Breast cancer screening in women: An integrative literature review.
OBJECTIVE
To (a) conduct a thorough search of the literature for breast cancer screening studies utilizing mammography, ultrasound, or breast magnetic resonance imaging (MRI), and (b) critically appraise these studies to aid the nurse practitioner in choosing the most appropriate screening tool for their individual patients.


METHODS
Articles were identified from the following databases: CINAHL, Medline, PubMed, EBSCO, ISI, and Cochrane Library. Reference lists from all articles were reviewed and an authority in breast cancer screening was contacted regarding the reference list.


CONCLUSIONS
Breast MRI had a higher sensitivity than mammography and ultrasound in all studies comparing breast MRI. The specificity was lower for breast MRI than for mammography in five out of six studies. The ultrasound had a higher sensitivity than mammography in all five studies examining women with dense breast tissue.


CONCLUSIONS
Women who fall into high-risk categories should be screened yearly with breast MRI and mammography. Women with dense breast tissue according to a standardized density score should be screened yearly with ultrasound and mammography. Women in the general population should be screened yearly with mammography.
Brigham Young University, Provo, Utah 84602, USA. patricia_ravert@byu.edu
Patricia K
PK
Ravert
Crystal
C
Huffaker
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D055088:Early Detection of Cancer / Q000379:methods* / Q000451:nursing; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008403:Mass Screening / Q000379:methods* / Q000451:nursing; D008875:Middle Aged; D009722:Nurse Practitioners; D024802:Nurse's Role; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D016217:Ultrasonography, Mammary; D014481:United States / Q000453:epidemiology