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Noninvasive Diagnostic Tests for Breast Abnormalities: Update of a 2006 Review [Internet]

Noninvasive Diagnostic Tests for Breast Abnormalities: Update of a 2006 Review [Internet]

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US)

Version: February 2012

Introduction

Breast cancer is the second most common malignancy of women. The American Cancer Society estimates that in the United States in 2010, 54,010 women were diagnosed with new cases of in situ cancer, 207,090 women were newly diagnosed as having invasive breast cancer, and there were 39,840 deaths due to this disease. In the general population, the cumulative risk of being diagnosed with breast cancer by age 70 is estimated to be 6 percent (lifetime risk of 13%).,

Methods

AHRQ requested an update of the evidence report Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities. The original report was finalized in February 2006. Due to technological advances and continuing innovation in the fields of noninvasive imaging, the conclusions of the original report are possibly no longer relevant to current clinical practice. Consequently, the topic was selected for update. The EPC recruited a technical expert panel (TEP) to give input on key steps including the selection and refinement of the questions to be examined. The expert panel membership is provided in the front matter of this report.

Executive Summary

Breast cancer is one of the most common malignancies of women, with approximately 200,000 new cases diagnosed every year in the United States. Some breast cancers are identified by physical examination (either self-examination or an examination performed by a physician). Population-wide screening programs that use x-ray mammography to examine asymptomatic women for early signs of breast cancer are also in common use.– If a suspicious area is seen on x-ray mammography, women are usually recalled for further examination. The results of these examinations are used to make decisions about further management: return to normal screening/return for short-interval followup/refer for biopsy. In current standard practice the examinations conducted after recall usually consist of diagnostic mammography and possibly ultrasound. More and more often women are being sent for additional imaging during recall workup. Extensive diagnostic ultrasound examinations and MRI are currently the most commonly chosen additional imaging added to the workup, but other imaging technologies are offered by some practitioners.

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