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2013 ; 126
(6
): 472-9
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Beyond mammography: new frontiers in breast cancer screening
#MMPMID23561631
Drukteinis JS
; Mooney BP
; Flowers CI
; Gatenby RA
Am J Med
2013[Jun]; 126
(6
): 472-9
PMID23561631
show ga
Breast cancer screening remains a subject of intense and, at times, passionate
debate. Mammography has long been the mainstay of breast cancer detection and is
the only screening test proven to reduce mortality. Although it remains the gold
standard of breast cancer screening, there is increasing awareness of
subpopulations of women for whom mammography has reduced sensitivity. Mammography
also has undergone increased scrutiny for false positives and excessive biopsies,
which increase radiation dose, cost, and patient anxiety. In response to these
challenges, new technologies for breast cancer screening have been developed,
including low-dose mammography, contrast-enhanced mammography, tomosynthesis,
automated whole breast ultrasound, molecular imaging, and magnetic resonance
imaging. Here we examine some of the current controversies and promising new
technologies that may improve detection of breast cancer both in the general
population and in high-risk groups, such as women with dense breasts. We propose
that optimal breast cancer screening will ultimately require a personalized
approach based on metrics of cancer risk with selective application of specific
screening technologies best suited to the individual's age, risk, and breast
density.
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