Topic
Mammography
About: Mammography is a research topic. Over the lifetime, 20643 publications have been published within this topic receiving 513679 citations.
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TL;DR: Over 10 years, one third of women screened had an abnormal test result that required additional evaluation, even though no breast cancer was present, and Physicians should educate women about the risk of a false positive result from a screening test for breast cancer.
Abstract: Background The cumulative risk of a false positive result of a breast-cancer screening test is unknown. Methods We performed a 10-year retrospective cohort study of breast-cancer screening and diagnostic evaluations among 2400 women who were 40 to 69 years old at study entry. Mammograms or clinical breast examinations that were interpreted as indeterminate, aroused a suspicion of cancer, or prompted recommendations for additional workup in women in whom breast cancer was not diagnosed within the next year were considered to be false positive tests. Results A total of 9762 screening mammograms and 10,905 screening clinical breast examinations were performed, for a median of 4 mammograms and 5 clinical breast examinations per woman over the 10-year period. Of the women who were screened, 23.8 percent had at least one false positive mammogram, 13.4 percent had at least one false positive breast examination, and 31.7 percent had at least one false positive result for either test. The estimated cumulative risk...
1,056 citations
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TL;DR: M mammography alone, and also mammography combined with breast ultrasound, seems insufficient for early diagnosis of breast cancer in women who are at increased familial risk with or without documented BRCA mutation, but if MRI is used for surveillance, diagnosis of intraductal and invasive familial or hereditary cancer is achieved with a significantly higher sensitivity and at a more favorable stage.
Abstract: Purpose To compare the effectiveness of mammography, breast ultrasound, and magnetic resonance imaging (MRI) for surveillance of women at increased familial risk for breast cancer (lifetime risk of 20% or more). Patients and Methods We conducted a surveillance cohort study of 529 asymptomatic women who, based on their family history and/or mutational analysis, were suspected or proven to carry a breast cancer susceptibility gene (BRCA). A total of 1,542 annual surveillance rounds were completed with a mean follow-up of 5.3 years. Diagnostic accuracies of the three imaging modalities used alone or in different combinations were compared. Results Forty-three breast cancers were identified in the total cohort (34 invasive, nine ductal carcinoma-in-situ). Overall sensitivity of diagnostic imaging was 93% (40 of 43 breast cancers); overall node-positive rate was 16%, and one interval cancer occurred (one of 43 cancers, or 2%). In the analysis by modality, sensitivity was low for mammography (33%) and ultrasoun...
1,050 citations
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TL;DR: In this paper, the authors compared contrast enhanced magnetic resonance imaging (CE MRI) with mammography for screening of women genetically predisposed to breast cancer and found that CE MRI is more sensitive than mammography.
1,023 citations
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TL;DR: Despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography has only marginally reduced the rate at which women present with advanced cancer, suggesting that screening is having, at best, only a small effect on the rate of death from breast cancer.
Abstract: BackgroundTo reduce mortality, screening must detect life-threatening disease at an earlier, more curable stage. Effective cancer-screening programs therefore both increase the incidence of cancer detected at an early stage and decrease the incidence of cancer presenting at a late stage. MethodsWe used Surveillance, Epidemiology, and End Results data to examine trends from 1976 through 2008 in the incidence of early-stage breast cancer (ductal carcinoma in situ and localized disease) and late-stage breast cancer (regional and distant disease) among women 40 years of age or older. ResultsThe introduction of screening mammography in the United States has been associated with a doubling in the number of cases of early-stage breast cancer that are detected each year, from 112 to 234 cases per 100,000 women — an absolute increase of 122 cases per 100,000 women. Concomitantly, the rate at which women present with late-stage cancer has decreased by 8%, from 102 to 94 cases per 100,000 women — an absolute decreas...
1,004 citations
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TL;DR: In the community, mammography remains the main screening tool while the effectiveness of clinical breast examination and self-examination are less, and new screening modalities are unlikely to replace mammography in the near future for screening the general population.
Abstract: ContextBreast cancer screening in community practices may be different from
that in randomized controlled trials. New screening modalities are becoming
available.ObjectivesTo review breast cancer screening, especially in the community and to
examine evidence about new screening modalities.Data Sources and Study SelectionEnglish-language articles of randomized controlled trials assessing
effectiveness of breast cancer screening were reviewed, as well as meta-analyses,
systematic reviews, studies of breast cancer screening in the community, and
guidelines. Also, studies of newer screening modalities were assessed.Data SynthesisAll major US medical organizations recommend screening mammography for
women aged 40 years and older. Screening mammography reduces breast cancer
mortality by about 20% to 35% in women aged 50 to 69 years and slightly less
in women aged 40 to 49 years at 14 years of follow-up. Approximately 95% of
women with abnormalities on screening mammograms do not have breast cancer
with variability based on such factors as age of the woman and assessment
category assigned by the radiologist. Studies comparing full-field digital
mammography to screen film have not shown statistically significant differences
in cancer detection while the impact on recall rates (percentage of screening
mammograms considered to have positive results) was unclear. One study suggested
that computer-aided detection increases cancer detection rates and recall
rates while a second larger study did not find any significant differences.
Screening clinical breast examination detects some cancers missed by mammography,
but the sensitivity reported in the community is lower (28% to 36%) than in
randomized trials (about 54%). Breast self-examination has not been shown
to be effective in reducing breast cancer mortality, but it does increase
the number of breast biopsies performed because of false-positives. Magnetic
resonance imaging and ultrasound are being studied for screening women at
high risk for breast cancer but are not recommended for screening the general
population. Sensitivity of magnetic resonance imaging in high-risk women has
been found to be much higher than that of mammography but specificity is generally
lower. Effect of the magnetic resonance imaging on breast cancer mortality
is not known. A balanced discussion of possible benefits and harms of screening
should be undertaken with each woman.ConclusionsIn the community, mammography remains the main screening tool while
the effectiveness of clinical breast examination and self-examination are
less. New screening modalities are unlikely to replace mammography in the
near future for screening the general population.
990 citations