Breast Cancer: Early Detection is Your Best Protection
While October is recognized as National Breast Cancer Awareness Month, it’s important to keep up on advances in the detection and treatment of breast cancer all year long. According to the ACRIN (American College of Radiology Imaging Network) death rates from breast cancer have been declining as much as 28% since about 2005, with larger decreases in women younger than 50. These decreases are believed to be the result of earlier detection through screening and increased awareness, as well as improved treatment.
Education, awareness and new strides in technology play a major role in the increased survival rate for breast cancer. You’ve heard it before but truly, Early Detection Is Your Best Protection. The American Cancer Society believes that the use of regular mammograms, the addition of Breast MRI for women who are at high risk and clinical breast exams offer the best opportunity for reducing breast cancer deaths. A combined approach is clearly better than any one test.
Sun Radiology radiologist, Manntej Sra, MD answers some of our basic questions about early detection and recent advances in woman’s imaging.
QUESTION: Who really needs to have a mammogram every year?
Dr. Sra: Women over 40 need an annual mammogram. It’s important to remember that some women who fall into higher risk categories may need this test sooner. Every woman should have a risk assessment through their primary physician to determine if they should be tested before the age of 40. If a woman has a family history of breast cancer or other high risk indications talk to your healthcare provider regarding when you should start getting annual mammograms.
QUESTION: What is the difference between a conventional mammography and newer digital mammography?
Dr. Sra: Digital mammography is newer technology. It works much like a digital camera for photography. There is no film – all images are stored on a computer. The x-rays are converted into electrical signals and produce higher quality images which can be viewed by the radiologist in more detail. Most importantly digital mammography has the ability to better detect cancers of the breast due to the high resolution of the images. This increased image resolution is an especially important advantage for women who have large or dense breasts.
There are also other factors that make digital mammography a better choice. Mammography uses x-rays to create images of the breast. In digital mammography the radiation dose is greatly reduced as compared to conventional analog mammography. For many women a mammogram can be painful. Digital mammography is more comfortable because it requires less pressure or compression of the breast to create the images. Only about 60% of the imaging centers in the United States offer digital mammography. It is important to make sure that the center where you schedule your mammogram is using digital technology.
QUESTION: What is a breast MRI?
Breast Magnetic Resonance Imaging or MRI uses a large magnet, radio frequency and computers to create images of the breasts without the use of radiation.
Question: Is breast MRI a more effective test than mammography?
Dr. Sra: MRIs can better detect some cancers that a mammogram can miss. Recently the American Cancer Society (ACS) recommended that women at high risk (greater than 20% lifetime risk) should get a breast MRI in addition to mammogram every year. Most insurance companies have adopted this recommendation and provide coverage for this exam. Sun Radiology can provide a checklist to determine if you would be considered at high risk or at moderately increased risk and should have both a mammogram and MRI every year. While the MRI is a more sensitive test and more likely to detect cancer than a mammogram, it may still miss some cancers that a mammogram would detect – so the two together provide the best detection.
- Have a mammogram annually after age 40.
- Report any breast changes or pain to your physician and have a yearly clinical examination with your primary care provider.
- Insist on Digital Mammography at a facility where they can provide continuation of care if needed, like Breast MRI, Breast Ultrasound or biopsy procedures. You will also want to be sure a fellowship trained physician interprets your tests.
- Check with your physician to see if you are in a higher risk category that may suggest Breast MRI in addition to the digital mammogram. Those women with strong family history, BRCA gene mutations, or know history of breast cancer should have both a mammogram and MRI to rule out instances of cancer.
Mt Sinai J Med. 2010 Jul;77(4):398-404.Mammographic screening for breast cancer: 2010. Margolies L. Mount SinaiSchool of Medicine, New York, NY.
Radiology. 2010 Jul;256(1):8-14. Breast cancer screening: from science to recommendation. Petitti DB, Calonge N, LeFevre ML, Melnyk BM, Wilt TJ, Schwartz JS; U.S. Preventive Services Task Force. Department of Biomedical Informatics, ArizonaStateUniversity, Phoenix, Ariz, USA.
Magn Reson Imaging Clin N Am. 2010 May;18(2):155-69, vii. Breast magnetic resonance imaging: current clinical indications. Yeh ED. Division of Breast Imaging, Department of Radiology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Harvard Medical School, 75 Francis Street, RA Building-014, Boston, MA 02115, USA
AmericanCollege of Radiology / American Roentgen Ray Society (2010, January 25). Digital mammography delivers significantly less radiation than conventional mammography. ScienceDaily. Retrieved August 26, 2010, from http://www.sciencedaily.com /releases/2010/01/100121135704.htm