A Trial of Occult Blood Examinations for Patients with Nipple Discharge in Mass Screening of Breast Cancer

Abstract

Since January 1981, mass screening for breast cancer has been carried out in Nagano Prefecture. The methods used for primary examinations have been physical examination combined with ultrasonic examination. Furthermore, since April 1994, occult blood examinations have been introduced for examinees with nipple discharge. One thousand two hundred eighty-nine (1.4%) subjects among approximately 91, 000 participants from April 1994 to March 1996, had nipple discharge. Of these, 1, 135 (88.1%) underwent occult blood examinations, of whom 404 were recommended to receive further examination, and 374 (92.6%) acutually did so. Four (1.1%) of these were diagnosed as having breast cancer by further examination, 5 (1.3%) as intraductal papilloma, 147 (39.3%) as mastopathy, 161 (43.0%) as no abnormality and 57 as other conditions.
The proportions of breast cancers related to the chraracteristics of the nipple discharge were 9.5% (2 of 21) in the bloody discharge group, 0.7% (1 of 137) in the serous discharge group, and 0% (0 of 106) in the milky discharge group. The proportions of breast cancers related to the occult blood reaction were 1.8% (4 of 228) in the blood positive group, and 0% (0 of 73) in both the suspicious positive group and negative group. One of 4 detected cancers was not revealed as a palpable mass.
It is suggested that the introduction of occult blood examination to breast cancer mass screening might be useful, as it was possible to reduce the number of patients requiring further examination in the group with nipple discharge, and the blood reaction of nipple discharge obtained from detected breast cancers was positive in all cases.