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1 Associate Professor in the Department of Community Health at the University of Kansas Medical Center in Kansas City, Kansas.
It is apparent that the BCDDP data base is unique because of the amount of information available about screening large numbers of women and about the nature of breast disease detected under screening conditions. Large numbers of women were successfully recruited into the screening program through the ACS volunteer network, and these women enthusiastically returned to the program for periodic screening and education over the five-year period. A majority of the participants came to all five annual screenings (51.7 percent). This high compliance to screening signified the importance with which women viewed the program. Of the 4,443 cancers recorded in the BCDDP population. more than 80 percent were detected by the 29 centers. Approximately one third (32.4 percent) of the 3.557 cancers detected by the centers were smaller cancers, either noninfiltrating or infiltrating cancers (<1 cm). More than 80 percent of all cancers detected showed no evidence of nodal involvement. Although there is no preselected comparison group. it is clear that a high proportion of cancers detected within the BCDDP are localized. and according to tumor registry data, these patients should have an excellent prognosis.' Physical examination and mammography both contributed cases not detected by the other, but the contribution of mammography was substantially greater. The relative contribution of mammography alone (in the absence of positive physical findings) was 41.6 percent compared with 8.7 percent for physical examinations (in the absence of positive mammogram findings.) This relative contribution of mammography was impressively high in the detection of smaller cancers—59 percent for noninfiltrating cancers and 52.6 percent for infiltrating cancers (<1 cm). The relative contribution of mammography was also impressively higher than had been shown in previous reports (the HIP study) for breast cancer detection in younger women. When mammography was removed as a routine screening modality for women under 50 years of age. the minimal cancer detection rates in this age group decreased. The information in this article represents only a part of the BCDDP data base. It is hoped that researchers from a multiplicity of disciplines will be able to use the data base to provide new insights into the detection of breast cancer and the natural history of this disease.
Breast Cancer Detection Demonstration Project: Five-Year Summary Report
Larry H. Baker M.D.1
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