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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:
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