Mammography screening causes anxiety in women.

Breast cancer is the most frequently diagnosed cancer affecting females in the world, including Taiwan, and is the leading cause of cancer-related mortality in women. Because of the sheer magnitude of this disease, its psychosocial impact and associated morbidity and mortality, screening for early diagnosis may be one of the best strategies we can employ to fight against this insidious ailment. Although various radiographic modalities are readily available to help practitioners identify potentially troubling and suspicious breast cancer lesions, mammography remains the mainstay of breast cancer screening. Dr. Pan and colleagues authored a very impressive article addressing the clinical outcome of an 8-year nationwide mammography screening in Taiwan. Based on the authors' findings, they concluded that there is still room to ameliorate the efficacy of the breast cancer screening process through comprehensive and continued education, improving the competence of cancer detection, and decreasing the number of false negative cases found in mammography screening in Taiwan. In addition, Dr. Pan and his colleagues responded to Dr. Wang's comment and wrote that the risk factors of breast cancer are multifactorial; therefore, it is impractical to expect to reduce the incidence rate of breast cancer from mammographic screening alone. However, this response did not appear to fully address the question. With the exception of certain extremely rare neoplasms, the risk factors for the vast majority of neoplasms are multifactorial. In addition, Pan and colleagues further favored the value of mammographic screening because a properly administered screening program is used to detect lesions at an earlier stage, and hopefully reduce subsequent medical expense and mortality. We completely agree with Dr. Pan's response. However, in our understanding, it would appear that the purpose of Dr. Wang inquiry might be to question the benefit of mammographic screening in Taiwan (did mammography screening indeed increase the outcome of breast cancer?). With this question in mind, a recently released report might be of some important to our audience.