Screening mammography: a missed opportunity

By age 80, 1/10 women will be diagnosed with breast cancer. Both positive and negative associations have been reported between alcohol consumption and breast cancer. Minority women are less likely to undergo breast cancer screening. All women admitted for alcohol detoxification in an urban setting with a high minority population were offered screening mammography, using American Cancer guidelines. Women with previously diagnosed breast cancer were excluded from the study. The mammograms were performed by standard technique in the hospital radiology department. The subjects with positive mammograms were referred for further diagnostic studies, as determined by the internist managing the patient's care. Of the 117 women admitted, 28 were excluded due to age. Only one woman, previously treated for breast cancer, was also excluded. Of the 88 women screened, abnormalities were detected in 32. The women with normal mammograms did not differ from those with abnormal studies in: (1) age; (2) years of alcohol consumption; (3) age at menarche; (4) parity; (5) age at first full term pregnancy; and (6) personal history of benign breast disease or family history of breast cancer. The alcohol detoxification unit provides a unique opportunity to screen women for breast cancer. Compliance with initial screening is high but resistance is encountered if further diagnostic studies are required to evaluate suspicious lesions. Surprisingly, in this study, the number of suspicious lesions detected was not higher than expected.