Interested In Thermography Keep These Points In Mind
Why isnt thermography more popular? Thats a good question. There are the cost and lack of insurance coverage. Plus some say that mammograms have become such big business in this country that any competition is frowned upon. Case in point when I asked the doctor who evaluated my ultrasound about thermography, he told me it was worthless. Keep in mind he runs a mammography center so his opinion is a highly biased one.
Screening For Women At Higher Risk
You can have screening from a younger age if you have a higher than average risk of breast cancer. This might be due to a family history or an inherited faulty gene.
Speak to your GP if you think you might be at increased risk. They can refer you to a genetic specialist, who can assess your risk. Not everyone with a family history of cancer is at increased risk themselves.
How Effective Are Mammograms
A Swedish study that evaluated 60,000 women discovered that 70% of the tumors detected by mammograms, werent actually tumors at all. These are called false positives and if youve had many mammograms, youve perhaps experienced this frightening experience. Youll receive a letter as I did and what is done is another mammogram, involving more radiation and typically a follow-up ultrasound to decide ultimately if the tumor is really a problem.
A little more personal information: This is exactly what occurred to my mother every couple of years. She diligently had her annual mammogram, only to be told on most occasions that there was something suspicious. She would then have one or two more mammograms before finally having an ultrasound where it was determined she was fine. I finally encouraged her to spread out her mammograms and if something came up to jump immediately to the ultrasound since that was where they ultimately made their decision that her tumor wasnt a tumor at all. She is now almost 91 and never had breast cancer, fortunately.
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What Is The Breast Imaging Reporting And Database System
The American College of Radiology has established a uniform way for radiologists to describe mammogram findings. The system, called BI-RADS, includes seven standardized categories, or levels. Each BI-RADS category has a follow-up plan associated with it to help radiologists and other physicians appropriately manage a patients care.
What You Should Know About Mammograms
So lets look at the data behind mammograms so that we can make informed decisions for ourselves, our daughters, and our mothers.
Breast cancer is the leading cause of death among American women between the ages of 44 and 55. Mammography involves ionizing radiation of the breast. There are many in the medical community who speak out against the dangers of so much radiation, along with an error rate that many consider unacceptable. One particular example is Dr. Gofinan in his book Preventing Breast Cancer, which states that breast tissue is highly radiation-sensitive and thats why mammograms can cause cancer. He goes on to say that such dangers are increased by genetic makeup, obesity, hormonal imbalance, and prior non-cancerous breast disease.
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History Of Mammogram Research
One reason that mammograms remain controversial is that much of the research done to determine their pros and cons was carried out decades ago, when the quality of imaging devices was much poorer. Clinical trials to determine if mammograms are beneficial and safe were first conducted in the 1970s, and since this time these trials have been criticized for having many flaws and limitations.
The U.S., Sweden, Canada and the U.K. all conducted trials in the 70s that showed women had a better chance of detecting breast cancer in its early stages if they were screened using mammograms while also receiving usual medical care, compared to women who were not being screened with mammograms but still receiving usual medical care.
Because of this finding, it was determined that it was unethical to purposefully withhold mammogram screenings from certain women going forward for the sake of research. That meant that well-controlled, randomized, blinded trials comparing mammograms to no mammograms were mostly discontinued after the 70s, making it hard to draw definitive conclusions.
Since this time other studies have found that mammography tends to be less accurate in women under the age of 50. Two reasons why mammograms are now recommended for women over 50 is that there are fewer breast cancer cases in younger women to begin with, and secondly that younger women have denser breast tissue that makes mammograms less accurate.
Who Interprets The Results And How Do I Get Them
A radiologist, a doctor trained to supervise and interpret radiology examinations, will analyze the images. The radiologist will send a signed report to your primary care or referring physician who will discuss the results with you.
You will also be notified of the results by the mammography facility.
You may need a follow-up exam. If so, your doctor will explain why. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique. It may also see if there has been any change in an issue over time. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention.
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So Whats The Bottom Line
Rahbar said that although itâs true some DCIS lesions might not need to be treated, thereâs currently no reliable way to determine this. The good news, he said, is that âthese lesions are the earliest form of breast cancer and are extremely curable.â
So what should a woman do if she gets a mammogram and is told she has DCIS?
âI would absolutely recommend that any patient diagnosed with DCIS seek treatment at a comprehensive cancer center that can provide a range of treatment options â including clinical trials â that best match the patientâs preferences and goals,â he said.
In the meantime, research is definitely moving us ahead.
Fred Hutch and SCCA, he said, are both âvery actively involvedâ in studies aimed at providing a more tailored, nuanced and individualized approach to women diagnosed with breast cancer, pointing to the the 75-site ECOG ACRIN trial and others coming down the pipeline. The new COMET trial, Etzioni said, will randomize women with low-risk DCIS to standard care or surveillance with treatment only upon evidence of disease recurrence or progression. A new Digital Mammography DREAM Challenge involving Fred Hutch and SCCA researchers aims to fast-forward breast screening technology through machine learning.
Etzioni and Rahbar also stressed that while there may be back and forth about how many women may or may not be overtreated because of mammograms, there is consensus about what needs to be done moving forward.
Regular Mammograms Increase Your Risk Of Breast Cancer
In the 1970s, radiation from mammograms was at a level of 5 to 10 rads . Currently, it is closer to 1 rad, a definite improvement, but still, a dose of radiation 1,000x higher than a chest X-ray. According to Dr. Rauscher, former director of the National Cancer Institute, women between the ages of 35 to 50 will experience an increased risk of breast cancer of 1 percent, each and every time they are exposed to that 1 rad of radiation. Dr. Blaylock puts the estimate at double that estimating that women suffer a 2 percent increased risk of breast cancer each year that they receive a mammogram. An authority on the effects of ionizing radiation on health, Dr. Gofman, feels that about 75 percent of breast cancer could be prevented by avoiding or minimizing exposure to ionizing radiation. This includes mammograms, x-rays, and other sources.
A chilling statistic is a correlation between a form of breast cancer called ductal carcinoma in situ and the introduction of mammograms as a screening tool. The incidence of DCIS has increased 328 percent since mammograms began. According to experts, 200 percent of that increase is due to mammography.
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Benefits Of Mammographic Screening
The ACS systematic review also examined the effect of screening mammography on life expectancy. Although the review concluded that there was high-quality evidence that mammographic screening increases life expectancy by decreasing breast cancer mortality, the authors were not able to estimate the size of the increase 23.
What You Should Know
Your healthcare provider may recommend a mammogram for breast cancer screening or for other symptoms in the breast like a lump, pain, changes in breast skin texture , or nipple discharge.
The United States Preventive Services Task Forceexternal icon recommends:
- Mammograms every two years for women who are 50-74 years old and are at average risk for breast cancer.
- Women who are 40-49 years old should talk to their healthcare provider about when or how often to get a mammogram based on personal risk and health history.
Work with your healthcare provider to decide on the best screening process and schedule for you. Your healthcare provider may recommend a mammogram when they believe that benefits outweigh the risks for your health.
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How Are Screening And Diagnostic Mammograms Different
The same machines are used for both types of mammograms. However, diagnostic mammography takes longer to perform than screening mammography and the total dose of radiation is higher because more x-ray images are needed to obtain views of the breast from several angles. The technologist may magnify a suspicious area to produce a detailed picture that can help the doctor make an accurate diagnosis.
If You Are Called Back
Around 4 out of 100 women are called back for more tests. If this happens, you might feel very worried. But many of these women wont have cancer.
If you are called back because your mammogram showed an abnormal area, you might have a magnified mammogram. This can show up particular areas of the breasts more clearly. These mammograms show the borders of any lump or thickened area. They can also show up areas of calcium .
You might also have an ultrasound scan of the breast or a test to take a sample of cells from the abnormal area
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Can Radiologist Tell If It Is Cancer
While even the most advanced imaging technology doesnt allow radiologists to identify cancer with certainty, it does give them some strong clues about what deserves a closer look. Today well discuss a few things that radiologists are on the lookout for when examining mammography and breast ultrasound images.
The Effect Of Screening On Total Mortality
Breast cancer mortality is the wrong outcome. Not only because it is biased in favour of screening but also because the treatment of overdiagnosed, healthy women increases their risk of dying. Radiotherapy, for example, may cause deaths from heart disease, lung cancer and other cancers, and these iatrogenic deaths are not counted as breast cancer deaths.
Figure 3 shows the effect of invitations to screening under three overly optimistic and partly erroneous assumptions: screening reduces breast cancer mortality by 20% screening does not increase mortality from other causes and assessment of cause of death is not biased.20 The effect of screening on total mortality is barely visible.
Cumulative risk of dying according to age for women invited to screening from age 50 years and for women who are not invited assuming screening reduces breast cancer mortality by 20% and does not increase deaths from other causes. Based on data for England and Wales for 2009 from Office for National Statistics. Reproduced with permission from Paul Pharoah.
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What Does The Mammography Equipment Look Like
A mammography unit is a box with a tube that produces x-rays. The unit is used exclusively for breast x-ray exams and features special accessories to limit x-ray exposure to only the breast. The unit features a device to hold and compress the breast and position it so the technologist can capture images at different angles.
Breast tomosynthesis is performed using digital mammography units, but not all digital mammography machines are equipped to perform tomosynthesis imaging.
Informed Choice Is In Jeopardy
Surveys indicate that women want to have balanced information and share the decision with their physician when it comes to whether or not they choose to go through screening mammography. However, many women have reported that they were never provided with information on the drawbacks of mammography, such as the risks of overdiagnosis, unnecessary cancer treatment, excessive radiation exposure, and potential for causing tumor rupture. The lack of balanced information about mammography provided for women jeopardizes their ability to make their own decisions regarding healthcare .
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Where Can I Find Current Recommendations For Screening Mammography
Many organizations and professional societies, including the United States Preventive Services Task Force , have developed guidelines for mammography screening, as summarized by the Centers for Disease Control and Prevention . All recommend that women talk with their doctor about the benefits and harms of mammography, when to start screening, and how often to be screened.
Although NCI does not issue guidelines for cancer screening, it conducts and facilitates basic, clinical, and translational research that informs standard clinical practice and medical decision making that other organizations may use to develop guidelines.
How Should I Prepare For The Mammogram
Before scheduling a mammogram, the American Cancer Society and other specialty organizations recommend that you discuss any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer.
Do not schedule your mammogram for the week before your menstrual period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.
The ACS also recommends you:
- Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.
- Describe any breast symptoms or problems to the technologist performing the exam.
- Obtain your prior mammograms and make them available to the radiologist if they were done at a different location. This is needed for comparison with your current exam and can often be obtained on a CD.
- Ask when your results will be available do not assume the results are normal if you do not hear from your doctor or the mammography facility.
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Myth #: I Dont Have Any Symptoms Of Breast Cancer Or A Family History So I Dont Need To Worry About Having An Annual Mammogram
Fact: The American College of Radiology recommends annual screening mammograms for all women over 40, regardless of symptoms or family history. Early detection is critical, says Dr. Sarah Zeb. If you wait to have a mammogram until you have symptoms of breast cancer, such as a lump or discharge, at that point the cancer may be more advanced . According to the American Cancer Society, early-stage breast cancer has a five-year survival rate of 99 percent. Later-stage cancer has a survival rates of 27 percent.
More than 75 percent of women who have breast cancer have no family history.
Is Mammography Good For Breast Cancer
Mammography is an excellent tool for finding breast cancer. Numerous studies show the effectiveness of mammograms in detecting cancer at its earliest stages and improving the mortality of women diagnosed with this horrible disease. Overall, the sensitivity of mammography ranges between 80-92 percent. This means that mammograms will find
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What Does It Mean When A Mammogram Is Negative
In cancer screening, a negative result means no abnormality is present. False-negative results occur when mammograms appear normal even though breast cancer is present. Overall, screening mammograms miss about 20% of breast cancers that are present at the time of screening. False-negative results can lead to delays in treatment and a false sense
Mammograms More Likely To Cause Unneeded Treatment Than To Save Lives
A new study offers a reality check to anyone who says a mammogram saved her life. For every woman in whom mammography detected a breast cancer that was destined to become large and potentially life-threatening the kind that screening is intended to head off about four are diagnosed with one that would never have threatened their health. But the surgery, chemotherapy, or radiation that follows such diagnoses can be traumatic, disfiguring, toxic, or even life-shortening even as its unnecessary.
Prior estimates of how many mammogram-detected cancers are overdiagnoses, meaning they dont need to be treated, have ranged from 0 to 54 percent. The new study published Wednesday in the New England Journal of Medicine, improves on those by using hard data rather than mathematical modeling, and 40 years of it.
The researchers compared records of breast cancers diagnosed in women 40 or older during two periods, 1975 to 1979, before mammography became common, and 2000 to 2002. As youd want with cancer screening, more small tumors and fewer larger ones are being diagnosed: 36 percent vs. 64 percent in the 1970s and 68 percent vs. 32 percent in the 2000s.
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