SATURDAY, Oct. 30, 2004 (HealthDayNews) -- The five-year survival rate for localized breast cancer is 97 percent if it's caught quickly.
But as with almost all cancers, early detection is the key to surviving the disease. And mammograms are key to early detection.
With the number of facilities that provide mammograms declining, however, there's increasing concern among physicians that many women will be without access to the life-saving examination.
That worrisome trend makes this year's National Breast Cancer Awareness Month, which concludes Sunday, more important than ever, with experts urging women to take whatever steps are necessary to get regular screenings.
About 215,990 American women will be diagnosed with breast cancer this year, about a third of the total cancer diagnoses for women.
But only 15 percent of cancer deaths will be from breast cancer, with 40,580 women expected to die in 2004. Deaths from breast cancer declined 2.3 percent every year over the 1990s, the result of early detection and improved treatments. Mamograms are the best available method to detect breast cancer in its earliest, most treatable stage -- an average of one to three years before a woman can feel a lump.
Women are told to get a mammogram and clinical breast examination every year after 40. However, a recent report by the Institute of Medicine found the number of imaging facilities women can go to for breast screenings has decreased by 700 since 2001, said Priscilla Butler, senior director of the Breast Imaging Accreditation Program at the American College of Radiology.
"Most facilities cite financial reasons for closing," Butler said. Some go bankrupt, others can't afford new equipment or qualified staff, and some can't make their malpractice insurance payments, she explained.
The loss of facilities hasn't yet affected the number of mammograms women receive, she said. In fact, those numbers have been increasing.
But Butler said she's concerned the loss of screening facilities will hurt women in poorer regions of the country.
"What I've been hearing is that women of means haven't been incredibly impacted," Butler said. "They will go out of their way to get a mammogram, although we're hearing anecdotal evidence that wait times have been increasing."
"Women who may not be of means -- in poorer areas and in African-American communities -- a number of those women may not be getting the mammograms they need," she continued. "Particularly in rural areas, will women travel a distance to have a mammogram? We don't know that answer."
The need for mammograms and clinical breast examinations has grown even more important, given the recent decision by the American Cancer Society that breast self-examination is not an effective early detection tool, said Susan Nathanson, national coordinator of the awareness month.
"By the time you can feel it personally, it's too large and you don't get the benefit of early detection," Nathanson said. "They [the cancer society] are not saying 'don't do it'; they're just saying it's not an early detection device. They still encourage women to know their own geography and test themselves regularly."
Physicians specifically trained to give breast examinations are an important part of screening, and women should make sure their doctor has received such training, Nathanson said.
"They know how to go around the breast so every part of the breast is covered by their examination," she said.
Younger women, from 25 up to age 40, don't receive as much benefit from a mammogram because their breasts are much denser, Nathanson said. For those women, it's particularly important they receive a clinical breast exam from a qualified physician.
"When a young woman has a pap smear, she should be having a clinical breast exam," Nathanson said. "It's just good to combine the two."
Meanwhile, research continues to find even more sophisticated early detection methods. MRIs and ultrasound imaging are being tested to see if they will prove more adept at finding cancer, she said.
Doctors also are investigating digital mammography, in which a single X-ray is taken and then examined in depth on a computer, Nathanson said.
But for the time being, mammograms are the gold standard for early detection.
"Mammography is still the best thing we have," Butler said. "The other technologies such as MRI and ultrasound, the juries are still out on them in terms of screening women."
More information
To learn more about mammography, visit the American Cancer Society.
