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The future of breast cancer screening is here

July 13, 2016
Jim Culley
From the July 2016 issue of HealthCare Business News magazine

Breast cancer is the second-most common cancer among American women (skin cancer is No. 1). One in eight women (12.5 percent) in the U.S. will develop invasive breast cancer during her lifetime.

Detecting breast cancer is one of the most important health challenges of our time. The best screening tool for finding breast cancers when they are small, easier and less costly to treat is a mammogram. It is the only tool approved by the Food and Drug Administration for screening. Ultrasound and breast MRI are useful diagnostic tools after an area of suspicion has been found with a screening mammogram.

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Mammograms aren’t perfect. Normal breast tissue can mask cancer so that it doesn’t show up on the mammogram, and on the flip side, mammograms sometimes identify abnormalities that look like cancer, but turn out to be normal tissue. For a significant percentage of women with dense breasts, seeing cancers with a mammogram is a challenge. In recognition of these limitations, health care providers continue to work on improving the way a mammogram is done.

Recent improvements in how we screen for, diagnose and treat breast cancer are many and significant. Breast tomosynthesis exams are the latest innovation in screening. Ten years ago, 80 percent of all the mammography systems in the U.S. were screen film-based systems. Today, 98 percent of the installed mammography systems are digital, and over 30 percent of the U.S. installed base is tomosynthesis-capable.

Mammography systems that are tomosynthesis-capable allow the radiologist to examine breast tissue layer by layer. For the tech and patient, tomosynthesis exams look and feel like a conventional mammography exam, but for the doctors tasked with reading the mammogram, tomosynthesis gives a clearer view of the overlapping slices of breast tissue and more confidence in their diagnosis.

Some argue breast tomosynthesis is still investigational
Breast tomosynthesis systems have been used in screening for more than eight years. The first systems were installed in Canada and Europe in 2009. In 2011, they were approved for use in the U.S. Tomosynthesis systems can now be found in over 50 countries and all 50 states. Of the 35 million women who will be screened for breast cancer this year in the U.S., more than 10 million will have a tomosynthesis exam.

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