Mammography

About: Mammography is a research topic. Over the lifetime, 20643 publications have been published within this topic receiving 513679 citations.

Screening for Cancer with PET and PET/CT: Potential and Limitations

Abstract: Screening for cancer remains a very emotional and hotly debated issue in contemporary medical practice. An analysis of published data reveals a multitude of opinions based on a limited amount of reliable data. Even for breast cancer screening, which is now widely practiced in the United States and many European countries, there is continuing controversy regarding the appropriate age limits for screening mammography and, in fact, concerning the value of mammography itself. Similarly, there is no agreement as to whether screening for lung or prostate cancer is meaningful as currently practiced. Recommendations and decisions regarding cancer screening should be based on reliable data, not good intention, assumptions, or speculation. Therefore, we first explain the underlying principles and premises of screening and then briefly discuss current controversies regarding screening for breast, prostate, and lung cancers. Recently, some authors advocated CT, PET, or PET/CT for whole-body screening without support from reliable data. We discuss the potential financial, legal, and radiation safety implications associated with whole-body CT or PET cancer screening. We conclude from the available data that neither CT nor PET/CT cancer screening is currently warranted. Far from providing a desirable binary answer (presence of absence of cancer), in nonselected populations the procedures frequently yield equivocal or indeterminate findings that require further evaluation, with associated costs and potential complications. The clinical and statistical relevance of occasionally detected cancers is likely too low to justify population-wide screening efforts with these 2 imaging modalities. Ultimately, the true utility, or lack thereof, of PET and PET/CT for cancer screening can be assessed only in a prospective randomized trial. Because of prohibitive costs and the required length of follow-up, it is unlikely that such a trial will ever be conducted. Rather than spending time and resources on screening studies, medical practitioners should continue using whole-body PET/CT for diagnosing, staging, and restaging cancer and for monitoring treatment effects. Researchers should also investigate the utility of whole-body PET/CT for the surveillance of selected groups of patients who have cancer, who have completed curative treatment, but who remain at high risk for recurrent disease.

Association of recall rates with sensitivity and positive predictive values of screening mammography.

Abstract: OBJECTIVE. The performance of screening mammography is measured mainly by its sensitivity, positive predictive value, and cancer detection rate. Recall rates are also suggested as a surrogate measure. The main objective of this study was to measure the effect on sensitivity and positive predictive value as recall rates increase in the community practice of mammography.MATERIALS AND METHODS. Mammography and pathology data are linked in the Carolina Mammography Registry, a population-based registry of screening mammography. Our mammography database is created from prospectively collected data from mammography facilities; the data include information on the woman and the imaging studies. Our pathology database is created from prospectively collected breast pathology data received from pathology sites and the Central Cancer Registry. Women in the registry who were 40 years old and older and who underwent screening mammography between January 1994 and June 1998 were included. “Recall rate” was defined as the p...

Qualitative [18F]FDG positron emission tomography in primary breast cancer: clinical relevance and practicability.

Abstract: Positron emission tomography (PET) using fluorine-18 2-deoxy-2-fluoro-d-glucose (FDG) is of potential value for the diagnosis of malignant tumours. The aim of this study was to evaluate the use of FDG PET in patients with breast tumours, appraising its applicability in visualising primary carcinomas and regional metastases in a clinical setting. Results of FDG PET were compared with those of mammography, breast ultrasonography and histology in 30 patients with inconclusive breast findings. For PET, transmission and emission images were taken in one or two scan positions, depending on the available time and the clinical status of patients. PET showed focal FDG uptake with high contrast in 21 of 23 primary carcinomas. In one patient, only PET correctly visualized multifocal disease (three foci, O 0.4–1 cm). The accuracy of PET in the detection of primary breast cancer was 90%, and in the detection of involved axillary lymph nodes, 94%. All metastases (lymph nodes, lungs, bones, soft tissues) covered by the field of view and demonstrated by other methods (X-ray, computed tomography, magnetic resonance imaging, bone scan) showed FDG uptake. In three patients, only PET initiated further diagnostic procedures. The results indicate that FDG PET can provide a rapid diagnostic study (45–60 min) and allows accurate tumour staging of several organ systems for primary tumour and metastases with a single imaging study in a routine clinical setting.