Breast cancer screening

Abstract

Mammography has been deployed to screen for early breast cancer since the 1980s. Its use has recently and increasingly been called into question in populations with long-established programs, as well as in emerging economies. The biology of breast carcinogenesis differs from those of other cancers amenable to screening in that there is no obligate precursor state. The available screening modalities yield a significant proportion of false positives, thus negatively affecting the benefit-to-harm tradeoff. Future efforts should focus on improving pretest risk stratification, considering new noninvasive adjunct technologies to reduce the need for invasive confirmatory procedures, and incorporating the risk preferences of individual women toward precision screening.