ReviewWorks

Breast cancer is the most common form of cancer in women and the second leading cause of cancer deaths in American women. In 2009, approximately 194,280 patients are estimated to be diagnosed with invasive breast cancer, and 62,280 with carcinoma in situ. An estimated 40,610 will die of this disease. For a woman of average risk, the lifetime incidence of breast cancer is one in eigh

Screening of asymptomatic women has been accredited for the decline in mortality of breast cancer. The current recommendations from the American Cancer Society for normal-risk women are as follows: 1) Yearly mammogram starting at age 40. The age at which screening should be stopped should be individualized by considering the potential risks and benefits of screening in the context of overall health status and longevity; and 2) Clinical breast exam every 3 years for women in their 20’s and 30’s, and every year for women 40 and older. The evidence to justify mammography for population-based screening is derived from both randomized and several non-randomized clinical trials. Eight randomized trials totalling hundreds of thousands of patients include the Health Insurance Plan of New York, four studies from Sweden, one from the United Kingdom, and two from Canada. The US BCDDP (Breast Cancer Detection Demonstration Project), the largest study of mammography and clinical breast exam, also demonstrated that screening decreases breast cancer mortality.