Women’s Health Update

By Kathleen Dallessio
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Breast cancer remains a significant health concern for women. In fact, the American Cancer Society estimates that 1 in 8 American women will be diagnosed with invasive breast cancer at some point in her life. 1 In 2007 alone, nearly 178,500 women will receive this diagnosis and approximately 40,500 will die of the disease. 1 While these numbers are still too high, the good news is that the number of deaths from breast cancer has dropped significantly since the widespread implementation of screening mammography. From 1970 to 1990, the death rate from breast cancer for all women increased approximately 0.4% per year. From 1990 to 2002, however, the rate decreased by 2.3% per year. 2 Experts indicate that this decline is because of early detection and improved treatment of breast cancer. 2

As the use of screening mammography increased and the technology improved, the percentage of cancer found at a smaller size and earlier stage, when it is most curable, increased as well. From 1980 to 1987, detection of tumors <2 cm in size more than doubled, while the number of tumors initially detected at sizes >3 cm dropped by 27%. 2 This trend toward smaller tumor detection continued to increase at a rate of 2.1% per year from 1988 to 1999, and then it stabilized. 2 A corresponding increase in the number of cases diagnosed in the early stages has also been noted. 2

Early detection is critical for breast cancer. When detected at a localized stage, the 5-year survival rate for breast cancer is 98%. Once the cancer has spread to the local lymph nodes, the survival rate drops to 83%. Once the cancer has metastasized to distant organs, the 5-year survival rate is only 26%. 3

It is clear that early detection holds the key to survival and that annual screening mammography remains the gold standard for breast cancer detection. To that end, the American Cancer Society recommends that all women 40 years and older should have a mammogram every year as long as they are in good health. 1

Despite all this strong evidence, nearly 40% of eligible women still do not receive annual mammograms, according to a recent federal study. 4 Among those without medical insurance, the situation is worse: nearly two thirds of uninsured women had not had a mammogram within the previous year. 4

Increasing the rate of breast cancer screening will clearly save lives. That is why projects such as Nevada Cancer Institute's Hope Coach, which brings digital mammography to women at their workplace and throughout the community, are so important and why advances in mammographic imaging technology, such as paddles designed to provide better, more comfortable compression and improved film-screen images, are important too.

But screening mammography is only the first step on the continuum of care for women with breast cancer. Of all women who undergo screening mammography, approximately 1 in 10 will be called back for additional work-up. 1 This may include additional mammographic studies, ultrasound, functional imaging with magnetic resonance or breast-specific gamma imaging (BSGI), and biopsy. Although the vast majority of these women will be found to be cancer-free, this can be an extremely stressful process for the patient and a challenge for the clinician. That is why technologies such as BSGI that can help reduce the rates of false-positive findings can have an important impact on the care of these women.

Each year, new advances in the detection and treatment of breast cancer are made, and each year more women are able to live with the diagnosis of breast cancer rather than dying from this disease.

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Women’s Health Update.  Appl Radiol. 

September 19, 2007



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