Benefits of screening mammography: a review for the primary care physician

Abstract

Background: Screening mammography, particularly for women in their 40s, has become a confusing issue for many physicians. Recent scientific and political controversies regarding screening guidelines have added to this confusion.

Methods: Many randomized clinical trials have shown the benefits of mammographic screening for women over the age of 50, and recent studies show a statistically significant benefit for women in their 40s as well. Understanding the screening controversy requires an understanding of the principle of screening for disease, the epidemiology of breast cancer, and the results of the many randomized clinical trials, particularly recent data from the Swedish two-county trials. An appreciation of the improvements in mammographic quality in recent years, and in the education of the radiologists who interpret these studies, will also heighten clinical acceptance of this screening technique.

Results: Both the American Cancer Society and American College of Radiology endorse annual mammographic screening for women over age 40, and there is compelling evidence to support these recommendations.

Conclusion: Radiologists, primary care providers, surgeons, and pathologists should work together to enhance the benefits of and access to screening mammography.