Asymptomatic Breast Cancer

ABSTRACT

BACKGROUND: With no current method of prevention available, early detection of breast cancer by regular self and clinical examination in conjunction with screening mammography is emphasized. The rate of asymptomatic breast cancer detection has been increased due to the ability of mammography. METHODS: To address questions about the biology and clinical manifestation of mammographically detected breast cancer, a retrospective analysis was performed to the 31 cases of asymptomatic breast cancer treated from Jan. 1989 to Dec. 1996 at Department of Surgery, Seoul National University Hospital. RESULTS: The mean age was 50.0 with ranges from 27 to 80. The peak age was 5th decade. The most common mammographic findings of asymptomatic breast cancer was microcalcification (22 cases, 71.1%). Eighteen patients underwent modified radical mastectomy (58.1%): simple mastectomy in 4 cases (12.9%), and breast conserving surgery in 9 cases (29.0%). The histologic types were as follows: infiltrating ductal carcinoma in 17 cases (64.5%), microinvasive carcinoma in 3 cases (9.6%) and ductal carcinoma in situ in 9 cases (29.0%). Twenty one patients showed smaller than 1 cm in tumor size. Only 3 cases of invasive ductal carcinomas had axillary nodal metastasis. All cases except four cases demonstrated stage 0 (29.1%) and stage I (54.8%) according to the AJCC classification: whereas the rate of stage 0 and I in symptomatic patients during same study period was 4.1% and 19.6% respectively. CONCLUSIONS: The result of our study indicate that several benefits of mammographic screening are likely the result of detection of invasive carcinoma at an early stage and detection of noninvasive carcinoma that may later develop into or mark increased risk of invasive carcinoma. A prospective and systematic approach for evaluating efficiency of screening mammography would be necessary in Korea.