methods that would facilitate effective breast cancer detection at screening, and the possibility of excluding CBE for routine screening was discussed. During a period of 2 years and 10 months, from January 2009 through October 2012, a total of 16,112women underwent screening at our institutions and 44 were found to have breast cancers. Their records at the time of initial screening, detailed examination and surgical operation were reviewed. The cancer detection rates were 40.9％ for CBE only, 90.9％ for mammography only, 97.7％ for US only, 100％ for CBE and MMG, 97.7％ for CBE and US, and 100％ for MMG and US. With regard to the stage of cancers at the time of detection, 0％ detected by CBE only were Stage0, which was a lower rate of detection than that for Stage I cancers by CBE only compared with those detected by other single examination methods, and the detection rate for Stage II cancers by any of the three methods was the same. The cancers not detected by CBE were those with calcification（which were detected by MMG）and small cancers less than 2cm in diameter（which were detected by US）. Cancers not detected by MMG were those in young individuals, those located in a dense breast mass, and small cancers less than 1.5cm in diameter（which were detected by US）. Cancers undetectable by US were those with calcification（which were detected by MMG） . From the above results, a combination of MMG and US appears to yield the best cancer detection rate. Stage analysis of detected cancers revealed that CBE was the least effective examination method. A combination of MMG and US proved to be effective for mutually detecting specific types of cancers that are difficult to visualize by any one of the two methods alone. CBE may be omitted from mass screening provided that screenees having symptoms are excluded by initially treating them as patients."},{"@language":"ja","@value":"現在，視触診（CBE），マンモグラフィ（MMG），乳房超音波（US）いずれかとその組合せが検診に最適かの議論があり，特にCBEは省略可能かについての議論があるが，一定の見解に至っていない。今回，モダリティ別の検出率や検出されない乳癌の特徴を検討 し，CBEが省略可能かについて明らかにすることを目的とした。 2009年1月～2012年10月に当施設での乳癌検診受診者のべ16,112人の女性のうち，44例 の発見乳癌を対象とし，検診・精検・手術記録を調査した。 検出率は，CBE単独40.9％，MMG 単独90.9％，US単独97.7％であり，CBE＋MMG 100％，CBE＋US 97.7％，MMG＋US 100％であり，CBE単独はいずれに比しても有意に低かった。発見時病期別では，Stage0でCBE単独の発見はなく，StageⅠまではCBE単独が他のモダリティ単独より検出率が低く，StageⅡで他と同様となった。検出されない乳癌の特徴は，CBEは「MMG で石灰化」 「USで2cm以下の腫瘤」 ，MMG は「若年者」「高濃度乳腺」 「USで1.5cm以下の腫瘤」 ，USは「MMG で石灰化」であった。検出率の観点からはMMG＋USが最良であり，病期分析からはCBEは他に劣後する，検出されない乳癌の特徴を整理するとMMG＋USが相補的であり，以上からCBEは省略可能と考えられるが，自覚症状例を確実に医療受診とする必要があると考えられた。 検診での自覚症状例を確実に医療受診とし，MMG＋USを検診として実施すれば，検出率の観点からはCBEは省略可能であると考えられた。"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410001204464955525","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000018670168"},{"@type":"NRID","@value":"9000396134312"},{"@type":"NRID","@value":"9000345430088"},{"@type":"NRID","@value":"9000345430081"},{"@type":"NRID","@value":"9000242093224"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/msugiyama"}],"foaf:name":[{"@language":"ja","@value":"杉山 迪子"},{"@language":"en","@value":"Sugiyama Michiko"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"社会医療法人財団石心会埼玉石心会病院乳腺内分泌外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410853649221998848","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000256520503"}],"foaf:name":[{"@language":"ja","@value":"大塚 博紀"},{"@language":"en","@value":"Otsuka Hironori"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"社会医療法人財団石心会さやま総合クリニック健診センター"}]},{"@id":"https://cir.nii.ac.jp/crid/1410853649221998849","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000396134314"}],"foaf:name":[{"@language":"ja","@value":"児玉 ひとみ"},{"@language":"en","@value":"Kodama Hitomi"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"社会医療法人財団石心会埼玉石心会病院乳腺内分泌外科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"09180729"},{"@type":"EISSN","@value":"18826873"}],"prism:publicationName":[{"@language":"en","@value":"Nihon Nyugan Kenshin Gakkaishi (Journal of Japan Association of Breast Cancer Screening)"},{"@language":"ja","@value":"日本乳癌検診学会誌"},{"@language":"en","@value":"J.Jpn. Assoc.Breast Cancer Screen."},{"@language":"ja","@value":"日乳癌検診学会誌"},{"@language":"en","@value":"J. Jpn. Assoc. Breast Cancer Screen. Journal of Japan Association of Breast Cancer Screening"}],"dc:publisher":[{"@language":"en","@value":"Japan Association of Breast Cancer Screening"},{"@language":"ja","@value":"特定非営利活動法人　日本乳癌検診学会"}],"prism:publicationDate":"2015","prism:volume":"24","prism:number":"1","prism:startingPage":"132","prism:endingPage":"138"},"reviewed":"false","url":[{"@id":"https://www.jstage.jst.go.jp/article/jjabcs/24/1/24_132/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2015206391"}],"availableAt":"2015","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E4%B9%B3%E7%99%8C%E6%A4%9C%E8%A8%BA","dc:title":"乳癌検診"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%A6%96%E8%A7%A6%E8%A8%BA","dc:title":"視触診"},{"@id":"https://cir.nii.ac.jp/all?q=%E3%83%9E%E3%83%B3%E3%83%A2%E3%82%B0%E3%83%A9%E3%83%95%E3%82%A3","dc:title":"マンモグラフィ"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%B9%B3%E6%88%BF%E8%B6%85%E9%9F%B3%E6%B3%A2","dc:title":"乳房超音波"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%A4%9C%E5%87%BA%E7%8E%87","dc:title":"検出率"},{"@id":"https://cir.nii.ac.jp/all?q=breast%20cancer%20screening","dc:title":"breast cancer screening"},{"@id":"https://cir.nii.ac.jp/all?q=clinical%20breast%20examination","dc:title":"clinical breast examination"},{"@id":"https://cir.nii.ac.jp/all?q=mammography","dc:title":"mammography"},{"@id":"https://cir.nii.ac.jp/all?q=ultrasonography","dc:title":"ultrasonography"},{"@id":"https://cir.nii.ac.jp/all?q=cancer%20detection%20rate","dc:title":"cancer detection rate"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2004293707"},{"@type":"CROSSREF","@value":"10.3804/jjabcs.24.132"},{"@type":"CIA","@value":"130007396925"}]}