28.1 INTRODUCTION

Breast cancer is the second greatest cause (after lung cancer) of cancer-related death among American women, accounting for approximately 40,000 deaths each year. At the present time, early detection and characterization of breast cancers is our most effective weapon, since local disease is in most cases curable. Breast imaging systems can thus be potentially useful if they either (1) are useful for detection of cancers or (2) are useful for characterization of suspicious lesions that may or may not be cancerous. Similarly, from a clinical perspective, methodologies used for breast cancer diagnosis (as opposed to therapy) fall into one of two broad categories: screening or diagnostic. Screening pertains to the population of women exhibiting no symptoms. Diagnostic imaging (otherwise known as problem-solving imaging) is used when there is some suspicion of disease, as a result of the manifestation of some physical symptom, of a physical exam, or of a screening study. The relative effectiveness of a given imaging modality at the tasks of detection and characterization determines whether it will be employed primarily in a screening or diagnostic context. At the present time, x-ray mammography is the only FDA-approved modality for screening, and is by far the most effective modality because of its ability to detect small cancers, when they are most treatable (i.e., prior to metastasis). The...