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To: pilapir who wrote (5933)	3/9/2001 7:16:22 AM
From: StockDung	Respond to of 6039

Scientific Review Backs Mammograms By LAURAN NEERGAARD .c The Associated Press WASHINGTON (AP) - Old-fashioned mammograms aren't perfect but so far, no new breast cancer detection system, including highly touted digital mammograms, has proved better, concludes an exhaustive scientific review of tumor-detecting technology. But other technologies may one day help catch more cancer, particularly in women with dense breasts, the Institute of Medicine reported Thursday, urging intensive research. For now, ``mammography is still the best way we have,'' said Dr. Janet Baum, a Harvard Medical School radiologist who co-authored the report. Consequently, access to mammograms for uninsured women must be increased, the report said. A program by the Centers for Disease Control and Prevention that gives free mammograms to the uninsured so far reaches only 15 percent of eligible women but should strive to quickly increase that number to 70 percent, the institute said. Additionally, a new federal law ensures Medicaid will pay to treat women whose cancer is detected in the CDC program, but states haven't yet adopted that change, the report said. American women undergo 30 million mammograms a year. The breast X-ray, which costs between $75 and $150, can detect early-stage tumors, when they're easier to treat. Routine screening mammograms can decrease breast cancer deaths by 25 percent to 30 percent, experts say. But they're not foolproof. They sometimes miss suspicious spots that turn out to be tumors. They can be ambiguous, leaving a doctor in doubt as to whether to do a biopsy immediately or wait six months and X-ray again. More often, suspicious spots on a mammogram are biopsied only to turn out to be benign lumps. ``The disappointing part of screening mammography is while it reduces mortality, it only does so by a fraction,'' explained Dr. Daniel Hayes, breast cancer director at Georgetown University's Lombardi Cancer Center. ``We think we can do better.'' Hence the hunt for improved technologies. Last year, the Food and Drug Administration approved the first digital mammograms, computerized X-ray images that proponents tout because the computer images may be lightened or otherwise manipulated for a closer look. For women, getting a digital mammogram is no different than getting one recorded on film - the breast is compressed and X-rayed the same way. And the institute, citing an ongoing U.S. Army study of 7,000 women, says so far there's no evidence digital mammograms are superior to film ones in spotting cancer. So if a woman's doctor offers digital mammograms, just be sure the physician is properly trained and feel confident it's an equally effective choice - but don't feel it's necessary to search out the newer technology, Baum said. Among the report's other findings: Some doctors use computer programs to double-check mammograms for suspicious spots. With less-experienced radiologists, studies suggest this computer re-check has potential, but nobody yet knows if it's worth wide-scale use or the cost. Some women demand their breasts be checked by MRI, or magnetic resonance imaging. Early studies suggest MRI might help detect tumors in women with breasts so dense that mammograms may not image them clearly, but for now, those women should get MRI only in clinical trials. Other techniques, like testing breast fluid for precancerous signs, remain experimental and require large studies. The Institute of Medicine is part of the National Academy of Sciences, an independent organization chartered by Congress to advise the government on scientific issues. On the Net: National Academy of Sciences: nas.edu AP-NY-03-08-01 1347EST

To: pilapir who wrote (5933)	3/14/2001 5:43:23 PM
From: StockDung	Read Replies (1) \| Respond to of 6039

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