Understand that mammograms come

上一篇 / 下一篇  2018-03-22 10:42:04 / 個人分類:教育


Standard mammograms take X-rays from two sides of the breast. With tomosynthesis, additional X-rays are taken at different angles -- not truly three-dimensional but a computer compiles them into a 3-D-like image. First approved by the Food and Drug Administration in 2011, they're not yet the standard of care in part because of questions that the new study aims to answer.
Some studies have found tomosynthesis detects more cancer with fewer false alarms; they're often advertised as particularly useful for younger women's dense breasts.
HOW TO DECIDE?
Understand that mammograms come with pros and cons, and weigh them, said Dr. Otis Brawley, the American Cancer Society's chief medical officer.
Breast cancer is far less common at age 40 than at age 50 and beyond. After menopause, tumors tend to grow more slowly and women's breast tissue becomes less dense and easier for mammograms to provide a clearer image.

Consider: For every 1,000 women screened every other year until their 70s, starting at 40 instead of 50 would prevent one additional death — but create 576 more false alarms and 58 extra unneeded biopsies, the task force estimated. Also, two extra women would be treated for tumors that never would have become life-threatening — that over-diagnosis problem.
As for what type to choose, some insurers, including Medicare, cover the 3-D version, and a small number of states mandate coverage. Other insurers may require women to pay $50 to $100 more out of pocket. Whoever ultimately pays, extra time to analyze the scans adds to the cost.
THE NEW STUDY

About 100 mammography clinics across the U.S., and a few in Canada, will enroll healthy women ages 45 to 74 who already are planning to get a routine mammogram. They'll be randomly assigned to get either the regular or 3-D version for five years. Most will be screened annually but post-menopausal women who don't have certain cancer risk factors will be screened every other year.
Researchers will track every woman's results including samples from biopsies plus genetic and other tests, as well as how any cancer patients fare. The giant database hopefully will help them tease out more information about which women benefit most from what type and frequency of screening.

"Mammography has been provocative over many decades. It's important that women have a better understanding of how mammography is important for them based upon their age and other risk factors," said McCaskill-Stevens.
This Associated Press series was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.




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