Mass General Imaging News & Events - Massachusetts …
Wednesday, October 25, 2017 Clinical
A comprehensive understanding of the glandular dose to the breast during tomosynthesis imaging, as well as the dose distribution to most of the radiosensitive tissues in the body from planar mammography, tomosynthesis and dedicated breast computed tomography was gained.
One problem that is present in standard planar mammography, which is not solved with the introduction of digital mammography, is the possible masking of lesions by normal breast tissue because of the inherent collapse of three-dimensional anatomy into a two-dimensional image.
AAPM Publications - AAPM Reports
Orton, Ph.D., Moderator Received 30 October 2007; accepted for publication 30 October 2007; published 9 January 2008 DOI: 10.1118/1.2825612 OVERVIEW Recent advances in cone beam CT and digital x-ray tomosynthesis suggest that three-dimensional 3D systems may soon replace conventional planar mammography as the modality of choice for imaging the breast and delineating cancer.
Geographically, this report is segmented into several key Regions, with production, consumption, revenue (million USD), and market share and growth rate of Digital Mammography Equipment in these regions, from 2012 to 2022 (forecast), coveringThen, the report focuses on Global major leading industry players with information such as company profiles, product picture and specifications, sales, market share and contact information.
AAPM is the American Association of Physicists in Medicine
An influential Pennsylvania group late Thursday asked the American Cancer Society to reconsider its new position that most women don't need annual mammograms until age 45.
"It's moving in the wrong direction. Women are going to drop out [of regular mammograms] because they are unsure. It's sowing massive confusion," says Pat Halpin-Murphy,
The coalition said it "fears these recommendations will lead to thousands of women skipping mammograms that could save their lives. There is no doubt the ACS's decision to change the suggested age and frequency of screenings will lead to a decrease in mammograms nationwide. Early detection saves lives. We encourage the American Cancer Society to revisit its decision to alter existing guidelines on mammography."
Earlier this week, the American Cancer Society raising the age to 45; it had been 40.
The American Cancer Society stressed the new recommendation applies only to woman who have average risk for breast cancer -- not those who are at high risk for reasons such as family history or a history of receiving high does of radiation to the chest area. It further said woman who feel safer getting a regular mammogram beginning at age 40 should do so.
But a fallout of the society's change is that three major organizations which advise women on mammograms now differ on the recommended age for beginning annual mammograms, which involve x-rays and are the main tool for detecting breast cancer.
The American College of Obstetricians and Gynecologists recommends beginning them at age 40, while the U.S. Preventative Services Task Force recommends starting them at 50.
Dr. Susann Schetter, co-director and chief of breast imaging at the Penn State Hershey Breast Center, said she worries the new recommendation will cause many younger women to delay mammograms they otherwise would have wanted, and some won't learn they have breast cancer until it is more advanced and harder to successfully treat.
The American Cancer Society based the new recommendation on the high rate of false-positive mammogram results for women under 45. Younger women tend to have denser breasts, making it harder to clearly distinguish tumors through mammogram. The society believes the high risk of false positives, combined with the resulting anxiety and need for additional tests which can include biopsies, outweighs the benefits of annual mammograms for women of average risk aged 40-44.
However, the society says women in that age group should get annual mammograms if they want them, provided they understand the risks.
The recommendation has proved highly controversial, with Halpin-Murphy and others arguing it will undermine hard won progress in convincing women to get regular mammograms.
Schetter said people should view the advice from the American Cancer Society, as well as the two other organizations, as "suggested guidelines" rather than hard and fast rules.
She said "women have to make the decision on their own" with input from their doctor, and knowledge of the risks and benefits. Schetter said most of the woman she sees aged 40-44 prefer to take a "proactive" approach of annual mammograms, and are comfortable with the risk of false positives and possible consequences.
The Penn State Hershey center will continue to advise women to begin annual mammograms at age 40, said Schetter, who noted 23 percent of breast cancer cases occur in women in their 40s.
However, Schetter also said if a woman of average risk expressed great discomfort stemming from the risk of a false-positive, or believes a false-positive would affect her willingness to receive future mammograms, she would advise the woman to hold off until 45.
The American Cancer Society has expressed concerns over woman avoiding future mammograms after having a false positive.
Dr. Theresa Lee, a breast medical oncologist for PinnacleHealth System, believes that for a woman of average risk, it is "reasonable" to begin annual mammograms at 45.
But she further said that for a woman who wants to be proactive, or for a woman who is uneasy for reasons such as having seen a friend stricken at a young age, there is "nothing wrong with starting at the age of 40."
Dr. Matthew Aungst, an ob-gyn at Holy Spirit-Geisinger, said he still leans toward mammograms beginning at age 40, but also believes "woman should know one of the downsides of a more stringent program is a higher risk of false positives."
Nationally, another concern stemming from the new American Cancer Society stance is that health insurers might raise the age at which mammograms are covered by insurance.
But that's not a worry in Pennsylvania, where a 1992 law requires health insurers to pay for the mammograms beginning at age 40. "I think we're lucky in this state -- not all women in all states share the same advantage," Schetter said.
Meanwhile, the breast cancer coalition's Halpin-Murphy says that, rather than allowing false-positives to undercut frequency of mammograms, she would prefer to see the American Cancer Society to put its weight behind promoting greater use of new mammogram technology to reduce false positions.
Halpin-Murphy, as well as the three doctors interviewed for this article, said newer, three-dimensional mammograms have lower rates of false positives. They further expressed confidence technological advancements will further reduce false-positives, which will eventually cease to be a factor.
Halpin-Murphy said early results of a state-wide survey of Pennsylvania's 367 mammography centers suggest about 27 percent have at least one 3D machine. She said use of 3D is "quickly moving forward because it is the new technology."
In an unrelated move, law applies to 3D mammograms, and there can be no additional charge for 3D mammogram.
The American Cancer Society revised other guidelines as well, saying woman needn't bother with routine manual breast exams by doctors, and that woman over 55 at average risk can opt for mammograms every other years, since breast cancer in woman past menopause tends to progress more slowly.
Halpin-Murphy said her organization is hearing from breast cancer survivors whose cancer was detected before age 45, and believe they wouldn't be alive if the new American Cancer Society recommendation had been in place.
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