Systematic Review of the Effectiveness of Mammography and Alternative Screening Methods in Breast Cancer Programs

Breast cancer is still one of the main reasons women get sick and die, which has brought a lot of attention to screening programs that try to find the disease early and increase survival rates. For a long time, mammography has been the usual way to check for breast cancer. However, it has some problems, like giving fake positives and negatives and not working as well in women with thick breast tissue. These problems have led to the search for other screening methods. This study looks at how well mammography and newer alternative screening methods find breast cancer. It looks at their pros and cons and how they might be able to improve current screening methods. Mammography is widely used, but it has been criticized for not being sensitive enough, especially in younger women and women with thicker breast tissue, where it may miss cancers or give false results that lead to tests that aren't needed. Even with these problems, mammography has been shown to lower the death rate from breast cancer in older women through regular screening, and it is still the gold standard in many national breast cancer programs. New options like ultrasound, MRI, DBT, and CEM show promise in making sensitivity and precision better. Ultrasound, especially when used with mammograms, can help find breast cancer in women with thick breasts, but the accuracy depends on how skilled the expert is. MRI is better at finding breast cancer, especially in people who are at a high risk, but it is more expensive and doesn't find as many cancers. This means that more false positives and needless treatments happen. Digital breast tomosynthesis (DBT) gives three-dimensional images, which compared to regular mammography increases the number of cancers found while decreasing the number of false positives and the need for follow-up images. Contrast-enhanced mammography (CEM), which combines the benefits of mammography with contrast agents, may help doctors make more accurate diagnoses, especially for women whose breast tissue is thick.