Problems with the Detection of Breast Cancer

Usefulness of Breast Self-Examination for an Early Detection of Breast Cancer. Results of a Study on 500 Breast Cancer Patients and 652 Controls

The knowledge and practice of breast self-examination (BSE) was investigated among 500 women with operable breast tumors between 35 and 64 years of age (all successively operated) and 652 healthy women, matched with the previous group for 5-year age groups from 35 to 54 years. Only 39.9 % of breast cancer women and 34.5 % of the controls practiced BSE, and only a third of these did it monthly. Such practice tends to progressively decrease, starting from 45 years, and it is used less frequently by the women with a poor education and those in a lower economic bracket. Among the 500 breast cancer patients, those who practiced the self-examination had a higher number of tumors with a diameter no greater than 2 cm and a lower number with a diameter larger than 4 cm. In addition, in this group the percentage of unaffected axillary lymph nodes (N–) was 58.8 % compared to 48.8 % for the group that did not practice self-examination, and the percentage of the cases with more than 3 metastatic lymph nodes (N+ > 3) was 20.0 % in the first group and 27.3 % of the second one. These differences are statistically significant. The correlation between tumor diameter and the histologic lymph node stage is equally evident, since there is a progressive reduction in N– cases and a contemporary progressive increase in N+ (> 3) cases with increasing breast tumor diameter. Therefore, we can infer that the lack of practice of BSE causes a diagnostic and therapeutic delay, which is responsible for aggravation of the prognosis.

Urinary tract cancers found by homescreening with hematuria dipsticks in healthy men over 50 years of age

In a homescreening study 235 asymptomatic men, 50 years of age and older without known causes of hematuria, tested their urine each week with a chemical reagent strip for the presence of blood for 1 year. Forty-four men had hematuria at least once, and 31 had a full urologic evaluation. Of these, eight were found to have urinary cancers and seven had nonmalignant diseases warranting immediate treatment. In six of these 15 men (only two with cancer) hematuria occurred in over 1/3 of the testings, and in four hematuria was found on microscopic urinalysis at the time of urologic evaluation. The degree of hematuria was unrelated to the seriousness of its cause. We conclude that in this population hematuria occurs intermittently and when found, regardless of quantity or symptoms, serious underlying pathology must be ruled out. Furthermore, regular hematuria home testing offers a promising means of detecting urinary cancers and other diseases that warrant therapy in asymptomatic men 50 years of age and older.