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By Joyce Frieden
WASHINGTON, Mar 08 (Reuters Health) - Although many new technologies look promising, conventional mammography still remains the "gold standard" for detecting breast cancer, an Institute of Medicine committee reported Thursday.
The committee released results from a 227-page report examining various types of breast cancer detection methods, including film and digital mammography, magnetic resonance imaging, and ultrasound. The committee also urged the US Food and Drug Administration (FDA) and the National Cancer Institute (NCI) to take more action to get promising technologies into the marketplace.
Some of the other technologies, such as digital mammography, looked promising, but none appeared to be any more successful than conventional mammography for detection of breast cancer, committee members said.
As useful as conventional mammography is, however, it still fails to prevent most breast cancer deaths. "Mammography is a gold standard, but it has only decreased deaths from breast cancer by 30%," said Dr. Joyce C. Lashof, committee chair and professor emerita at the University of California, Berkeley, School of Public Health. "We'd like to see 100% of breast cancers cured."
To that end, the FDA should adopt a process for breast cancer detection device approvals that is similar to the procedure used for approval of new drugs that are considered extremely valuable, said Dr. Craig Henderson, committee vice chair and adjunct professor of medicine at the University of California, San Francisco.
"The FDA could approve the device (first) as a supplemental diagnostic device conditioned on the company doing studies to see whether, if used as a screening device, the technology would improve breast cancer mortality rates," Henderson said.
The committee also recommended that the NCI sponsor clinical trials every 10 to 15 years to reassess the effectiveness of breast cancer screening devices, and urged public and private insurers to foot the bill for women who participate in such trials. To assist researchers with identifying what types of breast cancer are more likely to be lethal, the NCI should also facilitate expansion of and access to breast cancer tissue banks, Lashof said. Women who contribute specimens to the banks should be assured of confidentiality and that they will not be victims of genetic discrimination, she added.
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