Although I don’t enjoy the experience, I have continued to get regular mammograms because it is the most reliable breast cancer screening method currently available to most women. Thermography, a more recently available technology, does not definitively distinguish between active cancer and other inflammatory activity, and therefore raises as many questions as it answers. MRI imaging provides exceptionally clear visibility of breast tissue, but is so expensive as to be impractical for screening purposes.1
While thousands of lives have been saved by early detection of tumors by mammograms, many tumors have also been missed. It turns out that a single variable greatly increases or decreases the chances of tumor detection by mammograms: density of breast tissue. In less dense breasts, mammograms provide clear tumor visibility for about 80% of breast tumors. In dense breasts, visibility is only about half that successful, because tumors are difficult to distinguish visually from areas of breast density.
To add insult to injury, dense breast tissue is itself a significant risk factor for breast cancer. Thus tumors in premenopausal women, whose breast tissue tends to be denser, are particularly often missed by mammograms.
A new technology, Molecular Breast Imaging (MBI), improves visualization of tumors in dense breasts. In MBI, a radiotracer solution is injected into breast tissue. The solution is taken up by abnormal breast cells but not by normal cells. Cells that take up the radiotracer are clearly visualized using gamma rays, in a procedure that requires far less pressure on the breasts than a mammogram. Because abnormal cells are identified by tracer uptake activity rather than visual appearance, they are not obscured by dense breast tissue, which does not take up tracer. In a Komen Foundation-funded study, MBI detected three times as many malignancies in dense breasts as did mammograms.
This TED talk by Dr. Deborah Rhodes, codeveloper of MBI, is fascinating for its insights into the political roadblocks encountered even by promising new medical technologies. MBI technology continues to be safety-tested with good results to date, and may become available in the next few years.
In the meantime, Dr. Rhodes makes these recommendations to improve breast tumor detection:
—Know your breast density. If your breasts are less dense, you can have higher confidence in mammograms as your screening procedure. Breast density is noted on all mammogram reports.
–If you are premenopausal, schedule your mammogram during the first two weeks of your menstrual cycle, when your breasts are relatively less dense.
–-Know your breasts well. Should you detect a persistent change in your breast that is not clearly explained by a mammogram, be assertive about requesting followup procedures.
1 MRI visualization is typically reserved for followup in women who have already been treated for a high-risk form of cancer.
Copyright 2013 Shani Fox, ND, LLC. All rights reserved.
Keywords: Dr. Shani Fox, cancer prevention, cancer survivor, cancer survivor self care, survivorship care plan, breast cancer screening