Mammograms Imperfect, but Crucial to Early Detection

By Melanie R. Margolis

 

October is Breast Cancer Awareness Month. Are you aware that the Texas Department of Health (TDH) estimates that 13,100 women in Texas will be diagnosed with breast cancer this year, and 2,600 will die from it? See http://www.tdh.state.tx.us/news/ac093002.htm.

 

While mammograms are less than perfect detectors of breast cancer, early detection is the best means of beating cancer. On September 30, 2002, the Texas Department of Health issued a statement on breast cancer, noting that “[e]arly detection gives a woman the greatest chance for survival. And the combination of mammography and an annual clinical breast exam is still the best option a woman has for early detection.” See http://www.tdh.state.tx.us/news/ac093002.htm.

 

Mammograms are criticized for providing too many false positive results and being difficult to interpret, but the test saves lives. See id. A recent study examined false positive rates in mammographic interpretations. Screening Mammograms by Community Radiologists: Variability in False-Positive Rates, Journal of the National Cancer Institute, Vol. 94, No. 18, 1373-1380, September 18, 2002. Researchers analyzed medical records relating to 8,734 screening mammograms by 2,169 randomly selected women aged 40–69years, which had been interpreted by 24 radiologists in a community setting between 1985 and 1993. The study found that the radiologists produced a false-positive rate that varied from 2.6% to 15.9% with less experienced radiologists yielding higher false positive rates than more experienced ones.

 

A positive result, false or not, would lead to further testing. A false positive result would eventually reveal itself as such. A false positive result may be worrisome, inconvenient, and costlier than a ‘true negative’ result, but a false positive is far better than an untested positive. Just ask political columnist Molly Ivins. In December of 1999, Ms. Ivins announced to the world in her syndicated column that she had been diagnosed with “’an outstanding case of breast cancer,’” and she urged women to “’Go. Get. The. Damn. Mammogram. Done.’” The Dallas Morning News, December 15, 1999 at 45A; The Atlanta Journal and Constitution, December 22, 1999 at 13E.

 

The state of Texas is working to make mammograms accessible to more of its citizens. TDH contractors across Texas offer breast exams and mammograms at no cost to women ages 50 to 64 with limited incomes. For more information about the TDH program, call the TDH Breast and Cervical Cancer Control Program at 1-800-452-1955.

 

In addition, on October 15, 2002, U.S. Department of Health and Human Services Secretary Tommy Thompson approved Texas’s application for a federal program that allows the state to offer Medicaid benefits to uninsured women who are diagnosed with breast or cervical cancer through a federal screening program. Participation in the BCCPT is optional for states, but states that offer the benefit will receive an enhanced matching rate for women who enroll. Texas is the 46th state to take advantage of the federal Breast and Cervical Cancer Prevention and Treatment Act (BCCPT) that was signed into law in October 2000.

 

This law extends the full Medicaid benefit package to women who were screened and found to need treatment through the National Breast and Cervical Cancer Early Detection Program of the Centers for Disease Control and Prevention (CDC). To qualify for the new program, women must be under age 65, not eligible for Medicaid, and without creditable health care coverage. Since the CDC program began in 1990, more than 3 million breast and cervical cancer screening tests have been provided to more than 1.8 million women. Under the BCCPT law, these women may now be eligible for Medicaid benefits for the duration of their cancer treatment. More information about this program is available at http://www.hcfa.gov/medicaid/bccpthm.htm and http://www.cdc.gov/cancer/nbccedp/index.htm.

 

Heed the warning of Molly Ivins…make your mammogram appointment today.

 

10/25/02