SCREENING FOR BREAST-CANCER

To be successful, screening procedures must have certain properties: s implicity, acceptability, reasonable costs, and adequate sensitivity. The evolution of mammography over the past 10 years has allowed the ex amination to fall within accepted standards for these properties, and it has become a widely accepted procedure. Its expanded use has result ed in an increase in the detection of early stage disease with a profo und effect upon the treatment of the disease. Survival continues to co rrelate with cancer size and nodal involvement, and the increase in th e number of early cases diagnosed eventually should be reflected in a decreasing mortality rate. Though the efficacy of screening mammograph y for women between the ages of 50 and 69 is well-established, its use fulness in women aged 40-49 has provoked considerable debate. Despite the disagreements concerning appropriate screening thresholds and inte rvals, the American Cancer Society and the American College of Radiolo gy have concluded that sufficient evidence exists to maintain publishe d guidelines.