Transillumination in breast cancer detection: screening failures and potential.

This prospective study of 1265 women referred to a multimodality breast diagnostic center compares the sensitivity for breast cancer detection of state-of-the-art transillumination light scanning and film-screen mammography. Of 33 biopsy-proven cancers, transillumination light scanning detected 58%, while mammography detected 97% of the cancers. Light scanning did detect 55% of the nonpalpable breast cancers, and 30% of those tumors smaller than 1 cm. Detection of breast cancer by light scanning was affected by breast size, but not architecture, and was directly related to tumor size. Although transillumination light scanning can detect some small curable breast cancers (smaller than 1 cm), it does not do so at a sensitivity adequate for screening. An example is illustrated in which light scanning detected an occult breast cancer before the development of recognizable mammographic changes.