The current investigation reviewed the efficacy and effectiveness of breast cancer screening techniques used in community practice. An extensive array of databases were examined to obtain English-language articles focusing on randomized controlled trials, meta-analyses, reviews and other studies of community breast cancer screening and new technologies for screening.
- Randomized trials have shown reductions in breast cancer mortality for women between 50 and 69 years of age due to mammography screenings. Studies of community screenings using mammograms show a sensitivity of 75 percent and specificity of 92.3 percent.
- Newer technologies such as full-field digital mammography, computer-aided detection, ultrasound and magnetic resonance imaging (MRI) have varied in efficacy and effectiveness. Ultrasound has been used in focused diagnostic procedures but may have a higher rate of false positives. Breast MRI has higher sensitivity than mammography or ultrasound but generally has lower specificity.
- Clinical breast examination can be improved in terms of sensitivity if physicians spend more time on them and a systematic approach is used. Cancer detection through clinical breast examination is lower than that expected from the randomized trials. Breast self-examination is not done by a large segment of the population and it has low sensitivity in cancer detection.