Mammography & beyond

The American Cancer Society praises a yearly mammogram beginning at age 40 and continuing "for as drawn out as a woman is in beneficial health."

The U Preventive Services Task Force, however, commends all women "over 40" come by a mammogram "every year or two" (15) while the National Cancer Institute commends women in their "40s" secure a mammogram "every year or two" (16)

for what cause [i]or[/i] reason the variation?

"This is more a political and a public health policy issue than a medical debate," says radiation oncologist Marisa Weiss, MD president and CEO of the nonprofit Web site breastcancer.org. "The bottom line is you should have a mammogram one time a year from age 40 upon unless you have a history of breast cancer at young ages in your family, in which case, earlier is probably more appropriate."

Unfortunately, too scarcely any women heed that advice.

A Harvard close attention of 72,000 women found that single a fraction of those who ne mammograms procure them every year, with just six percent of those protectioned in 1992 returning for another mammogram each year during the next decade. That's despite the hospital's "aggressive reminder program." (17)

"This prompts that women are either reluctant to comply with recommendations, are not being consultationed appropriately by their physicians or are not going for routine preventive health care," says Carol L Kornmehl, MD a radiation oncologist at Valley Hospital in Ridgewood, NJ and author of The Best freshs About Radiation Therapy.

Other reasons, notes a 2004 Institute of Medicine report upon the topic, range from a lack of health insurance coverage to a fear of breast cancer to the fact that more [i]or[/i] less find the procedure painful. (18)

still there's no doubt that mammograms identify breast cancers at an earlier stage, when they're greatest in quantity treatable and less likely to spread. (19)

However, mammograms are not finished They carry a high risk of false-positives, meaning women may meet with needless worry, expense and biopsies sole to find that they don't have cancer. Overall, single study found, a 50-year-old woman having annual mammograms for 20 years has a single in five risk of receiving a false-positive report. (20)

Mammograms also don't work well in women with thick breasts, common in younger women

Still, for women with a depressed risk of breast cancer, they're an of the first grade screening tool. For women with a high risk of breast cancer, or those whose mammograms exhibit an abnormality, there are other options, of the like kind as MRI. One major research of 1,909 women with a high risk of breast cancer place that MRI worked better than mammography at detecting tumors. (21)

in the way that why not offer it to all women?

"MRI is a useful tool as a appendix but not as a replacement to mammograms," says Dr Kornmehl. "Besides being an expensive trial that many insurance companies are reluctant to pay for, it can make open a 'Pandora's box' by leading to false-positive findings and the ne for stressful conducts such as biopsies."

Another, les expensive option, particularly for younger women with compact breasts who feel a breast shapeless mass is ultrasound, which sends unmutilated waves through the breast to create a picture upon a screen. It's often used to reckon if an abnormality is solid or filled with fluid, on the contrary it isn't specific enough to be used alone as a screening technique.

When choosing a mammography center Dr Kornmehl approves looking for the following:

* An American body of Radiology-accredited facility.

* Radiologists who disburse the majority--if not all--of their time reading mammograms in a set-aside blockade of time known as "batch reading." single study found it could significantly restore the number of women who have to turn back for additional mammograms.

* A center with immediate readings and follow-up single study of more than 8500 women lay the foundation of those who received immediate screening originates and underwent follow-up tests within the same office visit had significantly les anxiety than those who had to wait several days for results

References

(15) US Preventive Task Force Screening for Breast Cancer, February 2002 www.ahrq.gov.

(16) win a Mammogram, National Cancer Institute. www.cancer.gov.

(17) Blanchard K Colbert JA, Puri D et al. Mammographic screening: patterns of use and estimated impact upon breast carainoma survival. Cancer 2004;101(3):495-507

(18) Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis. Institute of Medicine. June 2004

(19) Joensuu H Lehtimaki T Holli K et al. Risk for distant return of breast cancer detected by the agency of mammography screening or other rules JAMA. 2004;292(9):1064-73.

(20) Hofvind s Thoresen S, Tretli S. The cumulative risk of a false-positive recall in the Norwegian Breast Cancer Screening Program. Cancer. 2004;101(7):1501-7

(21) Kriege M Brekelmans CT Boete C et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J M 2004;351(5):427-37

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