Breast cancer screening in women: An integrative literature review

Purpose: 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. Data sources: 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. Implications for practice: 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.