Breast cancer is the second-most common cancer in women and the leading cause of cancer-related mortality.1 An early diagnosis of breast cancer is essential to maximize the likelihood of successful treatment and long-term survival. Screening mammograms significantly reduce breast cancer mortality, however, the age at which screening should be initiated is controversial. Most breast cancer screening guidelines recommend that screening for most women should begin at age 40 and that women should undergo mammography every 1 to 2 years.2 Screening at earlier ages may be considered for some high-risk patients. Accurate patient positioning is essential for optimal breast screening, diagnosis, and subsequent care. The mammographer has the critical responsibility to perform an accurate review of patient history and previous images and provide quality images in spite of different breast and body types. Screening mammograms are performed on asymptomatic patients and are typically limited to craniocaudal and mediolateral oblique views, however additional views may be required for certain situations. Very few abnormal findings on screening mammograms are diagnosed as breast cancer and, therefore, many patients will require additional imaging or biopsy to further evaluate the suspicious finding. Mammography is essential in other diagnostic imaging and interventional procedures as well including breast sonography, breast ultrasound-guided biopsy, breast magnetic resonance imaging (MRI), MRI-guided biopsy, needle-wire localization, and stereotactic breast biopsy.
After reading this article, the participant should be able to:
- DESCRIBE the impact of screening mammography on breast cancer mortality.
- SUMMARIZE legislation and recent screening guidelines that are relevant to mammography.
- DISCUSS the most common imaging approaches and patient positioning techniques for patients undergoing screening or diagnostic mammography.
- ANALYZE the role of mammography in breast biopsy, magnetic resonance imaging, and needle wire localization.
Categories: Mammography, sonography/ultrasound, MRI