Is mammography screening always reliable? A case study on women’s breast health and breast cancer Summary of USPSTF (2016) breast cancer screening guidelines: For women aged 50-74 years, mammography screening is recommended every 2 years (level B recommendation); for women <50 years, when to start mammography screening is based on individual circumstances; for women aged 40-49 years for whom the benefits outweigh the harms, mammography screening is recommended every 2 years (level C recommendation); for women ≥75 years, there is insufficient evidence to assess the benefits and harms of mammography screening. The USPSTF believes that there is insufficient evidence to evaluate the benefits and harms of digital breast tomosynthesis as a primary breast cancer screening measure. For patients with negative mammography but increased breast density, the USPSTF believes that there is insufficient evidence to evaluate the benefits and drawbacks of adjuvant screening measures such as ultrasound, magnetic resonance, and digital breast tomosynthesis. The USPSTF guidelines apply to women ≥40 years of age who are asymptomatic, have no preexisting breast cancer, have no previously diagnosed high-risk breast lesions, and are not at high risk for known genetic mutations (e.g., BRCA1 or BRCA2 genes) or other familial breast cancer syndromes. For all women, breast self-examination is not recommended (level D recommendation) because of increased overmedication. For women aged ≥40 years, clinician mammography is not recommended because there is no evidence to support that it is helpful (level I recommendation), as large randomized studies have shown that breast cancer detection rates by this method are extremely variable, 3% to 57%, which certainly does not preclude experienced physicians from continuing to do this test. Guidelines, after all, are general principle norms for the general public. However, an unfortunate and exceptional case was recently encountered by Old Knife. The patient was almost the same age as Lao Dao, 50+ nearly 60 years old, without any significant risk factors or family history. She had a routine screening mammogram only a year ago. The report was normal. However, at the end of the year, the patient herself found a hard lump with unclear edges like a date during her self-breast examination in the shower. Her husband, who is also a doctor, was immediately alerted and consulted, and the mammogram was taken again, and the image was shown above. It was a relatively high malignancy "medullary breast cancer"! The biopsy diagnosis was confirmed by routine pathology and designated as clinical stage II. Several weeks after surgery, chemotherapy and radiotherapy were started. This is a rare case in which the mammogram was normal a year ago, but a little over a year later, breast cancer appeared, and it was a "triple-negative" breast cancer with a high degree of malignancy. The physiology and pathology of each person are different and varied. Therefore, despite what the above guidelines say, it is important for you to pay extra attention to your own body, especially for women who are in the age group with high incidence of breast cancer! It is not complicated to learn proper breast self-examination, but it is important to check the monitoring from time to time to detect any suspicious problems and seek medical advice in time for proper and timely diagnosis and treatment. At present, the medical level in the United States, the survival rate for stage I breast cancer is over 99% in 5-10 years. Even in the case of stage II breast cancer, the surgical removal of the lesion can be followed by reconstructive breast surgery, which not only does not affect the life of the patient, but also restores the gender-specific organ of the woman - the breast - and improves the quality of life, helps the patient's mental health and good image, and restores normal social interaction activities! The prerequisite and key to all this is early detection, accurate diagnosis and timely treatment!