There has been controversy for years over the use of screening mammograms as well as the use of breast ultrasound. Well, the controversy continues with some statisticians reporting that screening mammograms cause over-diagnosis, that screening mammograms are key to early breast cancer detection, that 3D mammography may have better detection, and that ultrasound may be a viable alternative (with additional training). None of these articles addresses the potential radiation exposure to mammograms. Clinically what I know is this: that mammography has detected breast cancer in my patients for which they have been able to seek treatment options AND that breast self-examinations have also been important in the detection of breast cancer. At this point, I recommend screening mammograms annually after 50 years of age, although there is increasing evidence that we may be able to reduce screening to once every 2 years. There is also controversy regarding the use of breast MRI screening–I recommend this technique for women with dense breast tissue (per mammogram report) and/or as clinically indicated.
