A new era of radiation-free breast cancer screening has arrived

Ultrasounding the Alarm

It’s usually pretty dull business at the annual meeting of the Radiological Society of North America. Radiology this. CAT scans that. Big yawn. But this year several fist fights broke out, vicious shouting matches erupted here and there, and a number of meeting attendees were seen weeping openly.

Okay, truth is, I don’t know if any of that actually happened. But if it did, who would be surprised?

The 2009 RSNA meeting opened just two weeks after new mammogram recommendations exploded in the media. And in the wake of the emotional outpouring from TV pundits on this issue, it’s easy to imagine tempers running high during presentations, panel discussions, etc.

For instance, Marijke C. Jansen-van der Weide, Ph.D., might have had a hard go of it after informing the meeting that low-dose radiation from mammography puts some women at higher risk of cancer.

Yikes! They don’t generally encourage that kind of talk at RSNA.

The RSNA press release about the study stresses that the risk was only seen in women with a family history of breast cancer and those with a breast cancer gene mutation.

Of course, the problem is that if you ARE in one of those high-risk groups, then you’ve probably been encouraged to get mammograms starting at a young age. And that, says Dr. Jansen-van der Weide’s study, is where the danger starts.

What to do?

The press release offers this suggestion: “Alternative screening methods such as ultrasound and MRI may be made available to younger women, but are generally used as an adjunct to mammography.”

Alternative screening methods? Imagine that!

Staying flexible

Speaking of ultrasound…

Another study presented at the RSNA meeting showed that a relatively new diagnostic method called elastography vastly improves the results of breast ultrasound images. This is a big deal for two reasons:

1) No radiation. (How the heck did zero-radiation guys get into the annual RSNA party?)

2) It could drastically reduce the need for biopsies.

Around one million breast tumor biopsies are performed each year. And about 800,000 turn out to be benign. A two-in-ten success rate is a pretty dreadful record. Especially considering that biopsies are often expensive and cause considerable anxiety while patients wait days, sometimes weeks for the results.

Ultrasound can detect tumors, but can’t confirm malignancy, so the next step is biopsy. But when elastography is used with ultrasound, everything changes because tumor flexibility can be detected. Benign tumors are softer and much more flexible than cancerous ones.

In the study presented at RSNA, elastography/ultrasound detected 98 percent of malignant tumors in nearly 180 breast cancer patients.

Time will tell if this really is a new era in radiation-free breast cancer diagnosis. We can only hope! Meanwhile, in tomorrow’s Week in Review e-mail, I’ll tell you about an excellent article that discusses thermography, another safe alternative for breast cancer screening.

To Your Good Health,

Jenny Thompson

Sources:
“Mammography May Increase Breast Cancer Risk in Some High-Risk Women” Press release of the Radiological Society of North America, 21/1/09, eurekalert.org
“Elastography Reduces Unnecessary Breast Biopsies” Science Daily, 12/1/09, sciencedaily.com