ICA: Biennial mammograms would save many lives

Israel ranks first in a list of European counties for mammography screenings; attempts made to encourage Arab, haredi women.

By
July 9, 2011 22:39
Breast Imaging Specialists looking at mamogram

Breast Imaging Specialists looking at mamogram 311. (photo credit: Courtesy)

 
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Undergoing a biennial mammogram between ages 50 and 74 (or earlier in high-risk women) for early detection of breast cancer reduces the mortality risk by 30 percent, according to new research. The Israel Cancer Association said that 133,000 Swedish women between 40 and 74 were followed up over 29 years. The prospective study examined the effects not only of mammograms, but also whether sending printed reminders to women that it was time for another mammogram significantly improved their compliance and saved lives.

ICA director-general Miri Ziv said the association initiated a national mammography screening program years ago, making Israel the best in a list of European countries, with 70% going to breast screening. It is working further to reduce the gap in screening between women in the center and the periphery and among different sectors, such as haredi and Arab women who are more conservative (and bashful) and less likely to go for a mammogram.

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Meanwhile, at the recent Jerusalem Conference for Community and Family Health, breast imaging specialist Dr. David Gekhtman lectured on how often to undergo mammograms to achieve optimal results, at what ages they should be performed and at what age to start.

Gekhtman of the Rachel Nash Jerusalem Comprehensive Breast Clinic told an audience of 200 physicians that on average, a malignant tumor doubles its size from one centimeter in diameter to two in just 1.7 years. While 95% of women will live for 15 years (regarded as a total cure) after breast cancer treatment if the tumor is one centimeter, only 65% will survive that long if it is two centimeters.

Thus for every additional millimeter the tumor grows, the mortality level increases by 2% to 3%. An earlier diagnosis will save 100 Israeli lives annually.

There are more than 4,000 new cases of breast cancer diagnosed here each year. The health basket covers a mammogram between 50 and 74 once in two years. However, said Gekhtman, following the recommendations for annual mammograms that have been made by researchers abroad would save 150 more lives a year.

He also recommended that every woman start screening at 40 rather than a decade later, as 18% of all breast cancers develop between the ages of 40 and 49. Studies in Scandinavia, where 40 is the starting age, have shown this, he said.



As there are arguments by some credible critics against having an annual mammogram due to increased radiation, Gekhtman noted that it had minimal significance. The mortality risk for one round trip from Tel Aviv to New York equals the risk of accumulated radiation from seven annual mammograms, he said.

Comparing two groups of 1,000 women each – the first screened annually from age 40 to 84 and a control group of 1,000 who opted not to be screened at all, Gekhtman said that of those diagnosed with breast cancer in the screened group, only 5% died from breast cancer, while 55% of those in the unscreened group died of breast cancer.

The one-stop breast cancer diagnostic center in Jerusalem’s Givat Shaul quarter is regarded as the best in the country. Over 120,000 people (including men, who can get breast cancer as well) have visited Hala since its establishment by the Nash Family Foundation over a decade ago. The nonprofit center diagnoses more breast cancers than any other medical institution here.

HALA founder and chairman Rabbi Michael Sorotzkin is planning a new women’s health center nearby – a free-standing, three-story building with over 2,000 square meters of space. Construction is due to be completed in two years. HALA director Dr. Selwyn Strano added that in addition to serving over 30,000 women annually, the new center will incorporate Israel’s first breast-dedicated MRI unit, tomosynthesis digital mammography units and a LumaGem Molecular Breast Imaging system, as well as expanded lab facilities and tissue bank for use by breast cancer researchers.

FACTORY BAKERS, BEWARE OF FLOUR DUST Bakers in traditional bread factories that work mostly by hand are at high risk for inhaling flour particles and suffering from asthma and other respiratory diseases, according to a new study conducted at the University of Haifa’s School of Public Health.

Writing in the latest issue of Harefuah, the Hebrew-language journal of the Israel Medical Association, Dr. Raphael Carel and colleagues examined 111 bakery workers in 20 factories in the Galilee. All were Arab, as they are the ones who make bread by hand.

Most of those doing the manual preparation of dough were young and over half smoke.

The smoking, and their intense and long exposure to flour dust greatly increased their risk of asthma and other breathing problems, the researchers found.

Half of the workers already had respiratory complaints, and said they were worried that they came from exposure to the flour for many hours a day. The Haifa researchers called for monitoring of the biological and environmental risks faced by workers in factories making bread by hand, using respiratory function tests and clinical examinations, as the damage caused by the dust exposure cannot be reversed.

PARKINSON DAMAGE COULD BE PREVENTED WITH LITHIUM Lithium – a drug that has been used for years to treat bipolar disorder (the mood disease better known to laymen as manic depression – is now suggested as an important way to prevent brain damage connected to Parkinson’s disease.

Researchers at California’s Buck Institute for Age Research who studied a mouse model in the preclinical stage now head for human trials on lithium. Lead researcher Prof. Julie Andersen, who wrote a recent article in the Journal of Neuroscience Research.Lithium, said lithium profoundly prevents the aggregation of toxic proteins and cell loss associated with PD. “This is the first time lithium has been tested in an animal model for it,” she said.

“The fact that lithium’s safety profile in humans is well understood greatly reduces trial risk and lowers a significant hurdle to getting it into the clinic.”

Lithium has recently been suggested to be protective against several neurodegenerative conditions including Alzheimer’s disease, Huntington’s disease and amyotrophic lateral sclerosis (ALS), and has been touted for its anti-aging properties in simple animals. “We fed our mice levels of lithium that were at the low end of the therapeutic range,” she said.

“The possibility that lithium could be effective in PD patients at subclinical levels is exciting, because it would avoid many side effects associated with the higher dose range.”

Overuse of lithium has been linked to hyperthyroidism and kidney toxicity.

PD is a progressive, incurable neurodegenerative disorder, and results in tremor, slowness of movement and rigidity, and it is the second-most common neurodegenerative disease after Alzheimer’s. Age is the largest risk factor, and it usually begins to appear between the ages of 45 and 70.

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