are then repeated to take side view images of the breast. For women with breast implants, more pictures and views may be needed. The entire process takes only twenty minutes. The x- ray images are then acknowledged and read by a radiologist doctor and sent to the medical provider. A diagnostic mammogram is often done if a woman has breast symptoms or if a change is seen on a screening mammogram, with spot or magnification views for a closer look to the area of concern (American Cancer Society, 2017). Validity and Reliability of Mammograms The efficacy of mammographic screening in the reduction of breast carcinoma mortality has been demonstrated in randomized controlled trials. Randomized controlled trials showed a dramatic decrease of breast cancer death at 63 percent amongst women ages 40-69 who went for regular mammogram screenings (Tabar et al., 2001). In 2017, the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), researchers enrolled healthy women ages 45 to 74 in a randomized trial to compare two types of digital mammography, conventional 2-D or 3-D, for breast cancer screening (National Cancer Institute, 2017). Once the efficacy of mammographic screening was established, organized breast carcinoma screening, also known as service screening, began to be recommended in many countries to women belonging to defined age groups. Sensitivity and Reliability
As with every diagnostic test, the sensitivity and specificity of mammography screenings are not 100 percent conclusive. An article states, with various spectrums of sensitivity and specificity for detecting breast cancer, the risk of receiving a false positive mammogram for women undergoing biennial screening from age 50 to 69 years in Europe is about 20 percent, and the risk of experiencing a biopsy due to a false positive test is only 3 percent (Tabár et al., 2001). The risk is more prevalent in the US, where the 10-year false positive rate is higher at 30%, and 50% of all women will at some point experience a false-positive mammogram result (Tabár et al., 2001). Psychological and financial challenges come with having a false positive test, losing time, money, and impaired well-being and health behavior. The economic barriers include higher use
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