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Dont be confused; mammography is still the most effective way to detect breast cancer early

by: OUTLOOK FILE PHOTO - Dr. Donna Launey, a radiologist with the Breast Health Center at Legacy Mount Hood Medical Center, says regular mammogram screenings can help doctors detect breast cancer up to two years before a lump is felt. The cure rate for breast cancer approaches 98 percent if it is found at an early stage.

Cancer touches the lives of many, especially the diagnosis of breast cancer. I am certain many of you have been affected directly by this disease, whether it’s been a wife, sister, daughter, friend, neighbor or coworker that has been diagnosed.

We have learned in the past 20-25 years that early detection of breast cancer is so important. The most effective way to detect breast cancer early is with regular mammography screening.

It seems every couple of years a study regarding mammography screening is published questioning the utility of what is commonly known to be a lifesaving tool. When these studies are broadcast by the media, a wave of confusion emerges among the public and medical community.

You may have heard of the latest such study, which was published by the British Journal of Medicine on Feb. 11. The study concluded that death rates of women ages 40-59 were unchanged whether or not women received regular mammogram screenings. The researchers went on to say in their conclusion that policy makers should reassess the rationale for mammography screening. This commentary, if left unchallenged, can set us back decades.

Let’s examine this latest misleading study a little closer. First of all, the study relies on equipment (circa 1980s) that would be considered outdated and inadequate by today’s standards.

Second of all, the technicians and interpreting radiologists were not specifically trained in breast imaging.

And finally, the study results are faulty because the patients were not randomized which is crucial for the integrity of the results obtained in any such study.

In short, this study is not a valid assessment of modern screening technology and capability. Is it reasonable to rely on information obtained when teen fashion was dictated by Madonna’s Material Girl and before cell phones were in use?

Now let’s advance into the 1990s. One may argue that fashion did not improve (think Kurt Cobain and the grunge look). However, one thing is certain. Many strides were made in the area of breast imaging and treatment. By 1990, it was widely recognized that regular high-quality mammography screening diagnosed patients at an earlier stage.

In October 1992, Congress passed MSQA, a law tightly regulating equipment quality and personnel requirements for technologists, radiologists, physicists and equipment service personnel. The purpose of this law was to ensure all women getting mammograms were receiving the highest quality exam and interpretation possible.

But it hasn’t stopped there. Advancement in technology and treatment since the early 1990s has had an enormous impact on outcomes of patients with this disease. From an imaging standpoint, the advent of digital mammography, breast specific ultrasound, breast specific MRI, BSGI and the latest technology of 3D tomosynthesis, combined with the ability to perform needle biopsies using many of these techniques, have allowed us to make a diagnosis earlier.

In addition, treatment options have aided in the lowered mortality and morbidity of this disease.

Numerous studies in the medical literature support the value of regular mammography screening and the importance of diagnosing this disease at the earliest stage possible.

Two of the largest and longest-running breast cancer screening studies (by Hellquist et al and Tabar et al) have documented a significant reduction in the mortality rate by least one in three women over the age of 40 who are regularly screened with mammography.

Our 20-25 years since the implementation of a high-quality mammogram screening program have taught us that screening matters. Every major American medical organization with expertise in breast care, including the American Cancer Society, American College of Radiology, American College of Obstetrics and Gynecology and Legacy Cancer Institute, recommends routine screening mammograms for women over the age of 40.

So don’t be fooled by the latest media stir regarding breast cancer screening. The recently published British Journal of Medicine study should not be used as a basis for breast cancer screening recommendations. This would put many women at increased risk of dying needlessly from breast cancer. Reputable studies have proven the lifesaving benefit of regular screening mammograms.

In summary, all women over 40 should have regular screening mammograms. Our biggest defense against this common and deadly disease is to catch it early. Early detection allows for more effective treatment that not only saves lives, but is less invasive and helps preserve the quality of life. This is a priceless benefit.

Donna Launey, M.D., is a radiologist at the Breast Health Center on the campus of Legacy Mount Hood Medical Center, 24988 S.E. Stark St., Medical Office Building 3, Suite 100, Gresham. For more information or to schedule an appointment, call 503-413-7800.

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