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One-view versus two-view mammography in baseline screening for breast cancer: a review

National Expert and Training Centre for Breast Cancer Screening, St Radboud University Hospital, Box 9101, NL-6500 HB Nijmegen, The Netherlands ^* Department of Medical Informatics and Epidemiology, University of Nijmegen, Kapittelweg 54, NL-6525 EP Nijmegen, The Netherlands

Two-view mammography is generally preferred as an initial screening examination because the number of missed carcinomas and false positive results in one-view mammography is considered too large. The present review was performed to assess the difference in screening quality between one- and two-view mammography. Nineteen previous studies were reviewed and differences in sensitivity as well as specificity between two-view and one-view mammography were calculated. The results ranged from –5.7% to 19.4% (median 3.9%), and 2.7% to 36.1% (median 14.8%), respectively, and indicate a higher screening quality of two-view mammography. However, in the studies considered there is a large variation in study population, screening tests used and assessment of disease outcome, which makes the numerical results less conclusive. None of the studies provided adequate information for deciding whether two-view mammography in baseline screening for breast cancer is preferable to one-view mammography. If a screening programme using one-view mammography has already achieved high sensitivity and specificity, the value of an additional craniocaudal view is only marginal.

Key Words: Cancer screening • Mammography • Number of views

Received for publication February 18, 1992. Revision received May 21, 1992. Accepted for publication June 22, 1992.

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