Improving the accuracy of screening by focusing on calcification in mammography screening and building a foundation for new management

2023 Fiscal Year Final Research Report

• Project/Area Number: 18K17350
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58020:Hygiene and public health-related: including laboratory approach
• Research Institution: Tohoku University
• Principal Investigator: Sato-Tadano Akiko 東北大学, 医学系研究科, 大学院非常勤講師 (50723912)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Keywords: 対策型乳がん検診 / マンモグラフィ / 検診層別化

Outline of Final Research Achievements

In order to further improve the accuracy of breast cancer screening by mammography (MG), this study examined the following items: (1) For category 3 calcifications, which have a low positive predictive value (PPV) and often represent low-grade non-invasive cancer, the usefulness of comparative reading was examined from the perspectives of both screening and screening institutions; (2) The possibility of breast composition and compression breast thickness as screening stratification factors for dense breasts, where detection sensitivity is reduced, was investigated; (3) Survey of the actual status of preventive breast cancer screening by age group in Japan, where the aging of the population is accelerating, in search of risk-stratified screening that takes into account age, medical economics, and effectiveness.

Free Research Field

腫瘍外科

Academic Significance and Societal Importance of the Research Achievements

マンモグラフィ(MG)検診開始から20年を経て成熟してきた乳癌検診であるが、限界も明らかになり、精度向上や死亡率減少の達成を目指した取り組みが継続されている。本研究により年齢階級別の対策型検診の意義が明らかになり、検診精度の向上、医療経済・効果を考慮したリスク層別化を模索する中で、年齢は重要な因子であることを報告した。また検診感度が低い高濃度乳房対策においては、MG撮影の際に得られる乳房圧迫厚が層別化の一助となる可能性を提示した。さらには陽性的中率が低いが要精査となるカテゴリー３の石灰化は比較読影の有用性を検診と精査機関の両面から検証し、６か月の経過観察期間は妥当であることを証明した。