Update in Breast Cancer Screening
HS Lam
Hong Kong J Radiol 2004;7:171-80
Breast cancer screening by mammography has been practised in many countries on the basis of the results of published randomised controlled trials. Recently, there has been a lot of discussion about the validity of these trials. This review presents a history of the controversies surrounding mammography screening. The protocols in breast cancer screening in various countries are discussed, and limitations and risks of mammography screening are listed. Finally, several modalities that have the potential to improve the efficiency of breast cancer screening are highlighted. All told, mammography with or without clinical breast examination remains the gold standard for breast cancer screening, and mammography screening will reduce breast cancer mortality. However, its benefit decreases and harm increases as the incidence of breast cancer decreases. It is important that women be informed about the potential benefits, risks, and limitations when they undergo breast cancer screening.