J Korean Med Assoc.  2015 May;58(5):408-419. 10.5124/jkma.2015.58.5.408.

The Korean guideline for breast cancer screening

• Lee EH
• Park B
• Kim NS
• Seo HJ
• Ko KL
• Min JW
• Shin MH
• Lee K
• Lee S
• Choi N
• Hur MH
• Kim DI
• Kim MJ
• Kim SY
• Sunwoo S
• Dang JY
• Kim SY
• Kim Y
• Lee WC
• Jeong J

• KMID: 2195037
• DOI: http://doi.org/10.5124/jkma.2015.58.5.408

Abstract

Breast cancer is the second most common malignancy among Korean women. The 2002 National Cancer Center screening guideline breast cancer was revised via an evidence-based approach to provide medical personnel with a standard protocol of screening breast cancer. There is moderate-level evidence that biennial screening mammography in asymptomatic women aged 40 to 69 reduces breast cancer mortality, while low-level evidence suggests that screening mammography in women 70 years or older does not reduce breast cancer mortality. The committee concluded that the current evidence is insufficient to assess the benefits and harms of either ultrasonography or clinical breast examination as screening modalities for breast cancer. Future researches about the benefits and harms of the National Breast Cancer Screening Program in Korea are strongly required because the characteristics of breast cancer in Korea are different from those in the West, especially regarding dense breast. In conclusion, the committee recommends biennial screening mammography in asymptomatic women aged 40 to 69 years (grade B recommendation). The committee recommends selective screening mammography in women 70 years or older according to individual risk and preference (grade C recommendation). The committee neither recommends nor opposes ultrasonography and clinical breast examination as screening modalities (grade I recommendation). Symptomatic and high-risk women, however, should be offered complementary measures including ultrasonography and clinical breast examination under clinical supervision.

Keyword

Breast neoplasms; Mass screening; Guideline; Mammography

MeSH Terms

Breast
Breast Neoplasms*
Female
Humans
Korea
Mammography
Mass Screening*
Mortality
Organization and Administration
Ultrasonography

Figure

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  Figure 1 Framework of developing a guideline for breast cancer screening. Key question (KQ) 1, effectiveness of breast cancer screening using mammography (reduction of breast cancer mortality and all cause mortality, and stage shift); KQ 2, starting and ending age, and appropriate period of breast cancer screening using mammography; KQ 3, hazard of mammography screening; KQ 4, effectiveness of breast cancer screening using ultrasonogrphy; KQ 5, hazard and accuracy of breast cancer screening using ultrasonogrphy; KQ 6, effectiveness of breast cancer screening using clinical breast examination. CBE, clinical breast examination.

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  Figure 2 Forest plot for breast cancer mortality (all age). Relative risk of breast cancer mortality in screening with mammography is 0.81 (95% confidence interval [CI], 0.73 to 0.91) on the meta-analysis using 7 randomized clinical trials.

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  Figure 3 Forest plot for breast cancer mortality (all age). Relative risk of breast cancer mortality in screening with mammography is 0.81 (95% confidence interval [CI], 0.73 to 0.91) on the meta-analysis using 7 randomized clinical trials.

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