Mammography

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

Neglected aspects of false positive findings of mammography in breast cancer screening: analysis of false positive cases from the Stockholm trial

Abstract: Objectives: To examine the implications of false positive results of mammography in terms of the time lag from screening and complete mammography to the point when women with false positive results are declared free of cancer; the extra examinations, biopsies, and check ups required; and the cost of these extra procedures. Design: Review of women with false positive results from the Stockholm mammography screening trial. Setting: Department of Oncology, South Hospital, Stockholm. Subjects: 352 and 150 women with false positive results of mammography from the first and second screening rounds of the Stockholm trial. Main outcome measures: Extra examinations and investigations required and the cost of these procedures. Results: The 352 women from the first screening round made 1112 visits to the physician and had 397 fine needle aspiration biopsies, 187 mammograms, and 90 surgical biopsies before being declared free of cancer. After six months 64% of the women (219/342) were declared cancer free. The 150 women in the second round made 427 visits to the physician and had 145 fine needle aspiration biopsies, 70 mammograms, and 28 surgical biopsies, and after six months 73% (107/147) were declared cancer free. The follow up costs of the false positive screening results were Kr2.54m (pounds sterling250000) in the first round and Kr0.85m (pounds sterling84000) in the second round. Women under 50 accounted for about 41% of these costs. Conclusions: The examinations and investigations carried out after false positive mammography—especially in women under 50—and the cost of these procedures are a neglected but substantial problem. Key messages Key messages These extra costs come from the examinations and investigations required during follow up—for example, repeated biopsy of benign tissue—before the patient is declared cancer free In this series the costs of following up women with false positive mammograms were almost one third of the cost of screening all women in the randomised Stockholm mammography trial These extra costs and other negative aspects of false positive results of mammography—especially in women under 50—are a neglected but substantial problem The benefits of mammography must be carefully weighed against the potential negative aspects, especially in women under 50

Cancer screening. Degrees of proof and practical application.

Abstract: The purpose of this paper is to clarify the short-term and long-term objectives of screening for various cancers, and to indicate the kinds of data that are needed to determine whether or not the objectives are met Cancers at various sites differ with respect to their innate suitability for screening Criteria that enhance screening suitability include the potential for serious complications and a high rate of mortality (applicable to most cancers), a prolonged preclinical phase, and an existing therapy that is simpler and more effective in reducing the mortality rate when applied to preclinical disease than to clinically evident cancer Tests and procedures suitable for screening are simple to perform, inexpensive, acceptable to patients and physicians, safe, relatively painless, and accurate, as measured by the test's sensitivity and specificity The actual yield of previously undiagnosed cancer arising from a screening program will depend heavily on prevalence of disease in the screened population, specificity of the screening test, and successful follow-up of screen-positive patients with diagnosis and treatment These issues are discussed in the context of four cancers and their respective screening modalities: cervical cancer and cytologic studies, breast cancer and mammography, colon cancer and fecal occult blood tests, and lung cancer and sputum cytologic studies The quality of data on which screening decisions have been made for each of these cancers and tests varies The cancers vary in terms of their relevant biologic characteristics and treatment effectiveness Similarly, each screening procedure has its own particular advantages and disadvantages Current American Cancer Society Guidelines for early detection of three of the cancers are presented

Comparison of Digital Mammography and Screen-Film Mammography in Breast Cancer Screening: A Review in the Irish Breast Screening Program

Abstract: OBJECTIVE. Clinical trials to date into the use of full-field digital mammography (FFDM) for breast cancer screening have shown variable results. The aim of this study was to review the use of FFDM in a population-based breast cancer screening program and to compare the results with screen-film mammography.MATERIALS AND METHODS. The study included 188,823 screening examinations of women between 50 and 64 years old; 35,204 (18.6%) mammograms were obtained using FFDM. All films were double read using a 5-point rating scale to indicate the probability of cancer. Patients with positive scores were recalled for further workup. The recall rate, cancer detection rate, and positive predictive value (PPV) of FFDM were compared with screen-film mammography.RESULTS. The cancer detection rate was significantly higher for FFDM than screen-film mammography (6.3 vs 5.2 per 1,000, respectively; p = 0.01). The cancer detection rate for FFDM was higher than screen-film mammography for initial screening and subsequent scree...