Novel Breast-Imaging Methods

Abstract

For the past several decades, mammography has been the cornerstone of screening for breast cancer. Technology has improved greatly, as has radiologists’ skills in interpreting fi lms. Many studies have attempted to analyze the contribution of regular mammography screening to decreasing mortality from breast cancer. These studies have demonstrated varying results. In 2001, Olsen and Gotzsche published a meta-analysis of mammography screening studies and concluded that no evidence existed that the regular use of screening mammography decreased mortality from breast cancer. This meta-analysis subsequently was attacked for its selection process and methodology, and, in 2002, the U.S. Preventive Services Task Force published guidelines supporting the use of screening mammography for women aged 40 and older, citing “fair evidence that mammography screening every 12–33 months signifi cantly reduces mortality from breast cancer” (p. 344). Despite the endorsement of the U.S. Preventive Services Task Force, screening mammography has its shortcomings. Even in facilities that perform a large number of mammograms, the sensitivity of mammography to detect breast cancer is approximately 80%–85% (Yaakob, 2003). This is a limitation of mammography itself and, in part, results from the diffi culty of imaging dense breast tissue and interpreting the fi lms. For this reason, continual attempts have been made to improve the technology of screening mammography or develop new imaging techniques to replace or complement mammography. Two methods currently under investigation are full-fi eld digital mammography (FFDM) and magnetic resonance imaging (MRI).