The outcome of breast cancer is biologically predetermined by the presence or absence of micrometastases. The investigation of any breast abnormality must involve ‘triple assessment’-clinical examination, imaging and cytology. Each of these diagnostic modalities complements the others, and together improves the diagnostic yield. Screening for breast cancer in women aged 50-65 years enables the detection and treatment of cancers at an asymptomatic stage and the mortality can be reduced by a quarter. However, the problems of bias (lead time, length and selection) and interval cancers are the short-comings. In addition, there is an ongoing debate as to the value of mammographic screening in women under 50. The article reviewed the role of ‘triple assessment’ in the detection of breast cancer and the rationale for a breast screening programme.
Elroy Patrick Weledji and Joshua Tambe
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