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Mammography is the gold standard in breast cancer detection, but a new
study shows that fewer women have been getting mammograms in recent years. According to the study, after years of increased
mammography rates, between 2000 and 2005, mammography rates leveled off and then eventually fell by 4%. The American Cancer
Society (ACS) suggests several possible reasons for the decline, including the higher cost of insurance, the thought that
mammography is not effective, less concern over breast cancer, and fewer doctors available to read mammogram results. Regardless
of the reason, ACS encourages all women 40 years of age and older to have mammograms to help detect breast cancer at an early
stage, when the chances for successful treatment and survival are the greatest.
Mammography is a special type of x-ray imaging used to create detailed images of the breast and detect breast cancer years
before a lump can be felt by touch. Mammography plays a major role in early detection of breast cancers. Mammography can
show changes in the breast well before a woman or her physician can feel them. Once a lump is discovered, mammography can
be key in evaluating the lump to determine if it is cancerous. If a breast abnormality is found or confirmed with
mammography, additional breast imaging tests such as ultrasound (sonography) or a breast biopsy may be performed. The
U.S. Food and Drug Administration reports that mammography can find 85 to 90 percent of breast cancers in women over 50
and can discover a lump up to two years before it can be felt.
To determine how many women get mammograms, Nancy Breen, Ph.D. of the National Cancer Institute and her colleagues
examined mammography rates from 1987 through 2005 as a baseline. Then, Breen and her colleagues examined data from the
2000 and 2005 National Health Interview Survey (NHIS) to understand recent trends and patterns in mammography use. For
each year, 35,000 women were surveyed. The researchers asked women 40 and older if and when they had last received a mammogram.
Mammography use increased rapidly from 1987 to 2000, contributing to fewer deaths from breast cancer. However, Breen and
her colleagues found that mammography rates remained steady from 2000 to 2003 and then dropped from 2003 to 2005. In
2000, about 70% of women received mammograms while in 2005 about 66% of women received the exam.
The ACS points out that an alarming finding of the study was that mammography rates declined even among women who
had traditionally high rates. These include white women, those with higher levels of education, those with a regular
source of medical care, and those with private health insurance. When the data were examined by age, Breen and her
colleagues found the largest drop in mammography rates among women between the ages of 50 to 64 (the rate dropped
from 79% to about 72%).
While the study did not explore the causes of the decline in mammography use, the ACS finds the results troubling. Women
40 years and older who do not receive annual mammograms are more likely to be diagnosed with later stages of breast
cancer when treatment can be less successful.
In the United States, the American Cancer Society recommends that all women 40 years of age and older receive
yearly mammograms. Women at high risk of breast cancer may benefit from screening at an earlier age, based on
the advice of a physician.
Guidelines for early breast cancer detection:
- Women 20 years of age and older should women should be told about the benefits and limitations of breast
self-exams. Women should be aware of how their breasts normally
feel and report any new breast change to a health professional as soon as they are found.
- Women 20-39 should have a physical examination of the breast at least every three years, performed by health
care professional such as a physician, physician assistant, nurse or nurse practitioner. Women 20-39 should also
perform monthly breast self exams.
- Women 40 and older should have a physical examination of the breast every year as well as a
screening mammogram. The American Cancer Society advocates annual mammograms for women 40 years of age and older.
Additional Resources and References
- The study, "Reported Drop in Mammography," was published
in the May 14, 2007 issue of Cancer, http://www3.interscience.wiley.com/cgi-bin/home
- The American Cancer Society news report, "Mammogram Rates Dropping Nation-Wide, Experts Worry About Effect on
Breast Cancer Detection," was published on the ACS website on May 14, 2007, http://www.cancer.org/
- To learn more about mammography, please visit http://www.imaginis.com/breasthealth/mammography.asp
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