The number of women receiving mammograms is higher than ever, according to the results of a study conducted by the Board of Sponsors for National Breast Cancer Awareness Month (NBCAM). The study found that more women are getting annual mammograms and that cancer mortality rates are declining.
Despite this encouraging news, the study also found that minority and elderly women are far less likely to have regular screenings (every 1 or 2 years). This trend is reflected in the breast cancer mortality rates among black women, as they are more likely to be diagnosed with breast cancer at a later, less treatable stage.
"We’ve come a long way from the time that breast cancer screening was not a test that women routinely had done, but we know that more needs to be done to reach minority women," said National Breast Cancer Awareness Month National Coordinator Susan Nathanson. "While the efforts of NBCAM and our members have contributed to the increase in mammography rates and subsequent decrease in death rates, we all need to focus on helping minority and lower-income women understand the benefits of mammography screening and the resources that are available to them to practice good breast health."
Factors Affecting Screening
The study found that regular screening of minority women may be hindered by low income, no insurance coverage, or lack of information. Overall, the proportion of women aged 40 years and older receiving mammograms rose steadily, from 58.3% in 1990 to 76.1% in 2000. "For the past 10 to 15 years, we have made mammography available throughout this country to more and more women," said Ellen Mendelson, MD, director of breast imaging at Northwestern Memorial Hospital and professor of radiology at Northwestern University Medical School. "However, we’re concerned that minority groups haven’t taken advantage of the opportunities that mammography can provide."
Moreover, the failure of physicians to discuss mammography with their patients may also be discouraging minority and elderly women from having mammograms. Recommendation for mammography was found to be more frequent among women who had a regular physician and health insurance. The study found that socioeconomic status, age, and other characteristics, excluding race and ethnicity, were related to a physician recommendation for screening mammography. About 62% reported an adequate level of referrals for screening mammograms.
In addition, the shortage of diagnostic radiologists available to perform mammograms, low reimbursement rates, and decline in the number of imaging centers around the United States contribute to current and future access issues. Whether the closing of imaging centers and increased regulation to ensure quality services has significantly limited patient access to mammography remains undetermined. The demand for routine or annual mammography will increase as the population ages, and these issues must be monitored carefully to ensure that access to mammography is not put at risk.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
