Increased access to high-quality mammography needed to reduce cancer deaths.

2004 JUL 1 - (NewsRx.com & NewsRx.net) -- While new technologies hold promise for increasing the accuracy of breast cancer detection, improving access to mammography and broadening the pool of medical personnel who can interpret mammograms offer the greatest potential for immediately reducing the number of lives lost to breast cancer in the United States, says a new report released June 10, 2004, by the Institute of Medicine (IOM) and National Research Council (NRC) of the National Academies.

"There is a suite of new devices under evaluation, such as ultrasound and computer-aided detection (CAD), that should make early detection even more effective in the future, although improvements in the next few years are likely to be incremental rather than revolutionary," said committee chair Edward Penhoet, director of science and higher education programs, Gordon and Betty Moore Foundation, San Francisco, and former dean, School of Public Health, University of California, Berkeley.

New technologies based on protein or gene profiling hold promise for providing more personalized screenings and identifying women at greatest risk for breast cancer. It remains to be shown, however, whether these technologies will yield results that are reliable enough to be useful in the early detection of breast cancer, said the committee that wrote the report.

"In the meantime, because current mammography technology is good but imperfect, and because there are many barriers hindering access to mammography, too many women will die from breast cancer [in 2004]," Penhoet said. "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."

One of the biggest problems facing women today is that their access to breast cancer screening is endangered due to a shortage of breast imaging specialists, the report says. Each year, more than 1.2 million American women turn 40, the age when most are recommended to get their first mammogram, but there are not enough breast imaging specialists to keep up with the demand.

Fewer radiologists are going into breast imaging because of heavy regulation, fear of lawsuits, and low reimbursement for long hours. At the same time, mammography facilities are closing faster than new ones are opening. 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% decrease. As a result, women are being made to wait up to 5 months for mammograms in some areas, the report notes.

Studies in the United Kingdom show that trained, nonphysician, healthcare professionals can interpret results with the same accuracy and speed as radiologists. Given the failure of the U.S. healthcare system to keep pace with the growing demand for mammography, the committee recommended that mammography facilities should enlist specially trained nonphysician personnel to pre-screen or double-read mammograms to expand screening facilities' capacity. Nonphysician personnel would not make diagnoses, and every mammogram would be independently viewed by a breast-imaging specialist.