Beyond mammography

Townsend Letter for Doctors and Patients, June, 2004 by Len Saputo

Overview

The most devastating loss of life from breast cancer occurs between the ages of 30 to 50. Fortunately, women today have more options available to them to help in the detection of breast cancer than in past decades. Unfortunately, education and awareness of these options and their effectiveness in detecting breast cancer at different stages in life are woefully deficient.

The first, part of this in-depth article explores the latest findings on the effectiveness and shortcomings of various detection methods used by the mainstream medical community, including mammography, clinical breast exams, and to a lesser extent, magnetic resonance imaging (MRIs) and PET scans.

The second part of this article goes beyond mammography, exploring a highly advanced but much maligned detection tool for breast cancer--breast thermography. Breast thermography, which involves using a heat-sensing scanner to detect variations in the temperature of breast tissue, has been around since the 1960s. However, early infrared scanners were not very sensitive and were insufficiently tested before being put into clinical practice, resulting in misdiagnosed cases.

Modern-day breast thermography boasts vastly improved technology and more extensive scientific clinical research. In fact, the article references data from major peer-reviewed journals and research on more than 300,000 women who have been tested using the technology. Combined with the successes in detecting breast cancer with greater accuracy than other methods, the technology is slowly gaining ground among more progressive practitioners.

"Beyond Mammography" concludes that breast thermography needs to be embraced more widely by the medical community and awareness increased among women. Not only has it demonstrated a higher degree of success in identifying women with breast cancer under the age of 55 in comparison to other technologies, but it is also an effective adjunct to clinical breast exams and mammography for women over 55. Finally, it provides a non-invasive and safe detection method, and if introduced at age 25, provides a benchmark that future scans can be compared with for even greater detection accuracy.

Introduction

The most devastating loss of life from breast cancer impacts women between the ages of 30 and 50. For women between the ages of 40 and 44, breast cancer is the leading cause of death, according to the American Cancer Society. Yet the November 10, 2003 issue of the AMA journal, American Medical News, reports little evidence documenting that mammography saves lives from breast cancer for premenopausal women, which are many of the women who fall into these age ranges. (1)

Good evidence supports mammography as a valuable breast cancer screening tool for women in their late 50s and 60s, but reveals room for substantial improvement. For women over the age of 70, accumulated data documents limited value in doing mammograms since they do not significantly extend life. (2, 9, 10)

Obviously, as a detection tool, mammography has a valued place in clinical practice; however, other technologies are proving to be more effective in breast cancer detection and should become part of mainstream clinical practice in order to save more lives.

The Prevalence, Fear and Risk Factors of Breast Cancer

According to the American Cancer Society (ACS), breast cancer is the leading cause of death in women between the ages of 40 and 44. Although breast cancer has only 10% the morbidity and mortality of coronary heart disease, it is generally more feared. (3)

ACS statistics further document that every year in the United States there are approximately 200,000 new cases of breast cancer and more than 40,000 deaths. Not included in this number are more than 47,000 new cases of carcinoma in situ breast cancer, which is better known as DCIS (ductal carcinoma in situ) or LCIS (lobular carcinoma in situ) and is a very early form of breast cancer.

DCIS and LCIS are very mild cancerous lesions that only become malignant in about 2% of cases. For this reason many physicians do not consider DCIS and LCIS true cancers.

The risk of breast cancer at age 25 is less than one in 19,000 whereas by age 35 it is one in 217. (4) Yet, the statistic people are most familiar with is that one in eight women will eventually develop breast cancer. It is important to appreciate that this number is a cumulative risk that only applies to women who have reached the age of 90.

The hereditary breast cancer genes, referred to as BRCA 1 and 2 genes, are known to be associated with both breast and ovarian cancers, but only account for 5 to 10% of all breast cancer. Newer, less well-known factors are estimated to account for another 10% of all breast cancers. In at least 70% of cases, however, the cause of breast cancer is yet unknown. (5)

Generally Accepted Risk Factors

The risk for breast cancer is increased if you:

* Had your first period before age 12

* Went through menopause after age 50

* Had your first child after age 30 or never were pregnant