Mammography and Early Breast Cancer Detection

Early detection of breast cancer is critical. Yet efforts to cut back on mammography or even stop screening altogether have been gaining ground in the medical community’s decades-long debate over testing and treatment. It is not a purely scientific debate—back-room politics and hidden agendas have played as much a role as clinical data, leading to some surprising conclusions.
Written by one of the first physicians in the country to specialize in breast cancer risk assessment, genetic testing and high-risk interventions, this book focuses on the screening controversy and explains the arguments used on both sides. The author covers the history of screening, from the first mobile unit on the streets of Manhattan to the cutting edge imaging technology of today.

Alan B. Hollingsworth, M.D., serves as medical director of Mercy Breast Center, a screening and diagnostic facility at Mercy Hospital, Oklahoma City. He received his MD with Distinction from the University of Oklahoma College of Medicine in 1975 where he was elected First vice-president of Alpha Omega Alpha Honor Medical Society. He completed a residency in general surgery at the University of Oklahoma that included a one-year fellowship in surgical pathology at UCLA. He limited his practice to breast cancer surgery in the 1980s and was the founding medical director of Oklahoma’s first multidisciplinary breast clinic at his alma mater where he was also named as the first holder of the G. Rainey Williams Chair in Surgical Breast Oncology. He was one of the first physicians in the country to begin a formal risk assessment program in 1993, and today his practice is limited to risk assessment, genetic testing, and multimodality screening for high-risk patients.

Alan B. Hollingsworth, M.D.

Format: softcover (7 x 10)
Pages: 260
Bibliographic Info: 10 photos, notes, bibliography, index
Copyright Date: 2016
pISBN: 978-1-4766-6610-5
eISBN: 978-1-4766-2588-1
Imprint: McFarland
Series: McFarland Health Topics

Acknowledgments vii
Preface 1
1. Last Word vs. Final Word 5
2. Early Diagnosis May Be the Key, but It’s Not a Lock 10
3. Biology Can Trump, but Size Matters 16
4. Prostate Is Not Breast, So Give It a Rest 22
5. The Four Horsemen That Inflate the Power of Mammography 31
6. The Four Horsemen Are Throttled by Clinical Trials, but O Canada! 41
7. The Mammography Civil War (1993–1997) 49
8. The Number Games 61
9. The (Over)Selling of Mammography 67
10. The Evidence for ­Evidence-Based Medicine (or, How to Raise the
Bar of Bias: An Editorial) 74
11. Blame It on Canada (and Something’s Rotten in Denmark, Too) 82
12. Overdiagnosis: Embracing Your Inner Malignancy 88
13. Overdiagnosis Part 2: A Way Out of the Wet Paper Bag 95
14. The Task Force Opens Fire 105
15. The Zombies Among Us 121
16. Circumstantial ­Evidence-Based Medicine 128
17. The Social Tsunami of ­Anti-Screening 137
18. The 2015 ACS Peace Accord—Science or Societal Pressure? 144
19. A Journey to the Pathology Lab to View the ­By-Products of Screening 152
20. Risk-Based Screening—It Feels So Right, but Wait… 168
21. The Greatest Story Never Told 178
22. The Myth of Mammography 184
23. Do These Genes Make Me Look Dense? 192
24. The Emperor of All Modalities 201
25. The Bright Side of the Dark Side of the Force 210
26. The Crystal Ball Is Fair to Partly Cloudy 222
Chapter Notes 229
Bibliography 241
Index 247

• “detailed, clearly written chapters…the author…uses his expertise and current findings to convince readers that screening is still worth it. There are an abundance of ‘less-is-more’ resources available on this subject; however, Hollingsworth’s confident, accessible argument against such a philosophy provides a welcome look at another option”—Library Journal
• “Hollingworth provides some fascinating insight into how the medical establishment’s thinking on mammograms…will be helpful to those who are undecided about the efficacy of screening mammograms…intriguing book for a public library to consider for readers looking to delve deeper into the history of yellow fever through first-hand accounts”—Watermark Review
• “What a prodigious accomplishment! My congratulations to Dr. Hollingsworth!”—Stephen Feig, M.D