Screening for Breast Cancer
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.