What price reassurance?: The high cost of routine mammography in younger women

摘要

The incidence of breast cancer has been declining for more than a decade, perhaps as a result of the dramatic reduction in the use of postmenopausal therapy with combined estrogen and progestin. Far more significantly, breast cancer deaths have been declining for the past 25 years. This is likely due to an improved understanding of relevant cancer biology, better therapies, and advances in screening technologies and their utilization. However, the prevalence of breast cancer rises with age, making screening more efficacious in older women and lowering the positive predictive value (PPV) of screening in younger women.