Advances in breast cancer detection with screening mammography.

Breast cancer is a leading cause of death among women in the United States, but good evidence equates early detection with reduction in breast cancer mortality. X-ray screening mammography remains the most sensitive noninvasive technique for detecting early tumors when women are asymptomatic and cancers may still be noninvasive. Limitations that reduce both sensitivity and specificity are inherent in all medical testing and mammography has been reported to miss 10%-15% of breast cancers. Federal standards, along with marked improvements in technology have led to improved regulation, inspection, and compliance requirements. Refinements continue to be made in film/screen combinations, but the ability to obtain the high contrast required to resolve fine structures with only minor density differences is limited by a narrow dynamic range. Recent technologic developments include Computer-Aided Detection (CAD) and Digital Mammography, which work on the principle that cancers cause specific patterns of abnormality and are immune to fatigue, illness, and distraction. The ImageChecker (R2 Technology, Inc, Los Altos, CA), currently the only FDA approved CAD system, was installed at the Breast Imaging Center of Ochsner and three comprehensive studies were performed by R2 Technology, Inc. The technology is promising.