How To Detect Breast Cancer
September 9th, 2011 | 
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Breast cancer is the most common cancer in women and the second leading cause of cancer death in American women. In 2009, approximately 194 280 patients were estimated to be diagnosed with invasive breast cancer and 62 280 with carcinoma in situ. An estimated 40 610 die from the disease. The average risk of a woman who has an incidence of breast cancer throughout the life of eight.
Evaluating asymptomatic women to reduce mortality from breast cancer is accredited. The current recommendation from the American Cancer Society normal women at risk are: 1) an annual mammogram after age 40. The age at which screening should be stopped should be individualized, taking into account the potential risks and benefits of screening in the context of overall health and longevity, and 2) clinical breast exam every three years for women 20 -30 years, and annually for women over 40 years.
BCDDP USA (project for breast cancer detection demonstration), the largest trial in mammography and clinical examination, also shows that screening reduces mortality from breast cancer.
In the last ten years of development in mammography, including digital technology and computer-aided detection. Film (not digital) mammography is estimated to be approximately 65-80% of the sensitivity of the desired specificity of 90%. Researchers DMIST (Digital Mammography Imaging Study) reported that the overall diagnostic accuracy of digital mammography and film alike. However, digital mammography is more accurate in women under 50, the females before the menopause or peri-menopause, and those with dense breasts for the radio. Two years later, another large study comparing mammography mammography digital cinema to read computer-aided detection software. The researchers found that the diagnostic specificity was significantly reduced by 90.2% to 87.2%, and computer-aided detection, but the sensitivity does not change. The biopsy was increased by 19.7%. This technology is expensive and not always translate into better results.
In women at high risk of developing breast cancer, breast cancer screening may include ultrasound and / or MRI (magnetic resonance). High-risk factors are the carriers of BRCA gene, a strong personal or family history of breast cancer, atypia before the ADH (atypical ductal hyperplasia) or LCIS (lobular carcinoma in situ), and prior irradiation of breast. Ultrasound can be useful in dense breasts. Ultrasound testing can lead to biopsies from 4% to 2% of women, the cancer is found in 10% -16% of biopsies. In previous reports, MRI offers a biopsy in 7% -18% of women, breast cancer is detected in 24% -88% of the biopsies. We do not know if the ultrasound or MRI of the breast cancer mortality in the population to reduce the risk that obtained by mammography.
Currently, breast MRI for women with newly diagnosed unilateral breast cancer. A recent publication demonstrates that MRI can detect cancer in the opposite breast missed mammography and clinical examination, 3.1% of cases. The sensitivity of MRI of the contralateral breast was 91%, specificity 88%, and NPV 99%.
Despite the proven success of mammography screening for breast cancer, many researchers in the United States was a decline in its use. The NHS (National Health Interview Survey) estimates for 2005 showed a decrease in mammography screening to 66% versus 70% in 2000. Unfortunately, this may explain the decrease in the incidence of breast cancer is the discovery of new breast cancer.
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