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Women at High Risk Using Mammography in a Sporadic Manner |
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Written by Theresa Maher
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Tuesday, 15 May 2007 |
Mammography is a procedure designed to detect breast cancer early so as to increase a patient's chances of survival. Mammograms are routinely recommended for all women on an annual after the age of 40. It is the best method to detect breast cancer when it is in the initial stages and is easier to treat.
However a federal study finds that mammography rates in the United States have dropped steadily from 2000.
Researchers from the National Cancer Institute found a four percent decline in mammography rates from 2000 to 2005. Women who do not use mammography regularly might have breast cancer diagnosed very late and this could hamper their chances of surviving the cancer.
Breast cancer is the second most common cancer in US women. The American Cancer Society estimates that in 2007 about 178,480 new cases of invasive breast cancer will be diagnosed among women in the United States and 40,460 women and 450 men will die from breast cancer in the country.
In April the American Cancer Society altered its recommendations and called for an annual MRI exam in women at greatest risk of breast cancer. Routinely it advises that women aged 40 and older get regular mammograms as a part of their annual check up. The FDA says there are about 33.5 million mammography procedures performed in the United States annually.
Experts say mammography is the single most effective way of finding breast cancer early. The earlier the cancer is detected, the better are the chances of successful treatment and in effect survival as well.
However the present study says mammography is not being used frequently enough or regularly enough. The study appears Cancer, a peer-reviewed journal of the American Cancer Society.
It said mammography rates rose steadily from 1987 to 2000 in women aged 40 and over. In fact the widespread usage of mammography is credited as being responsible for the decline in breast cancer mortality rates in the country. In the 13 years from 1987 to 2000 mammography rates increased from 39 percent to over 70 percent.
Since then many studies have documented the decline in mammography rates in the US. The current study found a relatively flat rate between 2000 and 2003. However in 2005 mammography rates fell four percent as compared to 2000 figures from 70 percent to 66 percent. The study used data from the National Health Interview Survey in which 35,000 people are surveyed each time.
The study indicated the biggest decline in mammography rates was observed in women aged 50 to 64 years as well as in women belonging to the higher socio-economic strata. In the 50-64 age group, which is deemed to be at the highest risk of breast cancer, mammography rates fell from 79 percent to 72 percent from 2000 to 2005.
Lead researcher Nancy Breen of the National Cancer Institute notes this trend is worrisome. "Women who weren't diagnosed early because they didn't get their on-schedule mammogram might be diagnosed later with a later stage of cancer," she noted.
However the study does not say why the mammography rates have declined. Nevertheless the researchers stress they need to inform women that mammography remains the best weapon to catch breast cancer at an early stage. Women over 40 years must take all factors into consideration before arriving at any conclusion regarding their own breast cancer risk and undergoing mammography.
Following are the American Cancer Society recommendations for Early Breast Cancer Detection
* Women age 40 and older should have a screening mammogram every year, and should continue to do so for as long as they are in good health.
* Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. After age 40, women should have a breast exam by a health professional every year.
* BSE (breast self-exam) is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away.
* Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.
* For women at high risk of breast cancer, such as those with BRCA gene mutations or a strong family history, both MRI and mammogram exams of the breast are recommended.
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