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Taking The Mystery Out Of Breast Cancer Screening By Dr. Ranit Mishori Publication Date: 10/19/2008 Related Video The Facts About Breast Cancer Learn more about breast cancer, including important signs and symptoms. Watch now » Many of my female patients feel guilty. They’ve heard that one of the best defenses against breast cancer is a monthly self-examination. But they haven’t done it—out of forgetfulness, lack of time, or fear of what they may discover. Sheepishly, they’ll tell me, “I know I should be checking, but…” Recent research suggests that such guilt may be unnecessary. Self-exams have shown little benefit in reducing death rates from breast cancer. In fact, most medical organizations no longer recommend that women perform them. Which raises the question: What should women be doing to detect breast cancer as early as possible? The answer is critical, says Dr. Elizabeth Steiner, director of the Oregon Cancer Institute’s Breast Health Education Program, because “when we catch breast cancer early, when it is confined to the breast, we can cure it 95% of the time.” Here’s what you need to know about the different screening methods. CLINICAL BREAST EXAM This test puts you, literally, in the hands of an expert. The clinical breast exam involves a doctor systematically exploring your breasts with his or her fingertips—called “palpating”—and searching for small lumps or irregular shapes. To ensure a thorough job, the doctor usually will spend a few minutes examining each breast. Physicians have been performing clinical exams for decades, and they’re still a key component of early detection, especially when done in combination with mammograms. “Clinical breast examinations are 80% to 85% sensitive in women in their 40s,” says Dr. Steiner. “That’s pretty darn good.” So, out of 100 women with breast cancer, hands-on exams will find the disease 80% of the time. The clinical breast exam is an essential part of your annual “well woman” examination. MRI Magnetic Resonance Imaging (MRI) has been touted as a more sensitive diagnostic tool than a traditional mammogram. So, should MRIs be used for annual screening? The answer is no—for most women. Much costlier than a mammogram, an MRI requires the injection of a dye into the bloodstream, which may exacerbate other medical conditions. Also, MRIs done to detect breast cancer result in too many false positives. Right now, “MRIs are recommended only for women at highest risk,” says Dr. Debbie Saslow, director of breast and gynecologic cancers at the American Cancer Society. That includes women with a genetic mutation, a strong family history of breast or ovarian cancer, or a history of radiation to the chest. Patients who fall into any of these categories should get an annual MRI— and a mammogram—starting at age 30. THE BASIC MAMMOGRAM Mammograms have been widely used since the 1960s. They rely on traditional X-ray technology to spot tiny calcium deposits that frequently signal the presence of cancer. “It’s not a perfect test,” says Dr. Joann Elmore, professor of medicine at the University of Washington School of Medicine in Seattle. “In two out of 10 women with cancer, the cancer either will be missed or is not visible.” The procedure also can be uncomfortable and time-consuming. However, a mammogram is still the best tool currently available to detect breast cancer. “It’s the gold standard,” says Dr. Elmore. An annual mammogram is recommended for all women age 50 and over. For women who are 40 to 49, the guidelines are more complicated. Their breast tissue is denser, which leads to more false positives—and often unnecessary follow-up tests, biopsies, medical expenses, and anxiety. For women younger than 40, who have even denser breast tissue, mammograms are not recommended at all—unless there’s a family history of early breast cancer or a recorded genetic mutation. DIGITAL MAMMOGRAM A new generation of mammogram technology—called digital mammography—allows the image taken by your radiologist to be stored on a computer hard drive. That way, it can be viewed and enlarged on a computer screen rather than held up to a lightbox. Many experts hoped that this advance would lead to earlier detection of a greater number of cancers, but a 2005 New England Journal of Medicine study showed that this benefit may apply only to women under 50 and those with dense breast tissue. Computer-Aided Detection (CAD) is another innovation. This method relies on computer software to examine an image and look for patterns so that radiologists can pay more attention to certain areas. But the jury is still out as to whether CAD actually improves the accuracy of a diagnosis. Some evidence suggests that CAD creates more false positives and increases the rate at which patients are called back for follow-up exams. For now, the basic mammogram, though not perfect, is the screening method of choice. SELF-EXAMINATION So what happened to the advice that women were given for years, telling them to check for lumps while dressing or in the shower? Studies found that self-exams did not reduce actual death rates from breast cancer. Too often they were performed incorrectly or not regularly enough, setting off too many false alarms. Still, doctors recommend that women pay attention to their bodies. Talk with your physician to learn which changes may normally occur with your breasts and which changes warrant further attention. If something doesn’t feel or look right, see your doctor immediately—even if you’ve just had a mammogram. Dr. Elmore notes that 40% of new cases of breast cancer are picked up by women or their physicians. If caught early, your treatment may be easier and more effective. http://link.brightcove.com/services/link/bcpid1119311736/bclid196214856/bctid44147265
Study: New way to spot breast cancer shows promise By MARILYNN MARCHIONE, AP Medical Writer2 hours, 1 minute ago A radioactive tracer that "lights up" cancer hiding inside dense breasts showed promise in its first big test against mammograms, revealing more tumors and giving fewer false alarms, doctors reported Wednesday. The experimental method — molecular breast imaging, or MBI — would not replace mammograms for women at average risk of the disease. But it might become an additional tool for higher risk women with a lot of dense tissue that makes tumors hard to spot on mammograms, and it could be done at less cost than an MRI, or magnetic resonance imaging. About one-fourth of women 40 and older have dense breasts. "MBI is a promising technology" that is already in advanced testing, said Carrie Hruska, a biomedical engineer at the Mayo Clinic in Rochester, Minn., which has been working on it for six years. She gave results in a telephone news briefing Wednesday and will present them later this week at an American Society of Clinical Oncology conference in Washington, D.C. Mammograms — a type of X-ray — are the chief way now to check for breast cancer. MBI uses radiation, too, but in a different way. Women are given an intravenous dose of a short-acting tracer that is absorbed more by abnormal cells than healthy ones. Special cameras collect the "glow" these cells give off, and doctors look at the picture to spot tumors. Researchers tried both methods, on 940 women who had dense breasts and a high risk of cancer because of family history, bad genes or other reasons. Thirteen tumors were found in 12 women — eight by MBI alone, one by mammography alone, two by both methods and two by neither. (The two missed cancers were found on subsequent annual mammograms, physical exams or other imaging tests.) Looked at another way, MBI found 10 out of 13 tumors, missing three; mammograms detected three out of 13 tumors and missed 10. Using both methods, 11 out of 13 tumors would have been detected. "These images are quite striking. You can see how the cancers would be hidden on the mammograms," Hruska said. Mammograms gave false alarms — led doctors to conclude that cancer was present when it was not — in about 9 percent of patients, compared to only 7 percent for MBI. The MBI tests led to more biopsies than mammograms did, but they more often revealed cancer. The Susan G. Komen for the Cure foundation and Bristol-Myers Squibb, which makes the imaging agent used in the study, paid for the work. The next test will be to see how MBI stacks up against MRI. The federal government is paying for a new study Mayo is leading that compares the two in 120 high-risk women with dense breasts. MRI is often used now for women with dense breasts, but it gives many false alarms that lead to unnecessary biopsies. Doctors hope MBI will prove more accurate and cost less — under $500 versus more than $1,000 for an MRI. "We all know that mammography is, in and of itself, an imperfect tool, and we clearly need to do better in the future," said Dr. Eric Winer of the Dana-Farber Cancer Center in Boston, a spokesman for the oncology group. "It is fair to say that MRI will not solve all problems either." One drawback of MBI: It uses about 8 to 10 times the radiation of mammograms, a dose that engineers like Hruska are trying to lower with newer technology. Other medical centers also are testing MBI. "We're just beginning to see what this technology can do," she said. ___

PLEASE DO THIS!

PLEASE DO THIS! A favor to ask, it only takes a minute.... Please tell ten friends to tell ten today! The Breast Cancer site is having trouble getting enough people to click on their site daily to meet their quota of donating at least one free mammogram a day to an underprivileged woman. It takes less than a minute to go to their site and click on " donating a mammogram" for free (pink window in the ! middle) . This doesn't cost you a thing. Their corporate sponsors /advertisers use the number of daily visits to donate mammogram in exchange for advertising. Here's the web site! Pass it along to people you know. http://www.thebreastcancersite.com/ AGAIN, PLEASE TELL 10 FRIENDS TO TELL 10 TODAY
IF TOMORROW WAS YOUR LAST DAY STOP AND THINK, IF TOMORROW WAS YOUR LAST DAY, WOULD YOU BE CONSUMED BY WORK OR, TAKE YOUR KIDS AND PLAY? WOULD YOU STILL BE THINKING ABOUT YOUR DREAMS? WOULD YOU SEIZE THE MOMENT AND FORGET YOUR SCHEMES? WOULD YOUR THOUGHTS BE OF WHAT HAS COME TO PAST? WOULD YOU SQUEEZE EVERY SECOND AND TRY AND MAKE IT LAST? TAKE THE TIME EACH DAY, TO SEE THE BEAUTY THAT’S BEEN GIVEN YOU. TAKE THE TIME TO BE THOUGHTFUL AND HELPFUL IN ALL YOU DO. TOO MANY DAYS ARE WASTED BY WORRY’S OF TOMORROW AND REGRETS OF THE PAST. YESTERDAY IS A MEMORY AND THE TOMORROWS COME WAY TOO FAST. TAKE TIME TO REFLECT EACH DAY, OF BLESSINGS IN YOUR LIFE. BE THANKFUL OF A HOME TO LIVE IN, FRIENDS, FAMILY, A HUSBAND OR A WIFE. DON’T DWELL ON POSSESSIONS THAT YOU WANT OR, THAT YOU’VE BOUGHT. ON YOUR LAST DAY HERE ALIVE, YOU’LL FIND, THAT THEY WON’T MEAN A LOT. IF YOU THINK, YOU DON’T HAVE A LOT OF WEALTH EVER THINK, OF SOMEONE DYING WISHING THEY HAD YOUR GOOD HEALTH. WHEN, YOU’RE WISHING FOR THAT NEW HOME OR A NEW CAR. SOMEONE’S OUT THERE HOMELESS WISHING, THEY WERE WHERE YOU ARE. WHEN, YOU PASS THAT BEGGAR ON THE STREET, BE THANKFUL, YOU’RE NOT GOING WITHOUT ANYTHING TO EAT. STOP AND THINK, WHAT’S IMPORTANT AND WHAT DOESN’T MEAN A THING OVERLOOK A BAD MOMENT BE THANKFUL OF THE GOOD EACH DAY BRINGS AND IF TOMORROW, THIS LIFE WOULD COME TO END, YOU’VE TRULY BEEN BLESSED IF, YOU HAVE GOOD FRIENDS Chris
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