Women need more mammograms, study finds

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Training more technicians to do mammograms and making it easier for women to get them will do far more to prevent breast cancer deaths in the near future than new technology, the Institute of Medicine reported on Thursday.

Women across the United States are forced to wait months to get mammograms because facilities are overstretched, the report from a panel of experts found.

Although new technology promises to make breast cancer screening easier and perhaps more efficient, it will be years before these techniques are perfected and approved.

“In the meantime, because current mammography technology is good but imperfect, and because there are many barriers hindering women’s access to mammography, too many women will die from breast cancer this year,” committee chair Edward Penhoet of the Gordon and Betty Moore Foundation in San Francisco said in a statement.

“Improving and increasing the use of current mammography technology is the most effective strategy we have right now for further reducing the toll of breast cancer.”

Instead, radiologists are leaving the field for fear of lawsuits and clinics are closing, the report found.

“Between 2000 and 2003, the number of mammography facilities operating in the United States has dropped from 9,400 to 8,600—an 8.5-percent decrease,” the Institute, an independent organization that advises the federal government on health matters, said in a statement.

“As a result, women are being made to wait up to five months for mammograms in some areas.”

Jean Lynn, who operates a free mobile screening clinic at George Washington University, said a lack of demand was not the main problem.

“Our schedule is booked a year ahead of time—fully booked,” Lynn told a news conference.

TECHNICIANS, COMPUTERS

The committee, which included breast cancer specialists, activists, nurses and business and policy experts, turned to other countries for ideas.

“For instance, in the United Kingdom radiologic technologists, who are not physicians, are trained to meet national certification standards, and have proven comparable in accuracy and speed to radiologists,” the report says.

Computer-aided detection to back up the laborious process of reading mammogram X-rays should also be developed, it says.

New technologies will help someday, but not now.

“Recent headlines to the contrary, it will be many years—if ever—before blood tests replace mammograms,” the report says. “No existing blood test—for breast or any other cancer—rivals mammography as a screening method.”

Lives would be saved if more women got mammograms, although it is hard to put a number on it, said Dr. Martin Abeloff, a breast cancer specialist on the panel.

“Between 62 and 65 percent of women in this country who should be getting mammography according to current guidelines are getting mammography,” Abeloff said in an interview.

“The breast cancer mortality rates in the United States and U.K. are falling steadily. It is really felt that it is a combination of two things; one is screening for breast cancer with mammography and the other is the utilization of adjuvant therapy,” such as the drug tamoxifen, Abeloff said.

More than 200,000 new cases of breast cancer will be diagnosed this year in the United States alone, and more than 40,000 women will die from it.

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