Chatelaine October 2004, Vol. 77 No. 10
Think of a mammogram as a worthwhile ouch. Although this breast cancer screening and diagnostic tool has been around since the 1960s, Dr. Linda Warren Burhenne, provincial chief radiologist of the screening mammography program of British Columbia, says, "Mammography is excellent - the best we’ve got." In fact, the Canadian Cancer Society says women between the ages of 50 and 69 should have a mammogram every two years. Some doctors even recommend an annual mammogram after age 40.
By showing internal breast changes that are too small to feel, mammograms catch cancers early and reduce deaths by up to 40 per cent. Still, some cases of breast cancer get missed and mammograms can also give false positives. Furthermore, cancer specialists say the results aren’t specific enough and can be difficult to interpret, so patients often have to take the test again.
All of this could improve in as little as five years, says Dr. Martin Yaffe, senior scientist in the imaging research program at Sunnybrook & Women's College Health Sciences Centre in Toronto. Dr. Yaffe has been involved in developing digital mammography, which works like traditional x-ray mammography, but records pictures digitally instead of on film. He is very enthusiastic about this and other technologies on the horizon (see chart right). Still, he says, "Any new technique needs to be carefully evaluated." A major study on digital mammography is underway, with results expected in early 2005.
In the meantime, talk to your doctor and have regular clinical breast examinations.
(Chart)
Method: Digital mammography
How it works: Works like traditional x-ray mammography, but records pictures digitally instead of on film.
Experts say: Creates larger, more precise images that can be magnified and manipulated. Makes file storage and sharing easier and telemedicine possible.
Availability: Currently avialable in some cities, possibly for a fee. Will be widely available within five years.
Method: Computer-aided detection (CAD)
How it works: Computers analyse digitized mammograms to flag problem areas. Can be used with both traditional and digital mammography.
Experts say: Helps detect some cancers that radiologists miss. May find 15 to 20 per cent more cancers than mammography alone.
Availability: Currently available in some cities, possibly for a fee. Might be more widely available within five years.
Method: Breast MRI
How it works: Shows the presence of new leaky blood vessels in the breast that are nourishing the tumour.
Experts say: Good for early detection, particularly in women with breast cancer genes. But not for everyone, since it’s expensive and requires an invasive injection.
Availability: Diagnostic centres are incorporating this technique now, although patients may have to wait for MRI time.
Method: Tomosynthesis
How it works: New 3D-imaging technique that could improve detection. May require less breast compression than mammography.
Experts say: A technique that holds promise, especially for women with dense breast tissue.
Availability: Should be available in Canada in two to three years, depending on clinical studies results.
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