J.Jpn. Surg. Soc.. 122(3): 297-302, 2021

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Feature topic

CURRENT STATUS AND ISSUES OF BREAST CANCER SCREENING

Japan’s countermeasure-type breast cancer screening was introduced using the visual and palpation method in 1987. By 2000, it had evolved into mammography screening with better control of accuracy which has shown evidence of mortality reduction. During that time, a decrease in the diagnostic accuracy of mammography in young people was confirmed, and the J-START trial was carried out among women in their 40s to verify the effectiveness of the additional effect of ultrasonography. Although increased sensitivity was confirmed, the disadvantage of decreased specificity was also reported, and a comprehensive judgment method was proposed as an attempt to overcome it. Furthermore, since J-START targeted people in their 40s, many of whom have high-density breast tissue, much knowledge has been obtained regarding the high-density breast problem for which countermeasures are currently required, and analysis of the mortality reduction effect is awaited. In recent years, the importance of breast awareness, which is a medical policy along with physical examinations, has been recognized, and widespread recognition of its importance in Japan is an important issue for the future. Breast cancer screening has matured after a long period of 20 years, but it is necessary to continue efforts to improve it.

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