Breast cancer is a leading cause of cancer in women. Despite declining mortality rates, breast cancer ranks just below lung cancer as a major cause of cancer death. Traditional screening mammography, which uses analog-film technology, has improved identification of abnormalities in breast architecture and evidence of calcification. Newer, computer-based digital equipment was developed to overcome the limitations of film mammography by improving the early detection of cancerous lesions, streamlining the processing and dissemination of images, and increasing diagnostic accuracy. However, instances of false-positive examinations and over-diagnosis remain problems with both modalities. A number of large-scale randomized clinical trials have demonstrated that digital mammography is more accurate and reliable in women below the age of 50 and possibly in those with dense breast tissue. The relative merits of these screening methods in other demographic groups, such as in premenopausal, perimenopausal, and postmenopausal women, and in those with a genetic predisposition to breast cancer, remain to be explored. The findings have helped shape the development of treatment guidelines issued by medical societies, cancer advocacy groups, and governmental bodies, and have important implications for radiologic technologists.
After reading this article, the participant should be able to:
- Explain the epidemiology of breast cancer and role of mammography in improving detection and evaluation.
- Distinguish the comparative advantages and disadvantages of digital and film mammographic technologies.
- Summarize the results and clinical implications of the key large-scale comparative clinical studies.
- Assess how those findings have been incorporated into the major practice guidelines.
- Evaluate which technical approach is better for different patient subsets.