Early detection of breast cancer: mammography.

Detection of early breast cancer utilizing mammography can be accomplished through more frequent and earlier use of the test as well as exploring techniques to improve sensitivity and specificity. Efforts at educating primary care physicians about the role of mammography as well as training technologists and radiologists in performing optimum examinations and correctly interpreting them is of prime importance. The use of computers may aid in increasing the sensitivity of the examinations and may also provide improved feature analysis for the radiologist, thus enhancing the separation of benign and malignant disease. New technologies also show promise to improve the accuracy of mammography. Direct digital mammography and digital enhancement of standard mammograms are actively being investigated. The use of MRI and specifically 31P spectroscopy shows initial promise to increase the specificity of mammography. Several clinical trials are also under way to assess a possible niche which fine needle aspiration biopsy (FNAB) may occupy in the quest for early breast cancer detection. Any future collaborative work between Japan and Western countries should take into account the potential of these new methods for improving the sensitivity and specificity of mammography.