Tackling breast cancer on the road

Mammomat NovationThe fully digital mammography system Mammomat Novation by Siemens Medical Solutions has now been approved for mobile screening. For the first time, breast cancer screenings are performed with digital systems built into trailer trucks. The trailers are connected to a stationary screening center where the final diagnosis is made. This type of mobile digital breast cancer screening is especially suitable for women living in rural communities or those who are more homebound than before. In Germany, women between 50 and 69 years of age are entitled to free mammography examinations every other year.

In Germany, the “Mammo Screening“ program for early breast cancer detection is in place since 2002. Breast cancer screenings are held in stationary as well as mobile facilities. The first physicians using a fully digital system in a mobile environment are, among others, Dr. Norbert Uleer and Dr. Katrin Samse who, in addition to their practices operate a mobile mammography trailer in the area of Göttingen – Hildesheim – Hameln, Germany. Within the framework of the project, both physicians have examined more than 900 women in either stationary or mobile facilities. "The objective of the screening program is to reduce breast cancer mortality by 35 percent. With this objective in mind, the European Guidelines require a 70 percent participation of the women invited for screening. We obtain this percentage only when combining stationary and mobile examination units and by applying fast, digital technologies", said Dr. Norbert Uleer while explaining his decision to operate a mammography trailer with fully digital equipment. "Through especially high-quality images that are immediately available, the new reporting system based on the diagnosis of two physicians as well as interdisciplinary consensus conferences is optimally supported and facilitates my work as the physician responsible for the program."

Women between 50 and 69 years of age are contacted per mail to participate in mammography screenings. For the X-ray examination, they are sent directly to the mobile trailer or a stationary screening practice. Comfortable trailer trucks fully equipped with a digital mammography unit are used for mobile digital screening. Siemens is using the digital mammography system Mammomat Novation and a special workstation for patient data acquisition and image processing. An image server is used for temporary image storage. The mobile stations are connected to a stationary screening center via a so-called MIS system (Mammography Screening Information System). From there the data of all patients are distributed to the respective examination facilities and diagnosed by specially trained physicians in accord with the “second set of eyes“ principle or, if additional diagnostic clarification is required, discussed further in interdisciplinary meetings. Requirements regarding personnel and technology that have been standardized across Europe ensure high-quality mammographies.

Within the approved mammography screening program, 80 regional units which may include mobile solutions as well have been equipped in Germany since 2004 in accordance with the requirements of the European Guidelines. In parallel to this effort, area-wide central screening centers are established which plan additional examinations in case of positive or ambiguous diagnostic findings. When suspecting a malignancy, a separate patient discussion is held or additional, more extensive clarification diagnostics are applied.

Mammomat Novation by Siemens works with the newest full field detector technology based on amorphous selenium (a-Se). A photo conductor, which converts X-rays directly into electrical signals, avoids scattered radiation effects that may occur with other technologies and compromise image quality. A large detector surface (24 x 29 cm) ensures that not more than one exposure is necessary even for larger breasts and that the entire breast including the pectoral muscle is displayed. A new compression plate enables central positioning of the breast in all projections without cumbersome readjustments of the X-ray arm. And the Opcomp function ensures low-pain examinations. During the examination, this function ensures that only the pressure required for optimal digital imaging is applied to the breast.

The comprehensive system solution for digital mammography is supplemented by a dedicated acquisition workstation as well as the reporting station syngo MammoReport. A new case (up to eight mammograms) is selected with syngo MammoReport in less than a second. Also earlier reports or evaluations acquired with other modalities can be displayed quickly and effectively.

"We are glad to hear that digital mammography is now mobile as well and provides women in rural communities with regular early breast cancer screening using a new technology", explained Holger Schmidt, head of the Special Products Division at Siemens Medical Solutions.

Breast cancer continues to be the most frequent cause of death for women between 40 and 60 years of age. In Germany, 48,000 women per year are diagnosed with breast cancer, of these 17,000 will succumb to the disease. However, according to statements made by the president of EUROPA DONNA, the European Coalition against Breast Cancer, and Karin Jöns, congresswoman of the European Parliament, 90 percent of all breast cancer cases can be cured when diagnosed early and treated correctly.

Siemens Medical Solutions is one of the world's largest suppliers to the healthcare industry. The company is known for bringing together innovative medical technologies, healthcare information systems, management consulting, and support services, to help customers achieve tangible, sustainable, clinical and financial outcomes. From imaging systems for diagnosis, to therapy equipment for treatment, to patient monitors to hearing instruments and beyond, Siemens innovations contribute to the health and well-being of people across the globe, while improving operational efficiencies and optimizing workflow in hospitals, clinics, home health agencies, and doctors' offices. Employing approximately 33.000 people worldwide and operating in more than 120 countries, Siemens Medical Solutions reported sales of 7.6 billion EUR, orders of 8.6 billion EUR and group profit of 1 billion EUR for fiscal 2005. Further information can be found under: http://www.siemens.com/medical

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