In 1895, Wilhelm Röntgen discovered a high-frequency portion of the electromagnetic spectrum, which he named "X-radiation." The usefulness and success of the technology based on Röntgen's discovery is such that for generations every schoolchild has not only known the term X rays but can give you a basic idea of their most common application: to "see" into and through solid objects. Diagnosing cavities and broken bones are merely the most common of X rays' many medical applications.
This topic page summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on breast cancer screening.
The new breast cancer screening recommendations for women over 40 are surprisingly fraught.
A number of tech companies are now using AI to try to improve the way breast cancer screenings are read. The French startup Therapixel, part of Nvidia’s Inception accelerator program, says its tech can cut down false-positive rates by 5% compared with current state-of-the-art diagnostic tools. An AI program developed at the Houston Methodist Research Institute in Texas recently proved 99% accurate in identifying signs of breast cancer risk by reading mammograms—and could read those images 30 times faster than humans. And in 2017, an annual nine-month-long competition—the Digital Mammography Challenge—attracted over 1,200 participants, illustrating how many AI companies are interested in tackling the challenge of improving breast cancer screening.
Studies have generally shown that the 3-D test is slightly better at detecting cancers than the 2-D test, and women typically have to return less often to have additional images taken. But the jury is still out on whether the newer technology is any better at identifying the advanced cancers that will become lethal.
Artificial intelligence is a ubiquitous term in health tech that has gained both promise and suspicion. In radiology, AI is being investigated as a solution to enable radiologists to more efficiently and effectively improve cancer detection. But as is often the case with new technologies, marketing hype often exceeds the reality of what the solution can actually do.
Physical structures and clinic access are only a piece of the cancer screening problem for people with disabilities.
The task force emphasized that it was not advising against screening for women under 50 or over 74, or against screening every year as opposed to every other year. Rather, it says that women should choose for themselves — but that its guidelines offer the best overall balance of benefits and risks.
While the message of this new study is clear — mammography may not be as good as we thought — it isn’t at all clear what women should do with this information. It’s likely that in light of these concerns, recommendations will change in the future. But how?
The new analysis is refreshing, and significant, because it looks at how mammography affects outcomes besides survival. The investigators examined screening’s capacity to reduce treatment in women who are diagnosed with breast cancer.
I was harmed by mammography screening despite never called back for more views and never having a biopsy resulting in a false alarm, known as a false positive. My harm, known as a false negative, resulting in an advanced breast cancer diagnosis, surfaced within weeks of my annual mammogram. It was after my surprising stage 3C diagnosis that my dense breast tissue, which occurs in 40% of women of mammographic age, was revealed to me.
A 17-year study has concluded that screening mammography — in which all women in certain age groups are routinely screened for breast cancer — does not reduce the incidence of advanced tumors, but does increase the diagnosis of lesions that would never have led to health problems.
If mass mammography was a total public-health success, we’d see the red line for metastatic cancer drop at the same time the blue line for small cancers rises.
Instead, researchers increasingly worry, mammography has failed to reduce illness and death in women with advanced-stage disease. Conversely, more women with tumors that may have never advanced to anything serious are undergoing difficult, costly procedures like surgery and chemotherapy.
Screening may help a few, there's no question. But people need to know both sides of the deal. They need to recognize that all the screening survivors in the media, particularly in breast, thyroid, and prostate cancers, are much more likely to represent the harm of screening — unnecessary diagnoses that were never going to bother anybody — than the benefit of screening, or someone who has actually been spared a cancer death.
Mammography can be an inherently lousy screening test for breast cancer. Women deserve better! Now is an opportune time to replace this outmoded screening tool. The only problem is there is nothing on the horizon, yet.
October is National Breast Cancer Awareness Month. No more excuses! Get your pink on and help create a world without breast cancer.
Putting special interest groups aside, don’t we owe it to ourselves to raise our voices and our pink ribbons in support of the development of even better methods and means of screening for breast cancer for the women we love?
Recent news reports aside, mammography is effective and should begin at age 45.
This may be an opportune time to consider replacing the controversial and imperfect 'gold standard' mammogram with a less invasive screening tool. There must be something out there!
This study is going to make a whole lot of people upset. It’s a large, well designed randomized control trial with a really long follow-up period. The people in the mammogram groups actually complied with screening in surprisingly high numbers. It’s hard to find fault with much of this. The data make a really good case that universal screening with mammograms does almost no good, and likely does harm.
Along with the controversial recommendations of a government panel, the journal provides the most thorough review of accuracy of digital mammography I’ve read. This new study finds that false positives–when women get called back for additional tests, but don't have cancer–turn out to be not so common: just 12% per screen. And most of those are for additional images; only 1.6% led to biopsy. What’s more, in this large analysis of modern screening, radiologists missed less than 0.15% of cancers.
The debate over mammograms centers on two questions. First, how many lives are saved by mammography? Or more specifically, how many tumors are detected early enough with this technology but would be missed by a physical exam until it was too late? Second, to what extent do mammograms increase over-diagnosis?
Cancer screening has come under scrutiny as health care expenditures soar.
A British breast-cancer specialist argues that mammograms may shorten more lives than they extend.
A new study on the value of mammograms in preventing death—or lack thereof—will inspire extremely important discussion. One key distinction in terms is "survival rate."
More evidence that routine mammograms make healthy people sick.
The new guidelines, which apply to women at average risk, are closer to the U.S. Preventive Services Task Force’s 2009 recommendation that women wait until 50 and have mammograms only every other year.
For women with dense tissue, mammograms can be less accurate so new tests offer better detection but often more false alarms
A new study is merely the latest suggesting that mammograms may net more harm than good. With a new "breast-friendly" procedure in the works, perhaps now is the time to put the mammogram out to pasture.
The MISSION of Are You Dense, Inc. is to educate the public about the risks and screening challenges of dense breast tissue and its impact on missed, delayed and advanced stage breast cancer to reduce advanced disease and mortality.
Breast cancer screening guidelines...
DenseBreast-info.org is an educational resource developed to provide breast density information to both patients and health care professionals.
If you're 40 or older and have an average risk of breast cancer, we recommend that yearly screening mammograms should be part of your healthcare.
Three recent advances in mammography include digital mammography, computer-aided detection and breast tomosynthesis.
The United States Preventive Services Task Force (USPSTF) recommends:
•Women ages 50 to 74 years should get a mammogram every 2 years.
•Women younger than age 50 should talk to a doctor about when to start and how often to have a mammogram.