Q.What types of technology are available for breast cancer screening? Is a mammogram still my best choice?
A. There are a number of imaging technologies that are used to screen for breast cancer; however, a mammogram continues to be one of the most powerful tools in early detection.
While none of these screenings prevent breast cancer, they can save lives by finding cancer as early as possible, which may decrease the risk of dying from breast cancer by 25 to 35 percent.
Traditional mammograms
Mammograms have been used for approximately the last 30 years. They are likely still the most common and important tool health providers have to help them evaluate and diagnose breast disorders. Traditional mammography involves a low dose x-ray that provides smaller exposure to radiation than a typical chest x-ray. During the procedure, a technician positions each breast between two plates that compress the breast tissue after which two pictures are taken from two directions.
The procedure can be mildly uncomfortable, but compression is necessary to decrease the thickness of the breast, so that better views of the tissue can be obtained. It may be helpful to schedule a mammogram at a time in the menstrual cycle when breasts are less tender. In all reality, 10 minutes of discomfort should never prevent a woman from having a mammogram.
At least one radiologist, a doctor specializing in imaging technology, reads and interprets the mammogram. Having two radiologists read the mammogram decreases the chance of missing an abnormality by 10 percent.
There is a recent technology development in which a computer program gives a "second opinion" called computer-aided detection (CAD). This program highlights areas that have extra thickness to it allowing the radiologist to re-examine and decide if further follow-up is needed. Many area radiology departments offer this technology.
Digital mammography
Digital mammography is a newer take on traditional film mammography and is not widely available in our area. Breast images are obtained through breast compression and are recorded directly into a computer. Suspicious areas can then be enlarged or highlighted to allow further evaluation of the tissue.
At this point, some doctors feel that digital mammography is not always quite as clear as the images they see with film. However, most feel that this technology is a step in the right direction to improving early detection. In the future, digital mammography will be more common and will even allow the mammogram to be transmitted directly to your healthcare provider by computer.
Other breast screening tools
Other less common methods of screening for breast cancer include breast MRI and breast thermography. Breast MRI determines what is inside of the breast by obtaining hundreds of cross-sectional images. MRI has been shown to detect small breast lesions sometimes missed by mammography, and it is very successful in imaging breast implants as well as the dense breasts most common in younger women.
There is concern that MRIs have some trouble distinguishing between cancerous and non-cancerous breast changes and difficulty detecting early suspicious areas such as groupings of small calcifications. At this time, MRI is currently most useful in following women at high risk for breast cancer or in women who have a history of breast cancer. Ultimately, MRI is an evolving technology and should not replace traditional mammograms for screening and diagnosis.
Thermography is a less common screening method which detects and records infrared heat radiating from the surface of the body. It can aid in early detection of subtle abnormal changes of the breast but does not look at the actual structures of anatomy as do mammograms and MRI. Thermography is most useful in women under age 50 and is sometimes used in conjunction with more traditional methods but should never replace mammogram, ultrasound, or MRI.
The power of
early detection
Breast imaging is evolving and making great strides in earlier detection of breast cancer. Although new technologies are emerging, there is still no single method for screening.
Since no one method is perfect, complete breast cancer screening includes three components:
• monthly self breast exam
• yearly clinical breast exam by a trained health professional
• yearly mammograms after the age of 40, or after age 30 in higher risk women
Please see your healthcare professional for a yearly exam or if you notice any breast changes. The best bet for protection is early detection.
- Dr. John. Schuetz is an internal medicine physician in the Adult Medicine Department. To schedule an appointment with Dr. Schuetz, please call Monroe Clinic at 324-2200.
A. There are a number of imaging technologies that are used to screen for breast cancer; however, a mammogram continues to be one of the most powerful tools in early detection.
While none of these screenings prevent breast cancer, they can save lives by finding cancer as early as possible, which may decrease the risk of dying from breast cancer by 25 to 35 percent.
Traditional mammograms
Mammograms have been used for approximately the last 30 years. They are likely still the most common and important tool health providers have to help them evaluate and diagnose breast disorders. Traditional mammography involves a low dose x-ray that provides smaller exposure to radiation than a typical chest x-ray. During the procedure, a technician positions each breast between two plates that compress the breast tissue after which two pictures are taken from two directions.
The procedure can be mildly uncomfortable, but compression is necessary to decrease the thickness of the breast, so that better views of the tissue can be obtained. It may be helpful to schedule a mammogram at a time in the menstrual cycle when breasts are less tender. In all reality, 10 minutes of discomfort should never prevent a woman from having a mammogram.
At least one radiologist, a doctor specializing in imaging technology, reads and interprets the mammogram. Having two radiologists read the mammogram decreases the chance of missing an abnormality by 10 percent.
There is a recent technology development in which a computer program gives a "second opinion" called computer-aided detection (CAD). This program highlights areas that have extra thickness to it allowing the radiologist to re-examine and decide if further follow-up is needed. Many area radiology departments offer this technology.
Digital mammography
Digital mammography is a newer take on traditional film mammography and is not widely available in our area. Breast images are obtained through breast compression and are recorded directly into a computer. Suspicious areas can then be enlarged or highlighted to allow further evaluation of the tissue.
At this point, some doctors feel that digital mammography is not always quite as clear as the images they see with film. However, most feel that this technology is a step in the right direction to improving early detection. In the future, digital mammography will be more common and will even allow the mammogram to be transmitted directly to your healthcare provider by computer.
Other breast screening tools
Other less common methods of screening for breast cancer include breast MRI and breast thermography. Breast MRI determines what is inside of the breast by obtaining hundreds of cross-sectional images. MRI has been shown to detect small breast lesions sometimes missed by mammography, and it is very successful in imaging breast implants as well as the dense breasts most common in younger women.
There is concern that MRIs have some trouble distinguishing between cancerous and non-cancerous breast changes and difficulty detecting early suspicious areas such as groupings of small calcifications. At this time, MRI is currently most useful in following women at high risk for breast cancer or in women who have a history of breast cancer. Ultimately, MRI is an evolving technology and should not replace traditional mammograms for screening and diagnosis.
Thermography is a less common screening method which detects and records infrared heat radiating from the surface of the body. It can aid in early detection of subtle abnormal changes of the breast but does not look at the actual structures of anatomy as do mammograms and MRI. Thermography is most useful in women under age 50 and is sometimes used in conjunction with more traditional methods but should never replace mammogram, ultrasound, or MRI.
The power of
early detection
Breast imaging is evolving and making great strides in earlier detection of breast cancer. Although new technologies are emerging, there is still no single method for screening.
Since no one method is perfect, complete breast cancer screening includes three components:
• monthly self breast exam
• yearly clinical breast exam by a trained health professional
• yearly mammograms after the age of 40, or after age 30 in higher risk women
Please see your healthcare professional for a yearly exam or if you notice any breast changes. The best bet for protection is early detection.
- Dr. John. Schuetz is an internal medicine physician in the Adult Medicine Department. To schedule an appointment with Dr. Schuetz, please call Monroe Clinic at 324-2200.
