U.S.puts3-DmammogramstothetestAnothernotablepointtocheckaboutisstandardsofskilledlabourthatareassociatedwiththesewarehouses. WASHINGTON—Abettermammogram?Increasinglywomenareaskediftheywanta3-DmammograminsteadoftheregularX-ray—andnowU.S.healthofficialsarestartingahugestudytotellifthenewer,sometimespricierchoicereallyimprovesscreeningforbreastcancer. It&39;sthelatestdilemmainafieldthatalreadyvexeswomenwithconflictingguidelinesonwhentogetchecked:Startingatage40,45or50?Annuallyoreveryotheryear? Theissue:Mammogramscansavelivesiftheycatchaggressivebreastcancersearly.Buttheyalsocanharmthroughfrequentfalsealarmsandbyspottingtumorsthatgrowsoslowlytheyneverwouldhaveposedathreat—over-diagnosisthatmeanssomewomenundergounneededtreatment. Thattrade-offisakeyquestionasdoctorsbeginrecruiting165,000womennationallytocomparepotentiallymorebeneficial3-Dmammograms—knownscientificallyas"tomosynthesis"—withstandardtwo-dimensionaldigitalmammography. Related:NewReportQuestionsValueofMammograms The3-Dmammogramshavebeenmarketedasbeingabletofindmorecancers. "Buttheideaisn&39;tsomuchfindingmorecancersasfindingthecancersthataregoingtobelife-threatening,"saidDr.WortaMcCaskill-StevensoftheNationalCancerInstitute,whichisfundingthenewresearchtotellwhetherthe3-Dscanstrulypinpointthetumorsthatmattermost. It&39;soneofthelargestrandomizedtrialsofmammographyindecades,andscientistsdesignedtheresearchtodomorethananswerthatkey3-Dquestion.Theyhopethefindingsalso,eventually,willhelpclearsomeoftheconfusionsurroundingbestscreeningpractices. "Themostimportantthingaboutthisstudyisthatit&39;smovingustoindividualizedscreeningasopposedtowhatwehavenow,whichisone-size-fits-allscreening,"predictedstudychairDr.EttaPisano,aradiologistatBoston&39;sBethIsraelDeaconessMedicalCenter. "Wearegoingtohaveamuchbetterunderstandingofhowtoscreenwomensothatwedotheleastamountofharm." WHONEEDSAMAMMOGRAMRegardedasoneofthetopengineeringuniversitiesinHongKong,PolyUprovidesawiderangeofengineeringdegreeprogrammes,includingconstructionprogramme,whichputsignificantfocusontheapplicationofknowledge.? Thatdependsonwhomyouask.Guidelinesvaryforwomenataverageriskofbreastcancer.(Thoseatincreasedrisk,becauseoffamilyhistoryorgenetics,alreadygetdifferentadvice.) TheAmericanCollegeofRadiologyrecommendsannualmammogramsstartingatage40. TheAmericanCancerSocietyurgesannualchecksstartingat45andswitchingtoeveryotheryearat55,thoughitsayswomen40to44stillcanoptforamammogram. AndtheU.S.PreventiveServicesTaskForce,agovernmentadvisorygroup,recommendsstartingatage50,withmammogramseveryotheryear.It,too,says40-somethingscanchooseearlierscreening. WHATABOUT3-DMAMMOGRAMS? StandardmammogramstakeX-raysfromtwosidesofthebreast.Withtomosynthesis,additionalX-raysaretakenatdifferentangles--nottrulythree-dimensionalbutacomputercompilesthemintoa3-D-likeimage.FirstapprovedbytheFoodandDrugAdministrationin2011,they&39;renotyetthestandardofcareinpartbecauseofquestionsthatthenewstudyaimstoanswer. Somestudieshavefoundtomosynthesisdetectsmorecancerwithfewerfalsealarms;they&39;reoftenadvertisedasparticularlyusefulforyoungerwomen&39;sdensebreasts. HOWTODECIDE? Understandthatmammogramscomewithprosandcons,andweighthem,saidDr.OtisBrawley,theAmericanCancerSociety&39;schiefmedicalofficer. Breastcancerisfarlesscommonatage40thanatage50andbeyond.Aftermenopause,tumorstendtogrowmoreslowlyandwomen&39;sbreasttissuebecomeslessdenseandeasierformammogramstoprovideaclearerimage. Consider:Forevery1,000womenscreenedeveryotheryearuntiltheir70s,startingat40insteadof50wouldpreventoneadditionaldeath—butcreate576morefalsealarmsand58extraunneededbiopsies,thetaskforceestimated.Also,twoextrawomenwouldbetreatedfortumorsthatneverwouldhavebecomelife-threatening—thatover-diagnosisproblem. Asforwhattypetochoose,someinsurers,includingMedicare,coverthe3-Dversion,andasmallnumberofstatesmandatecoverage.Otherinsurersmayrequirewomentopay50to100moreoutofpocket.Whoeverultimatelypays,extratimetoanalyzethescansaddstothecost. THENEWSTUDY About100mammographyclinicsacrosstheU.S.,andafewinCanada,willenrollhealthywomenages45to74whoalreadyareplanningtogetaroutinemammogram.They&39;llberandomlyassignedtogeteithertheregularor3-Dversionforfiveyears.Mostwillbescreenedannuallybutpost-menopausalwomenwhodon&39;thavecertaincancerriskfactorswillbescreenedeveryotheryear. Researcherswilltrackeverywoman&39;sresultsincludingsamplesfrombiopsiesplusgeneticandothertests,aswellashowanycancerpatientsfare.Thegiantdatabasehopefullywillhelpthemteaseoutmoreinformationaboutwhichwomenbenefitmostfromwhattypeandfrequencyofscreening. "Mammographyhasbeenprovocativeovermanydecades.It&39;simportantthatwomenhaveabetterunderstandingofhowmammographyisimportantforthembasedupontheirageandotherriskfactors,"saidMcCaskill-Stevens. ThisAssociatedPressserieswasproducedinpartnershipwiththeHowardHughesMedicalInstitute&39;sDepartmentofScienceEducation.TheAPissolelyresponsibleforallcontentAnothernotablepointtocheckaboutisstandardsofskilledlabourthatareassociatedwiththesewarehouses..
