Trying to decrease breast cancer deaths


An article in the "To Your Health" section of yesterday's Sun incorrectly reported a recommendation for how often women should get mammograms. Women age 40 to 49 are advised to have mammograms every year or every other year.

The Sun regrets the errors.

Cancer prevention and early detection move into the spotlight this afternoon, when Governor William Donald Schaefer is expected to announce formation of a 15-person "Council on Cancer Control."

AIt is part of an ongoing state effort to encourage Marylanders to take advantage of tests and procedures with the potential of saving their lives.

For women who do not get mammograms (breast X-rays for detection of tumors too small to be felt by hand) because of their cost, the encouragement is frankly financial.

A state law went into effect July 1 requiring health insurers to pay the full or partial cost of mammograms for women aged 35 and over who have group or individual policies with non-profit or commercial companies.

The level of reimbursement will follow the pattern of the rest of the policy, according to Fran Tracy, vice-president for legislative affairs at Blue Cross/Blue Shield of Maryland: If your contract calls for full coverage, you get full coverage; if it normally pays 80 percent of the cost, you'll have to pay 20 percent.

The state also has launched the Coordinated Breast Cancer Screening Program, under which specific hospitals throughout the state are offering mammograms for $45. According to Tori Leonard, spokesperson for the State Department ofHealth and Mental Hygiene, that cost will be reduced or waived for women unable to pay.

(To make an appointment for a low-cost mammogram in Baltimore, call the radiology department at Bon Secours

Hospital, Harbor Hospital Center, Maryland General Hospital or the University of Maryland Medical Center. On the Eastern Shore, call McCready Hospital in Crisfield; and in Western Maryland, call Sacred Heart Hospital in Cumberland, or Garrett Memorial Hospital in Oakland.)

The state also will be checking the payment records of the 97,500 women aged 35 and older who are covered by Medicaid "to identify women who have not had mammograms in the past year and encourage them to take advantage of it," said Nelson Sabatini, director of the health department. Those women will receive letters urging them to ask their doctors about having a mammogram.

Mammography is generally recommended as a one-time procedure for women between 35 and 39; women from 40 to 49 are advised to have the procedure annually or semi-annually; and those aged 50and above should have mammograms every year. Women with palpable breast lumps and those at risk because of their own medical history or their family's medical history may be advised to have the procedure more often.

"It is strictly a question of time and numbers," said Dr. JosepAisner, director of the cancer center at the University of Maryland Medical Center. "If you wait until [a breast tumor] is obvious, it's been there for years. If you can feel it, it's about a centimeter, or half an inch, in size. That's about as small as most people can feel. With a mammogram, you can find it at one-third that size."

Unfortunately, mammograms do not detect all tumors, Dr. Aisner said; in some women, the cancer will not be apparent until it can be felt, which is why regular manual examination is also recommended.

Nevertheless, the benefit of the procedure is considerable. It's expected that 800 Maryland women will die of breast cancer this year: According to Dr. Aisner, "If four years ago, we had them all in screening, the death rate would be decreased by one-third."

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