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Spring 2002 Vol. 2 No. 1



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OPINION


It's Time to Improve Methods for
Breast-Cancer Detection

BY MARIA CAROLINA HINESTROSA

Photo courtesy M. Carolina Hinestrosa It has been more than seven years since I was first diagnosed with breast cancer at age 35. Since then, my life has changed in more ways than I could have imagined. I became an activist, founding a nonprofit advocacy organization for Latin American women with breast cancer. And I learned that I am by no means alone. Each year, more than 180,000 new cases of invasive breast cancer are diagnosed and more than 40,000 women die from it. Breast cancer is still a leading cause of cancer death in this country, and it's the leading cause of death for women ages 35 to 50.

I also learned a lot about what is needed to fight this disease. One of the most obvious areas for improvement is in breast-cancer detection. Since the 1970s, X-ray film mammography has been the main tool for breast-cancer screening. However, mammography has many limitations, so new technologies and tools to detect breast cancer are urgently needed. I served on a National Academies committee that examined several new and promising imaging and molecular biological technologies that may someday improve our ability to detect breast cancers at a curable stage. We found that more evaluation and development of these tools are required and warranted.

The federal government needs to develop a more systematic approach to evaluating these technologies. Clinical trials -- designed with support and input from relevant federal agencies and breast-cancer advocates -- are needed to assess screening tools. The National Cancer Institute should create a permanent infrastructure for testing new detection technologies and reassessing the effectiveness of established screening tools. It's also essential that women be able to participate in these studies. Private insurers should cover the costs of screening tests for women who participate in clinical trials but are not eligible for Medicare or Medicaid.

But before any real breakthroughs are possible, researchers need a better understanding of the basic biology of breast cancer. And even the best technologies will be of limited help unless women have greater access to them. The breast- and cervical-cancer screening program offered by the Centers for Disease Control and Prevention -- which provides free screening mammography to uninsured, low-income women -- reaches only 15 percent of eligible women. Congress should expand this program to reach at least 70 percent, and state legislatures should provide Medicaid funds for timely treatment of women diagnosed through this screening program.

There may never be a single technology that can detect all breast cancers. But taking these important steps will most certainly improve understanding of the disease -- and save women's lives.


Maria Carolina Hinestrosa, co-founder and executive director of Nueva Vida, Support Network for Latinas with Cancer, Silver Spring, Md., served on the committee that produced the report Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer.

This article was adapted from a piece distributed by the National Academies Op-Ed Service. Visit the Service's Web site at <national-academies.org/op-ed> for a comprehensive collection of authoritative commentary on issues involving science, technology, and medicine.



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Copyright 2002 by the National Academy of Sciences