Breast cancer will claim an estimated 40,480 women this year, and an estimated 182,460 women will be diagnosed with the disease in 2008, according to the National Cancer Institute. It is the second leading cause of cancer deaths, after lung cancer, in women today.
Mammography, the process of using X-rays to examine the breast, provides a good chance of detecting breast cancer before it has spread to the lymph nodes. The American Cancer Society recommends that women age 40 and older have a screening mammogram every year for as long as they are in good health.
According to the Susan G. Komen State of Breast Cancer Report released in the fall 2007, there are 2.3 million people in the United States living with breast cancer or who have survived the disease.
"It is expected that about 1,600 Nevada women will be diagnosed with breast cancer this year and 300 Nevadans will die from the disease," said Stacey Gross, community programs manager for the Southern Nevada affiliate of the Susan G. Komen for the Cure.
A SAFE PROCEDURE
The federal government has made an effort to ensure mammography is as safe as possible. In 1992, Congress passed the Mammography Quality Standards Act "to ensure all women have access to quality mammography for the detection of breast cancer in its earliest, most treatable stages," according to the Food and Drug Administration Web site. Congress charged the FDA in 1994 with creating and implementing regulations in accordance with the Mammography Quality Standards Act. The FDA's regulations went into effect in 1999, and require every facility providing mammograms to be accredited by the FDA or an FDA-approved accreditation body and be certified by either the FDA or the state. The facility must also undergo annual inspections.
In addition, the FDA reviews mammography images from each facility to ensure the radiation levels are low.
The FDA also requires adequate training for any physician who interprets mammograms, as well as for technologists who perform the mammography and medical physicists who survey the mammography equipment.
WHY WOMEN DON'T GET SCREENED
Even though mammograms have been shown to be a reliable method of breast cancer detection, there are several reasons why some women do not undergo the noninvasive procedure.
"There are so many reasons why women do not have mammograms," Gross said. "In Nevada, we have such a large uninsured population here, and a lack of health insurance or an inability to pay for one is a huge deterrent. There are a lot of cultural factors that tie in. And, a lot of people are scared and they would rather not know (if they have breast cancer). They may have a relative who has it and the thought can be really scary for them."
Gina Arnold, a mammography technologist and manager of Breast Center at Sunrise, said there are a variety of reasons why women will avoid getting a mammogram. One of the most common is the reputation the procedure has for being uncomfortable.
"The compression component is typically why women don't want to have them," Arnold said.
To obtain a good image, the breast must be compressed during the procedure.
"It spreads out the structures and makes it easier to look at all the areas," Arnold said. Proper compression also makes it possible to use a low level of radiation, she added.
Arnold has some tips for women who are concerned about the discomfort of a mammogram. "Taking something like Tylenol or Advil before the procedure makes a big difference," Arnold said. Also, women who experience premenstrual breast sensitivity should try to schedule the procedure for shortly after their periods.
In addition, some technological advances have been made to reduce the compression discomfort. MammoPads, soft foam cushions placed over the bottom plate, are now used by many facilities to make the compression more comfortable. In addition to providing a softer surface, the MammoPad makes the surface warmer.
Concerns about radiation exposure also make some women reluctant to get a mammogram. Arnold says the Breast Center at Sunrise, like many facilities, now uses digital technology -- which requires less radiation than analog equipment. Federal law requires all mammography facilities to implement rigorous quality assurance procedures, and every facility must undergo an annual on-site inspection to ensure that the equipment is sound, the procedures are being followed and the radiation levels are safe.
HELP FOR THE UNINSURED
Assistance is available for uninsured women who need mammograms. A portion of the Susan G. Komen for the Cure's year-round fundraising efforts helps provide screening and treatment for those who can't afford it.
"Those who are recommended to have a mammogram and are unable to afford it may contact our organization for guidance. There is a state program that funds mammograms for women who are 50 and older, and we try to fill in those gaps. We provide funding for women 49 and under through Mammovan of Nevada, Breast Cancer at Sunrise Foundation, and the Red Rose Program through St. Rose Dominican Hospital," Gross said.
Nevada Health Centers, Inc. developed its Mammovan program with the goal of increasing accessibility of mammograms. The program features a fully equipped van from which mammograms may be conducted that travels across the state of Nevada. About 3,200 patients were served in 2007.
"We are a private nonprofit organization that serves the needs of Nevadans. We tour the entire state with our Mammovan to help the underserved women in Southern Nevada and rural areas as well," said Lonnie Haralson, regional operations director for NHCI. "The cost varies depending on if you have insurance. Through grant programs, we have we are able to serve communities regardless of the ability to pay."
Among the stops planned in June are a Smith's grocery store parking lot in North Las Vegas, a Planned Parenthood and a family health center in Las Vegas, and a community center in Pahrump. Advance appointments are required. For the Mammovan's schedule and appointments, call 1-877-581-6266.
If you are diagnosed with breast cancer, myriad resources are available, including informational materials, support groups and counseling through Susan G. Komen for the Cure of Southern Nevada. Additionally, the American Cancer Society offers information and support to Southern Nevada cancer patients.
"We have what's called Cancer Resource Centers that are located within University Medical Center, Sunrise Hospital and the Comprehensive Cancer Center (located at Eastern Avenue and Viking Road) where patients can come in and get free hats, wigs, turbans and information," communications manager Paulette Anderson said. She added that the UMC location is available to patients of other medical facilities and similar services are available by appointment at the American Cancer Society's Southern Nevada office.
"We have patient navigators who are American Cancer Society staff at each facility and they work directly with patients and they help them from start to finish," Anderson said. "If patients need transportation to and from treatments, we can help through our Roadtrip to Recovery Program. ... We have a Feel Good makeover program to help patients look and feel better where they can meet with licensed cosmetologists and learn how to apply makeup differently, use donated gorgeous wigs."
Anderson said breast cancer patients can also contact the association to gain personalized, one-on-one support through women who are breast cancer survivors.
Early detection vastly improves the odds of surviving breast cancer and mammograms make early detection more likely.
"It is the single best screening tool we have," Gross said. "It is the gold standard."
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