The impact of mammography screening on the diagnosis and management of early-phase breast cancer

This chapter provides a comprehensive review of the conflicting theories concerning better control of breast cancer. The evidence from randomized controlled trials and service screening, based upon individualized patient data, overwhelmingly confirms that detection and treatment of breast cancer at an earlier phase have accomplished a significantly reduced mortality from the disease. The revolution in breast imaging and its impact upon breast cancer management, despite the unquestionable benefits, have incited a debate over the perceived benefits and risks of current practice. The pros and cons of this ongoing debate are carefully analyzed in this chapter. As breast cancer is detected at an ever-earlier phase, the complexity of the disease challenges the current terminology and necessitates the diagnostic and therapeutic team members to reevaluate the standards of care, which have been based upon palpable, advanced breast cancer. Better correlation of imaging with histopathology necessitates large-section histopathology technique to provide a more reliable determination of surgical margins, tumor extent, and especially demonstration of the multifocal and diffusely infiltrating forms of breast cancer. Adding the mammographic tumor features to the current histologic prognostic features improves the prediction of long-term patient outcome and facilitates treatment planning.