The New Digital Mammography
By Linda Bily
Last month I went for my annual mammogram at the breast center where I have had every mammogram since my baseline at age 40 ten years ago. I filled out the forms, was escorted into the changing room (which is really no bigger than a small closet. It has a bench and a hook.) The nurse knocked on the door and I entered the mammo room. I asked her if this was the new digital mammo machine. She said "no". I expressed my disappointment and explained that as an advocate, I was interested in the new machinery.
When she read my chart and realized that I was a survivor, she told me that all women who had breast cancer were routinely being screened with the newer technology. We switched to the other room. I was disappointed. The machine, a GE model, looked exactly the same. The procedure was the same - position, squish, hold your breath and you're done. To be fair, this is the first mammo I have had in 3 years (since I was diagnosed with breast cancer) where they did not take additional views. There is no difference in the feeling of compression, or the length of the exam.
When I saw my breast surgeon two days later, I asked him about the machine. I had read a lot about it and wanted his opinion. He told me that the digital machine could zoom in to denser tissue. From what I've read, I believe he meant that the computer technology could change the angle of view, or depth of the picture. I know there have been several small studies done to date which have found no significant difference in the detection of cancer. Simply put, the radiologist must still know how to read the material, whether it is computer-generated or a radiologic film. In one study, the radiologists found as many (and missed as many) on both types of machines. The advantage to the digital machine is that it can maneuver the pictures. Storage is easier (images can be stored on a computer disc). One of the best parts of the digital technology is the application for areas worldwide where a radiologist is not always available. I have a friend in the Phillipines. This country consists of several islands, hundreds of miles apart from each other. Although they have a mammography machine on one of the outer islands, they can not afford to hire a full-time radiologist. In the past, they have had students, or any medical personnel they could find, read the films. With a digital machine, they can email the pictures to a radiologist any where in the world. The storage also takes less space, takes seconds to retrieve and produces clearer images.
One of the disadvantages at my hospital is the price. I have great health insurance and have never paid anything but the co-pay for my exams. My surgeon told me that to help recoup the cost of this machine, they are charging a larger fee for digital mammography. Unfortunately, most insurance companies follow national standards and there is one "common and usual" charge for mammography, which has not been increased due to this new technology. I have not received a bill for the difference, but I will keep you informed.
Although there seems to be no major difference in diagnosis at this point, I am still in favor of digital mammography. The technique can only get better and better, the storage is simple and almost fool-proof, and this opens mammography to a whole new group of women who have no access to a doctor on a regular basis.
You can check out digital mammography at GE's breast site: www.herSource.com It's a good site for lots of information and is easy to navigate.
I know there have been several controversial articles about the benefit of mammography lately, but until we have another definitive tool, I am still going to recommend that women have mammograms according to the suggestions of the major cancer organizations - American Cancer Society, Susan G. Komen Foundation and Y-Me. As a card-carrying member of NBCC, I know that this is a grey area, but personally, I feel that mammos are not that uncomfortable and I will continue to have my annual "squoosh". There are some new techniques on the horizon with potential, but until there is hard evidence that mammograms due damage, I will continue to stress breast self-exam, annual PAP smears and mammograms for women over 40.
Good health!
About the Author:
As a breast cancer survivor, I became passionate about the need for all cancer patients to have the tools necessary for them to advocate for their own best health care. I work in an academic medical center, serve as a patient advocate and continue to volunteer within the community, and on a national level, as a community outreach educator, grant reviewer, hotline counselor and mentor/buddy.
Article courtesy of www.suite101.com.
