McLelland R, Pisano E D
Department of Radiology, University of North Carolina School of Medicine, Chapel Hill.
Radiol Clin North Am. 1992 Jan;30(1):235-41.
Mammography has had a major impact on the earlier detection, treatment options, and management decisions and survival and mortality rates of breast cancer. Consequences include overwhelming demand for mammography; problems with optimum response by radiology; limited availability of the examination, especially to the socioeconomically disadvantaged; self-referral for mammography by unqualified physicians for less than altruistic reasons; and unrealistic expectations of mammography by women, physicians, and lawyers. Responses to the overwhelming demand for high-quality mammography include ACR postgraduate and continuing education courses and its mammography accreditation program; a more comprehensive examination on mammography for certification by the ABR; and increasing state and federal government interest and legislation for reimbursement, quality assurance, and delivery of mammography. The precedents this sets for radiology if not all of medicine suggests that collaboration of the private and public sectors offers the greatest promise of an appropriate response, namely reproducible optimum mammography accurately interpreted with the lowest possible radiation dose for all eligible women in the United States.
乳腺X线摄影术对乳腺癌的早期检测、治疗方案、管理决策以及生存率和死亡率产生了重大影响。其后果包括对乳腺X线摄影术的需求激增；放射科的最佳响应存在问题；该检查的可及性有限，尤其是对社会经济地位不利的人群；不合格医生出于非利他原因自行推荐乳腺X线摄影检查；以及女性、医生和律师对乳腺X线摄影术抱有不切实际的期望。针对对高质量乳腺X线摄影术的巨大需求，采取的应对措施包括美国放射学会（ACR）的研究生和继续教育课程及其乳腺X线摄影认证计划；美国放射学会（ABR）进行的更全面的乳腺X线摄影检查认证；以及州和联邦政府对乳腺X线摄影术报销、质量保证和提供方面的兴趣增加及相关立法。这为放射学乃至整个医学树立的先例表明，公私部门的合作最有可能带来恰当的应对，即在美国为所有符合条件的女性提供以尽可能低的辐射剂量进行准确解读的可重复的最佳乳腺X线摄影检查。
