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The Use of Diagnostic Tests for Screening and Evaluating Breast Lesions

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Grant support: The development of this paper by the Clinical Efficacy Assessment Project was funded by the John A. Hartford Foundation.

▸Requests for reprints should be addressed to Linda Johnson White; Clinical Efficacy Assessment Project, Department of Health and Public Policy, American College of Physicians, 4200 Pine Street; Philadelphia, PA 19104.

*This paper was authored by Alvin I. Mushlin, M.D., and was developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Donald E. Olson, M.D., Chairman; David Banta, MD.; Howard S. Frazier, M.D.; Richard B. Hornick, M.D.; Seymour Perry, M.D.; and Willis C. Maddrey, M.D. Members of the Health and Public Policy Committee for the 1984-85 term include Edwin P. Maynard III, M.D., Chairman; John H. Eisenberg, M.D.; Richard G. Farmer, M.D.; Daniel D. Federman, M.D.; John R. Hogness, M.D.; Leo E. Hollister, M.D.; Charles E. Lewis, M.D.; Donald E. Olson, M.D.; Malcolm L. Peterson, M.D.; Theodore B. Schwartz, M.D.; and Helen L. Smits, M.D. This paper was adopted by the Executive Committee of the Board of Regents on 28 January 1985.

AMERICAN COLLEGE OF PHYSICIANS; Philadelphia, Pennsylvania

© 1985 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1985;103(1):143-146. doi:10.7326/0003-4819-103-1-143
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Each year approximately 115 000 cases of breast cancer are diagnosed in the United States; this malignancy is the commonest cause of cancer-related mortality in women (1). Because evidence exists that early detection is beneficial, such efforts may represent the best opportunity for the practicing physician to lessen cancer mortality in women. Screening for breast cancer in asymptomatic women depends upon tests with high sensitivity in order to detect cancer at early stages, whereas adequate specificity is required in order to avoid the financial and personal costs associated with unnecessary diagnostic efforts in women without malignancy. Evaluation of a palpable




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