Breast cancer is among the common chronic diseases in the United States. After skin cancer, it is the second killer chronic illness as physicians diagnose more than 230,000 patients per year with the condition. As a result, healthcare leaders use mammography because it is a critical step towards creating a society that is free from breast cancer. Mammography is an x-ray screening tool that the healthcare settings use to detect breast cancer at an early stage before the manifestation of its symptoms. The approach's aim is detecting cancer at an early stage when still treatable. The mammography test machine work in a simple manner because it is computerized ( Brodersen, 2019). The machine takes breasts' picture with a safe, low-dose, X-ray machine. The image helps the physician to understand and diagnose breast cancer. There are two types of this test, which are computer-Aided detection and digital mammography. Both tests' aim is revealing the abnormal areas of density , mass, or calcification that may indicate the presence of cancer .
During the process, the patient stands facing the mammography machine and places each breast at a time on a flat surface. The technologists lower the upper pad or the compression pad to compress the breast gently against the lower surface. The compression is necessary and desirable for the test as it ensures the breast tissues are spread out, and there is minimal movement during the process. The compression sometimes makes the client feel uncomfortable but it does not hurt. The patients should continuously communicate with the technologists to ensure that the process does not harm them. Any dense tissue such as cancer or calcification appears bright while other less dense tissues such as breast fats appear gray and dark in color.
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There are two critical purposes of why physicians should perform mammography to breast cancer patients. The first is screening mammography, which is essential for the early detection of the condition. Screening is important as it shows changes in the breast caused by cancer years before the patient can feel them. Current American College of Radiology (ACR) and the National Comprehensive Cancer Network (NCCN) guidelines recommend screening mammography every year for women from 40 years. The screening tool targets the alimentation of breast cancer from society and reduces its prevalence. The screening mammography is critical because it creates awareness, mostly for women who have a history of breast cancer. Also, the technique helps ladies at risk of breast cancer due to family history, know their health condition. The next reason for the test is for its diagnostic purposes. During this process, the test examines clinical findings like breast lump or nipple discharge that have discovered by the patient or a physician. In most cases, physicians perform diagnostic mammography after an abnormal screening mammogram to evaluate the area of concern on the screening exam (Atakpa et al., 2018).
The validity and reliability of mammography is a controversial question in the healthcare sector. Different research studies have ascertained that to some level, mammography tools can miss out on about 13% of breast cancer. It is a considerable percentage that has brought about many questions, mostly on the degree of reliability and validity of this tool. Looking at the validity and reliability of this tool can explain the nature of its accuracy as a cancer screening and diagnostic tool. The reliability of a tool or a measurement instrument is its ability to produce consistent results despite the number of times in use to measure a specific attribute. Therefore, the reliability of mammography is at stake because many studies show that under different circumstances, the result varies. For instance, Che Mohamed, Moey & Lim, (2019) did research on this topic to understand the reliability and validity of this tool. From the findings, the authors note that the results are inconsistent. A significant factor that led to the inconsistency was the mammography tool operators' experience and knowledge during the interpretation of the results. In research aiming at establishing the validity and consistency of mammography, Hill & Robinson (2015) discuss that this tool is not entirely reliable. It is because factors like inter- and intra-operator variability and the variability due to lack of proper agreement on interpretation conspire to reduce its reliability. Hill & Robinson (2015) also reveal that in the oncology field, there are many cases of inconsistencies in the mode of interpretation while using the tool. It is because breast images from the mammography based on different features, such as the nipple line, are common.
The validity of a test is the ability to perform its purpose by accurately measuring and providing consistent results. Therefore, a reliable tool must be valid because it measures what people expect of it at any time and produces consistent results. Thus, mammography is not entirely valid to some extent. According to Bairati, Julien & Chiquette (2019) in their study that tries to understand the consistency of mammography, they reveal that the tool is not valid. The authors critique the validity because of the differences in diagnoses due to the perceptions and the level of knowledge of the interpreter. Additionally, other factors like patients' movements during the process reduce the validity of the instrument. Validity means that an instrument must be consistent while measuring the results. Therefore, since there is a question on whether mammography is consistent with its findings, it would be difficult to validate the test.
Another way of understanding whether the mammography test is accurate is knowing its false positive and negative. According to Tsuruda et al. (2018 ), the test is not entirely accurate because it is vulnerable to both false positive and negative. The research reveals that screening mammograms do not diagnose about one in five breast cancers. From the research results, women who have dense breasts are less likely to get accurate results, and they are the victims of false-negative results. Therefore, such results make women think they are safe, yet at risk of developing breast cancer. Tsuruda et al. (2018) also argue that young women often become victims of false-positive results after taking the mammography test. The study shows that false-positive results are more common in younger women with dense breasts, breast biopsies, breast cancer in their families, or are taking estrogen. Furthermore, Tsuruda et al. (2018) emphasis that about half of the women getting annual mammograms over ten years will have a false-positive diagnosis at some point. These are issues experts should address to improve the mammography test.
In conclusion, mammography is the best tool available for breast cancer screening and diagnoses. The instrument is simple to use, and it generally has great importance in the field of oncology and nursing. However, people question its validity because of its inconsistency that is a topic of research in the field of nursing. Fortunately, if experts address the accuracy issues of the mammography test, the tool will be the best for breast cancer screening.
References
Atakpa, E. C., Thorat, M. A., Cuzick, J., &Brentnall, A. R. (2018). Mammographic density, endocrine therapy, and breast cancer risk: a prognostic and predictive biomarker review. Cochrane Database of Systematic Reviews , (8).
Bairati, I., Julien, A. S., & Chiquette, J. (2019). QIM19-119: Validity of the French-Language Mammography Satisfaction Instrument Evaluating Women’s Satisfaction With an Organized Breast Cancer Screening Program: A Confirmatory Study. Journal of the National Comprehensive Cancer Network , 17 (3.5), QIM19-119.
Brodersen, J. (2019). How should we measure the psychological consequences of false-positive screening mammograms adequately?.
Che, Mohamed, N., Moey, S. F., & Lim, B. C. (2019). Validity and Reliability of the Health Belief Model Questionnaire for Promoting Breast Self-examination and Screening Mammogram for Early Cancer Detection. Asian Pacific Journal of Cancer Prevention , 20 (9), 2865-2873.
Hill, C., & Robinson, L. (2015). Mammography image assessment; validity and reliability of current scheme. Radiography , 21 (4), 304-307.
Tsuruda, K. M., Sagstad, S., Sebuødegård, S., &Hofvind, S. (2018). Validity and reliability of self-reported health indicators among women attending the organized mammographic screening. Scandinavian journal of public health , 46 (7), 744-751.
