Study of limitation of mammogram

Abstract

Purpose: The purpose of the study is that mammography screening for breast cancer is widely available in many countries. The goal of screening mammography programs is to decrease mortality from breast cancer. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. Although much attention has been paid to the female breast and its pathologic conditions, the male breast is often times ignored given its rudimentary and nonfunctional nature. However, the male breast is the source of a wide variety of benign and malignant conditions, and particular attention must be paid to palpable abnormalities of the male breast to ensure accurate characterization and diagnosis of these lesions. Mammography has been traditionally used as the imaging modality of choice in the evaluation of the male breast, particularly in distinguishing between gynecomastia and breast carcinoma. Method: The researchers reviewed of several researches discusses the benefits, limitations and harms of mammography screening in light of findings from randomized trials and from more recent observational studies performed in the era of modern diagnostics and treatment. Results: The main benefit of mammography screening is reduction of breast-cancer related death. Relative

reductions vary from about 15 to 25% in randomized trials to more recent estimates of 13 to 17% in meta- analyses of observational studies. In an update of the 2006 review, Gøtzsche and Nielsen reassessed screening

mammography's effect on mortality and morbidity. Eight eligible trials were identified, with one trial excluded due to bias, providing an analysis with 600,000 women. Consistent with the findings of the 2006 review, the three trials with adequate randomization did not show a significant reduction in breast cancer mortality at 13 years (RR= 0.90, 95% CI: 0.79-1.02). These trials did not find an effect of screening on cancer mortality, including breast cancer, after 10 years (RR=1.02, 95% CI: 0.95-1.10) or on all cause mortality after 13 years (RR=0.99, 95% CI: 0.95 -1.03). According to the authors, “Screening is likely to reduce breast cancer mortality. As the effect was lowest in the adequately randomized trials, a reasonable estimate is a 15% reduction corresponding to an absolute risk reduction of 0.05%. Screening led to 30% over diagnosis and overtreatment, or an absolute risk increase of 0.5%. It is thus not clear whether screening does more good than harm Conclusion: Researchers concluded that evidence from studies of varied quality indicate that, overall, mammography screening has a modest effect on breast cancer mortality. When analyzed in absolute terms, the death rate is reduced by just 0.05%. Like with all medical interventions, there are harms associated with screening mammography such as misdiagnosis and overtreatment. Screening mammography can produce inaccurate results, and as a result, many women receive false-positive or false-negative results. A false-positive

result occurs when a mammogram shows a suspicious image, but there is actually no breast cancer. A false- negative result occurs when a woman's mammography results are normal, but she actually has breast cancer.