Developing the Ideal Breast Cancer Screening Test

Thirty-five years after mammography screening demonstrated a 30 percent mortality reduction,1 researchers are still searching for an ideal breast cancer screening tool. At the recent American Society of Clinical Oncology (ASCO) meeting in San Francisco, members of an Institute of Medicine panel described their recommendations to spur development of such a test. Earlier this year, the panel issued a report titled Mammography and Beyond: Developing New Technologies for the Early Detection of Breas

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A premise of the report is that mammography is the gold standard to which all emerging detection technologies should be compared. Because nothing yet has proven more effective than mammography, "wider use of mammography should be encouraged," Craig Henderson, IOM panel vice chair and adjunct professor of medicine at the University of California, San Francisco, told ASCO attendees. Yet even though the panel considered mammography as the only test to prove effective for population-wide screening (i.e., testing healthy asymptomatic individuals for early signs of breast cancer), the panel nonetheless drew attention to its limitations.

"Despite advances in mammography, it has never proven better than it was 35 years ago when it was relatively crude," said Henderson. Additionally, mammography has important limitations. Among Henderson's concerns were the 15 percent of interval tumors [that] develop between screening exams and the difficulty imaging dense breasts and breasts of women on hormone replacement therapy. ...

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