Mammography and Early Breast Cancer Detection: How Screening Saves Lives

Publication Date:  August 8, 2016

Publisher: McFarland & Co., Inc. (Jefferson, NC)


…a book intended to offer frank discussions about difficult screening controversies, without the veneer of political correctness that can shroud true understanding.

Mammography and Early Breast Cancer Detection: How Screening Saves Lives covers the history of mammography and population screening, the epidemiology behind screening, and an in-depth look at the controversies over guidelines.  Politics, personalities, and hidden agendas are covered in detail, as the reader will get an inside look at the battles being waged behind the scenes.  The message is simple — major breakthroughs have occurred in breast imaging technology, yet their implementation is being held in check on the basis of data that originated from what is now obsolete technology.  The book concludes with the strategies being used to customize multi-modality screening in order to improve detection rates, minimize harms, and simultaneously improve cost-effectiveness.

Table of Contents

Acknowledgments vii
Preface 1
1. Last Word vs. Final Word 5
2. Early Diagnosis May Be the Key, but It’s Not a Lock 10
3. Biology Can Trump, but Size Matters 16
4. Prostate Is Not Breast, So Give It a Rest 22
5. The Four Horsemen That Inflate the Power of Mammography 31
6. The Four Horsemen Are Throttled by Clinical Trials, but O Canada! 41
7. The Mammography Civil War (1993-1997) 49
8. The Number Games 61
9. The (Over)Selling of Mammography 67
10. The Evidence for ­Evidence-Based Medicine (or, How to Raise the
Bar of Bias: An Editorial) 74
11. Blame It on Canada (and Something’s Rotten in Denmark, Too) 82
12. Overdiagnosis: Embracing Your Inner Malignancy 88
13. Overdiagnosis Part 2: A Way Out of the Wet Paper Bag 95
14. The Task Force Opens Fire 105
15. The Zombies Among Us 121
16. Circumstantial ­Evidence-Based Medicine 128
17. The Social Tsunami of ­Anti-Screening 137
18. The 2015 ACS Peace Accord–Science or Societal Pressure? 144
19. A Journey to the Pathology Lab to View the ­By-Products of Screening 152
20. Risk-Based Screening–It Feels So Right, but Wait… 168
21. The Greatest Story Never Told 178
22. The Myth of Mammography 184
23. Do These Genes Make Me Look Dense? 192
24. The Emperor of All Modalities 201
25. The Bright Side of the Dark Side of the Force 210
26. The Crystal Ball Is Fair to Partly Cloudy 222
Chapter Notes 229
Bibliography 241
Index 247