Radiologic clinics of North America
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Radiol. Clin. North Am. · Sep 2010
ReviewThe use of breast imaging to screen women at high risk for cancer.
Although there currently is no evidence of reduced breast cancer mortality for screening women at high risk with mammography, magnetic resonance (MR) imaging, or ultrasonography (US), the presumptive evidence of early cancer detection provided by numerous observational studies has led to the publication of guidelines and recommendations for the selective use of these imaging modalities. In general, annual screening mammography is recommended for women of appropriately high risk beginning at age 30 years, supplemental screening with MR imaging is recommended for a subset of women at very high risk, and screening US is suggested for women for whom MR imaging is appropriate but unavailable, impractical, or poorly tolerated. The use of screening US remains controversial among women who have no substantial risk factors other than dense breasts.
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Radiol. Clin. North Am. · Sep 2010
ReviewCost-effectiveness of mammography, MRI, and ultrasonography for breast cancer screening.
Screening mammography performed annually on all women beginning at age 40 years has reduced breast cancer deaths by 30% to 50%. The cost per year of life saved is well within the range for other commonly accepted medical interventions. Various studies have estimated that reduction in treatment costs through early screening detection may be 30% to 100% or more of the cost of screening. ⋯ Further studies are needed to determine whether MRI is cost-effective for those at moderately high (15%-20%) lifetime risk. Future technical advances could make MRI more cost-effective than it is today. Automated whole-breast ultrasonography will probably prove cost-effective as a supplement to mammography for women with dense breasts.