Ask virtually any woman who has undergone a mammogram this question: Do you think there could be a better screening technique? Her answer would probably be a resounding yes. Surely, there must be something slightly less draconian than the vice-like mammography machine and the use of X-rays to clarify internal structures of the breast.
And even if mammography must stick around, women ask if there is a way to make it more precise.
There have been many instances in which mammography has failed to detect tumors in those with dense breast tissue. Because tumors and the dense breast tissue of younger women both appear white on a mammogram, doctors sometimes miss cancers-in-development.
As it turns out, there is progress on multiple fronts to improve screening and diagnostics for breast cancer.
Computer technology is being developed to improve the use of mammography. Further down the road, minimally invasive tests, which are being researched, will seek out biological markers for breast cancer in blood or other fluids long before a tumor takes hold. With an emphasis on biomarkers, doctors say, mammography could become a technology of the past.
“Mammography does not detect all breast cancers and it cannot distinguish well among the various kinds of breast cancer,” said Fran Visco, president of the National Breast Cancer Coalition, an advocacy group for breast cancer patients with headquarters in Washington. What Visco and other advocates would like to see is a screening technique that is more precise and ultimately eliminates the use of radiation.
At the Era of Hope breast cancer conference held recently in Atlanta, researchers presented data on the progress of computer-aided diagnosis, or CAD. The meeting attracted hundreds of scientists, doctors and patient advocates, and was sponsored by the U.S. Department of Defense’s breast cancer research program.
CAD does not eliminate the use of radiation in screening, but it provides enhanced computerized pictures of breast tissue already imaged mammographically. The technology can help doctors spot early-stage breast cancers, which might otherwise go undetected. It works this way: At a CAD workstation, a laser scanner is used to transform the mammography film into a detailed matrix of digital data. Precision-driven computer programming guides the system’s vision and artificial intelligence to scan the digital matrix. In so doing, it can sift out background images, such as those of normal soft tissue, and emphasize patterns that are most likely to be cancerous lesions.
Suspect areas highlighted by the program are instantly and automatically flagged with arrows. This is what can draw a radiologist’s attention to unusual patterns in a new way, doctors say.
“CAD cannot pick up lesions that are invisible to mammography, but it can compensate for some cases of radiologist oversight,” said Dr. Kunio Doi, professor of radiology at the University of Chicago. “We believe the increasingly positive results with CAD demonstrate it can serve as a ‘second opinion’ for traditional screening mammograms.”
Under a contract from the University of Chicago’s Defense Department grant, radiologists there are now using CAD as a second opinion in a study of all screening mammograms conducted at one Illinois diagnostic radiology facility. Doi and his team of researchers will analyze data from that study after information has been collected for about two years. At that point they will determine whether CAD indeed helps improve detection of breast cancer. Positive results from the study could help speed CAD into more generalized use, researchers say.
For most of individuals, ordering cheap prescription drugs presents benefits not affordable from a local drugstore, including: the greater handiness and wide assortment of products, etc.
Tags: breast, mammography machine, screening