https://orcid.org/0000-0001-9131-3974
-
Views
-
Cite
Cite
Jennifer A Harvey, Screening: Looking into the Crystal Ball, Journal of Breast Imaging, Volume 2, Issue 3, May/June 2020, Pages 177–178, https://doi.org/10.1093/jbi/wbaa019
Close - Share Icon Share
Extract
When I started reading mammograms in the 1990s, they were film-screen images with an occasional xeromammogram from an outside facility. Every year the quality improved, and I would think, “How could we see any cancers on those older mammograms?” Then came digital mammography, which made me pool all film-screen mammograms into the term “gray-o-grams,” as the contrast was much improved with digital mammography. Screening was straightforward—all women of screening age had a mammogram (hopefully) every year.
Over time, we have recognized the limitations of mammography, particularly for women with dense breasts (1–4), accompanied by a push from our patients with the rise of breast density notification laws. In this issue of JBI, we see that the overwhelming majority (91%) of radiologists responding to a Society of Breast Imaging survey support the communication of density to our patients, with the majority (66%) supporting communication to all patients whether they have dense breasts or not (5). Those who responded to the survey also support notifying patients about the relationship of density and masking as well as the relationship of density to risk, in addition to the possible benefit of supplemental screening, all written at the eighth grade level or less. In our last issue of JBI, Miller et al (6) surveyed women with dense breasts on a prior mammogram and found that although 60% stated that a cancer was likely or very likely to be missed on mammography, only 9% had undergone supplemental screening. Cost, pain, and concern that supplemental screening could lead to additional procedures were cited as the most common barriers. Even if the science demonstrates a benefit to supplemental imaging beyond mammography, use may vary.
