Archive for Mammogram
It seems that almost weekly, there is a new study or analysis of a study questioning or extolling the virtues of breast cancer screening. Several decades ago, the medical community was repeatedly encouraging women to get breast cancer screening, all in an effort to lower the death from breast cancer. Treatments were admittedly severe with total mastectomy, radiation therapy causing severe side effects, and harsh chemotherapy.
Breast cancer treatments have come a long way since then, and many women are successfully treated for breast cancer without disfiguring surgery or devastating radiation and chemotherapy. We may be tempted to attribute this improvement of treatment with earlier detection, and that may be the case for many women.
Many advancements include identifying specific cell types and tailoring treatment towards that cell type. This is where some of the controversy has arisen. There’s one type of cancer, called DCIS (ductal carcinoma in situ) that many women have been treated for and perhaps unnecessarily so.
Specialists initially felt this cancer type was as potentially life threatening as any type of breast cancer you may think of. It turns out however that this type is unlikely to ever progress beyond a localized tumor. This has caused many studies and data crunching to evaluate whether mammograms have actually lowered the breast cancer death rate.
It is clear that the final answer is not in yet. I suspect a more stratified evaluation guideline will eventually emerge regarding when and how often to get mammograms, and how having a higher risk for this disease will change that testing algorithm. For now however we are stuck with getting yearly or bi-yearly mammograms. I cannot help but believe that in many circumstances, a mammogram can discover a cancer earlier than it otherwise would have been discovered. In so doing, treatment would theoretically be kinder and gentler than the mastectomies and blasting radiation and chemotherapy of the 70′s and 80′s.
An interesting new study has introduced the use of a modality that is still somewhat controversial within the conventional medical community. It has been considered an alternative testing strategy, but this study raises its value.link to study***
Thermoscans have been around for a while and utilize the heat of blood flow to look for areas of growth within breast tissue. It does not use radiation, but an infrared technology. A growing cancer requires a blood supply that is otherwise not present to that degree in normal breast tissue. There for, an increased heat signal could indicate a growth. This will hopefully become a more accepted screening method within the medical community as it may give different information from standard mammograms.
Regardless of your personal feeling regarding breast cancer screening, it is wise to speak with your provider about your risk factors and determine a schedule and modality that is safe and effective for you.
Mammograms are part of most women’s health screening if they are over 40. Mammograms are never enjoyed, often feared for the information they may give forth; but usually endured on a regular basis. Woman are often relieved, if not happy; when they get their letter stating everything is fine for another year at least. Until now, most women were not routinely told if their breast tissue was dense and may limit the sensitivity of mammogram screening.
Mammograms detect a cancer by evaluating the density of normal breast tissue, and looking for an area of higher density which may represent an area of growth. Normal breast tissue is usually not all that dense by the time we are menopausal, and this is a normal changing associated with age. Any area that appears more dense than most the surrounding tissue is then felt to be abnormal, perhaps suspicious for a cancer. This is one reason that mammograms in younger women are usually not very good at picking up a cancer, as the breast tissue in younger women is usually fairly dense.
There are some women that do maintain density in the breast tissue as they age. Estrogen is one of the causes of breast tissue density, so it stands to reason that late onset menopause can cause breast tissue to remain dense because of prolonged amounts of estrogen in the system. For the same reason taking HRT can also cause breast tissue density. This, in and of itself is not a problem; except for the fact that screening accuracy can be affected.
If you have dense breast tissue, and you are at increased risk for breast cancer; you may want to talk to your provider about different forms of breast cancer screening such as MRI or ultrasound of a specific lump or mass. It is now required in some states that a patient be informed if her breast tissue is dense enough to limit sensitivity of screening.
Mammograms continue to be a useful and sensitive screening tool for detection of breast cancer. Like anything though, it has its’ limitations. They may be painful and a dreaded event; and many specialist would point out the amount of over diagnosis that a false positive mammogram causes. It is up to you and your provider what you do for screening and how often this screening occurs.
What are you doing about mammograms? Is your doctor recommending you get one yearly, every few years, or how often? Does he or she believe in the recent guidelines or do they think you should be screened more often? Anne weighs in with some advice for women in menopause.
What do you think? How should it be done for you? Join in our conversation here. You can find Mammogram guidelines at the National Cancer Institute, and the USPSTF
Become a member, a gift to you from Anne, simply sign up below and follow the instructions emailed to you from Female Menopause Mentors.
There are many ways to evaluate breast tissue for cancer.
Which modality is used in which situations when screening for breast cancer or evaluating a breast lump? Thank goodness we have ways of evaluating for breast cancer. Many women are concerned about the amount of radiation involved in mammograms.
When an area of concern is found,
- what type of study is appropriate to fully evaluate this area?
- d0 we need to do anything at all?
For decades we have had conventional mammography which utilizes X-rays (radiation) to look for areas of increased density within breast tissue. This is how many breast cancers will appear, as an area of increased density within the less dense breast tissue.
Because their breast tissue is already very dense, mammograms are not as useful in young women who find a mass in their breast. It is more difficult to detect a difference in densities. This is one situation where ultrasound is useful.
Ultrasound utilizes sound waves to penetrate breast tissue. These sound waves bounce against different structures and give a characteristic “signal” which can help to determine if a lump or mass is solid or fluid filled. Fluid filled is usually benign, solid CAN be a cancer but may also be a fibroadenoma (a benign problem). Ultrasound is also used in menopausal and post menopausal women to further evaluate a mass, in addition to mammograms.
Digital mammogram is a newer technology with utilizes X-rays as in conventional mammograms, but is analyzed more effectively and gives a greater detail. Many radiology practices use digital mammography for routine screening as it is more exact. Digital mammography generally involves less compression, and is therefore less painful. It does tend to be more expensive but may very well be worth it as there is less follow-up for questionable areas not well seen on conventional mammography.
MRI of the breast. This gives the most detailed picture of breast tissue. The MRI machine is very large and logistically would be unable to screen the numbers of women that are regularly screened in mammography suites. MRI utilizes a magnetic type process and does not involve radiation. It is used primarily in staging of breast cancer or in patients who are at a high risk for breast cancer. It is extremely expensive and unfortunately at this point in time, not practical for mass screening.
It is important to understand the reasons different screening modalities are chosen, and to understand that although mammograms do involve radiation, they are the most practical screening method to use. Many experts report figures that indicate the standard radiation exposure of a mammogram is equal to 3 months of normal environmental exposure. This does not seem like much unless you are someone who has had a lot of radiation already, or have a very strong family history of cancer. It is important to know there are other options of evaluation of breast tissue and it is important to speak with your provider to decide which method is best for you.
What has been your experience with breast cancer screening? Do you have questions about when to do it or how it is done. Let me know in the comments section.
Remember all the controversy about mammograms?
When should a woman begin to have them and how often. It seems that there is no formula in medicine. What is the woman’s risk factors? What sets her up to have a breast tumor? We have written about this topic in posts on Breast Cancer tests for the type of Chemotherapy,
Now there is a news article about the science behind the guidelines. It is confusing when you try to apply a formula and not do what is best for patients. Some women obviously need screening earlier and some can wait. Click on the link to read more about the opinion of a Harvard Radiologist.
We all know that many women in menopause tend to gain weight. There are multiple factors for this that we have documented and some Ways to Eat we recommend to help with this problem. This news article on Weight gain after 50 being related to Diabetes after age 65 is one of a long list of reasons to become an expert on controlling your own eating and exercise habits.
What are your Challenges? Leave us a comment and tell us what you think, want and need.