Screening for breast cancer

Abstract

Breast cancer is the leading cause of cancer in women accounting for 30% of all cancers, affects one in eight women, and is the second most common cause of cancer mortality. The size of the cancer at the time of diagnosis has been shown to be the single most important prognostic factor that determines disease outcome. The role of screening mammography is to detect cancer early in the preclinical phase where the chance of cure is the highest. The incidence of breast cancer has been rising in the recent decades, and multiple randomized clinical trials and other studies evaluating the efficacy of screening for breast cancer with mammography have conclusively and overwhelmingly proven the benefit of screening mammography in reducing mortality from breast cancer. This chapter outlines pertinent information useful to clinicians to understand the current data on the effectiveness of screening for breast cancer as well as the potential benefits and harms. The current guidelines and recommendations are outlined. The mammographic signs of cancer, optimizing mammographic interpretation, and the increasing use of digital breast tomosynthesis are discussed. The future trend toward introducing personalized screening tailored to the risk of developing breast cancer is presented, and the role of screening for breast cancer in men who are at a high risk of developing breast cancer is also described.