The Evolution of Mammography

From Table Top gray images to dedicated 3D high quality breast imaging. Still the best way to detect early cancer of the breasts.

I entered private practice after my radiology residency in 1984. We believed yearly screening would catch breast cancer sooner, and that would save lives. Early screening was performed with existing X-ray equipment. The images were inconsistent, and the image quality was poor. Those early attempts were quickly discarded, and dedicated mammography equipment became the standard of care, leading to dramatic improvements in results.

Three Canadian studies (Canadian National Breast Screening Study (CNBSS)) results had been published in the early 1990s and 2000, shaping international guidelines. These studies declared that screening Mammography had little effect on improving the detection and, therefore, the treatment and outcomes of breast cancer.

The most devastating study, which got widespread media attention, was in 2014. “Twenty-five-year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomized screening trial” appeared in BMJ, 2014. Fortunately, subsequent review of this study debunked those studies. Findings showed that the equipment was outdated and often performed, as we had done in the early 80’s, on ordinary X-ray machines. The results were predictably poor.