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2005 Press Releases

Digital Mammography Can Save Lives.

LONG BRANCH, NJ, October 28, 2005 - When Debra Capezzuto went to have her annual screening mammography at a women's center in Ocean County in June 2004, she had a standard film study, the kind that have been in use for more than 35 years.

But when the radiologist there found something suspicious, she took her films to the Jacqueline M. Wilentz Comprehensive Breast Center at Monmouth Medical Center, Long Branch. There she had additional tests, including a digital mammography, in which a machine takes an electronic image of the breast and stores it directly in a computer where the data can be enhanced, magnified or manipulated for further review.

"They both hurt," said Capezzuto, 54, of Manchester, of her mammographies. "They're necessary evils. Honestly, I don't have a preference. I just know they're very important, whichever one you have."

Ultimately, Capezzuto learned she had breast cancer and opted for a lumpectomy, radiation and chemotherapy. Now, a year later, she is cancer-free, she said.

Capezzuto's experience with the new technology, the digital mammography, is gradually becoming more common. But it may not be any more helpful for women in her age group — above 50.

According to a study published yesterday in the New England Journal of Medicine, standard film mammographies were found to be just as efficient for women like Capezzuto.

For younger women, however, digital mammography may be the preferred route.

New study's findings

The Digital Mammographic Imaging Screening Trial, DMIST, which began in October 2001 in 33 sites in the U.S. and Canada — including Monmouth Medical — enrolled 49,528 women who had no signs of breast cancer.

The $26 million study, funded by the National Cancer Institute and conducted by the American College of Radiology Imaging Network, showed that for women under age 50, women of any age with dense breasts and pre- or perimenopausal women of any age, digital mammography was 15 percent more accurate in determining whether cancer was present.

Dr. Melinda J. Staiger, medical director of the Wilentz Center, called the DMIST study the largest federally funded trial of screening mammography ever to be undertaken in this country.

Staiger said sometimes film mammographies can be hard to read, particularly if there is a lot of calcification. "It is like trying to find a polar bear in a snowstorm. It was noted years ago, if you could just adjust the brightness or contrast in the picture, without having to reshoot every picture, we might be able to see the dense breast easier."

About 760 women participated from Monmouth, but Staiger said the data wasn't available to report how those women fared. She said most of the institutions that participated were well-known breast cancer facilities.

"We were permitted to take part and we acquitted ourselves well," she said of Monmouth, which was the first institution in the state to offer full-field digital mammography.

Other advantages of digital mammographies: They can be e-mailed from one office to another, accelerating the process of second opinions; they are easily stored, less likely to be damaged or destroyed and can be manipulated by computer.

And they emit slightly less radiation, said Dr. Beth M. Deutch, founder and medical director of HerSpace Breast Imaging Associates in West Long Branch, which also offers digital mammography.

Digital is more expensive

Because digital mammography only became available for clinical use in 2001, and the new machines cost substantially more than the old ones, there are fewer in use. The federal government says only 8 percent of the breast imaging units across the country are digital.

Staiger said a traditional mammography unit costs about $70,000 while a digital one can cost $400,000 to $700,000. Monmouth has two digital mammogram machines.

Medical insurance reimbursements also vary greatly, with some insurance companies covering little if any of the cost for digital mammography, Deutch and Staiger said.

In 2005, the Medicare reimbursement for a screening mammography done on film is $85.65 while a digital one is $135.29. The cost of digital mammographies can run from $300 to $600, "which is usually out of the price range for most women," Staiger said. But "for most women, the film screening mammography can be just as good as digital."

"Put it this way, any quality mammography is better than no mammogram," she said. "If for some reason you cannot find an appointment for a digital one within the year you should have the test, which is unlikely, you should have the film." She said it was best for women to seek a facility with an expert on breast imaging and one that can read the films while the patient is present.

David Momrow, the American Cancer Society senior vice president for cancer control in the New York-New Jersey region, said he does not know if mammography will ever be completely digital, but said he is concerned about a trend toward fewer women getting mammographies, despite studies that show they have contributed to reducing the mortality rate.

He believes this study will help convince women to have the screening done.

"Anything we can do to reinforce that message" is positive, he said.

"Life goes on"

"Here I am, at my desk" Capezzuto said from work. She is an assistant manager at Manasquan Savings Bank in Brick.

"I was out of work for six months. I came back Feb. 21 with a promotion and a wig," she said about losing her hair to cancer treatments.

"You get through it step by step, hour by hour, day by day," she said. "Life goes on."

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