The White House in Washington, D.C., and the Rhode Island State House are glowing with pink this month to promote breast-cancer awareness. And retailers are going “pink” as well, offering a wide range of goods — from foods to fashions to home décor and small appliances. Generally a portion of the proceeds go to fund the battle against-breast cancer. Cross is selling the pink “Starlight” pen, above. KN Karen Neuburger offers Tickled Pink PJs, and, below, KitchenAid adds pink to kitchen appliances.

NEWPORT NEWS, Va. First, there was film mammography, used for more than 35 years to detect early breast cancer.

“It’s proven to be effective even before women might find a lump or exhibit any symptoms of breast cancer,” says Kelly Allison, co-medical director at the Dorothy G. Hoefer Comprehensive Breast in Newport News, Va.

Now, there’s digital mammography, which was federally approved for use in 2000.

Q: What does a digital mammogram offer that’s different from film?

A: For the majority of women, standard mammography is an effective and reliable way of screening for breast cancer. However there are limits to film mammography. Because images are created directly on film, this media offers limited enhancements to the image such as altering the contrast which makes interpretation of the image easier.

Digital mammography, which produces electronic images, offers some strong advantages. Electronic images are displayed on a computer monitor and can be enhanced, enlarged, or even interpreted using the help of computers. Contrast and other image enhancements be done electronically to aid in evaluation of the image.

Q: Who benefits most from digital mammography?

A: This has been a topic of research and debate for years with a number of small studies suggesting that there was no diagnostic difference between digital and film mammography.

Since then, a landmark study known as the Digital Mammographic Imaging Screening Trial (DMIST) began in October 2001. A total of 49,528 women, who had no signs of breast cancer, were enrolled around the U.S. Both digital and film mammograms were taken that month and compared. Findings from that study show no difference in detecting breast cancer for the general population of women in the trial.

Digital mammography was found to be significantly better than film mammography in screening a limited population — women who were younger than 50, or women of any age who had very dense breasts, according to results reported Sept. 16, 2005 in a special online publication of the New England Journal of Medicine and at a meeting of the American College of Radiology Imaging Network (ACRIN) in Pentagon City, Va.

The addition of digital mammography makes who’s reading your mammogram an important consideration. Radiologists who have completed a fellowship training program in mammography and or women’s imaging have that added expertise.

Q: What’s the next advanced screening?

A: The radiologist or mammographer may see something suspicious or even abnormal on your mammogram. Sometimes additional evaluation will be necessary through a diagnostic mammogram that images just the questionable tissue, a breast ultrasound and/or a biopsy as a way to take a sample of breast cells for laboratory testing.

Q: When should a woman have her first mammogram?

A: As women age, their risks of breast cancer increases. The American Cancer Society recommends women age 40 and older have a screening mammogram every year and should continue to do so for as long as they are in good health. We suggest a baseline mammogram at age 35 as a basis for comparison of future mammograms. Women age 20-30 should have a clinical breast exam (CBE) by a health professional every three years. After age 40, women should have a breast exam by a health professional every year. But the best breast protection is a layered approach. If nothing else, women should recognize that none of these recommendations or techniques should stand alone. Done in combination, they each have their place in maintaining long-term breast health.

Q: Are self exams advisable?

A: Self breast exams are one method for women to be familiar with their bodies. I see women every day in my practice who have found their own breast cancer through self breast exam. I am a firm believer that self breast exams — are one of the easiest, cheapest methods of good breast health, especially in partnership with other screening tools.

Q: How has breast cancer treatment changed?

A: The most striking change is the move toward “targeted therapy.” Regular chemotherapy kills rapidly dividing cancer cells but also good cells, especially bone marrow. We’ve learned that breast cancers are not all the same and now we can treat the specific kinds of each.

Elizabeth Harden, a medical oncologist certified in blood and cancer diseases, sees a patient in her 80s whose breast cancer metastasized — spread to her bones — seven years ago. The woman is doing well and has not required additional chemotherapy. She’s not cured but enjoys a good quality life.

“Fifteen or 20 years ago, we could not have offered that,” says Harden, who’s been with Virginia Oncology Associates 17 years.

Q: What’s new in breast-cancer prevention drugs?

A: Tamoxifen, around for 30 years, is now joined by Evista. Both block the growth of estrogen-sensitive breast tumors. Evista was developed to treat osteoporosis in women who couldn’t take estrogen replacement, but studies found those olden women were not developing breast cancer as expected. Evista was recently approved as a breast-cancer prevention drug in post-menopausal women whose family histories and other risk factors indicate they need it. Tamoxifen and Evista are both taken in pill form and there is no hair loss or nausea with either. They are in a class of estrogen-blocking drugs known as selective estrogen receptor modulators.

There’s a class of Aromatase inhibitors, called “AIs,” that interfere with the body’s ability to produce estrogen, which many breast tumors feed on. These are used in postmenopausal women. A “wonderful drug” is Herceptin, which is used intravenously for aggressive breast cancers with a certain genetic makeup; about 15 to 25 percent of all breast tumors fall into that category.

About 182,460 new cases of invasive breast cancer will be diagnosed in women in the U.S. in 2008.

About 1,990 men will be diagnosed with breast cancer in ’08.TREATMENT

• Cancer treatment varies widely depending on the type and stage of the cancer, as well as the age and medical history of the patient. Treatment may include surgery: a lumpectomy or mastectomy. Other treatments are chemotherapy, radiation therapy, hormone therapy and targeted therapy.

• Treatment decisions are made by the patient and her doctor after consideration of the stage and biological characteristics of the cancer, the patient’s age and preferences, and the risks and benefits associated with each treatment. Most women with breast cancer will have some type of surgery. Surgery is often combined with one or more additional treatments. Guidelines from the National Comprehensive Cancer Network (NCCN) are available through the American Cancer Society Web site at www.cancer.org.

• One exciting area of progress is the development of treatments that target certain types of tumors. For example, the drug trastuzumab (Herceptin) has been successful in treating certain women with particularly aggressive breast tumors that have a specific genetic makeup. These tumors account for 15 to 25 percent of all breast cancers. Herceptin can reduce the risk of recurrence in women with early-stage tumors and can shrink some advanced tumors that return after chemotherapy or continue growing during treatment. The drug lapatinib (Tykerb) targets the same type of breast tumor, and is used when trastuzumab is no longer working.

• Aromatase inhibitors are hormonal drugs that stop estrogen production in women past menopause. Three have been approved for use in postmenopausal women with early or advanced breast cancer that is hormone-receptor positive: letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin). Studies have shown that using an aromatase inhibitor, either alone or after tamoxifen, reduces recurrences more than tamoxifen alone. However, these drugs are not effective in premenopausal women.

Source: American Cancer SocietyRISK FACTORS

• Being female and increasing age are the most important risk factors for breast cancer.

• Other risk factors include a long menstrual history, being overweight or becoming obese after menopause, recent use of oral contraceptives, use of postmenopausal hormone therapy, never having children or having one’s first child after 30, consumption of one or more alcoholic beverages per day and being physically inactive.SCREENING GUIDELINES

• Yearly mammograms are recommended starting at age 40.

• A clinical breast exam should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women age 40 and older.

• Women should know how their breasts normally look and feel and report any breast change promptly to their health-care providers. Breast self-exam is an option for women starting in their 20s.Changing lives

Laurie Davis is a calendar girl for ’09 — but not by choice. A diagnosis of breast cancer in March catapulted her into a special sisterhood called Beyond Boobs!, a Virginia support group for young women diagnosed with breast cancer before menopause. Like Davis, many of them pose for the group’s annual fund-raising calendar.

“My first thought was, ‘I’m too young to die,’ ” says Laurie, 36. The former Air Force nurse is now a Newport News, Va., stay-at-home mother of three kids. “I don’t have my scrapbooks up to date.

“I was alone with my 4-year-old, playing Barbies, so I couldn’t totally lose it. I cried later in the shower where no one could hear me.”