Thursday, December 2, 2010

Screening for Breast Cancer

Mammography has been the "gold standard" for detection of breast cancer, and with fears of breast cancer taking the forefront in many women's minds today, the medical industry continues to push the use of mammography for prevention and early detection of this deadly disease. But we need to take a closer look at this concept.

Mammography does not prevent breast cancer, but the earlier breast cancer is detected, the greater the woman's chances of survival. That much is clear. However, mammographic x-rays fail to detect as much as 20 percent of breast cancer in women over 50, and as much as 40 percent in younger women. Other major drawbacks include the invasive use of radiation, which is a known carcinogen. With the annual exposure to ionizing radiation, coupled with the mechanical pressure on breast tissue, the safety of mammography is more than questionable. Another critical factor to consider is that, on average, breast tumors must have been growing eight to ten years before they can be picked up by mammography.

The value of mammography is in its ability to detect masses as well as tiny calcifications that are often present in an area of abnormal tissue. These calcium deposits often appear at sites of chronic inflammation, which can be a precursor to cancer. Other detection methods do not show these microcalcifications.

Are there alternative or additional imaging methods that can complement mammography? Luckily, yes. Thermography, a non invasive, 100-percent safe procedure that registers the infrared heat waves omitted from the breasts can be useful in the early detection of abnormal physiological patterns that can suggest breast cancer, or indicate a higher risk physiological pattern that could eventually become breast cancer later in life. I have used thermography as an adjuvant tool in my practice for quite some time. Based on my clinical experience I many times prefer to use thermography as my ongoing imaging procedure for early detection, as well as a way to assess my treatment protocol. Since thermography is a physiological dynamic assessment, improvement in systemic patterns such as estrogen/progesterone imbalance or 2OH/16OH estrogens imbalance will many times be reflected in an improved thermographic reading. These changes are not typically seen in mammography.

For younger women with dense breast tissue, mammography is much less accurate than later in life when breast density is reduced. Thermography can play a valuable role because women can start thermographic screening in their 20’s and 30’s as a baseline which can be compared with their results as they age.

Breast ultrasound is another non-invasive method of assessing breast tissue. Sound waves are used to detect the difference between a cystic (or fluid-filled) “mass” and a solid mass. Cystic masses are most often benign. A solid mass is often benign, but sometimes, it can be malignant. In this case, further testing is needed. A new technique, called elastography, is currently being added to ultrasound computer software. Measurements are taken during the ultrasound procedure that detects differences in the consistency of a detected solid mass, the firmness or “stiffness” of the tissue. These changes have a fairly high accuracy in predicting abnormal as opposed to normal solid tissue. Elastography increases the detection capabilities of traditional ultrasound techniques.

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