Technical developments in mammography.

The art, science, and technology of mammography have developed steadily over the past 35 y. Mammography is a central tool for diagnosis of symptoms of breast cancer. In addition, periodic screening of asymptomatic women in certain age groups has been clearly demonstrated to contribute to reduction of mortality from breast cancer. Technical improvements have allowed the examination to be carried out at substantially lower radiation dose than was necessary to obtain a good image in the 1970's, while at the same time providing greatly improved contrast, spatial resolution, dynamic range and tissue coverage. Digital mammography overcomes many of the technical limitations inherent in screen-film mammography and has been shown to offer increased accuracy for women under 50 and those with dense breasts. The radiation risk associated with mammography cannot be ignored, however, modern analysis suggests that it is very low, especially compared to the benefits from the exam. Nevertheless, imaging should be conducted with careful attention to efficient use of the radiation. New techniques, currently under development and evaluation, promise to add further to the value of mammography.