Mammogram Rate Declining, Study Suggests

(CBS)  Women older than 40 are supposed to have mammograms every year to try to spot breast cancer early, but a new study suggests that fewer women in that age range have been getting them in recent years.

Research by Dr. Nancy Breen of the National Cancer Institute, among others, shows the mammography rate fell by as much as 4 percent nationwide between 2000 and 2005.

The report's authors call that drop "significant" and say theirs is the first study to detect that the decline is nationwide.

The study appears in the June issue of the journal Cancer of the American Cancer Society.

Some of the sharpest declines were seen among women who previously reported high screening rates — women between 50- and 64-years-old, and women in higher socioeconomic levels.

Dr. Breen and her co-authors noted that the dip in screening rates coincides with a fall in the reported cases of breast cancer, and say they "are concerned that some of the observed decline in incidence (of breast cancer) may be due in part to the leveling-off and reduction in mammography rates."

On The Early Show Monday, Dr. Michele Blackwood, a breast cancer surgeon and medical director of the Connie Dwyer Breast Center (www.cathedralhealth.org/connie_dwyer.html) in Newark, N.J., called the possible trend "scary."

She told co-anchor Julie Chen the drop among women 50-64, "the baby boomers, the well-educated, the ones with the most insurance" is "shocking." Their decrease is seven percent.

One factor, Blackwood noted, may be the sudden drop in the use of hormone replacement therapy for the symptoms of menopause, after a 2002 study tied HRT to an increased risk of breast cancer and heart disease. Many women in that age group had gotten into the habit of going to their doctors for hormone replacement therapy, and getting annual mammograms as part of that process. When women stopped visiting their doctors for HRT prescriptions, they may not have continued going just for mammograms.

Another possible factor is the closing of roughly 10 percent of mammography centers in the U.S. due to lower insurance reimbursement rates for the procedure as well as a rise in lawsuits.

Some complacency may also be at work here, Blackwood said: The medical community has done such a good job of treating breast cancer and making it less of a death sentence that certain women may have lost their fear of the disease. Of course, it's early detection that allows for more successful treatment.

"Breast cancer can be cured if it's caught in an early stage. The way to do that is to have an annual mammogram," Blackwood stressed. "If you're in your 40s or 50s, you have 25 to 40 percent less chance of dying from breast cancer if you have an annual screening mammogram."

Blackwood offered suggestions on how women older than 40 can remember to get their annual mammograms. One was to tie it to an important date, such as your birthday or that of someone in your family. Also, go for the test with someone you know: "Bring them with you. Make a day of it! Go to lunch." And pamper yourself afterwards, with something simple, such as having your nails done.

"You shouldn't be dreading" having a mammogram, Blackwood said. "You're doing something good for yourself" that day.

As for women who don't have their own doctor or health insurance, Blackwood said, "Actually, there are many programs around the country sponsored at the state, county or city level where women can go for convenient mammograms that are free or very inexpensive. Women should call their local health authorities to find out how to obtain those mammograms."

So, she concluded, there's no excuse not to get a mammogram!

"If I told you I had a cheap way to spend just a few minutes and help yourself prevent a serious disease, wouldn't you take advantage of it? That's what a mammogram is. It's as simple as that."

[kmason]

I believe some of the answer could become clear if you correlate your April 7, 2007 story about computerized mammogram readings with the date this computerized processing began. I still recall its beginning, yes gee, around year 2000, because it DOUBLED the price of a mammogram. Even if uninsured or partially insured women could afford it before, they can't now. So I agree with MissChris49. What's changed is the cost.

[sal567]

My last mammogram was five years ago. It was so painful up to now I cannot bring myself to undergo another torture. Until they find a less excruciating way of testing I'll just take my chances and hope the cancer cells will elude me.

[sheriimage]

3 things influence me to stall having mammograms: a rude skinnymini (I am far from skinny), after-pain lasting many days due to spondylosis, disk degeneration, and osteoarthritis, and a mistakenly sent test-positive letter over Thanksgiving weekend.

[erasmus6]

They may say that there is little radiation but if you consider that you have it once a year or whatever and then there is the xrays that you get from the dentist or other xrays you have through out your life. The radiation from your televisions, smoke detectors, the list goes on and on. The point is, that the radiation that you get, NEVER leaves your body, EVER!

[carolull]

The reason that I (I am 48) only get a mammogram every two years is that my health insurance only
covers it every two years, even though I am over 40. This could be one reason that many women don't get it done according to what is recommended.

[scottiemac52]

What a bunch of babies! I've been getting mammos for 20 years and the actual four compressions (two views per breast) take about fifteen seconds each. Geez.

As for radiation, the amount in a standard mammogram is the same as daily background radiation (the kind we are all exposed to just walking around) we get in 3 months. By contrast, a CT scan involves 3 years' worth of radiation. And the dose received these days is far lower than 20 years ago due to improved equipment, especially digital versus film mammography.

As for ultrasound:

"Ultrasound has excellent contrast resolution. This means, for example, that an area of fluid (cyst) and an area of normal breast tissue are easy to differentiate on an ultrasound image. However, ultrasound does not have good spatial resolution like mammography, and therefore cannot provide as much detail as a mammogram image. Ultrasound is also unable to image microcalcifications, tiny calcium deposits that are often the first indication of breast cancer. Mammography, on the other hand, is excellent at imaging calcifications. Ultrasound may be able to detect macrocalcifications (larger calcium deposits) in some cases.

Though most true breast lumps will be found by mammography or ultrasound, some abnormalities escape detection on both imaging tests. For example, a lump may be able to be felt but does not appear on mammography or ultrasound images. If this is the case, then fine needle aspiration biopsy (FNA) is often performed."

[misschris49]

If fewer women are getting mammograms, my belief is that the reason boils down to dollars and cents. Insurance coverage worsens each year, with companies putting a larger percentage of the costs on its employees and their dependents. And, as hospital procedures become more expensive, the patient's share of the costs are rising considerably. Women are practical and also usually put the needs of the family above their own. They would certainly skip their mammogram for a year, or even two or three, if other family needs are deemed more important.

[solaria-2009]

Yes it can hurt but if you get a good technician who knows what she's doing, that can be kept to a minimum. And it's not like it lasts for hours and hours--it's only a few minutes of discomfort. A small price to pay.

[erasmus6]

I know of several women who have had breast cancer and it was not detected through regular mammograms, it was the doctor that found something.

[meep318]

Why are these comments not shared in the news stories?? In all the 15 years I have gotten mammos, only ONE of the persons doing them was gentle and compassionate about how much it HURTS!! I agree that if men had to endure these, the technology would change quickly. Last year was the first year I skipped mime, and I feel guilty about it, but just dread the whole experience.