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Early detection of breast cancer is critical. Yet efforts to cut back on mammography or even stop screening altogether have been gaining ground in the medical community's decades-long debate over testing and treatment. It is not a purely scientific debate--back-room politics and hidden agendas have played as much a role as clinical data, leading to some surprising conclusions. Written by one of the first physicians in the country to specialize in breast cancer risk assessment, genetic testing and high-risk interventions, this book focuses on the screening controversy and explains the arguments used on both sides. The author covers the history of screening, from the first mobile unit on the streets of Manhattan to the cutting edge imaging technology of today.
The outlook for women with breast cancer has improved in recent years. Due to the combination of improved treatments and the benefits of mammography screening, breast cancer mortality has decreased steadily since 1989. Yet breast cancer remains a major problem, second only to lung cancer as a leading cause of death from cancer for women. To date, no means to prevent breast cancer has been discovered and experience has shown that treatments are most effective when a cancer is detected early, before it has spread to other tissues. These two facts suggest that the most effective way to continue reducing the death toll from breast cancer is improved early detection and diagnosis. Building on the 2001 report Mammography and Beyond, this new book not only examines ways to improve implementation and use of new and current breast cancer detection technologies but also evaluates the need to develop tools that identify women who would benefit most from early detection screening. Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis encourages more research that integrates the development, validation, and analysis of the types of technologies in clinical practice that promote improved risk identification techniques. In this way, methods and technologies that improve detection and diagnosis can be more effectively developed and implemented.
In this report The Breast Cancer Research Foundation (BCRF) and the Institute of Medicine (IOM) present a one-day symposium that was held at the IOM to further disseminate the conclusions and recommendations of the joint IOM and National Research Council report, Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis. The committee assembled for this event was asked to share insights and consider ways in which the objectives of the report could be achieved from the standpoint of what women need to know, the best models of screening programs, manpower, risk stratification, basic research, and payment. This symposium seeks to provide continuing food for thought and ideas for actions in support of breast cancer detection and diagnosis and saving women's lives.
'This book gives plenty of examples of ad hominem attacks, intimidation, slander, threats of litigation, deception, dishonesty, lies and other violations of good scientific practice. For some years I kept a folder labeled Dishonesty in breast cancer screening on top of my filing cabinet, storing articles and letters to the editor that contained statements I knew were dishonest. Eventually I gave up on the idea of writing a paper about this collection, as the number of examples quickly exceeded what could be contained in a single article.' From the Introduction The most effective way to decrease women's risk of becoming a breast cancer patient is to avoid attending screening. Mammography screening is one of the greatest controversies in healthcare, and the extent to which some scientists have sacrificed sound scientific principles in order to arrive at politically acceptable results in their research is extraordinary. In contrast, neutral observers increasingly find that the benefit has been much oversold and that the harms are much greater than previously believed. This groundbreaking book takes an evidence-based, critical look at the scientific disputes and the information provided to women by governments and cancer charities. It also explains why mammography screening is unlikely to be effective today. All health professionals and members of the public will find these revelations disturbingly illuminating. It will radically transform the way healthcare policy makers view mammography screening in the future. 'If Peter Gotzsche did not exist, there would be a need to invent him ...It may still take time for the limitations and harms of screening to be properly acknowledged and for women to be enabled to make adequately informed decisions. When this happens, it will be almost entirely due to the intellectual rigour and determination of Peter Gotzsche.' From the Foreword by Iona Heath, President, RCGP 'If you care about breast cancer, and we all should, you must read this book. Breast cancer is complex and we cannot afford to rely on the popular media, or on information from marketing campaigns from those who are invested in screening. We need to question and to understand. The story that Peter tells matters very much.' From the Foreword by Fran Visco, President, National Breast Cancer Coalition.
Breast Imaging presents a comprehensive review of the subject matter commonly encountered by practicing radiologists and radiology residents in training. This volume includes succinct overviews of breast cancer epidemiology, screening, staging, and treatment; overviews of all imaging modalities including mammography, tomosynthesis, ultrasound, and MRI; step-by-step approaches for image-guided breast interventions; and high-yield chapters organized by specific imaging finding seen on mammography, tomosynthesis, ultrasound, and MRI. Part of the Rotations in Radiology series, this book offers a guided approach to breast imaging interpretation and techniques, highlighting the nuances necessary to arrive at the best diagnosis and management. Each chapter contains a targeted discussion of an imaging finding which reviews the anatomy and physiology, distinguishing features, imaging techniques, differential diagnosis, clinical issues, key points, and further reading. Breast Imaging is a must-read for residents and practicing radiologists seeking a foundation for the essential knowledge base in breast imaging.
The enormous expansion seen over the last decade in the mammo graphic detection of breast cancer lesions, especially the use of screen ing procedures for the early detection of clinically unsuspected tumors, has made it necessary to summarize the experience made by various centers in the world. The 2nd International Copenhagen Symposium on Detection of Breast Cancer afforded an opportunity of gathering scientists from all over the world to discuss the various problems of early breast cancer detection with special reference to screening procedures. This book forms a synthesis of the information presented by leading scientists from many of the world's mammo graphic centers, particularly those in Sweden and the USA. Hence, the reader will have the opportunity to study the outstanding work carried out by various institutes and centers of breast cancer screening. It is our sincere hope that a study of this volume will encourage other scientists to join in the work on screening procedures. S. Brunner B. Langfeldt P. E. Andersen Contents S. A. Feig: 1 Hypothetical Breast Cancer Risk from Mammography S. A. Feig: Benefits and Risks of Mammography 11 R. L. Egan and M. B. McSweeney: Multicentric Breast Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . 28 M. B. McSweeney and R. L. Egan: Breast Cancer in the Younger Patient: A Preliminary Report 36 M. B. McSweeney and R. L. Egan: Bilateral Breast Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . ' 41 N. Bjurstam: The Radiographic Appearance of Normal and Metastatic Axillary Lymph Nodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 M. Moskowitz, S. A. Feig, C. Cole-Beuglet, S. H.
This book provides a comprehensive description of the screening and clinical applications of digital breast tomosynthesis (DBT) and offers straightforward, clear guidance on use of the technique. Informative clinical cases are presented to illustrate how to take advantage of DBT in clinical practice. The importance of DBT as a diagnostic tool for both screening and diagnosis is increasing rapidly. DBT improves upon mammography by depicting breast tissue on a video clip made of cross‐sectional images reconstructed in correspondence with their mammographic planes of acquisition. DBT results in markedly reduced summation of overlapping breast tissue and offers the potential to improve mammographic breast cancer surveillance and diagnosis. This book will be an excellent practical teaching guide for beginners and a useful reference for more experienced radiologists.