There are a wide range of technological innovations that have fundamentally altered the field of health care. One such innovation is mammography. Mammography is a breast imaging method that involves the use of x-ray technology to create images of the breast and identify signs of breast cancer and other diseases. It can be used for both the screening and diagnosis of harmful breast conditions. When evaluating an image, the doctor looks for areas of the breast tissue that appear different from other areas, which can indicate abnormalities like malignant tumors, benign tumors, fibroadenomas, and complex cysts (“Mammography,” 2017).
Mammography has changed significantly over the course of its history, so its usage is far different today than it was when it was first introduced in the field of health care. The first scientist to attempt to use x-ray technology to visualize breast cancer was Dr. Albert Salomon in 1913, but it was not until 1930 that U.S. research Stafford L. Warren produced scientific evidence that mammography could be used to diagnose breast conditions and introduced the idea that comparing right and left breasts was important when evaluating mammograms. The method of mammography advanced in 1951 when radiologist Raul Leborgne in Uruguay introduced breast compression (“The History of the Mammogram,” 2015). This led to the familiar procedure for a mammogram exam that is used today, in which the breast is place on a flat support plate, compressed with a paddle, and then imaged by passing a burst of x-rays through the tissue (“Mammography,” 2017). In 1969, the film mammogram was invented, making it possible to record the images on film, and in 1972, the technology was enhanced with the introduction of a high-definition intensifying screen, which created better images while also exposing the patient to less radiation (“The History of the Mammogram,” 2015).
By the mid 1970’s, mammography had gained widespread acceptance as a breast cancer screening tool in the medical community, and it was endorsed by the American Cancer Society in 1976. In 1993, The American College of Radiology established the Breast Imaging and Reporting Data System (BI-RADS), which was a number-based scoring system for reporting mammogram results.
This changed the way that mammography was being used by standardizing it across the health care field (“The History of the Mammogram,” 2015). Another major innovation came in the year 2000, When the Federal Drug Administration (FDA) approved digital mammography. This made it possible to record an image of the breast that could be stored in a digital file, rather than creating a hard copy (Bassett, 2000). As a result, it became possible to store mammograms directly within electronic health records (EHRs) and to organize them with annotations and procedural reports within a patient’s EHR (National Institute of Biomedical Imaging and Bioengineering, 2011). Then, in 2013, digital breast tomosynthesis, also known as 3D mammography, was introduced. This makes it possible to create mammograms that allow physicians to evaluate individual slices of breast tissue when identifying or treating breast disease (Hodgson et al, 2016).
There are both positive and negative implications of mammography use. On the positive side, mammography enables the early detection of breast cancer and other breast diseases. According to the CDC, breast cancer is the most common cancer in women, with 230,815 women diagnosed in 2013 (U.S. Cancer Statistics Working Group, 2016). Early detection can increase the patient’s chances of survival. After detection, mammography can also be used to diagnose the patient’s condition and to monitor their condition over time. Moreover, now that digital mammography has made it possible to store mammograms in electronic health records, it is easy to transmit images between different members of the patient’s health care team, enabling a higher degree of integrated care (Bassett, 2000).
However, it is important to note that there are also negative implications of mammography use. For example breast tissue exposure to radiation can pose a safety risk for the patient undergoing a mammogram, especially if she is under the age of 40. Mammograms can also sometimes be difficult to interpret, making it difficult for physicians to provide and accurate diagnosis without supplementing the mammogram with additional images from ultrasound and magnetic resonance imaging (MRI) exams (“Mammograms,” 2017).
Another recent concern about mammograms is that they are leading many women to get health care treatment that they do not actually need. For example, some studies have shown that as many as one-third of the breast tissue abnormalities that are identified by mammograms do not end up causing health problems. Nevertheless, women are being treated with mastectomies and lumpectomies, which can be both traumatic and expensive. Still, the debate about the usefulness of getting regular mammograms continues (Stein, 2017). The American Cancer Society changed its recommendations for the age at which women should get mammograms in 2015, pushing back the starting age from 40 to 45 (Stein & Inskeep, 2015), but mammograms continue to be the main tool for breast cancer screening.
In the future, research on digital breast tomosynthesis is likely to continue. Specifically, researchers are looking for ways to improve the reliability and cost-effectiveness of the technology (Houssami, 2015). The growing concern about unnecessary breast cancer treatment also has the potential to change the way that mammography is used in the health care field in the future. Either way, there is no doubt that this innovation has had a significant impact on the field of health care since its inception.
