- Screening is for asymptomatic women for the early detection of breast cancer.
- Screening mammography needs to be of high quality and expertly interpreted to detect cancers at an early stage.
- For screening mammography to be effective in significantly reducing the death rate from breast cancer in Australian women, large numbers of women in the target age group must attend regularly.
- Diagnostic mammography is for women who have clinical breast symptoms which require investigation.
Rationale and practice
There is an important distinction between the use of mammography for screening, and its use for diagnostic purposes.
Screening mammography is performed on asymptomatic women for the purpose of detecting unsuspected cancer at an early stage. The early detection of breast cancer increases the likelihood of successful treatment and often allows for more treatment options.
Where screening mammography has been provided in an organised and systematic manner it has been shown to be effective in decreasing mortality from breast cancer by around one third to a half in women over 50 years of age who regularly attend.
Screening mammograms need to be of extremely high quality and be interpreted expertly in order to detect very small cancers. These skills are acquired by training and by experience in the taking and reading of large numbers of screening mammograms by the professionals concerned. An excellent system for assessment is also essential when abnormalities are detected.
To be effective on a population basis, a high compliance rate of attendance of women in the appropriate age range for screening mammography is necessary. Recruitment activity to a screening mammography program needs to be given high priority.
Diagnostic mammography is for women who have clinical breast symptoms which require investigation. Diagnostic mammograms are usually taken in conjunction with clinical assessment. The use of other investigations, particularly breast ultrasound and fine needle aspiration biopsy may also be performed to assist in diagnosing the symptom.
Diagnostic mammography services are not designed to recruit and screen large numbers of women who are likely to benefit from regular screening mammography.
BreastScreen Australia ensures that women for whom screening mammography is most likely to be beneficial are specifically targeted. It also provides an integrated, systematic and high quality service.
A doctor's referral is not required for screening mammography through BreastScreen Australia. Women are systematically recruited to the Program by various strategies aimed at the target population of women aged 50-69 years.