Albuquerque Journal
April 27, 2008
The number of women having breast cancer screenings on a regular basis has declined in recent years, experts agree.
New technology may not be enough of an incentive to get women back into the screening rooms. But the director of diagnostic imaging for Lovelace Women's Hospital figures talking about digital mammography just might help raise awareness.
"People think cancer of the breast is on a decline, but it's not," says Barbara Becker, who oversees operation of the new technology installed at the hospital a couple of months ago.
Becker says digital mammography, which replaces the traditional analog system, makes mammograms more accurate for many patients, and faster for almost all.
"We can get you in and out and on your way in 15 minutes," says Becker. And, she says, the images are sharper, easier to read, take less radiation, require little patient preparation and help reduce inconvenience.
Computer image
Digital mammography, also called full-field digital mammography, uses a process similar to digital photography that produces images of the breast that can be seen on acomputer screen. Computer software can then search the image for abnormal areas of density, mass or calcification that may indicate the presence of cancer.
Becker says the digital images are clearer and easier to adjust than the older film images. A radiologist has the ability to lighten or darken the image, adjust its contrast and zoom in to study a possible problem area.
Dr. Gary Wood, president and director of breast imaging for Radiology Associates of Albuquerque, agrees that digital imaging is more accurate for many women. He cites a study that found detection rates had improved by as much as 28 percent for women with dense breasts or who were premenopausal or perimenopausal.
Those statistics, combined with good business sense, were reasons RAA was the first in Albuquerque to begin offering digital mammograms nearly a year ago, says Wood. The business recently was designated by the American College of Radiology as a Breast Imaging Center of Excellence, the first and only facility in the state to receive such recognition, Wood says.
"We did it because we thought it was the best thing to do for patient care," the doctor says. "Digital is one more tool that allows us to be state of the art."
Wood blames the national decline in mammograms on several factors: decreased public attention to breast cancer awareness, a drop in the number of people insured and insurance companies that are now requiring deductibles for the screenings. He isn't convinced that converting to digital technology will improve screening compliance, but it might help get the discussion going again.
Becker and Wood agree there is a practical side to digital mammography as well. The results are easier to store and access, they say.
Half the time
The digital mammograms also allow for quicker exams, Becker says, which can be beneficial for patients and facilities alike.
She says an analog mammogram took 30 to 40 minutes, most of that time spent waiting to see if the image came out OK. Because digital imaging is almost immediate, that time has been cut in half. That's nice for patients; it's also good for places like the Lovelace Women's Center, which can now book more than 1,000 mammograms a month.
RAA schedules mammograms every 10 minutes. Wood says the facility has done more than 42,000 mammograms since converting to digital.
Becker says the digital technology also allows physicians quicker and easier access to screening results. With the appropriate software, which Lovelace will provide for free, physicians can have the results sent to them online and then review them at their convenience in their offices. However, Wood warns that these doctors should have high-resolution monitors and experience reading mammograms.
Digital mammography is more expensive than its predecessor, and the price patients are charged reflects the cost increase. Lovelace increased its fee by about $12, to $200, to cover the expense, Becker says, adding that annual screenings typically are covered by insurance.
Because the technology is expensive, few facilities in the state have made the transition to digital mammography. Wood says a digital machine costs about $400,000, compared to $80,000 for the analog machines. "You've got to be able to do high volume" to justify the cost, he says.
He says women in areas that don't have access to digital mammograms shouldn't lose faith in the older system. It's important that women continue to get screened for breast cancer, Wood says, recommending that women age 40 and older have a mammogram once a year.
Breast cancer is still the second-leading cause of cancer death for women, and statistics show that when it is discovered early, there is a 95 percent cure rate, he says.
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