[Early diagnosis of breast cancer]

Despite the increasing incidence of breast cancer in recent years, early detection of breast cancer improves the curative rate and quality of life (QOL). Advances in diagnostic imaging are making early detection increasingly common. Although mammography (MMG) is the most popular examination method and yields excellent image description, diagnosis is influenced by imaging technique and ability to read the images. A clear image can be achieved if the MMG image acquired at 28 Kv using an M0 filter is energy subtracted at 32 Kv using an Rh filter. Ultrasonography can be excellent for qualitative diagnosis of a tumor, but changes in blood flow volume, as demonstrated by Doppler imaging, makes early detection difficult. Breast scintigraphy by 201TlCl can clearly demonstrate palpable breast cancer and also lymph node metastasis, but poor spatial resolution remains a problem. High resolution CT is effective for detection of lymph node metastasis. MRI offers excellent qualitative diagnosis of tumors, but detection of ultra-small lesions is difficult even using contrast medium. The detection rate and proportion of early breast cancer detected on the whole will rise if MMG is introduced into the present mass screening for breast cancer, but its implementation requires improved facilities, imaging capability, and experience in image reading.