Latest News About Detecting and Treating Breast Cancer
You have probably heard that early detection significantly improves breast cancer survival rates, and that the National Cancer Institute advises mammograms are key to early detection. The American College of Radiology (ACR) reports mammography has helped reduce breast cancer mortality in the U.S. by nearly one-third since 1990.
“Mammography is the key to early diagnosis, which dramatically improves outcomes,” says Catherine Appleton, MD, Washington University breast radiologist at the Siteman Cancer Center.
“But it is not a preventive treatment. Even today, threefourths of the women diagnosed with breast cancer have no family history of the disease and are not considered high risk. It is important to follow screening recommendations.”
Who should get a mammogram?
Current guidelines are:
• Women age 40 and older should have screening mammograms every year.
• Any woman who has a lump or notices changes in her breast should be evaluated by a health care provider.
• Women who are at higher than average risk of breast cancer (for example, because of a family history of the disease or because they carry a known mutation in either the BRCA1 or the BRCA2 gene) should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.
Annual mammograms can detect cancer early — when it is most treatable. In fact, mammograms might show changes in the breast years before a patient or physician can feel them. Early detection can help prevent or minimize the need for extensive treatment for advanced cancers and improve chances of breast conservation.
“Of course there can be minor discomfort during a mammogram,” Dr. Appleton says. “But it is temporary and well tolerated. To minimize discomfort, I advise patients to avoid being screened right before their menstrual period, since that’s when breasts are particularly sensitive. However, if you are symptomatic, do not delay evaluation.
“Many women worry about a positive diagnosis, while some worry about getting recalled when there is really nothing wrong (a false positive),” she says. “False positive screening exams do happen; however, only 10 percent of women are recalled from a screening exam. Of those recalled, overwhelmingly, most will be told everything is fine. Only a few per thousand will actually be diagnosed with cancer. So even though it may be scary, odds are, you will be told all is fine.”
While a traditional mammogram continues to be the recommended procedure for routine patient screenings, new technologies continue to be tested including:
• Digital mammography that uses digital technology to create an electronic image of the breast which is stored as a computer file. Advantages of digital mammography include post-processing by the radiologist (it can be enhanced, magnified, or manipulated for further evaluation more easily than information stored on film) and it can be more easily shared by physicians.
• Clinical trials of diagnostics are being conducted to evaluate magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning.
How to get a better mammogram
Dr. Appleton is collaborating with Washington University researchers including Lihong Wang, PhD, to evaluate entirely new technologies, including photoacoustic tomography that combines light and sound to create less invasive, more accurate diagnostic images and new treatment options. “However the thing to remember is to come for your mammogram, and stay informed about current, sometimes changing, guidelines,” Dr. Appleton says. Breast screening has evolved tremendously during the past two decades, and is a radiology specialty. For this reason, Dr. Appleton advises women to seek a facility like Barnes-Jewish West County Hospital that performs a significant number of mammograms and offers a continuum of care.“Radiologists who specialize in this area are better at reading film,” she says. “And technologists at high volume facilities are better prepared to position patients to get the most accurate images.”
To schedule a mammogram at Barnes-Jewish West County Hospital, call (314) 542-9378.