Mammography

Facts every woman needs to know

The importance of early detection of Breast Cancer

The key in combatting breast cancer is early detection. The size of the breast cancer is the single most important factor that determines prognosis or survival; women with smaller tumors have a significantly better survival rate particularly when the cancer is not palpable. The aim of screening then is to save lives by detecting cancer when they are small and preferably before they can be felt as a breast lump . Numerous large mammography screening trials have unequivocally demonstrated that diagnosing breast cancer in the early preclinical stage reduces significantly the mortality rate. The reduction in advanced stage breast cancer is the most important factor to reduce breast cancer mortality and this is best achieved by timely and appropriate screening. 

Methods of early detection

At the present time mammography is the only modality recommended for screening for breast cancer. The American Cancer Society recommends annual screening for women 40 years and older. Women with a family history of breast cancer should commence screening five to 10 years earlier. Screening with breast ultrasound has been shown to be effective but has not yet been tested in large trials. At the present time ultrasound is not recommended for screening of breast cancer. It may be used as an adjunctive tool in certain specific subsets of women, such as those with a dense tissue pattern on a mammogram or in those who are at a higher risk for breast cancer. Screening with Breast MRI is reserved for a specific set of women with a high risk of breast cancer. 

What can you expect when you undergo screening mammography?

About 1 in 10 women undergoing screening mammography will be asked to come back for additional views usually to clarify a finding on the initial examination. Whenever possible making available prior mammograms aids in the interpretation and reduces the need to return to undergo additional evaluation. Of the women called back following mammographic screening about 10% will be recommended to undergo biopsy for a possible cancer. Among the women undergoing a biopsy procedure about 25-30% may end up with a diagnosis of breast cancer.

Does mammography miss identifying breast cancer?

Yes, about 15% of cancers may be missed at mammography. These are usually in women with dense breasts where a cancer can be obscured, but remember a majority of cancers are diagnosed and mammography is still the best modality available at the present time for early detection of breast cancer.

In conclusion, the regular use of high quality mammography aims to bring about a shift in the balance of breast cancer cases from mainly palpable advanced cases to small impalpable cases still localized to the breast, consequently reducing mortality from breast cancer. Mammography does indeed save lives!

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Board-certified radiologists interpreting imaging procedures for women and newborns in Houston, Texas. Imaging interpretation services to inpatients and outpatients, including emergency services, at The Woman's Hospital of Texas.
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