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Study: Many Women Diagnosed with Advanced Breast Cancer Do Not Undergo Regular Screening (dateline December 19, 2004)

A recent study finds that many women diagnosed with advanced, or metastatic breast cancer, had not undergone routine mammography within the prior one to three years. Advanced breast cancer is a Stage IV cancer, which is associated with a much lower chances of survival compared with early stage breast cancers.

The U.S. National Institutes of Health (NIH) reports that, "As many as 92 percent of late-stage breast cancer cases in the United States could be diagnosed and treated earlier, when there is greater likelihood of effective treatment, if the healthcare system focused on recruiting women who have not been recently screened, and if early detection techniques could be improved to more accurately detect cancer."

The study was conducted by researchers at the National Cancer Institute, part of the National Institutes of Health, and the Cancer Research Network (CRN), a consortium of integrated health plans. Researchers reviewed medical care received by 2,694 women during the three years prior to their breast cancer diagnosis. All of the women participated in one of seven integrated healthcare plans across the United States which provide breast cancer screening mammograms at little or no cost. At the start of the study in 1999, 7% to 81% of the women had undergone mammograms.

The researchers found that women who had not had mammograms one to three years prior to their breast cancer diagnosis were more than twice as likely to have late-stage breast cancer. Specifically, the study’s results showed that not having had a screening mammogram for one to three years prior to diagnosis was associated with 52% of late-stage breast cancer cases.

"The good news is that there is a lot known about how to reach women who have never been screened or who fail to get regular mammograms," said Stephen Taplin, MD, MPH, a senior scientist at the National Cancer Institute, in an NIH news release. "The challenge is to put this knowledge into practice."

While the study indicates the need for women to undergo routine mammograms, the researchers also found a need for improved breast cancer screening. Nearly 40% of the women with late-stage breast cancer had a negative mammogram one to three years before their diagnosis, meaning that the mammogram did not indicate signs of cancer.

Mammography is currently the gold standard in breast cancer detection. It has the ability to detect approximately 80% of breast cancer, and can find cancer before a lump can be felt by hand. It is recommended that all women 40 years of age and older undergo annual screening mammograms. Women are also encouraged to perform monthly breast self-exams and receive regular clinical breast exams, beginning at age 20.

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