The Use of Diagnostic Tests for Screening and Evaluating Breast Lesions
Journal: Annals of Internal Medicine (1985)

Position Papers1 July 1985The Use of Diagnostic Tests for Screening and Evaluating Breast LesionsHEALTH AND PUBLIC POLICY COMMITTEEHEALTH AND PUBLIC POLICY COMMITTEESearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-1-143 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEach year approximately 115 000 cases of breast cancer are diagnosed in the United States; this malignancy is the commonest cause of cancer-related mortality in women (1). Because evidence exists that early detection is beneficial, such efforts may represent the best opportunity for the practicing physician to lessen cancer mortality in women. Screening for breast cancer in asymptomatic women depends upon tests with high sensitivity in order to detect cancer at early stages, whereas adequate specificity is required in order to avoid the financial and personal costs associated with unnecessary diagnostic efforts in women without malignancy. Evaluation of a palpable...References1. Facts and Figures. New York: American Cancer Society; 1984. Google Scholar2. HALLADAMSSTEINSTEPHENSONGOLDSTEINPENNYPACKER DCGHMH. Improved detection of human breast lesions following experimental training. Cancer. 1980;46:408-14. CrossrefMedlineGoogle Scholar3. PENNYPACKERBLOOMCRISWELL HHE. Toward an effective technology of instruction in breast self-examination. Int J Mental Health. 1982;11:98-116. CrossrefGoogle Scholar4. HALLGOLDSTEINSTEIN DMG. Progress in manual breast examination. Cancer. 1977;40:364-70. CrossrefMedlineGoogle Scholar5. . BSE: Breast Self-Examination: A Health Practice for Everyone. New York: American Cancer Society; Form #246. Google Scholar6. BYRD B. Close-up: Standard breast examination. CA. 1974;24:290-3. Google Scholar7. Women's Attitudes Towards Breast Cancer. New York: Gallup Organization; 1973. Google Scholar8. MAHONEYBIRDCOOKE LBG. Annual clinical examination: the best available screening test for breast cancer. N Engl J Med. 1979;301:315-6. CrossrefMedlineGoogle Scholar9. HUGULEYBROWN CR. The value of breast self-examination. Cancer. 1981;47:989-95. CrossrefMedlineGoogle Scholar10. FOSTERLANGCOSTANZAWORDENHAINESYATES RSMJCJ. Breast self-examination practices and breast-cancer stage. N Engl J Med. 1978;299:265-70. CrossrefMedlineGoogle Scholar11. GREENWALDNASCALAWRENCE PPC. Estimated effect of breast self-examination and routine physician examinations on breast-cancer mortality. N Engl J Med. 1978;299:271-3. CrossrefMedlineGoogle Scholar12. FELDMANCARTERNICASTRIHOSAT JAAS. Breast self-examination: relationship to stage of breast cancer at diagnosis. Cancer. 1981;47:2740-5. CrossrefMedlineGoogle Scholar13. CAINE P. Teaching breast self-examination. In: Marchant D, Nyirjesy I, eds. Breast Disease: Proceedings of an International Symposium. New York: Grune & Stratton; 1979. Google Scholar14. BOICEMONSON JR. Breast cancer in women after repeated fluoroscopic examinations of the chest. JNCI. 1977;59:823-30. CrossrefMedlineGoogle Scholar15. KOPANSMEYERSADOWSKY DJN. Breast imaging. N Engl J Med. 1984;310:960-7. CrossrefMedlineGoogle Scholar16. HICKSDAVISLAYTONPRESENT MJJA. Sensitivity of mammography and physical examination of the breast for detecting breast cancer. JAMA. 1979;242:2080-3. CrossrefMedlineGoogle Scholar17. MOSKOWITZ M. Screening for breast cancer: how effective are our tests? A critical review. CA. 1983;33:26-39. Google Scholar18. SHAPIROVENETSTRAXROESER SWWR. 10-14 year effect of screening on breast cancer mortality. JNCI. 1982;69:349-55. MedlineGoogle Scholar19. BAKER L. The Breast Cancer Detection Demonstration Project: five-year summary report. CA. 1982;32:194-225. Google Scholar20. EGAN R. Experience with mammography in a tumor institution: evaluation of 1000 studies. Radiology. 1960;75:894-900. CrossrefMedlineGoogle Scholar21. KARSELL P. Mammography at the Mayo Clinic: a year's experience. Mayo Clin Proc. 1974;49:954-7. MedlineGoogle Scholar22. CLARKCOPELANDEGAN RMR. Reproducibility of the technic of mammography, and fine-needle aspiration cytology in diagnosis of breast tumors. Am J Surg. 1965;109:127-33. CrossrefMedlineGoogle Scholar23. THOMASFITZHARRISREDDING JBW. Clinical examination, xeromammography, and fine-needle aspiration cytology in diagnosis of breast tumors. Br Med J. 1978;2:1139-41. CrossrefMedlineGoogle Scholar24. FORREST A. Cancer of the breast: early diagnosis. Br Med J. 1970;2:465-7. CrossrefGoogle Scholar25. JOHANSSON N. Thermography of the breast: a clinical study with special reference to breast cancer detection. Acta Chir Scand (Suppl). 1976;460:3-91. MedlineGoogle Scholar26. COLE-BEUGLETGOLDBERTKURTZRUBINPATCHEFSKYSHABER CBACAG. Ultrasound mammography: a comparison with radiographic mammography. Radiology. 1981;139:693-8. CrossrefMedlineGoogle Scholar27. KLINENEAL TH. Needle aspiration biopsy: a critical appraisal. Eight years and 3, 267 specimens later. JAMA. 1978;239:36-9. CrossrefMedlineGoogle Scholar28. SCHONDORF H. Aspiration Cytology of the Breast. Philadelphia: W. B. Saunders; 1978. Google Scholar29. . Periodic health examination: a guide for designing individualized preventive health care in the asymptomatic patient. Ann Intern Med. 1981;95:729-32. LinkGoogle Scholar30. EDDY E. ACS report on cancer-related health checkup. CA. 1980;30:194-240. Google Scholar31. VERBEEKHOLLANDHENDRICKSMRAVUNACSTURMANSDAY ARJMFN. Reduction of breast cancer mortality through mass screening with modern mammography: first results of the Nijmegen Project, 1975-81. Lancet. 1984;1:1222-4. CrossrefMedlineGoogle Scholar32. COLLETTEDAYROMBACHDE WAARD HNJF. Evaluation of screening for breast cancer in a non-randomised study (the DOM project) by means of a case-control study. Lancet. 1984;1:1224-6. CrossrefMedlineGoogle Scholar33. TABARGAD LA. Screening for breast cancer: the Swedish trial. Radiology. 1981;138:219-22. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: AMERICAN COLLEGE OF PHYSICIANS Philadelphia, Pennsylvania*This paper was authored by Alvin I. Mushlin, M.D., and was developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Donald E. Olson, M.D., Chairman; David Banta, MD.; Howard S. Frazier, M.D.; Richard B. Hornick, M.D.; Seymour Perry, M.D.; and Willis C. Maddrey, M.D. Members of the Health and Public Policy Committee for the 1984-85 term include Edwin P. Maynard III, M.D., Chairman; John H. Eisenberg, M.D.; Richard G. Farmer, M.D.; Daniel D. Federman, M.D.; John R. Hogness, M.D.; Leo E. Hollister, M.D.; Charles E. Lewis, M.D.; Donald E. Olson, M.D.; Malcolm L. Peterson, M.D.; Theodore B. Schwartz, M.D.; and Helen L. Smits, M.D. This paper was adopted by the Executive Committee of the Board of Regents on 28 January 1985. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe costs and effects of cervical and breast cancer screening in a public hospital emergency room. The Cancer Control Center of Harlem.Breast Cancer Screening for Elderly Women with and without Comorbid Conditions A Decision Analysis ModelJeanne S. Mandelblatt, MD, MPH, Mary E. Wheat, MD, Mark Monane, MD, MS, Rebecca D. Moshief, MBA, James P. 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MUSHLIN, M.D., Sc.M. 1 July 1985Volume 103, Issue 1Page: 143-146KeywordsBreast cancerCancer detection and diagnosisCancer screeningLesionsMortalityPrevention, policy, and public healthPublic policySafetySpecificitySub-specialty care ePublished: 1 December 2008 Issue Published: 1 July 1985 Copyright & Permissions© 1985 American College of PhysiciansPDF downloadLoading ...