What are the limitations of mammography for breast cancer screening?

Updated: Apr 10, 2019
  • Author: Erin V Newton, MD; Chief Editor: Marie Catherine Lee, MD, FACS  more...
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Mammographic sensitivity for breast cancer declines significantly with increasing breast density, and the risk of breast cancer is higher in women with dense breasts. Hormonal status has no significant effect on the effectiveness of screening independent of breast density.

Although mammography remains the most cost-effective approach for breast cancer screening, it is far from a perfect screening test, with a sensitivity of 76.5% and a specificity of 87.1% for women younger than 40 years. [10] By comparison, the sensitivity and specificity for mammography in women age 75-79 years is 88.4% and 93.5%, respectively. [11]

A retrospective trend analysis compared rates of breast cancer mortality in pairs of neighboring European countries where mammography screening had been implemented at different times. Findings suggest that mammography screening has little detectable impact on mortality due to breast cancer. [12]

Mammography uses low-dose ionizing radiation, which may be harmful to the patient. Nevertheless, the benefits of mammography far outweigh the risks and inconvenience.

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