- The Washington Times - Friday, September 16, 2005

From combined dispatches

Mammograms that use digital imaging to help doctors spot cancer are better than standard X-rays for women under 50 and those with dense breasts, but others can skip the extra cost and get the old-fashioned kind, a landmark study says.

Digital mammograms proved 15 percent more accurate than standard film X-rays among women under 50, in whom breast cancer is relatively uncommon. Among women with dense breasts and those not yet in menopause, digital mammograms were 11 percent and 15 percent better, respectively, said the study by the American College of Radiology Imaging Network.

Mammograms cut the risk of dying of breast cancer by up to 35 percent among women 50 and older, and by 15 percent to 20 percent among younger women, who tend to have dense breasts that standard film X-rays have trouble penetrating.

“We don’t have enough digital mammography for everyone to get it, and some women won’t benefit from it anyway,” said the lead researcher, Dr. Etta Pisano, chief of breast imaging at the University of North Carolina at Chapel Hill.

Only 8 percent of mammography equipment today is digital, largely because of cost. Medicare pays an average of $85.65 for a standard film mammogram and $135.29 for a digital one.

Robert Smith, director of screening at the American Cancer Society, said no woman should delay getting a mammogram if a digital one is not available. The society recommends annual mammograms starting at age 40; the federal government advises them every one to two years for women in their 40s and then annually starting at age 50.

As for the study results, “we’d always like a newer technology to do better in every way,” but improving mammograms for certain groups of women is still a gain, Mr. Smith said.

The study involved 42,760 women in the United States and Canada and was funded by the National Cancer Institute.

A total of 335 breast cancers were found. Both types of mammograms missed about 30 percent of them.

Digital machines sell for $400,000 to $500,000 compared with $75,000 to $125,000 for the standard equipment, said Vince Polkus, a products manager for GE Healthcare, one of four companies whose equipment was used in the study.

Savings in film and storage space and the increased efficiency of the newer machines make up for some of the additional cost, he said.

Researchers expect to complete a cost-benefit analysis of digital-versus- film mammograms in about two months, Dr. Pisano said.

Doctors still expect digital mammograms to become more common because of their many advantages, including that they can be stored on a computer and sent electronically whenever a woman moves or a new doctor needs to see them.

“Everything is going filmless. If there’s no disadvantage to digital mammography, I would presume over time it will replace film screening,” said Dr. Kathy Brandt, chief of breast imaging at the Mayo Clinic in Rochester, Minn., who had no role in the study.

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