Reprinted with permission,
Courtesy, Asbury Park Press, a Gannett Co. newspaper.
CAROL GORGA WILLIAMS
COASTAL MONMOUTH BUREAU
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
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
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
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.
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
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
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
"Anything we can do to reinforce that message" is positive,
"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
"You get through it step by step, hour by hour, day by day," she
said. "Life goes on."
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