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Tags: mammogram | thermography | breast cancer

Better Ways to Diagnose Breast Cancer

William Maxfield, M.D. By Friday, 20 November 2015 04:56 PM EST Current | Bio | Archive

Lately, there have been reports in the media about changing the recommendations for women regarding screening mammograms. In the past, women were advised to begin getting mammograms age 40, and continue receiving them on yearly basis.

But new data from the American Cancer Society, reported in the October 20, 2015 issue of The Journal of the American Medical Association has amended those recommendations. The new protocol is that women with an average risk for breast cancer begin mammograms at age 55, and then receive them every other year — not every year.

The change is recommendation is based on an increased recognition that medical examinations should be based on the needs of the individual, rather than taking a “one plan fits all” approach, as has been the practice up till now.

Once again, this is a move towards precision medication.

Part of the reason for the change is that with annual screening mammograms, patients undergo a significant amount of radiation exposure. In fact, exposure is greater for younger women because their breast tissue is more dense, and therefore requires more intense radiation to produce a mammogram reading that can be properly interpreted.

This same problem, in my opinion, occurs with women who have been taking hormones and then have a mammogram. This goes all the way back to work that I co-authored in 1971 in The Cancer Research Journal 31, page 166-8, that showed a synergism between estrogen and radiation in production of breast cancer in a rat.

This same type of phenomenon has been noted in women: As we have seen a decrease in the use of estrogen therapy for breast problems, the incidence of breast cancer has dropped significantly. Data that we reported showed that with both estrogen exposure and radiation exposure, the time to develop breast cancer was decreased by 50 percent and the number of breast cancers increased by 50 percent.

The other problem with screening mammograms is that they result in a significant number of procedures, such as breast biopsy that come back with negative results. In fact, in the United States only about 20 percent of breast biopsies based on mammograms report a malignancy. That means, of course, that 80 percent come back negative.

Those are factors that need to be taken into consideration, especially when there are other, safer methods than mammograms for diagnosing breast cancer.

We should increase the use of breast ultrasound as an adjunct to mammography. There has also been a resurgence in the use of thermography, a procedure that measures heat production from the breast as a way of evaluating and screening for cancer — without exposing the breast to radiation.

Another fact that I used was nuclear medicine studies to evaluate dense breast tissue. By using the nuclear medicine breast scan in combination with mammography, my positive biopsy rate was 65 percent and indeterminate rate was 12 percent, making my true negatives only slightly more than 20 percent. In other words, the results were the opposite of those when mammograms alone were used to determine whether or not a biopsy was necessary.

These changing trends, again, are part of the movement toward precision medication and developing medical procedures that suit the individual patient and not one recommendation fits all.

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Lately, there have been reports in the media about changing the recommendations for women regarding screening mammograms.
mammogram, thermography, breast cancer
Friday, 20 November 2015 04:56 PM
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