Nearly 40,000 women will die of breast cancer this year alone. That's the bad news. The good news is that with early detection, breast cancer survival rates skyrocket.
According to the American Cancer Society (ACS), the 40% increase
in the reported incidence of breast cancer seen from 1973 to 1999
indicates that, with the advent of widespread screening mammography
programs, more early-stage cancers are being detected when a cure
is still a strong possibility.
As the effectiveness of these programs has become widely
accepted, more women are getting regular mammograms. The most
recent ACS statistics show that in 2000 approximately 70% of women
aged >=40 years reported having had a mammogram within the past
2 years. This is up from only 29% in 1987 and 67% in 1998.
Specifically, the ACS recommends that all women aged >=40
years undergo an annual mammogram and clinical breast examination
by a healthcare professional.
They also recommend that women at increased risk of breast cancer
should discuss with their physician the benefits and limitations of
starting mammography screening earlier, having additional tests
(eg, breast ultrasound or MRI), or having more frequent exams.
The National Cancer Institute recommends that all women aged
>=40 undergo screening mammography every 1 to 2 years, and that
those at increased risk for breast cancer have the exam more often.
These risk factors include a history of breast cancer in the woman
herself or in a first-degree relative, presence of BRCA1 or BRCA2
markers, delayed childbearing, early onset of menses, dense
breasts, or history of radiation therapy, particularly before the
age of 30.
In addition to the increasing number of patients undergoing
breast cancer screening exams, the technology used in these studies
has also advanced significantly in recent years.
The first full-field digital mammography system was approved for
use in the United States >3 years ago and breast centers and
hospitals have begun to switch from analog to digital systems for
breast exams. The benefits of digital mammography include decreased
exam time, increased patient throughput, and the ability to review
images nearly instantaneously without the problems associated with
film handling. Digital images can also be easily stored on a PACS,
radiology information system (RIS), or hospital information system
(HIS) for retrieval at any site across the enterprise.
Furthermore, computer-aided detection (CAD) is being used more
frequently. It is widely estimated that the use of CAD technology
results in the detection of 10% to 20% more cancers, particularly
the more treatable, early-stage cancers that may be difficult to
spot without CAD.
In addition to improvements in standard mammography technology,
other modalities are being explored for use in breast cancer
detection. One that is gaining popularity is breast ultrasound.
This technology is most often used to evaluate findings noted on a
screening or diagnostic mammogram, particularly to determine if a
mass seen on an earlier study is a cyst. This exam can often save
the patient from having to undergo needle aspiration. Some
researchers have suggested that breast ultrasound may, in some
cases, be an appropriate screening tool as well, particularly in
women with dense breasts.
In the hands of skilled radiologists, these advanced
technologies, along with those still to come, hold the promise of
longer, healthier lives for women throughout the world.