Detection of breast cancer. A practitioner's viewpoint

Ultimate responsibility for the early diagnosis of breast cancer rests upon the front line or primary care physician, just as management decisions following diagnosis fall principally upon the surgeon, radiotherapist, and oncologist. The value of mammography as an effective screening test for the early detection of disease has been enthusiastically endorsed over the past several years on the basis of encouraging results of several studies. Serious reservations regarding the safety of mammography as a screening procedure have subsequently been raised. The practicing physician is faced with a serious problem of time lag in gathering information upon which to base clinical decisions. The purpose of this article is to review the pros and cons in the controversy over mammography so that informed decisions can be made on behalf of patients.