Usefulness of Mammography

The practice of mammography can be divided into three categories: screening, diagnosis and surveillance. Screening involves examination of asymptomatic women in an attempt to detect breast cancer before a lesion is palpable. Diagnostic mammography is performed on women having symptoms or physical findings suspicious for breast cancer or for further mammographic workup of a nonpalpable finding detected at screening. Surveillance mammog-raphy provides follow-up of a breast that has been treated for cancer. The usefulness of mammography in the symptomatic patient is undisputed; mammography is primarily used to demonstrate the presence of breast cancer and, specifically to indicate the size, location and extent of tumor. There is also considerable evidence indicating the ability of mammography to detect nonpalpable cancer. In addition, randomized controlled trials of screening mammography have demonstrated a significant decline in breast cancer mortality among screened women age 50 and older (Strax et al., 1973; Tabar et al., 1985; 1987; 1992; 1996; 2000; 2001), age 40 to 49 (Chu et al., 1988; Shapiro et al., 1988), and overall for women age 40 and older (Hendrick et al., 1997; Humphrey et al., 2002; Tabar, 1987; Tabar et al., 1993; 1995).

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