U.S. Mammography Rates Falling

As Breast Cancer Awareness Month ends, one expert warns of disturbing trend

SUNDAY, Oct 30, 2005 (HealthDay News) -- Monday marks the end of Breast Cancer Awareness Month, filled with pink ribbons, benefit runs and walks and lots of media attention.

But while most American women may be familiar with the month's message, experts say they're still not as aware as they should be of the importance of the lifesaving value of mammograms in detecting breast cancer early.

In fact, recent years have seen a slight decline in breast cancer screening.

"Women are doing better [at getting mammograms] than they were 15 years ago, but in the last five they are doing worse," said Debbie Saslow, director for breast and gynecologic cancers at the American Cancer Society, Atlanta. "The numbers are dropping gradually."

A study published in the Oct. 15 issue of the journal Cancer found that although nearly three-quarters of women over 40 say they regularly undergo mammogram screening, less than two-thirds actually do.

The researchers used data from the New Hampshire Mammography Network, a registry that gets data from more than 90 percent of the mammography facilities in the state.

When the researchers checked registry records, they found that just 64 percent of women in the state went in for their mammogram within the recommended interval of two years. Studies generally find that about 65 percent to 82 percent of women say they have a mammogram within this interval. The American Cancer Society recommends women begin getting annual mammograms at age 40.

And the situation could get worse.

"We're expecting a bigger drop" over the next few years, said Saslow, who pointed to a number of troubling trends.

"The number of mammographers is decreasing," she noted, in large part because fewer medical school students are entering the profession due to legal liability fears. The problem, according to Saslow, is that many American women expect the accuracy of mammography to be perfect -- which it isn't.

"Mammograms don't find every cancer, and they aren't foolproof," Saslow said. But, she added, "the bottom line is, get a mammogram, get one every year. They do save lives."

Just as crucial, Saslow said, is for women follow up with doctors once something suspicious is found -- going for further testing and listening to treatment options should malignancy be confirmed.

Saslow advised women not to dwell on whether to get the newer digital mammograms versus traditional screening. "The latest research shows that in a subset of women who are younger and tend to have more breast density [and in whom mammograms are harder to read], and those on hormone replacement therapy, there may be some benefit to digital over regular screening."

"However, digital [mammograms] are not as widely available," Saslow said. "Don't worry if your place doesn't have digital." Women who are in the subset of patients that might benefit from digital mammography should choose it, if it happens to be available in their area. If it is not, it's still fine to get a traditional mammogram, she said.

One common mistake women make is waiting too long to make their appointment, Saslow said. Women who wait a year and then call may have to wait several months before they can get in, she said. She suggested making the appointment well in advance of the actual date the mammogram is due to be repeated.

And don't depend on your doctor to make the appointment, she said. "Women need to ask for a mammography, even if their doctor forgets."

According to Saslow, everyone is now in agreement that mammograms work. The drop in breast cancer death rates, steady since 1990, has been attributed to two factors: better treatments and earlier detection through mammogram screening, she said.

"It is probably half and half," she said.

A report in the Oct. 27 issue of the New England Journal of Medicine found that about 1,000 fewer American women die from breast cancer each year.

Mammograms are responsible for about 46 percent of the decline in the death rate from breast cancer, while adjuvant treatments such as chemotherapy and tamoxifen are responsible for an estimated 54 percent of the reduction in deaths, according to the study.

More information

For more on breast cancer, head to the American Cancer Society.

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