The essentials of screening mammography

Abstract

HE HISTORY of screening for breast cancer has been T sporadic but persistent, first with periodic physical examination of women's breasts at cancer centers,' then with the addition of mammography' and, more recently, attempts to screen with mammography all had promising results but little acceptance and utilization. Some reasons other than cost for not screening asymptomatic women include mis-informed or uninformed physicians and women; inertia, if not apathy; the low yield and skepticism regarding all screening procedures; fear of radiation exposure; and variable results with diagnostic mammography in screening symptomatic women.6 Another deterrent is the lack of coverage by insurance companies because preventive care, in any form, is usually not covered by medical insurance.With modern mammography most of these obstacles to screening have been or can be resolved. However, cost remains a major deterrent and needs consideration. At the outset it should be made clear that reducing the cost of screening mammography should not be at the expense of quality or accuracy of the examination. Various efforts to address the cost indicate the following: