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Women’s Cancer Q&A: Advances in Care

WebMD’s women's cancer expert, Harold J. Burstein, talks to WebMD's chief medical editor about treatment advances, research breakthroughs, and the prognosis for the future.

What about mammograms? Experts say they are the best detection we have, although not everyone agrees on how effective they are.

Mammography is a remarkably effective tool. That said, it is not a perfect tool, and that’s where the controversy lies. Even though it’s the best screening tool we have, it can still miss breast cancers in some women. And in other women mammograms may indicate something abnormal, but further testing shows there’s nothing to worry about. So some women undergo what some consider to be unnecessary testing, including a possible biopsy.

There is also debate about which women might need something more than a mammogram. For example, some women have dense breast tissue, which makes it more difficult to detect a tumor with a mammogram screening.

Even so, my view is that there’s no question women should get mammograms on a regular basis starting at age 40. There’s no question that the last decade’s decrease in breast cancer death rates in the United States and Western Europe is due in large part to public health programs such as widespread mammography.

The news on the screening front right now is trying to figure out who needs extra testing and what tests we should give. The most commonly discussed “other test” is the MRI, a very sensitive technique that allows a radiologist to look in more detail at breast tissue, to pick up smaller abnormalities that may be difficult to see or may be hidden on a mammogram.

Still, while our threshold for ordering an MRI has gotten lower, not every woman needs an MRI.

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