Mammography

WASHINGTON -- Courting women's support for health care reform, President Clinton called on state governments, insurance companies, medical facilities and businesses to adopt policies that widen access to appropriate and affordable mammography. He also pledged additional government support for breast cancer research."These resources can save the lives of countless women," the president said during an East Room ceremony as he signed a proclamation declaring today National Mammography Day.A September draft of the health care plan would provide free mammograms only to women 50 and older -- and only at two-year intervals.

A report in The Wall Street Journal raised troubling questions about the recent decision of the U.S. Preventive Services Task Force, a 16-member panel of independent medical experts, to cancel a meeting that had been set for around Election Day. One of the important items on the agenda was to have been a vote on the utility of prostate cancer screening. The most recent recommendations, from 2008, state that prostate screening should not be conducted for men older than 75. For younger men, the evidence around the preferred screening test (the prostate specific antigen, or PSA, blood test)

IT HAS BEEN widely (and with reason) charged that the makers and marketers of silicone breast implants, and self-interested plastic surgeons, made women their guinea pigs. But what of that other, and greater, scourge of women, breast cancer? There is reason to believe that women are equally ill-served by the cancer Establishment, especially in its unrelenting promotion of mammography.Breast cancer now strikes one in nine women, a dramatic increase from the one in 20 in 1950. This year, 180,000 new cases and 46,000 deaths are expected.

When a government advisory panel put out new recommendations last week that said women under age 50 need not be screened for breast cancer, the calls began flowing to Sen. Barbara A. Mikulski's office. Within days, the Maryland senator had responded with an amendment to the Senate's pending health care reform bill that would guarantee access to mammograms at age 40 through public insurance exchanges. With the health legislation as the backdrop, politicians in Maryland and across the country have reacted swiftly to the breast cancer lobby - a group that has made early screening a mantra and pink ribbons a powerful symbol in fighting the most commonly diagnosed cancer in women.

Hoping to lower breast-cancer death rates by detecting the disease early, the University of Maryland Medical Center will crisscross the state in a new, $260,000 specially equipped mammography van, bringing low-cost screening mammograms to women at their workplaces and in their communities."

WASHINGTON -- Upset and confused by recent government recommendations on mammography screening for breast cancer, female senators yesterday sharply questioned why President Clinton's health reform plan limits coverage of this important test to women 50 and older."

Kay Mayo didn't have a family history of breast cancer and didn't think she was at risk. But the 45-year-old Pasadena woman saw a notice about a low-cost mammography program offered by Harbor Hospital Center that even had evening hours."

Gaby Donovan welcomes patients into her office with a warm hug and a reassuring smile. She hopes her manner with women scheduled for a mammogram puts them at ease."

A Fredericksburg, Va., man hired to inspect mammography machines and other devices for nearly 15 years in Maryland and elsewhere was masquerading as a medical physicist and had no idea how to do some aspects of his job, federal authorities say. No patients are known to have been harmed at Harbor Hospital Center in Baltimore and 52 other facilities at which Perry M. Beale worked as a consultant, authorities said. They said that other safety checks were in place to prevent that. Beale, 50, a consultant whose hospital and other clients often paid him by mail, was charged Thursday in U.S. District Court in Roanoke, Va., with 38 counts of mail fraud.

To Judy Westphal, helping to create a mammography program for co-workers at North Arundel Hospital was "just doing a part of my job."It was taking care of family, explained the 54-year-old nurse. "We just felt like you need to look after your own family, and, of course, this was our work family."But to the Glen Burnie Business and Professional Women's Association, it was an effort that led them to name her Woman of the Year for 1996. She was selected for the award based on co-workers' nominations.

Cancer experts say there is new evidence that women at high risk for breast cancer should undergo magnetic resonance imaging to search for early malignancies typically missed by traditional breast exams and mammography. A study published this week in The New England Journal of Medicine said MRI exams found previously undetected cancer in the "healthy" breast of 3 percent of women already diagnosed with cancer in the other. Catching those hidden cancers early allows doctors to treat them and improve patients' chances for survival.

For years, mammography and manual breast exams have been primary tools for spotting breast cancer. But both tests are frustratingly imprecise and miss many cancers until the tumors have spread. Now another technique might offer better results for women at high risk. Magnetic resonance imaging is far more accurate, according to a study by Canadian researchers. The findings could lead to a sharp increase in the use of MRI, especially among high-risk women. "The MRI is very sensitive," said Dr. Steven Narod, an epidemiologist at the University of Toronto and an author of the study, which appears in today's issue of the Journal of the American Medical Association.

A Fredericksburg, Va., man hired to inspect mammography machines and other devices for nearly 15 years in Maryland and elsewhere was masquerading as a medical physicist and had no idea how to do some aspects of his job, federal authorities say. No patients are known to have been harmed at Harbor Hospital Center in Baltimore and 52 other facilities at which Perry M. Beale worked as a consultant, authorities said. They said that other safety checks were in place to prevent that. Beale, 50, a consultant whose hospital and other clients often paid him by mail, was charged Thursday in U.S. District Court in Roanoke, Va., with 38 counts of mail fraud.

Bureaucratic `beast' enhances our lives and protects citizens I wonder why The Sun gave space to Crispin Sartwell's silly diatribe about the federal bureaucracy ("The bureaucratic beast spits out only stupidity," Opinion Commentary, March 18). Mr. Sartwell's thesis that "every government bureaucracy that deals with the public is a huge, lumbering tribute to human ingenuity in making our lives impossible" is out of touch with reality. I have been around for six decades and have never found my life impossible or controlled on a day-to-day basis by these systems of power.

WASHINGTON - A new analysis of mammography, the latest in a series to address the question of whether breast cancer screening saves lives, has found that the tests reduce the risk of dying from the disease by one-fifth. The study, being released today by a team of Swedish researchers, concluded that the benefits of breast cancer screening were greatest for women older than 55. Among younger women, the benefits were not statistically significant, the study found. The research is likely to do little to settle the debate among scientists and statisticians over the value of mammograms.

As debate flares anew over the ability of routine mammograms to prevent breast cancer deaths, Dr. Naji Khouri knows what he can and cannot claim. The Johns Hopkins radiologist can't claim that he can detect every tumor, or that every tumor he detects can be cured. But he does contend -- vehemently -- that some tumors, perhaps the majority, can be cured if they are caught at an early stage. And for that to happen, he says, a woman needs routine mammograms, no matter what the critics say. "The majority of breast cancers are going to be slow-growing, and that allows us to cure them," says Khouri, an associate professor of radiology at the Johns Hopkins School of Medicine.

Washington. -- As the premier government agency for dealing with the most feared disease, the National Cancer Institute should realize that the average citizen is not certified in oncology or statistics.Clarity and explanatory skill are required when professionals address lay people about cancer. But these qualities have been scarce in the institute's declarations concerning one of the most complex issues in cancer diagnosis, mammography for breast cancer. In this matter, the cancer institute has made the worst of a difficult situation.

In the wake of the National Cancer Institute's decision to stop recommending regular mammograms for women in their 40s, many radiologists and other doctors who treat patients continue to be convinced by their clinical experience and intuitive reasoning the benefit of routine screening for these women would be obvious if the proper studies were done.Meanwhile, women and their doctors are left in a quandary about the best use of this weapon for early detection of breast cancer, the disease women fear most.

A new study in a British medical journal has stirred a passionate debate among doctors in Europe and the United States by asserting that mammograms do not prevent women from dying of breast cancer or help them avoid mastectomies. The question is dividing experts and women's health advocates, many of whom acknowledge that they do not know what to think about the new report. For more than two decades, annual mammograms have been part of life for millions of women, with the American Cancer Society and the National Cancer Institute urging women to have them.

Saying they are losing money on each breast X-ray, some mammography centers are closing, and few new ones are opening, raising fears that women may encounter increasing difficulty getting screened. A year ago, 167 Maryland facilities performed mammograms, but the number has dropped to 150, according to the American College of Radiology, the professional group that accredits mammography centers. Nationally, the number of centers has slipped from 9,873 in March to 9,534 today , the American College of Radiology says.