by Betty Russell

There’s good news in the fight against breast cancer. The number of women who develop the disease has declined, and more women are surviving it.

Despite that progress, breast cancer screening rates aren’t as high as they could be. A lack of awareness about screening methods and schedules may bear some of the blame.

As more places offer digital mammography, women may wonder if traditional film mammograms are out of date. And the rise of magnetic resonance imaging (MRI) as a breast cancer screening option for some women may add to the confusion. But sorting through the hype isn’t as hard as it may seem.

Mammography Is Still Tops
Experts say the evidence is clear. Mammography screening—low-dose X-ray images of the breast—is still the gold standard for breast cancer screening. It’s the most recommended screening method for the vast majority of women.

“Screening mammograms save lives,” says Julie Gralow, M.D., a spokeswoman for the American Society of Clinical Oncology.

“Mammography screening is the best thing women can do to reduce their risk of dying from or losing a breast to breast cancer,” adds Debbie Saslow, Ph.D., director of breast and gynecologic cancer for the American Cancer Society (ACS).

The ACS urges women to have yearly mammograms starting at age 40. Those who are at high risk for breast cancer may need to be screened sooner and more often.

Film vs. Digital Mammography
Women go through the same process whether they have a traditional or digital mammogram. While traditional mammograms are captured on film, digital mammograms are electronic images.

“Digital mammograms may be more sensitive in detecting cancers in young women with dense breast tissue. But there are no major differences between traditional and digital mammograms as far as their ability to detect breast cancers in most women,” Dr. Gralow says.

Some of the pros of digital mammograms don’t affect patient care much. Digital images are easier to store, for example. Radiologists can also manipulate images for better views of suspicious areas, and doctors can view the images from remote locations.

The Role of Breast MRIs
Instead of X-ray technology, MRI scans use magnetic fields, radio waves, and computer soft ware to create sharp images of the breast. Experts say MRI breast scans may be useful in some high-risk women. The ACS issued a guideline last year recommending MRI breast scans for women at very high risk for breast cancer.

“We recommend MRIs in addition to regular mammography screenings, not instead of them,” Dr. Saslow says. “MRI breast scans are another tool that has the potential to increase survival in a small group of women.”

About 1 to 2 percent of women fall into the very high risk category. Those women:

• Have the BRCA1 or BRCA2 gene mutations that increase breast cancer risk
• Have a first-degree relative (a parent, sibling, or child) who has these gene mutations
• Have a 20 to 25 percent lifetime risk for breast cancer based on family history and other factors

Some studies show MRIs may find problems that mammograms don’t. This can include additional cancerous areas in the affected breast or cancers in the other breast. But breast MRIs have some drawbacks. Dr. Gralow says women must choose with care where to have them.

“Breast MRIs have a much higher rate of false positive findings and lead to more negative biopsies than mammography screenings,” she says. “In addition, there are many different ways to perform MRIs, and there aren’t yet any standards for MRI scanning. So the quality of scans can vary considerably from facility to facility. Centers that perform mammographies have to comply with very specific national guidelines, so the quality of mammograms performed at accredited organizations is high.”

Safeguard Your Breast Health
You can make lifestyle choices to reduce your breast cancer risk, studies show. You can eat a diet rich in fruits and vegetables rather than red meat and high-fat dairy products. You can exercise, control your weight, and limit alcohol intake. Still, there are no sure-fire ways to prevent breast cancer. Working with your doctor can help raise the odds of finding breast cancer early, when it’s most treatable.

Talk with your doctor about your breast health and your risk for breast cancer. Let him or her know if a close family member develops the disease. Your doctor can gauge your breast cancer risk and let you know what tests you should have—and how often.

Breast Cancer Rates Fall
Breast cancer diagnoses among American women ages 50 and older dropped sharply in 2003. The rate of new breast cancer cases fell 6.7 percent in that group compared with 2002.

The rate in 2004 remained relatively stable. Some researchers suspect that the decline was likely linked to a drop in hormone replacement therapy in postmenopausal women.

INTEGRIS Health 3300 N.W. Expressway, Oklahoma City, OK 73112 (405) 949-3011 | HealthLine: (888) 951-2277