ABSTRACT
Breast cancer is the most prevalent cancer and ranks second as a cause of cancer death among American women (American Cancer Society, 2011). Despite the recent controversial recommendations by the U.S. Preventive Services Task Force (2009), considerable evidences continue to indicate that early diagnosis and treatment resulting from mammographic screening signicantly improve the chance of survival for patients with breast cancer (Hendrick and Helvie, 2011; Mook et al., 2011; Tabár et al., 2011; van Schoor et al., 2011). Although mammography has a high sensitivity for the detection of breast cancers when compared to other diagnostic modalities, studies indicate that radiologists’ sensitivities vary over a wide range (Breast Cancer Surveillance Consortium, 2009; Elmore et al., 2009). A major problem in screening mammography is the limited sensitivity in dense breasts (Mandelson et al., 2000; Pediconi et al., 2009) due to the reduced conspicuity of lesions obscured by overlapping dense broglandular tissue. Another problem in screening is the high recall rate (Schell et al., 2007). Many of these recalls are caused by overlapping tissue mimicking a lesion. Finally, the specicity of screening mammography for dierentiating lesions as malignant and benign is
very low. In the United States, the positive predictive value of recommended biopsies ranges from about 15% to 30% (Rosenberg et al., 2006). Recall and benign biopsies not only cause patient anxiety, but also increase health care costs.
