Mammography Quality Standards Reauthorization Act of 2004

Mr. President, I am pleased that today the Senate will pass the Mammography Quality Standards Reauthorization Act of 2004, H.R. 4555. It is fitting that Congress is reauthorizing the Mammography Quality Standards Act, MQSA, during Breast Cancer Awareness Month. This important bill is about saving lives. That is what the MQSA does. Accurate mammograms detect breast cancer early, so women can get treatment and be survivors.

Mammography is not perfect, but it is the best screening tool we have now. I authored MQSA 12 years ago to improve the quality of mammograms so that they are safe and accurate. Before MQSA became law, there was an uneven and conflicting patchwork of standards for mammography in this country. There were no national quality standards for personnel or equipment. Image quality of mammograms and patient exposure to radiation levels varied widely. The quality of mammography equipment was poor. Physicians and technologists were poorly trained. Inspections were lacking.

MQSA set Federal safety and quality assurance standards for mammography facilities for: personnel, including doctors who interpret mammograms; equipment; and operating procedures. By creating national standards, Congress helped make mammograms a more reliable tool for detecting breast cancer. In 1998, Congress improved MQSA by giving information on test results directly to the women being tested, so no woman falls through the cracks because she never learns about a suspicious finding on her mammogram.

Now Congress is renewing MQSA through 2007 and laying the foundation to improve it even more in the future. Next year, the Institute of Medicine, IOM, and the General Accountability Office, GAO, will release studies examining a number of issues relating to MQSA and mammography. These issues include ways to improve physicians' interpretations of mammograms, ways to ensure that sufficient numbers of adequately trained personnel are recruited and retained at all levels, and access to mammography. I look forward to receiving these IOM and GAO recommendations and considering them in the next MQSA reauthorization.

This legislation that the Senate passed today was passed by the House of Representatives earlier this week and now heads to the President for his signature. I acknowledge and thank Congressman Dingell for his longstanding leadership and work on MQSA, and appreciate the work of the House Energy and Commerce Committee on this issue. I thank Senators Gregg and Kennedy for working with me to make sure that the Senate made MQSA a priority in this Congress and that we reauthorized it this year. I also want to acknowledge Senator Ensign for his important work on MQSA. Senator Ensign joined me in introducing our MQSA reauthorization bill, S. 1879, that passed the Senate earlier this year.

I thank the Susan G. Komen Breast Cancer Foundation, American Cancer Society, National Alliance of Breast Cancer Organizations, American College of Radiology Association, Y-ME National Breast Cancer Organization, and the National Breast Cancer Coalition for their input and advice during this reauthorization of MQSA.

This year about 216,000 cases of breast cancer are expected to be diagnosed and over 40,000 women are expected to die of breast cancer in this country. MQSA saves lives. That is why it is so important that Congress is renewing and working to strengthen MQSA.

Mr. President, I thank the Senator from New Hampshire. He is right, we have just passed very important legislation, one of which is to reauthorize our mammogram quality standards. We have worked very hard on a bipartisan basis. I would like to thank him for his collegiality and cooperation. I see him smiling. Did I interrupt?

It was a little chaotic. I wanted to be quickly complimentary.

Literally, we are going to ensure the safety and security of our mammograms. I just finished the Race for the Cure in Baltimore. I did more of a ``walk for the cure'' this morning. But when you look at the survivors and you know what early detection from mammograms has meant, we really have done a good job.

I thank the Senator.

Mr. Speaker, I rise in support of H.R. 4555, the Mammography Quality Standards Reauthorization Act of 2004. I am proud to have introduced this bill, and proud to have helped author the original Mammography Quality Standards Act which has made a major contribution to improving the quality of mammograms.

Just a few months ago, the Institute of Medicine (IOM) published a detailed reported entitled: ``Saving Women's Lives, Strategies for Improving Breast Cancer Detection and Diagnosis.'' According to the IOM, ``[m]ammography is a safety net that saves lives each year, . . . and although mammography saves lives, it is not perfect.'' The IOM report noted that many women who would benefit from mammography do not undergo regular screening and others who do undergo regular screening develop breast cancers that were not detected by their mammography exam. While the report notes that progress has been made in reducing mortality from breast cancer, it is still the second leading cause of death for women.

While research will hopefully lead us to improved techniques for detecting and treating breast cancer, another IOM study entitled: ``Mammography and Beyond: Developing Technologies for Early Detection of Breast Cancer,'' concluded that mammography, while not perfect, is still the best choice for screening the general population to detect breast cancer at early and treatable stages. To be sure, there are important issues regarding quality and access with respect to screening and treatment services, and work on those will continue.

This legislation is almost identical to S. 1879, a bill introduced by Senator Mikulski that has already been passed by the Senate. The only substantive difference is the authorization period. Our bill extends the authorization period through FY 2007, two years longer than the Senate bill. But I support a timely completion of various mammography issue studies requested by Senator Mikulski, and I look forward to working with her, Chairman Barton, my other colleagues, and stakeholders, including the Susan G. Komen Foundation, to bring an MQSA reauthorization bill to the President's desk as quickly as possible.

Mr. Speaker, I move to suspend the rules and pass the bill (H. R. 4555) to amend the Public Health Service Act to revise and extend provisions relating to mammography quality standards, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on this legislation.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in strong support of H.R. 4555, the Mammography Quality Standards Act. I want to commend my good friend and ranking minority member, the gentleman from Michigan (Mr. Dingell) for bringing the bill forward.

It is particularly fitting that the House is considering this bill today, as the month of October is formally recognized as National Breast Cancer Awareness Month. It is estimated that this year over 200,000 women will be diagnosed with breast cancer. Like many other diseases, early detection of breast cancer is critical to saving lives. Right now, mammograms are the best screening tool available to women to help detect breast cancer at an early age.

In 1992, Congress enacted the Mammography Quality Standards Act to ensure that all women have access to quality mammography for the detection of breast cancer in its earliest, most treatable stages. The MQSA provides that screening and diagnostic services must be accredited and certified by the Food and Drug Administration. H.R. 4555 reauthorizes the Act through fiscal year 2007.

The bill includes a new provision to permit the Secretary of Health and Human Services to issue a temporary renewal certificate or a limited provisional certificate to any facility seeking reaccreditation under MQSA. The legislation also permits the Secretary to appoint individuals with expertise in

mammography equipment to the National Mammography Quality Assurance Advisory Committee and grants the advisory committee greater flexibility in how many times the committee must meet annually.

Mr. Speaker, this is a good piece of legislation and I would encourage my colleagues to support it.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I rise today in support of the Mammography Quality Standards Act. It is truly fitting for the House to pass a reauthorization of MQSA during October, which is Breast Cancer Awareness Month. This year, more than 215,000 individuals will learn that they have breast cancer. Hopefully, many of these will be early diagnoses, detected by mammograms that have proven time and again to be the most important tool for early detection.

Thanks to the efforts of HHS, the FDA and private advocacy groups, such as the Susan G. Komen Foundation, an estimated 40 million mammograms are performed annually. And thanks to the Mammography Quality Standards Act initially enacted over a decade ago, women all across America have benefited from uniform quality standards for mammography facilities.

For several years, I've been working with the FDA on issues related to silicone breast implants. I am concerned about recent studies on the effect of breast implants on mammography readings.

Specifically, an April 2003 NIH report highlighted clinical studies suggesting that women with breast implants have more advanced cancer at diagnosis than women without breast implants. And more recently, a January 2004 article published in the Journal of the American Medical Association concluded that breast implants decrease the sensitivity of mammography screenings to detect breast cancer.

The FDA has been extremely responsive on this issue and has acknowledged that breast implants can hide tumors or make it more difficult to include them in the image. As such, the FDA has suggested that medical professionals take special implant displacement views in addition to those taken during routine mammograms. These extra views are crucial to ensuring that women with breast implants have effective mammograms.

The folks at FDA have worked wonders on mammography standards thus far. I have every confidence that they will keep up the good work and take into consideration the unique circumstances of women with breast implants. With that, Mr. Speaker, I would encourage all of my colleagues to support this important legislation.

Mr. President, I ask unanimous consent that the Senate proceed to the immediate consideration of H.R. 4555, which was received from the House and is at the desk.

Mr. President, I ask unanimous consent that the bill be read a third time, passed, the motion to reconsider be laid on the table, and any statements relating to the bill be printed in the Record without intervening action or debate.

Mr. President, just to clarify, the bills we just passed are fairly significant pieces of legislation, the most significant of which is a bill which Senator Kennedy and I and many people in this body have been working on.

I am happy to yield the floor to the Senator from Maryland.

I appreciate that.

Mr. President, let me thank the Senator from Maryland for her generous comments and her hard work, especially on the mammogram bill which we just passed. I was trying to highlight one of these pieces of legislation which essentially saves the taxpayers from paying out a $100 million windfall to people who give loans to students. Those individuals were getting paid mostly by banks at 9.5 percent. This will roll that back to a reasonable interest rate of 4 percent. We will take those additional monies that have been saved and use them to waive the repayment requirements for teachers on their student loans for teachers who go into underserved areas and teach special needs kids. This is a

very important event and something that needed to be done, or we would have ended up with a windfall to these lenders and these individuals who go out and teach in these tough schools on difficult subject matters would have ended up with large student loans.

This is a very positive step. I thank the Senator from Massachusetts for his efforts in this area as the ranking member of the committee, and I thank the entire committee for its cooperation and appreciate the attention of the Senate.

I yield the floor.