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Mammography in symptomatic and asymptomatic patients
1Dana-Farber Cancer Institute, Boston, Massachusetts.
Hematology/Oncology Clinics of North America
|December 1, 1989
Summary
Screening mammography significantly reduces breast cancer mortality in women over 50. However, its benefit in women under 50 remains unclear, with some studies showing no reduction or even an increase in mortality.
Area of Science:
- Oncology
- Radiology
- Public Health
Background:
- Screening mammography is widely accepted for reducing breast cancer mortality.
- Evidence from randomized trials supports its efficacy in women aged 50 and above.
- Data on the benefit for women under 50 is limited and conflicting.
Purpose of the Study:
- To evaluate the effectiveness of screening mammography in reducing breast cancer mortality.
- To analyze the impact of mammographic screening across different age groups.
- To assess the role of mammography in detecting recurrent breast cancer.
Main Methods:
- Analysis of data from three randomized controlled trials (HIP, S2C, Mälmo) involving 238,000 women.
- Review of mortality results and subgroup analyses for women under 50.
- Examination of diagnostic yields and techniques in mammography screening.
Main Results:
- Significant reductions in breast cancer mortality were observed in two trials (HIP, S2C) for women aged 50+.
- One trial (Mälmo) showed a non-significant reduction.
- Conflicting results for women under 50, with some studies showing increased mortality, while one showed a benefit potentially attributed to other factors.
- Mammography detected 35% of recurrent cancers in irradiated breasts.
Conclusions:
- Screening mammography is effective in reducing breast cancer mortality in women over 50.
- The benefit of mammographic screening in women under 50 requires further investigation, particularly from ongoing trials.
- High-quality mammography techniques and routine follow-up are crucial for early detection and management, especially in post-treatment surveillance.