BREAST CANCER SCREENING
Despite the news, Screening Makes Sense for Patients 40 Years and Older
– Claudia Fosket MD
Breast cancer is the second-leading cause of death among women but its rate has decreased by almost 30% since 1990. Regarding the recent controversy involving screening mammography, the facts are irrefutable. At least seven controlled studies have shown that screening mammography has resulted in a statistically significant decrease in breast cancer mortality for women aged 40 years and older. Therefore, there is no question that we need
to continue with our screening of women age 40 and older. It is important to note that 70-80% of women who develop breast cancer have no family history. Clearly, screening only women with increased risk would result in many undiagnosed cases of breast cancer.
Digital mammography is one of the most recent advances in breast imaging. Although it uses conventional X-rays, the images are captured on a special electronic detector (similar to those used in digital cameras) which is then converted to a digital image to be viewed on a computer monitor. This allows manipulation of the image with contrast, brightness and magnification not available with film screen mammography. It also gives the radiologist more tools to detect early cancers. In many cases, this also makes the need for repeat images unnecessary. Studies have shown that digital mammography was superior to film screen mammography in detecting early cancers in women with dense breasts (those under the age of 50). It is also easy to incorporate the CAD (a computerized second look) into the system seamlessly. Computerized storage of these images gives us the ability to view them from multiple sites within the system, thus allowing our colleagues to render second opinions quickly. Studies are not lost and the comparison of several old studies is no longer cumbersome.