For example , mammography screening does not seem to create anxiety in women who are given a clear result after a mammogram .
The incidence of breast cancer and mortality increases with age , and the GDG extrapolated that the absolute health benefits are greater in women aged 45 to 49 than those aged 40 to 44 years .
However , for the 45- to 49-year age group , the higher breast cancer incidence and mortality compared with women between the ages of 40 and 44 , as well as observational evidence showing a greater benefit in this age group ( 33 ) , led the GDG to judge that the balance of health effects probably favors screening , although the required re sources for screening likely differ across setting s ( 34 , 35 ) .
Other EtD criteria also were generally in favor of implementing organized mammography screening in this age group .
Despite intensified efforts by the European Council since 2003 , the implementation of organized , population -based mammography screening is not uniform across Europe and depends greatly on the policies in place in different countries , the organization of health care , and available re sources ( 1 ) .
Since the last edition of the European Guidelines on Breast Cancer Screening and Diagnosis was published in 2006 ( 2 ) , new evidence regarding breast cancer and innovation in guideline methodology prompted the European Commission Initiative on Breast Cancer ( ECIBC ) to develop new evidence -based recommendations ( in short , the European Breast Guidelines ) .
These guidelines inform women , health professionals , and policymakers about important questions related to organized mammography screening and breast cancer diagnosis , but recommendations may apply in context s in which organized screening programs are not in place .
Women generally consider these undesirable effects acceptable ( low certainty of evidence ) , and a systematic review suggested that women place a relatively low value on the psychosocial and physical effects of false-positive results and overdiagnosis ; however , some studies raised concerns about whether women fully underst and the result ing implication s ( 15 ) .
How Often Should Women Attend an Organized Mammography Screening Program ?
Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI.
PURPOSE We investigated whether an abbreviated protocol ( AP ) , consisting of only one pre- and one postcontrast acquisition and their derived images ( first postcontrast subtracted [ FAST ] and maximum-intensity projection [ MIP ] images ) , was suitable for breast magnetic resonance imaging ( MRI ) screening . METHODS We conducted a prospect i ve observational reader study in 443 women at mildly to moderately increased risk who underwent 606 screening MRIs . Eligible women had normal or benign digital mammograms and , for those with heterogeneously dense or extremely dense breasts ( n = 427 ) , normal or benign ultrasounds . Expert radiologists review ed the MIP image first to search for significant enhancement and then review ed the complete AP ( consisting of MIP and FAST images and optionally their nonsubtracted source images ) to characterize enhancement and establish a diagnosis . Only thereafter was the regular full diagnostic protocol ( FDP ) analyzed . RESULTS MRI acquisition time for FDP was 17 minutes , versus 3 minutes for the AP . Average time to read the single MIP and complete AP was 2.8 and 28 seconds , respectively . Eleven breast cancers ( four ductal carcinomas in situ and seven invasive cancers ; all T1N0 intermediate or high grade ) were diagnosed , for an additional cancer yield of 18.2 per 1,000 . MIP readings were positive in 10 ( 90.9 % ) of 11 cancers and allowed establishment of the absence of breast cancer , with a negative predictive value ( NPV ) of 99.8 % ( 418 of 419 ) . Interpretation of the complete AP , as with the FDP , allowed diagnosis of all cancers ( 11 [ 100 % ] of 11 ) . Specificity and positive predictive value ( PPV ) of AP versus FDP were equivalent ( 94.3 % v 93.9 % and 24.4 % v 23.4 % , respectively ) . CONCLUSION An MRI acquisition time of 3 minutes and an expert radiologist MIP image reading time of 3 seconds are sufficient to establish the absence of breast cancer , with an NPV of 99.8 % . With a reading time < 30 seconds for the complete AP , diagnostic accuracy was equivalent to that of the FDP and result ed in an additional cancer yield of 18.2 per 1,000
For example , mammography screening does not seem to create anxiety in women who are given a clear result after a mammogram .
The incidence of breast cancer and mortality increases with age , and the GDG extrapolated that the absolute health benefits are greater in women aged 45 to 49 than those aged 40 to 44 years .
However , for the 45- to 49-year age group , the higher breast cancer incidence and mortality compared with women between the ages of 40 and 44 , as well as observational evidence showing a greater benefit in this age group ( 33 ) , led the GDG to judge that the balance of health effects probably favors screening , although the required re sources for screening likely differ across setting s ( 34 , 35 ) .
Other EtD criteria also were generally in favor of implementing organized mammography screening in this age group .
Despite intensified efforts by the European Council since 2003 , the implementation of organized , population -based mammography screening is not uniform across Europe and depends greatly on the policies in place in different countries , the organization of health care , and available re sources ( 1 ) .
Since the last edition of the European Guidelines on Breast Cancer Screening and Diagnosis was published in 2006 ( 2 ) , new evidence regarding breast cancer and innovation in guideline methodology prompted the European Commission Initiative on Breast Cancer ( ECIBC ) to develop new evidence -based recommendations ( in short , the European Breast Guidelines ) .
These guidelines inform women , health professionals , and policymakers about important questions related to organized mammography screening and breast cancer diagnosis , but recommendations may apply in context s in which organized screening programs are not in place .
Women generally consider these undesirable effects acceptable ( low certainty of evidence ) , and a systematic review suggested that women place a relatively low value on the psychosocial and physical effects of false-positive results and overdiagnosis ; however , some studies raised concerns about whether women fully underst and the result ing implication s ( 15 ) .
How Often Should Women Attend an Organized Mammography Screening Program ?