STUDY OF KNOWLEDGE OF BREAST CANCER AND ITS EARLY DIAGNOSTICS IN FEMALE TERTIARY HEALTH WORKERS

OBJECTIVE- To study the knowledge of breast cancer, early detection methods and whomto consult after detecting abnormality among female tertiary health workers.METHOD- This is a descriptive cross-sectional study of 70 female health workers age groupmore than 20 years carried out at various hospitals after taking consent.RESULT- Being majority of young married doctor respondents, below the age of 40 years(81.4%) study was conducted, almost all the respondents are aware of breast cancer, 69(98.5%). Majority of them got information from media (77.1%), followed by seminars(64.2%) and books (62.8%). Only 15.7% of respondents had a positive family history ofbreast cancer. Most participants were aware of BSE and thinks its useful tool (74.3%) butdoesn’t know about proper timing and method for BSE. They have been taught BSE (58.5%)out of which majority were taught by teachers (51.5%). 41.4% and 60% of respondents knewthat BSE should be done monthly and should start after age of 20 respectively. Onerespondent has discovered an abnormality. Respondents are relatively less aware about BSE28 (40%). 45 (64.3%) and 16 (22.9%) think that BSE should be done by a doctor and trainednurse respectively. The level of awareness of sonomammography was high amongrespondents- 43 (57.1%), but only 8 (11.43%) had undergone sonomammography, because of‘not of proper age’ 27 (38.57%).CONCLUSION- Practice and attitude of breast cancer screening should be promoted amonghealth workers and the general population

Impact of health education on knowledge and attitude of self-breast examination among female nursing students

Background: Breast cancer is the most common cancer among women and a leading cause of death worldwide, including in India. Breast cancer usually shows a slow development rate, and when recognized in the early stages, successful treatment results can be achieved. Breast self-examination is a screening option for young women. Objective: To assess the impact of health education on knowledge and attitude of self-breast examination among nursing students. Study Design: The present interventional study was conducted between September and October 2019. Setting: This study was done among 79 nursing students of a tertiary care hospital situated in a central district of Uttar Pradesh. Main Outcome Measures: The self-reported pre-designed and structured questionnaire was used. It included three sections Sociodemographic profile Knowledge regarding self-breast examination (SBE) 3. Attitude regarding self-breast examination (SBE). Knowledge and attitude scores were calculated and divided into the poor, average, and good categories. Results: There were 87.3% of girls had prior knowledge of the self-breast examination, while 12.7% of girls were not aware of the self-breast examination. Postintervention, there was a significant increase (p<0.05) in their knowledge about self-breast examination. Conclusion: Planned teaching intervention had a significant impact on the knowledge and attitude of self-breast examination.

KNOWLEDGE, ATTITUDE AND PRACTICE OF BREAST SELF-EXAMINATION AND BREAST CANCER AMONG FEMALE HEALTHCARE WORKERS IN SUPERCARE HOSPITAL: A PILOT STUDY

Objective: Breast cancer is the leading cause of mortality and morbidity among the females in India. Breast Self-examination (BSE) can play a huge role in early detection and diagnosis thereby signi?cantly reduce morbidity, and prompt timely treatment. The main aim of the study was to access the Knowledge, attitude and practice of breast self-examination and cancer awareness among the female healthcare workers. The cross-sectional pilot Methodology: study was conducted in Supercare hospital, Shillong and 27 female workers responded to the questioner. The questioners were divided into three categories to access the Knowledge, attitude and practice of BSE and awareness of breast cancer. Results: 22.22% of the participants had very good knowledge of breast cancer and BSE, 74% had good knowledge and 3.7% had average knowledge. 40.51±4.9 is the mean and SD for the knowledge for breast cancer and self-breast awareness. 48% respondents average practice BSE and 11% good and 41% poor practice of BSE was observed. The female healthcare workers attitude towards BSE was overall good. Majority of the respondents are aware of breast cancer but very few Conclusion: practice breast self-examination. It is recommended to educate and train female health worker to act as peer educator who are agent of health care information to the community and the society at large.

Mobile Health Application Applying the Health Belief Model for Breast Cancer Awareness: What Is Missing?

@#Breast cancer (BC) is one of the most common cancer incidents among women and is estimated at around 24.2% worldwide and 32.1% in Malaysia. Accessibility to current breast promotion is limited to those who seek the information, suggesting consideration of an alternative approach using a mobile app. This study aimed to identify existing breast awareness mobile apps based on the Health Belief Model (HBM) components with a descriptive observation review. Fifty-two apps fulfilled the inclusion and exclusion criteria and were reviewed. Eligible apps (N=52) which are standalone (n=41) and non-standalone (n=11). The categories of the eligible apps are health & fitness (n=31), lifestyle (n=6), medical (n=11), entertainment (n=2), book & reference (n=1), education (n=3). The apps focused on perceived susceptibility (n=33/52, 63.5%), perceived severity (n=30/52, 57.7%), perceived threat (n=48/52, 92.3%), perceived benefit (n=46/52, 88.5%), perceived barriers (n=23/52, 44.2%), self-efficacy (n=25/52, 48.1%) and cues to action (n=27/52, 51.9%). Most of the apps focused on perceived threat and benefit but lacking on a perceived barrier. This review could provide information to develop appropriately tailored content supported by health theories to promote breast cancer awareness.

Clinical profile of carcinoma breast patients in working women population in a metro city

Background: In India, breast cancer is the second most common malignancy among women next to carcinoma of cervix. Since it present as a painless lump patient often neglect and present to hospital late. With increasing prominence and greater visibility in country specific health profiles around the world, breast cancer and its prevention detection and treatment will continue to emerge as a major priority and challenge for health system. As carcinoma of breast is a quite common clinical problem encountered in clinical practice, this study was an attempt to study clinical presentation modes of management of the disease.Methods: 50 patients who were admitted with a diagnosis of carcinoma breast were studied though history taking, clinical examination, relevant investigations depending on the stage of the disease. After completion, the results were analysed using Microsoft excel software and are compared with other studies.Results: Majority of patients belonging to age group 41-50 years (42%) with lump as major complaint at the time of presentation (78%). Disease in most patients was on upper outer quadrant (78%). Majority of patients belong to stage II (84%) of the disease clinically.Conclusions: The simple and effective methods of detecting the disease early like self-breast examination, clinical breast examination, ultrasonography, mammography, fine needle aspiration cytology should be made aware among the people for early detection and effective treatment of the disease.

Effectiveness of self-instructional module on awareness on screening regarding breast cancer with Intelligent Breast Examination among primary schoolteachers in Karad

Aim: As Breast cancer is most common in developed and developing world. Despite of seriousness & importance of breast cancer the awareness is low. This Study highlights the primary screening of breast cancer with the device Intelligent Breast Examination. Objectives: The objectives of this study are to assess the knowledge regarding awareness on screening of breast cancer with Intelligent Breast Examination (IBE), to develop a self-instructional module (SIM) on awareness on screening regarding breast cancer with IBE, and to assess its effectiveness on awareness about screening breast cancer with IBE. Materials and Methods: Evaluative research approach was used. The study used preexperimental research design. The samples (60 primary schoolteachers) were selected by the use of two sampling techniques, i.e., random sampling (for schools) and purposive sampling (study participants). Data were collected in two phases (pre and post) using structured questionnaire followed by the administration of SIM. Results: The results revealed a significant increase in mean knowledge scores (mean pre 11.16 standard deviation [SD] = 2.631 to mean post 21.2 SD = 1.842) regarding awareness on screening of breast cancer with IBE. The calculated paired t value (23.902) is greater than the table value ( t = 1.67) at 0.05 level of significance. Conclusion: The study concluded that the SIM prepared proved to be effective in increasing the awareness regarding screening with IBE in breast cancer

A cross-sectional study on awareness regarding breast cancer and its screening techniques in field practice area of GMERS Medical College, Dharpur, Patan, North Gujarat, India

Background: Breast cancer is one of the most dangerous and lately diagnosed cancers which precipitate high number of morbidity and mortality. Breast cancer is now the most common cancer in most cities in India. To prevent its occurrence, women should be aware of early signs of it. Early detection can be done by different screening techniques such as self-breast examination, clinical examination, and mammogram. Objectives: The objectives of this study were as follows: (a) To assess the awareness regarding breast cancer and their screening techniques among women and (b) to find out the associated factors of breast cancer and their awareness among women. Materials and Methods: The study was carried out among 100 women selected by purposive sampling residing in the field practice area of Gujarat Medical Education and Research Society Medical College, Dharpur, Patan, during January 2019–March 2019 after approval of the institutional ethics committee. Self-tested semi-structured questionnaire was used after performing a pilot study. Results: Very few female had personal and family history of breast cancer. Awareness regarding breast cancer was found higher in educated as compared to illiterate. Working women had more knowledge regarding the issue than housewife. Awareness regarding how often breast self-examination (BSE) should be performed and what to look for while doing BSE was awareness regarding BSE as a screening tool was found only in half of the study participants. Conclusions: The study participants who had personal and family history of breast cancer were well aware of the clinical signs of breast cancer and its screening techniques. Literate and working women were having more knowledge regarding breast cancer. Overall awareness regarding the disease and its screening techniques was low in the study population.

Knowledge, Attitude and Practice (KAP) of Women about Breast Cancer in a Tertiary Care Teaching Hospital in Rohtas, Bihar

Breast cancer (BC) is an important cause of morbidity and mortality. The early detection of BC and its early and adequate treatment increases the chance of survival of patients. Breast Health Global Initiative guidelines for low and middle income countries suggests that diagnosing BC early by promoting self awareness and clinical breast examination (CBE) will reduce BC mortality. There is a paucity of data related to knowledge and awareness of BC in Bihar. We designed this hospital based cross sectional descriptive study to evaluate the current status of knowledge; attitude and practices (KAP) related to BC in the female rural population attending a tertiary care teaching hospital in Rohtas, Bihar. Methods: A random sampling was done to identify and enrol 400 women and their female relatives. Women who had already undergone a screening mammography or had a BC were excluded from the study sample. The data was collected by a self-administered questionnaire in local vernacular language. Results: The mean age of study population was 45.21 (±10.2) years. Only 5 (1.25%) females had a family history of BC. A whopping 82.75% of women did not have any knowledge about BC. Almost all of the women had firm belief that CBE by doctors was the only way for detecting BC. Conclusion: It is imperative to increase awareness about BC and its early detection methods in the community through health education campaigns. The government should have major policy changes to increase future screening programmes which could have an overall positive impact on reducing the BC burden in community.

Knowledge, attitude and practice about breast cancer and breast self‑examination among women seeking out‑patient care in a teaching hospital in central India.

BACKGROUND: Breast cancer (BC) continues to be a major cause of morbidity and mortality throughout the world. Early detection of BC and early treatment increases the chance of survival. According to Breast Health Global Initiative guidelines for low and middle income countries, diagnosing BCs early by promoting breast self‑awareness; clinical breast examination (CBE) and resource adapted mammographic screening will reduce BC mortality. There is a paucity of data on the knowledge and awareness of BC and self‑breast examination in India. We designed this hospital based cross sectional descriptive study to evaluate the current status of knowledge, awareness and practices related to BC and breast self‑examination in the female rural population attending a teaching hospital. MATERIALS AND METHODS: We did a random sampling to identify and enroll 360 women and their female relatives. We excluded a participant from the study if she had already undergone a screening mammography or had had a BC. The data was collected by a self‑administered questionnaire in vernacular language. RESULTS: Our study population included 360 women with a mean age of 45.81 (±10.9) years. Only 5 (1.38%) females had a family history of BC. A whopping 81% of women did not have any knowledge about BC. All the women thought that CBE by doctors was the only way for screening BC. CONCLUSIONS: We concluded that with the results of this study, it is imperative to increase awareness about BC and its detection methods in the community through health education campaigns. We should have major policy changes to increase future screening programs and health education programs which would have an overall positive impact on reducing the disease burden.

The accuracy of Breastlight in detection of breast lesions.

AIM: Breastlight is a new product to improve breast health awareness of women. However, its accuracy in detection of breast lesions (BLs) is unknown. The aim of this study was to determine the Breastlight accuracy in detection of BLs. MATERIALS AND METHODS: From July 2011 to September 2013, a total of 500 women referred to mammography unit in Yazd, Iran for screening were recruited to the study. The sensitivity and specificity of Breast light was measured with clinical breast examination (CBE), mammography and sonography. Sonographic and mammography examinations were performed according to breast density among women in two groups of younger (n = 105) and older (n = 395) than 30 years. RESULTS: The results have shown a statistically significant positive correlation between Breastlight, CBE, sonography, and mammography in detection of BLs. Breastlight significantly detected 60.3%, 35.8%, and 59% of lesions which were detected by mammography, CBE, and sonography, respectively. Its sensitivity varied significantly with breast density. Comparing the sensitivity of Breastlight among women younger and older than 30 years indicated that the Breastlight had a higher sensitivity for women older than 30 years. The greatest and lowest portion of positive predictive value occurred with CBE (94.7%) and mammography (91.1%). As well, its greatest and lowest portion of negative predictive value occurred with CBE (65.6%) and sonography (29.7%). CONCLUSION: The results of this study showed that the efficacy of Breastlight in detection of breast changes as domestic apparatus was appropriate. However, it is recommended further studies to evaluate the Breastlight efficacy and accuracy in detection of the BLs.

Acceptability of physical examination by male doctors in medical care: Taking breast palpation as an example / 华中科技大学学报（医学）（英德文版）

In this study, we conducted an investigation among medical workers, patients and college students concerning their acceptability of breast palpation performed by male doctors (hereinafter referred to as "acceptability", or "the examination", respectively, if not otherwise indicated), to get the information about their acceptability and reasons for accepting or declining the examination among the three population. A questionnaire investigation was conducted in 500 patients with breast diseases, 700 students of medical colleges, and 280 medical workers working in hospitals. The subjects were asked to choose between two options: accept or do not accept (the examination). The subjects were asked to fill out the questionnaire forms on free and anonymous basis and the questionnaire forms were collected on spot, immediately after completion. The questionnaires collected were coded, sorted out and checked. Data of the eligible questionnaires were input into Epidata software and analyzed by SPSS. Upon the establishment of the database, the intra-group data were tested by utilizing χ(2) test. Among 1480 questionnaires, 1293 (90.41%) questionnaires were retrieved. Our results showed that 56.78% of patients reported that they could accept breast palpation by male doctors. About 59.66% of medical staff expressed their acceptance of the examination, but only 35.03% of students said the examination. On the basis of this study, we were led to conclude that the examination is not well accepted by different populations, and therefore, (1) medical professionals and administrators should pay attention to the gender-related ethics in their practice and the feeling of patients should be respected when medical examinations involve private or sensitive body parts; (2) to this end, related departments should be properly staffed with doctors of both sexes, and this is especially true of the departments involving the examination or treatment of private or sensitive body parts; (3) health education should, among other things, include helping female patients to overcome the fear and anxiety in such examinations. This is of great importance since some women may miss the opportunity to get timely diagnosis.

Opinion of nurses regarding breast cancer screening programs.

Aim: Found to be effective in its treatment. The increased incidence of breast cancer supports the implementation of breast cancer screening programs. The present study evaluates the opinion among nurses regarding breast cancer screening programs in United Arab Emirates (UAE). Materials and Methods: The study population included 154 nurses practicing at different hospitals in United Arab Emirates (UAE), all nurses who participated in the breast cancer awareness programme organized by Gulf Medical University, Ajman, UAE. A self-administered, pretested, structured, close-ended questionnaire was used for data collection. Statistical Analysis was performed using Predictive Analytic Software (PASW 17). Results: The participants' age ranged between 20 and 59 years. Fifty percent of the participants strongly agreed with the early detection of breast cancer by performing breast self examination. Thirty-nine percent were of the opinion that women aged 40 years and older should have a mammogram every year and continue to do so and 25.3% strongly felt that women in their 20s and 30s should have clinical breast examination as part of their periodic health examination by health professionals. 33.8% of the respondents strongly agree on providing information on the benefits and limitations of BSE to the female population. Twenty-six percent of the participants strongly agree that women at high risk should get magnetic resonance imaging and mammogram done every year. Conclusion: The present study indicates the need for providing workplace training programs thus equipping them with better knowledge and enhancing their service among the general population.

Breast cancer screening (breast self-examination, clinical breast exam, and mammography) in women referred to health centers in Tabriz, Iran.

Background : Breast cancer is the most common cancer and the most common cause of death in Iranian women aged 35-55 years. Breast cancer screening comprises breast self-examination (BSE), clinical breast examination (CBE) and mammography. Objective:0 The study aimed to examine the performance of screening methods among women referring to health centers of Tabriz, Iran. Materials and methods : This was a descriptive-analytical research carried out on 400 women aged 20-50 years. The samples were chosen through random multistage sampling among health centers of Tabriz then active records of women. A questionnaire and observational checklist was used to elicit socio-demographic information and performance of women towards breast cancer screening methods. Descriptive and inferential statistics (chi-square and Fisher's exact test) were used to analyze the data. Results: Only 18.8% of women did breast self-examination, 19.1% had clinical breast examination and 3.3% had mammogram. Statistical test showed a significant relationship between performing BSE and educational level, employment, income, number of children, breastfeeding history, breastfeeding quality and family history of breast cancer. There was a significant correlation between performing CBE and history of breast tumor and also, between performing the mammography and family history of breast cancer and history of breast tumor (P < 0.05). Conclusions: The findings showed that the performance of breast cancer screening methods was not satisfactory. Performance in high risk women was very desirable than others. Implication for Practice: The presentation of imperative education about breast cancer screening methods through health staff especially in pregnancy, post-partum and even in pre marriage counseling periods seems necessary.

Detección del cáncer de mama en México: síntesis de los resultados de la Encuesta Nacional de Salud Reproductiva / Breast cancer examination in Mexico: summary of the results from the National Survey of Reproductive Health

OBJETIVO: Presentar una síntesis de los resultados de la Encuesta Nacional de Salud Reproductiva 2003 sobre la práctica de revisión y examen clínico de los senos. MATERIAL Y MÉTODOS: Por medio de estadísticas descriptivas y modelos de regresión múltiple se identificaron las principales características sociodemográficas y sitios de información sobre la práctica de revisión y el examen clínico de los senos en cerca de 20 000 mujeres, de 15 a 49 años, residentes en áreas rurales y urbanas del país. RESULTADOS: Las mujeres jóvenes con menor escolaridad y estrato socioeconómico, residentes de áreas urbanas, informaron un práctica significativamente baja tanto de la revisión como del examen clínico de los senos. La frecuencia de mujeres con cáncer de mama (CaMa) fue mayor en el área rural respecto de la urbana. CONCLUSIONES: Es necesario establecer medidas para la estandarización y control de la calidad del examen clínico de los senos y coadyuvar a la prevención y control del CaMa en México.

OBJECTIVE: To present a summary of the results of the National Survey of Reproductive Health 2003 regarding the practice of self and clinical breast examination. MATERIAL AND METHODS: The main sociodemographic characteristics and site of information about self and clinical breast examination, in 20 000 women 15 to 49 years of age residing in rural and urban areas, were identified by simple statistics and logistic regression models. RESULTS: Younger women with lower scholarity and socioeconomical status residing in rural areas informed a statistically lower self and clinical breast examination. A higher frequency of breast cancer was found in rural vs. urban area. CONCLUSIONS: Strategies for standardization and quality control for the clinical breast examination are needed to contribute in the prevention and control of breast cancer in Mexico.

Exame clínico das mamas no Programa de Saúde da Família: experiência no litoral sul do Brasil / Clinical breast exam in the health family program: experience in the south coast of Brazil

Objetivos: Avaliar a prevalência de achados benignos e incidência bruta do câncer de mama napopulação feminina atendida em três postos de saúde associados ao Programa de Saúde da Família(PSF) no município de Xangri-Lá, RS, Brasil. Métodos: A partir de um projeto de extensão daFaculdade de Medicina da Universidade Federal do Rio Grande do Sul, agentes de saúde ligadosao PSF convidaram mulheres com mais de 20 anos de idade a fazerem uma avaliação clínica dasmamas nos postos de saúde do município. Um questionário semi-estruturado foi aplicado e, a partirdas variáveis coletadas e do exame físico, fez-se um banco de dados. Resultados: Foram incluídas728 mulheres atendidas no PSF. As alterações benignas de forma e volume ocorreram em 11,4%, asalterações mamilares em 3,4% e a dor referida como mamária em 7%. A taxa bruta de incidência docâncer de mama foi de 128 por 100 mil mulheres. Conclusões: As alterações mamárias ocorreramem 15% das pacientes, e o câncer de mama pôde ser eficientemente diagnosticado por médico treinadono exame das mamas. Espera-se que, a partir dos resultados deste estudo, mais ações de saúdepossam ser estabelecidas para a prevenção e o controle do câncer de mama na atenção primária.

Objectives: To evaluate the prevalence of benign findings and breast cancer incidence among the femininepopulation examined in all the three public offices (PO) associated to the Health Family Program(PSF) in Xangri-Lá, RS, Brazil. Methods: Taking part in an extension project from the Medical Schoolof the Federal University of Rio Grande do Sul, agents from the PSF invited women older than 20 years ofage to perform a breast clinical evaluation in one of the PO. A semi-structured questionnaire was appliedand a database was created to store information from the collected variables and the physical examination.Results: Seven hundred twenty-eigth patients were included. Abnormal breast shape and volume weredetected in 11.4% of cases, nipple abnormalities in 3.4% and referred breast pain in 7.0%. The gross incidencerate of breast cancer was 128 per 100.000 women. Conclusion: Abnormal-benign examinationswere present in 15% of patients and breast cancer was successfully diagnosed by a physician trained inclinical breast examination. We hope that these results could stimulate new programs for prevention andcontrol of breast cancer, applied to primary attention.

Patterns of mammogram utilization and clinical profile of patients who underwent mammography at Cebu (Velez) General Hospital

BACKGROUND: Educating physicians on the proper utilization of mammography is vital to effective implementation of the breast cancer control program.OBJECTIVE: The general objective of this study was to determine the patterns of mammogram utilization and clinical profile of patients who underwent mammography at Cebu (Velez) General Hospital from January 1997 to February 2001.METHODS: Checklists embodying important breast health information, clinical data (age, sex, address, menstrual and obstetrical history, personal and family history of breast cancer, presenting breast signs and symptoms), referring physicians, and mammography reports over the last four years were reviewed.RESULTS: There were 468 mammograms done of which 279 (60 percent) were for diagnostics purposes and 189 (40 percent) for screening. The highest number of women who underwent screening mammography belonged to the 50-59 year age group. Gynecologists were the most frequent referring physicians for mammographic examination at 186 (40 percent) followed by 134 (29 percent) referrals from the general surgeons. There was an increasing trend of mammogram utilization noted over the past four years. Palpable mass in 172 (53 percent) patients was followed by mastodynia in 104 (33 percent) patients accounting for the most common indications for diagnostic mammography. Three hundred seventy-three (80 percent) mammogram results were negative and only 23 (5 percent) showed suspicious abnormalities warranting biopsy. Three hundred twenty-five (69.4 percent) of the mammograms showed extremely dense breasts which lowered sensitivity. There was a trend towards decreasing Grade IV radiographic density of the breast as the patients were older. Proper mammogram utilization at Cebu Velez General Hospital has increased over the last 4 years.

Clinical breast examination for screening of asymptomatic women: the importance of clinical breast examination for breast cancer detection

Of 489 asymptomatic women who were referred to our institute from other screening clinics, 46 were eventually proven to be breast cancer patients, and this number equated to 8.1% of the 565 breast cancer patients treated in our institute during the period of January 1997 to December 1998. Among the 46 cancer patients of the initial 489 asymptomatic women, twenty-five (54.35%) were detected by mammogram alone, six (13.04%) by clinical breast examination (CBE) alone, and the remaining 15 (32.61%) by both mammogram and CBE. In context with age, the mammographic sensitivity for cancer detection was 100% for women aged over 60, 91% for 50s, 78.9% for 40s, and 75% for 30s, and inversely correlated with the patient's age. Among the 25 cancers detected by mammogram alone, 18 (72%) belonged to DCIS or stage I. In contrast, four (66.7%) of six cancers detected by CBE alone and nine (60%) of 15 cancers by both CBE and mammography were included in stage IIa or IIb. However, the total incidence of early cancers (stages 0 and I) was significantly higher in the screening group than in the symptomatic group (p < 0.01). These results suggest that the role of mammography is important in the detection of cancers in their earlier stage and CBE is helpful in reducing false negative results in breast cancer screening. In conclusion, film mammography is the best tool for the detection of microcalcification and is useful for the detection of earlier lesions, but is not perfect for the detection of breast cancer particularly in young women. A careful CBE is an essential part of breast screening in order to reduce false-negative results.

The Importance of Clinical Breast Examination for Cancer Detection in Asymptomatic Women / 한국유방암학회지

Of 489 asymptomatic women who were referred to our institute from other screening clinics, 46 were eventually proven to be breast cancer patients, and this number equated to 8.1% of the 565 breast cancer patients treated in our institute during the period of January 1997 to December 1998. Among the 46 cancer patients of the initial 489 asymptomatic women, twenty-five(54.35%) were detected by mammogram alone, six(13.04%) by clinical breast examination(CBE) alone, and the remaining 15(32.61%) by both mammogram and CBE. In context with age, the mammographic sensitivity for cancer detection was 100% for women aged over 60, 91% for 50s, 78.9% for 40s, and 75% for 30s, and inversely correlated with the patient's age. Among the 25 cancers detected by mammogram alone, 18(72%) belonged to DCIS or stage|. In contrast, four(66.7%) of six cancers detected by CBE alone and nine(60%) of 15 cancers by both CBE and mammography were included in stage II a or II b. However, the total incidence of early cancers(stage 0 and I) was significantly higher in the screening group than in the symptomatic group(P<0.01). These results suggest that the role of mammography is important in the detection of cancers in their earlier stage and CBE is helpful in reducing false negative results in breast cancer screening. In conclusion, film mammography is the best tool for the detection of microcalcification and is useful for the detection of earlier lesions, but is not perfect for the detection of breast cancer particularly in young women. A careful CBE is an essential part of breast screening in order to reduce false-negative results.