New trends in breast cancer screening: a new wave from Japan

Although the incidence rate of breast cancer has increased in western countries, the mortality rate in those countries has decreased. Mammographic screening is one of the reasons for the decrease of the mortality rate. Japan is one of the countries with the lowest incidence rates of breast cancer. However, the rate of incidence and mortality has been rising quite rapidly in Japan. The percentage changes in breast cancer mortality between 1985– 1987 and 1995–1997 in women aged 50–70 and 25–49 were 30.6 and 25.8%, respectively. A similar tendency has been observed in Asian countries, such as the Republic of Korea, China, and Taiwan. In 2000, under notification by the Ministry of Health, Labor, and Welfare of Japan, mammographic screening with clinical breast examination was more prevalent in Japan. The Central Committee on Quality Control of Mammographic Screening in Japan (Central Committee) has conducted and established a training program for mammogram reading for physicians and mammograph handling for technicians. This training system works not only on estimating individual skill, but also on maintaining the quality of mammographic screening. More than 24,000 physicians and technicians have participated in the training courses. The chairperson of the Education Subcommittee of the Central Committee, Tokiko Endo, has conducted the training course in those Asian countries. In this special issue, her activity is introduced. The mortality reduction rate of mammographic screening in women aged 40–49 is lower than that in women aged over 50. Screening with new modalities, such as MRI or ultrasonography, has been tried. The effectiveness of mammographic breast cancer screening with ultrasonography in Japan is also reported in this issue. A new strategy for the reduction of breast cancer mortality will take effect in the near future in Asian countries.