BOX 1. Current Events in Breast Imaging
The recent US Preventive Services Task Force (USPSTF) recommendation regarding screening mammograms has stirred up a large amount of controversy and subsequent confusion.
In March of 1997, the American Cancer Society (ACS) began recommending annual mammograms starting at age 40. 2 On November 16, 2009 the USPSTF announced that it no longer recommended routine
screening mammography for women between the ages of 40 and 49. It went on to recommend screening
mammograms every other year for women between 50 and 74 years of age. The USPSTF felt that because
women in their 40s are at a lower risk of breast cancer than women 50 and above, the actual number of lives
saved is not enough to recommend widespread screening. 3, 4 According to the ACS“Breast Cancer Facts and
Figures” for 2009, 10% of estimated new breast cancer cases occurred in women under the age of 45. 5
Clearly, this recommendation seems to have “undone” forward strides made in breast imaging over
the past decade. According to Phil Evans, MD, president of the Society of Breast Imaging (SBI),“We’ve made
so much progress in the early detection of breast cancer. Since 1990, mortality from breast cancer has
dropped by 30%, largely due to people using screening mammography. 6 October 1, 1994 also marked a
milestone in respect to mammography and women’s breast health when the United States Congress
approved the FDA’s Mammography Quality Standards Act (MQSA) that requires all mammography facilities to adhere to strict quality standards. This foundation provided continued focus on mammography
and its role in detecting early stages of breast cancer.
Coupled with the recent economic downturn, the USPSTF recommendation seems to be part of the
cause of nationwide decreases in screening mammogram volumes. According to the National Consortium
of Breast Centers (NCBC), in February 2010, screening mammogram volumes have decreased anywhere
from 5%–35% across the nation. 7 The consequences of this decrease can be detrimental to the financial
health of an organization; it negatively affects the downstream volume, and revenue, of diagnostic mammograms, breast ultrasound, and breast MRI. More importantly, we will not know the true impact this will
have on women’s health until much further down the road.
By being positioned as an accredited breast center, an organization may be able to lessen the effects of
such negative environments. The National Accreditation Program for Breast Centers (NAPBC) has become
the “gold standard” when it comes to women’s breast centers. This accreditation requires rigorous evaluation and review of a facility’s performance and compliance with various standards of quality and care. By
achieving this accreditation, an organization demonstrates its ongoing commitment to provide the highest quality breast health services for its community while maintaining regulated standards of care. Physicians and their patients will consciously choose an accredited center when deciding where to screen for,
diagnose, and treat breast disease.
required of, but not limited to, a breast
• Medical oncology
• Radiation oncology
• Plastic surgery
• Physical therapy
• Behavioral medicine
Box 2 outlines services within SHWBC
along with the services located off site, but
still under the same unified leadership.
In 2001, SHWBC started off as an outpatient office that offered mammography as
part of its services. In essence, coming to
the office for a mammogram was the
same as coming in for any other imaging
exam. There was no “women only” waiting