Breast cancer: screening and early detection.

A comprehensive program for breast cancer screening and early detection has a number of components. First, an understanding of the magnitude of the breast cancer problem and the natural history of breast cancer is essential. Appropriate screening guidelines must be identified and adopted into practice. Screening recommendations must be promoted actively. While breast cancer screening guidelines can be applied broadly to the general population, patients who are at increased risk must be identified through formal risk assessment. For those at increased risk, earlier screening and prevention strategies can be recommended. Physicians must be prepared to manage the abnormalities identified in screening and make appropriate referrals for treatment. Finally, patients identified with cancer must be staged accurately, as this staging will determine the prognosis.