Breast cancer is the leading cause of cancer among women and the second-leading cause of cancer death in the United States.
While various screening methods have been introduced to permit early detection of breast cancer, only mammography has been shown to reduce the risk of death.
According to the Centers for Disease Control and Prevention, in 2005 (the last year for which data are currently available), there were more than 180,000 new cases of breast cancer in the United States and more than 41,000 deaths from the disease.
Symptoms of breast cancer may include breast pain, a new lump in the breast or armpit, thickening, redness or dimpling of the skin over the breast, or nipple discharge. Yet for many women with early breast cancer, symptoms may be absent. Early detection greatly enhances treatment options and can improve prognosis and outcomes, including reducing the risk of death from the illness.
While regular self breast examination by women and breast examination by a physician during an annual health exam have been advocated for breast cancer detection, these screening techniques have not been shown to reduce the risk of death from the disease.
By contrast, mammography has been shown to reduce the risk of death from breast cancer by up to 20 percent in women ages 40-49 and up to 35 percent in women 50 and older.
For this reason, many major health advocacy organizations have published recommendations for routine mammography for women. These organizations include the American Cancer Society, U.S. Preventive Services Joint Task Force and the American College of Obstetrics and Gynecology.
There is some variation regarding the recommended age and frequency of mammography screening. In general, mammograms are recommended every one to two years for women beginning at age 40 and annually for women beginning at age 50.
There is some controversy about the age at which mammograms are no longer needed. Women older than 70 have the highest risk of breast cancer. Yet, older women also may have coexisting medical problems that pose a greater threat to their survival than undiagnosed early breast cancer. The American Cancer Society recommends annual mammograms continue for older women who are otherwise in good health.
For many women in rural areas, access to mammography services can be an issue. We are fortunate to have access locally to high-quality mammography services offered at Mercy Regional Medical Center, which is engaged in a capital campaign to build a state-of-the-art comprehensive breast care center.
The cost of mammography is generally covered by state and federal programs such as Medicaid and Medicare, as well as most private health insurance plans. For many eligible low-income women without insurance, the CDC's National Breast and Cervical Cancer Early Detection Program provides funding for free mammography services. This program is locally administered by the Colorado Women's Wellness Connection, which can be reached by calling toll free (866) 951-WELL.
Dr. Matthew A. Clark is a
board-certified physician in internal medicine and pediatrics practicing at the Southern Ute Health Center in Ignacio.