»	Breast Cancer ‚ by the numbers
	»	1 million	»	new cases of breast cancer worldwide
	»	200,000	»	new cases of breast cancer in the US
	»	40,000	»	annual morbidity from breast cancer
	»	1:8	»	women who will get breast cancer

»	Screening Mammo ‚ by the numbers
	»	34 million	»	screening mammograms in the US annually
	»	500:1	»	normal vs abnormal screening mammos
	»	95%	»	5 year survival where early detection made
	»	20%	»	false negative mammograms without CAD

»	Problems with Screening Mammography
	»	shortage of radiologists
	»	low clinical payoff (1: 500 abnormal)
	»	tedious / boring / unfulfilling
	»	highest probability of malpractice event

»	Solution offered by MAMMEX MammoCAD
	»	computer never gets tired or stressed
	»	MammoCAD is reimbursable
	»	MammoCAD less expensive than 2nd Rad
	»	MammoCAD increases detection by 20%

Mammography comes under fire

Many in the healthcare profession have come to the conclusion that screening mammography in the U.S. is in crisis. Public confidence has been shaken. Recent medical and news reports have confirmed the misdiagnosis and misreading of patient films. Radiology has become the highest litigated medical specialty in the U.S.

In a past issue of the American Journal of Roentgenology, Dr. Leonard Berlin, chairman of radiology at Rush-Presbyterian, St. Luke's Medical Center in Chicago, wrote ''the number of medical malpractice lawsuits alleging injury due to missing or delaying the diagnosis of breast cancer has increased so rapidly that such lawsuits have now reached epidemic proportions."

Radiologists who read mammograms are the main targets of these lawsuits, which often result in multimillion-dollar jury awards, even when no medical error has been committed by the doctors involved (1).

Because of this sudden spike in litigation, malpractice insurance for radiologists in the field has increased dramatically. Just another reason young radiologists look elsewhere when entering a chosen medical profession.

A recent New York Times series questioned the competence of many radiologists who read mammograms, suggesting that too many doctors read too few studies to maintain their critical edge. At the same time, many screening facilities are closing or giving up screening mammography because reimbursement is so low it doesn't pay to continue.

MammoCAD: new technology here to help

While the situation may seem dire, there are signs that better organization and increased use of new technology can revive mammography. The specialty seems to be under less legal attack in Canada and Europe, and U.S. healthcare experts are taking a close look at how these countries manage. It's no surprise that both Canada and Europe have lead the charge in the adoption of image analysis software and systems to detect pre-cancerous tissue in mammograms.

With the adoption of computer-assisted-detection technologies like the MAMMEX MammoCAD system, radiologists can address the many concerns of the population and the medical community. This method of clinical decision support has the potential to help radiologists spot suspicious abnormalities with greater accuracy and frequency.

Dr. Timothy W. Freer presented the results of a study on computer-aided detection at the meeting of the Radiological Society of North America. The study, in which he ran 12,860 film mammograms through the CAD system, found that the system improved the detection of cancers by 20 percent. Dr. Freer said a large-scale multicenter study to prove the benefit of computer-aided detection.

''We think that in the future, digital mammography and CAD will enjoy a perfect marriage,'' said Dr. Freer, the owner and director of the Women's Diagnostic & Breast Health Center in Plano, TX.

Freer's group in Texas believes that enlisting technologies like CAD produces a significant improvement in early detection -- and thus decreases lawsuit vulnerability(2).

1. Programs cut through mammography's crisis, by Robert Bruce, 10/17/02
2. An Upgrade That Matters? Mammography's Next Step Is Assessed, by Laurie Tarkan, New York Times