New,Technologies,Breast,Imagin health New Technologies in Breast Imaging


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Accurate breast imaging technologies have been a hot political issue inthe world of medicine for the last decade. With the re-evaluation of theeffectiveness of mammograms by the American Cancer Society in 2009, expertshave begun to debate whether mammography is indeed a flawed technology,providing less than accurate diagnostic information in many cases. In addition,annual mammograms subject the patient to damaging levels of radiation and oftensteep health care bills. The heart of this issue is not modern medicine'spolitics and practices, but rather how to detect breast cancer in the majorityof women early enough to save lives. Deborah Rhodes, a physician at the Mayo Clinic, became passionatelyinvolved in the field of breast imaging technology when one of her pregnantpatients found a breast lump, which fortunately was benign. The patient posedthe question of how she would be able to know if any future mass was benign ormalignant? How confident was Dr. Rhodes that any tumor would be found on amammogram in this young woman? This began a journey of partnership between members of a number ofdisciplines, putting their heads together in order to adapt existingtechnologies for more accurate breast imaging. What these researchers came upwith was a technique called Molecular Breast Imagining (MBI). Although still in the testing phase, MBI uses gamma technology andpromises to be a very important imaging option because of its accuracy forwomen who have dense breasts; its use of a radioactive tracer – which is takenup by rapidly dividing cells, leaving normal cells alone, and uses themolecular characteristics of tumors which highlight abnormal tissueirrespective of breast density; and its use of pain-free compression to obtainimages. For more information about breast health and treatment options, downloadmy complimentary breast cancer wellness guide here.   One crucial fact for women to know before they opt for a mammogram isthat the higher your breast density, the lower the accuracy of your mammogram.This is a fact that has fueled the controversies over what age is mostappropriate to begin screening women with mammography. Of women in the 40-50age range, two thirds tend to have dense breast tissue, as do women usinghormone replacement therapy, as well as one-third of women who arepostmenopausal. As women age, the breast tissue tends to become less dense andmore fatty, making mammograms more accurate for these women. Breast density tends to be genetically determined. High breast densityitself is a greater risk factor for breast cancer than having a mother orsister with breast cancer. Although this information is very important, it hasnot been widely discussed and patients are rarely informed of the healthimplications of their breast density. Both tumors and dense breast tissue appear white on a mammogram, soit's very difficult to distinguish between the two. According to Dr. Rhodes,mammograms find over 80 percent of tumors in fatty, low-density breasts but asfew as 40 percent in extremely dense breasts. Even the much-acclaimed advent ofdigital technology has not shown an increase in accuracy over traditionalmammography, except in the group of women under age 40 with dense breasts. Inthis group, mammograms still found only 60 percent of breast lesions. We have essentially two groups of women—women who mammography workswell for and women for whom it does not. This issue has been highlypoliticized. So much so that the findings of Dr. Rhodes team were initiallyrejected for publication by four major peer reviewed journals, and finallyafter challenging possible vested interest interference, accepted by theJournal of Radiology. If you can detect a tumor when it is less than one centimeter, chancesfor survival are 90 percent. MBI can find tumors as small as 3 mm, and MBIfinds three times more tumors than mammography can detect in women with densebreasts. In a recent comparative study of 1,000 women with dense breasts,mammography found 25 percent of breast tumors, and MBI found 83 percent ofbreast tumors. Needless to say, this is a huge difference in accuracy. Other technologies that are currently available include ultrasound,which is noninvasive but has a high false negative rate, generating morebiopsies that turn out to be benign. MRI generates over a thousand images,which makes it very sensitive, but very expensive to interpret. If used toscreen the average young woman it would cost ten times what a digital mammogramcosts. The health care system cannot afford to offer this method as a generalscreening modality. Either of these may be appropriate for you aftermammography if you need or want further imaging and/or have other risk factorsthat increase your breast cancer risk. Thermography is another technology that uses thermal imaging of breasttissue to show abnormal vascularity and heat patterns. This can be provide veryuseful information but may also miss small or slow growing tumors. The fact of the matter is we desperately need new imaging technologies.The MBI imaging system, which has already been FDA approved, can fill in thatcrucial gap in accuracy for women with dense breasts. Experts are estimatingfive more years before it is widely available. MBI technology, as exciting asit is, still exposes the breast to radiation equaling the dose of one digitalmammogram.  With that mind, there are a few things you should know. Know yourdensity – ask your practitioner or get a copy of your last mammogram. If youare premenopausal, schedule a mammogram in the first half of your menstrualcycle when your breast tissue is less dense. Consider adding thermography asanother screening modality. Screening should be individualized based on breastdensity and other risk factors. Discuss having additional imaging with yourhealth care provider, especially if you feel there is something unusual in yourbreast. Hopefully researchers in this field can help work towards thedevelopment of screening technologies that do not involve radiation to thebreast. There needs to be more freedom and less politicization of women'sbreast imaging by mainstream medicine. Thermography should be much more widelyresearched, so we have better understanding of its potential strengths andweaknesses. None of our current breast imaging technologies can provide everythingwe need in a screening tool. None are both accurate enough and safe enough, soit's important to understand all of available options for a comprehensivebaseline screening that is as close to accurate as possible. For this reason, Iwelcome you to download my wellness guide,which provides critical information about breast health diagnosis andtreatment. It is my hope that this information can offer valuable guidance forwomen of all ages in their quest for better breast health, naturally.

New,Technologies,Breast,Imagin

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