Correcting a decade of negative news about mammography

Abstract

It's been ten years since the U.S. Preventive Services Task Force pulled back on recommendations for breast cancer screening in women ages 40-49 years. After a decade of negative reports, most physicians are aware of mammography's limits. Today, many women avoid, delay or deliberately skip getting screened. As invasive breast cancer rates have been rising, and breast cancer remains a leading cause of death, truthful information about screening is critical for public health. Unfortunately, many reports about mammography exaggerate its harms and overestimate overdiagnosis. The public should be aware of current evidence supporting the benefit of breast cancer screening, including a 40% decline in the U.S. mortality rate in the mammography era. Delayed diagnosis has a downside, about which women should be informed. Contrary to popular views, breast cancer stage remains a key determinant of long-term prognosis. For the most common form of breast cancer, small tumor size and lack of lymph node involvement portend significantly better outcomes than larger tumors with positive nodes. Although mammography is not full-proof, the technology continues to improve; it is currently the best tool for finding breast cancer before it is greater than 2 centimeters or has spread. Interdisciplinary discussion of this topic by primary care physicians, oncologists, radiologists, public health experts, pathologists, and patient advocates would serve women's health.

Application of molybdenum target X-ray photography in imaging analysis of caudal intervertebral disc degeneration in rats

“…As molybdenum target X-ray photography has high contrast, high resolution and favorable repeatability and produces clear images of micro-calcifications, it is often used for breast examination, especially the screening of breast cancer[ 17 ]. A conventional X-ray machine, with the tube anode surface made of tungsten, produces short waves, hard X-rays with strong penetrability.…”

The Role of Surgical Axillary Staging Prior to Immediate Breast Reconstruction in the Era of De-Escalation of Axillary Management in Early Breast Cancer

“…The low number of nodal metastasis, and particularly the low rate of SLN macrometastasis found in our study, may be explained by the well-established Swedish National Breast Cancer Screening program, which is available for all Swedish women within the age range of 40–74 years [ 10 , 11 ]. Mammography screening enables the detection of breast cancer at an early stage before palpation is possible.…”

“…Since the introduction of a public mammography screening service, the prevalence of breast cancer patients presenting with heavy burden lymphatic metastasis at the time of diagnosis has declined [ 10 , 11 ], and the importance of PMRT for breast cancer patients with minor metastatic burden has been questioned [ 12 ]. For patients with only sentinel lymph node (SLN) micrometastasis (≤2 mm), PMRT is today not routinely recommended [ 2 , 7 ].…”

Invasive lobular carcinoma mammographic findings: correlation with age, breast composition, and tumour size

“…Within the cohort of patients, women aged < 50 and ≥ 70 years showed statistically significantly larger tumours, and these results could be at least partially ascribed to the absence of routine examinations for most of these patients. In fact, previous studies reported that patients who perform routine breast examination show a smaller tumour size at diagnosis [ 36 , 37 ].…”