Exams That Dont Use Radiation Are Not A Substitute For Mammography Screening
While mammography uses X-rays to produce images, there are other breast imaging exams that dont use radiation. The FDA issued a warning last year about thermography, which uses an infrared camera to show patterns of heat in the body. Some health spas and alternative health clinics had been promoting this technology as a method of breast cancer screening, but the FDA stated that, There is no valid scientific data to demonstrate that thermography devicesare an effective screening tool for any medical condition including the early detection of breast cancer.”
Ultrasound is often used in breast cancer screening, but not as a standalone tool. Its most often used as a follow-up exam to obtain additional information about suspicious features found on a mammogram. Likewise, breast MRI is often used as a supplementary screening tool for women who have an elevated risk of breast cancer. Abbreviated breast MRI is an exciting new screening method that helps radiologists find hard-to-detect cancers in women with dense breast tissue who dont have an elevated cancer risk. Despite the high sensitivity of MRI exams, however, women who receive them are still advised to undergo mammography for primary breast cancer screening.
False Positives And Follow
Sometimes a screening mammogram shows something abnormal that might be cancer but turns out not to be cancer. This is called a false positive result.
If your mammogram shows something abnormal, youll need follow-up tests to check whether or not the finding is breast cancer.
If you have an abnormal finding on a screening mammogram, its normal to be concerned. However, most abnormal findings are not breast cancer .
Learn more about follow-up after an abnormal mammogram.
How Does The Procedure Work
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. The technologist carefully aims the x-ray beam at the area of interest. The machine produces a small burst of radiation that passes through your body. The radiation records an image on photographic film or a special detector.
Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of the radiation while soft tissue allow more of the x-rays to pass through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray, and air appears black.
Most x-ray images are electronically stored digital files. Your doctor can easily access these stored images to diagnose and manage your condition.
In conventional film and digital mammography, a stationery x-ray tube captures an image from the side and an image from above the compressed breast. In breast tomosynthesis, the x-ray tube moves in an arc over the breast, capturing multiple images from different angles.
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Low Radiation Doses Are Not Associated With Negative Health Effects
While medical imaging providers always err on the side of caution by keeping radiation doses as low as reasonably achievable , the evidence doesnt support the notion that low levels of radiation exposure increase ones cancer risk. Studies of people who have been exposed to radiation through medical imaging, occupational exposure, and increased environmental exposure have found increased cancer risk associated only with doses above 100 mSv. In fact, many researchers cite evidence that low doses of ionizing radiation may provide some protection against cancer, a phenomenon known as hormesis.
What Are Some Common Uses Of The Procedure
Mammograms are used as a screening tool to detect early breast cancer in women experiencing no symptoms. They can also be used to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain, skin dimpling or nipple discharge.
Screening MammographyMammography plays a central part in early detection of breast cancers because it can show changes in the breast years before a patient or physician can feel them. Current guidelines from the American College of Radiology and the National Comprehensive Cancer Network recommend screening mammography every year for women, beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.
The ACR and the National Cancer Institute also suggest that women who have had breast cancer, and those who are at increased risk due to a family history of breast or ovarian cancer, should seek expert medical advice about whether they should begin screening before age 40 and the need for other types of screening. If you are at high risk for breast cancer, you may need to obtain a breast MRI in addition to your annual mammogram.
See the Breast Cancer Treatment page for information about breast cancer therapy.
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Perceptions Of Mammography Benefits Vs Reality
In a survey of U.S. womens perceptions of mammography, 717 of 1,003 women said they believed that mammography reduced the risk of breast cancer deaths by at least half, and 723 women thought that at least 80 deaths would be prevented per 1,000 women who were invited for screening. However, based on U.S. mortality statistics, screening mammography prevents approximately one death per 1,000 women screened. Due to the influence of mammography propaganda, womens perceptions of the effectiveness of mammography are overly optimistic and not even remotely a reflection of the true efficacy of mammography for preventing breast cancer deaths .
Research also shows that women who are better informed about the risk of overdetection and overdiagnosis of breast cancer associated with mammography screening are less likely to participate in mammography screening 60123-4/abstract” rel=”nofollow”> 20).
How Does Breast Density Affect Mammography
Young women have a higher proportion of glandular and fibrous tissue compared to fatty tissue. These tissues appear dense and have a light grey or white appearance on a mammogram, while fatty tissue appears darker. Cancers also appear light grey or white so this can make them more difficult to detect amongst the background tissue. This is why mammography is not routinely used for breast screening in young women under the age of 40 .
The proportion of dense glandular tissue naturally declines after menopause making mammograms easier to read. However, women taking hormone replacement therapy have higher breast density, making mammography results less accurate. Annual screening is recommended in this group.
Women with high breast density may also be recommended to have annual rather than two-yearly screening.
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If You Have A Gene Mutation
If you have had tests that showed a change in a gene that increases the risk of breast cancer, the recommendations are slightly different.
UK guidelines recommend yearly MRI scans from:
- age 20 for women with a TP53 mutation
- age 30 for women with a BRCA1 or BRCA2 mutation
How Is The Procedure Performed
Mammography is performed on an outpatient basis.
During mammography, a specially qualified radiologic technologist will position your breast in the mammography unit. Your breast will be placed on a special platform and compressed with a clear plastic paddle. The technologist will gradually compress your breast.
Breast compression is necessary in order to:
- Even out the breast thickness so that all of the tissue can be visualized.
- Spread out the tissue so that small abnormalities are less likely to be hidden by overlying breast tissue.
- Allow the use of a lower x-ray dose since a thinner amount of breast tissue is being imaged.
- Hold the breast still in order to minimize blurring of the image caused by motion.
- Reduce x-ray scatter to increase sharpness of picture.
You will be asked to change positions between images. The routine views are a top-to-bottom view and an angled side view. The process will be repeated for the other breast. Compression is still necessary for tomosynthesis imaging in order to minimize motion, which degrades the images. During screening breast tomosynthesis, two-dimensional images are also obtained or created from the synthesized 3-D images.
You must hold very still and may need to hold your breath for a few seconds while the technologist takes the x-ray. This helps reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.
The examination process should take about 30 minutes.
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If You Are Called Back
Around 4 out of 100 women are called back for more tests. If this happens, you might feel very worried. But many of these women wont have cancer.
If you are called back because your mammogram showed an abnormal area, you might have a magnified mammogram. This can show up particular areas of the breasts more clearly. These mammograms show the borders of any lump or thickened area. They can also show up areas of calcium .
You might also have an ultrasound scan of the breast or a test to take a sample of cells from the abnormal area
Conflicts Of Interest And Mammography Recommendations
There is significant bias in the medical literature regarding mammography. This has led to significant breast cancer overdiagnosis and overtreatment, while also significantly influencing womens perceptions about the purported effectiveness of mammography.
A literature review of 171 articles in the journal Evidence-Based Medicine found that a significant number of studies examining the effectiveness of mammography were published by interest groups and authors with vested interests in mammography screening. Scientific journal articles on breast cancer screening written by authors who have a vested interest in the practice of mammography tend to emphasize the potential benefits of mammography, while downplaying or outright rejecting the major harms such as overdiagnosis and overtreatment. Authors may have a vested interest in promoting mammography if they are receiving income from mammography screening programs or if they are contributing to scientific journals tied to political interest groups such as the American Cancer Society, which has financial ties with the makers of mammography equipment .
Due to conflicts of interest, the research being used to develop recommendations for mammography screening protocols is biased and is not a true representation of the efficacy of mammography for reducing breast cancer mortality. This has had a large-scale impact on the development of mammography screening programs 00393-3/abstract” rel=”nofollow”> 18).
Pain And Skin Changes
During and just after treatment, your treated breast may be sore. Talk with your health care provider about using mild pain relievers such as ibuprofen, naproxen or acetaminophen to ease breast tenderness.
The treated breast may also be rough to the touch, red , swollen and itchy. Sometimes the skin may peel, as if sunburned. Your health care provider may suggest special creams to ease this discomfort.
Sometimes the skin peels further and the area becomes tender and sensitive. Its most common in the skin folds and the underside of the breast. If this occurs, let your radiation team know. They can give you creams and pads to make the area more comfortable until it heals.
Fatigue is common during radiation therapy and may last for several weeks after treatment ends.
Fatigue is mainly a short-term problem, but for some, it can persist .
You may feel like you dont have any energy and may feel tired all of the time. Resting may not help.
Regular exercise, even just walking for 20 minutes every day, may help reduce fatigue . Getting a good nights sleep is also important.
Talk with your health care provider if you are fatigued or have insomnia .
Learn more about fatigue and insomnia.
Screening Mammograms Do Not Correlate To A Lower Death Rate From Breast Cancer
A meta-analysis published in 2013 explored the findings of seven studies of the efficacy of using mammography to reduce the rate of death from breast cancer. These studies involved six hundred thousand women from the age of thirty-nine to seventy-four. The authors conclusions are a bit disturbing:
Subjects of some of the studies included in the analysis were not adequately randomized and were biased in favor of screening
-The trials that did fully meet scientific standards found no effect on death rate from breast cancer for women who were routinely screened using mammography versus those who were not
-The numbers of radiation treatments and surgeries were significantly higher for women who underwent mammograms
Breast cancer mortality is an unreliable outcome measure in screening trials and exaggerates the benefit.
A study published in The British Medical Journal a year later supported these conclusions. Furthermore, the authors compared breast cancer mortality with mammography and without : the results were virtually identical.
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A Brief History Of Mammography
Mammography screening for breast cancer was first introduced in the late 1970s, and by the early 1980s, it had been widely incorporated into clinical practice. Prior to the widespread use of mammography, breast cancer detection tests were primarily based on breast self-exams and clinical breast exams performed by physicians. In the very early days of mammography, this test was used only in women at high risk for breast cancer this included women who had a previous history of breast cancer, had a mother or sisters with breast cancer, or were over 50 years of age.
Fast-forward to the present day, and it is quite apparent that the use of mammography has increased dramatically. According to recent data, 66.8 percent of women over the age of 40 have had a mammogram within the past two years, an average of 15 million physician office visits have taken place per year in which a mammogram was either ordered or performed, and an additional 3 million outpatient visits have ordered or performed mammograms .
Could mammography screening do more harm than good? #breastcancer
Changes To The Reconstructed Breast
If you have a breast reconstruction using an implant, radiotherapy can cause the reconstructed breast to become firmer, change shape or become uncomfortable. You may hear this called capsular contracture.
If you have a breast reconstruction using your own tissue , radiotherapy can cause the tissue of the reconstruction to change shape or shrink.
If you notice changes to your reconstructed breast talk to your breast surgeon or breast care nurse.
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The Downside Of Mammograms
Mammography has been the medical industrys gold standard breast cancer screening tool for nearly four decades, and the procedure has been pushed on women with great zeal by physicians, public health programs, and cancer organizations. However, mounting scientific evidence indicates that mammography may not only be far less effective than we have been led to believe, but that it also has numerous drawbacks that are affecting women on a massive scale. Read on to learn about the major drawbacks of mammography, what the research recommends for breast cancer screening, and about promising breast cancer detection alternatives.
Coping With Emotional Side Effects
Daily radiation therapy treatments can trigger many different emotions. Fear, anger, or sadness can come up at any point in treatment. Coming to the treatment center every day can be a regular reminder of your diagnosis, fears about cancer coming back, and for many people, the entire cancer experience. In other words, it can feel overwhelming.
Fortunately, there are ways to get the treatment you need and still have some balance in your life. Katharine Winner, MSW, LSW, who works closely with radiation oncologists to provide emotional support to people receiving radiation therapy, says, âItâs important to find a balance between treatment and everyday life, when possible, to help maintain a sense of normalcy. We can help arrange your schedule to accommodate the important things outside of treatment: work, time with family, self-care.
We want to help find the best way to realign your schedule to accommodate radiation. Thereâs a reason why youâre doing radiation: to treat the cancer and prolong your life. Our goal is that treatment doesnât stall your life and that you can still do the things you love and enjoy doing. See how you can reschedule yourself to get a good balance for getting through treatment.
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What Is Breast Screening
Cancer screening involves testing apparently healthy people for signs that could show that a cancer is developing.
Breast screening uses a test called mammography which involves taking x-rays of the breasts. Screening can help to find breast cancers early when they are too small to see or feel. These tiny breast cancers are usually easier to treat than larger ones.
It is important to remember that screening will not prevent you from getting breast cancer but aims to find early breast cancers.
Overall, the breast screening programme finds cancer in around 9 out of every 1,000 women having screening.
Screening For Women At Higher Risk
You can have screening from a younger age if you have a higher than average risk of breast cancer. This might be due to a family history or an inherited faulty gene.
Speak to your GP if you think you might be at increased risk. They can refer you to a genetic specialist, who can assess your risk. Not everyone with a family history of cancer is at increased risk themselves.
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How Long Do Side Effects Last
Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.
Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.