Mammogram saves lives : Dr. Nilesh D. Mehta
Breast Cancer Screening
Breast Cancer : Dr. Nilesh D. Mehta
All over the world, breast cancer is the most frequently diagnosed malignancy, accounting for over a million cases each year. It continues to be the leading cause of cancer death in women worldwide. Value of mammography in lowering the risk of death from breast cancer has been well known for decades.
While the recommendations for screening women for this disease have gone through some changes, screening mammography is currently recommended every 1–2 years for women 40–74 years of age at average risk. It is imperative for the patients to engage in a dialogue and discussion with their physician about the latest in screening guidelines. In the field of Medicine, “one size fits all” does not always work and individualizing recommendations based on risk factors is the key. Those women who have a family history or a higher risk for developing breast cancer need to be screened more frequently than the general population and average risk women. Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. Discussions between patient and their health care provider should occur on a regular basis.
One of the major improvements in screening mammography was the transition from films and images to digital mammography. Another recent major technologic advance has been the availability of Digital Breast Tomosynthesis ( DBT) which is referred to as a pseudo “three-dimensional” mammography technique in which multiple low-dose mammographic images are acquired from multiple angles and are then reconstructed into overlapping thin slices. DBT is being increasingly used as a screening tool for the detection of breast cancer. Two-dimensional (2D) mammography and tomosynthesis can be obtained in a single compression, and synthesized 2D projection images can also be reconstructed from the DBT information. One of the facts that we need to remember is that the radiation dose that a woman would receive is nearly double that of digital mammography alone. However, it remains within the established safe dose limits for radiation exposure caused by the screening test. I would recommend to discuss with your physician to find out what type of mammography is being offered at your hospital. Comparison with previous mammograms is undeniably one of the most important issues before Radiologists issue their reports. Obviously, if there are any new findings or any changes that are suspicious, they would require further testing including possibly a biopsy.
Ultrasound and MRI :
Other modalities which are not screening tests but are often used as adjuncts if a woman is found to have an abnormal screening mammogram. Ultrasound is particularly helpful when fluid filled breast abnormalities ( cysts ) need to be confirmed. Ultrasound does not have any radiation exposure and has the ability to differentiate solid abnormalities from cysts. However, it should not be used as the only test for screening purposes. Magnetic Resonance Imaging ( MRI ) of breast is not a screening test for breast cancer for the average risk population. Depending on the clinical situation, breast cancer specialists may resort to getting additional testing with MRI. If a woman is found to have an abnormal mammogram or ultrasound or MRI, further testing with a diagnostic biopsy procedure is performed.
Mark your calendar :
One tip that I often give patients is to mark your calendar either around birthday, anniversary, or another important event to ensure that screening tests are performed on a timely basis. In addition to breast cancer screening in the appropriate population, women should also discuss with their physicians about their PAP smear ( for screening cervix cancer) and colonoscopy ( for screening of colon cancer).
Screening with mammography saves lives. As a reminder for all of us, October is Breast Cancer Awareness Month and serves to highlight the importance of prevention and early detection of Breast cancer.