Usefulness of mammography in the diagnosis and management of breast disease in postmenopausal women
A. M. Lamas, R. I. Horwitz and D. Peck
We evaluated the clinical usefulness of mammography in postmenopausal women
by conducting a "vertical" analysis using indexes of sensitivity and
specificity, and a separate "horizontal" analysis assessing the
relationship between the mammographic test result and the occurrence of
specific clinical management decisions. The patients included 105 women
with breast cancer, 104 women with fibrocystic breast disease, and 103
women with clinically benign breasts. Our study confirmed the generally
accepted high values reported for the sensitivity and for the specificity
of mammography as a test for breast cancer, while also helping to reconcile
the widely varying indexes of test efficacy reported in some studies. We
also observed that physicians' management decisions vary according to the
mammographic interpretation, and include such distinctive clinical
strategies as watchful expectancy (observe and follow), repeated
mammograms, or breast biopsy. Future studies will need to determine reasons
for specific management decisions, especially when they appear to
contradict authoritative recommendations.