Early
detection of breast cancer is critical to survival. One in eight women will
have breast cancer in their lifetime, with an early stage (American Cancer
Society) survival rate of 99 percent for five years. Given these figures and
the known limitations of the current detection of breast cancer,
it is
imperative to ask the difficult questions surrounding the detection of breast
cancer. Improved early detection translates into saved lives, less extreme
surgical procedures and lower costs.
The
following questions must be asked for better
detection of the condition:
How to
classify the breast abnormality?
The classification
system for Breast Imaging Reporting and Data Services (BI-RADS) was created to
help healthcare providers categorize breast abnormalities based on their
likelihood of malignancy (scale 0–6), but each category covers a wide range. An
additional BI-RADS system is also used to categorize the percentage of dense
breast tissue that appears in the breasts of a woman (A-D scale); patients are
reported in over half of the country density.
Is it
breast cancer or benign?
Anomalies
in the breast may be suspicious or questionable, but they are ultimately
benign. This can lead to uncertainty in patients receiving false positive test
results. All diagnoses have known ambiguity, which contributes to false
positive outcomes. When an initial finding is identified as breast cancer and
later determined to be benign, a false positive occurs.
Is the
possibility of cancer overlooked?
Breast
tissue consists of both glandular and fatty tissue. Increased glandular tissuecontributes to increased density of the breast, which may obscure some cancers.
On breast imaging, glandular tissue appears white, similar to cancer, making
early detection more challenging. Legislation in more than half of the country
mandates women is informed of their
breast density level, although the results are reported differently in most
states and are not necessarily met with adequate tools for cancer detection.
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