Screening for the early detection of breast cancer

The mortality rate of carcinoma of the breast has remained unchanged for the last 60 years. Screening by means of physical examination and mammography can significantly improve the mortality associated with this disease, but the procedures have been underutilized. Surveys indicate that among the major reasons for the failure of utilization are questions concerning efficacy, fear of radiation and costs. The amount of radiation delivered to the breast during mammography no longer poses a significant risk and there is ample documentation that screening mammography can detect occult disease. Although there is an unequivocal benefit for those older than 50 years of age, debate concerning the 40 to 50 age group continues. Objections center primarily about the expense of mammography. Current cost-cutting techniques suggest that the procedure can be justified for all women older than 40 years.