Mammography as a Screening Tool

By Priyanka Varma, Barbara Guido

BURLINGAME, Calif. Oct 29th, 2021

Mammography entails taking an X ray picture/ image of the breast. It is the current recommended modality to screen for breast cancer per the Centers for Disease Control and Prevention [1]. The goal of screening is to ultimately reduce the risk of breast cancer associated deaths and complications[2]. 

Screening for breast cancer implies checking for breast cancer in women not presenting with any signs or symptoms of the disease. The biggest benefit of mammography is that it helps catch the disease early, when the patients can avail of several treatment modalities, which can eventually improve the prognosis for the patient. Early detection of the disease is the key to improved prognosis [3].

The limitations of mammography are low sensitivity ~67.8% and specificity 75%. It has a high false positive rate, which leads to unnecessary supplemental diagnostic tests and biopsies to confirm the diagnosis, causing undue anxiety. It is also less effective in women younger than 40 years and those with dense breasts, which make up approximately 50% of the women getting mammograms aged 40 and older [2, 3,4].

Besides screening, mammography is also indicated as a diagnostic tool when a woman presents with a lump or other symptoms potentially indicative of breast cancer, like breast pain, thickening of skin of breast, nipple discharge, change in breast size or shape. Diagnostic mammograms can also be used as a supplemental test to a screening mammogram. The difference between the two lies in more number of images taken, higher dose of radiation, magnification of the suspicious area and the longer duration of the procedure in diagnostic mammograms [5].

Footnote:

• Sensitivity: Denotes the fraction of people with the disease who tested positive.
• Specificity: Denotes the fraction of people without the disease who tested negative.
• False Positive: Denotes receiving a positive test result of breast cancer when there is none.

Bibliography:

1. What Is a Mammogram? | CDC
2. https://www.uspreventiveservicestaskforce.org/Home/GetFileByID/2811
3. Wang L. Early Diagnosis of Breast Cancer. Sensors (Basel). 2017;17(7):1572. Published 2017 Jul 5. doi:10.3390/s17071572
4. Dense Breasts: Answers to Commonly Asked Questions - National Cancer Institute
5. https://www.cancer.gov/types/breast/mammograms-fact-sheet#how-are-screening-and-diagnostic-mammograms-different

‍

‍