The largest federally-funded clinical trial on medical imaging
is under way at UCLA’s Jonsson Cancer Center.
The cancer center is seeking 2,475 women to participate in the
Digital Mammographic Imaging Screening Trial to determine whether
digital mammography is equal or superior to standard film
mammography.
“This study is part of the digital revolution,” said
Dr. Lawrence Bassett, director of the Iris Cantor Breast Imaging
Center at the Jonsson Cancer Center, and principal investigator for
UCLA.
“Digital mammography is the future, but a large study is
necessary to see whether digital mammography really is better than
or as effective as standard mammography.”
UCLA is part of a nationwide trial of 49,500 women to take part
in the three-year study coordinated by the National Cancer
Institute and the American College of Radiology.
UCLA is the only Southern California center to participate in
the trial.
As a new weapon in the arsenal against breast cancer, Bassett
believes digital mammography has huge potential.
Much like a digital camera, digital mammography has the ability
to play with a photo’s hard copy. The magnification,
orientation, brightness and contrast of the mammogram image may be
altered, reducing any need for repeat mammograms due to under- or
overexposure.
This improved dynamic range and contrast detectability would
allow smaller and previously undetectable calcifications to be
spotted before any lump can be felt, which is especially helpful in
women with dense breasts.
Digital mammography also has the potential to increase
efficiency in the imaging process.
Results from digital mammograms would be networked to a central
analyzing center, overcoming the lag in results due to the current
shortage of radiologists, according to Bassett.
Using digital mammography, doctors and patients can receive
results within the hour, whereas traditional film mammography could
take days ““ even weeks ““ before seeing results.
“That’s the beauty of this technology ““
efficiency for physicians and peace of mind to patients,”
said Tony Anderson of Siemens, a major vendor of digital
radiography equipment.
One digital radiography room could process as many patients as
three conventional film rooms, or about 38 percent more patients,
according to Anderson.
Exam time between doctors and patients could also be cut down,
resulting in quicker traffic in and out of the doctors’
office.
“It is more than just swapping old technology,”
Bassett said. “It is a cultural change in
radiology.”
However, despite the excitement and potential of digital
mammography, some doctors remain cautious.
“Before we replace the (standard mammography) process that
is accepted by most people to be a strong tool to detect early
(stages of) breast cancer, we want to be sure we’re not doing
more harm than good,” said Dr. Etta Pisano, lead researcher
for DMIST.
Digital mammography also remains grounded by huge cost factors.
It is priced four to five times as much as standard mammography
equipment.
With the 10,000 standard mammography sites across the United
States, it would take years for this current equipment to be
updated or replaced before digital mammography was widely used.
But for some patients, cost is no object.
“No one ever believes that (breast cancer) will happen to
them, as I felt exactly the same way,” said Sherry Goldman, a
nurse practitioner who found a tiny cancerous lump in her breast
last year. “But it can, and it does. If we have more tools to
detect breast cancer early, we would all feel reassured.”
Bassett agrees.
“Mammography is more than a test,” he said.
“It is saving lives. Improving the technology means saving
more lives.”
October is National Breast Cancer Awareness Month. This year
alone, 203,500 new cases of female invasive breast cancer will be
diagnosed, and 39,600 women will die from the disease.