Nov 11, 2008 10:02 am US/Eastern
HealthWatch: Breast Cancer Detection Technology
CBS 2's Dr. Max Gomez Has Important Information Regarding The Best Available Detection Options
NEW YORK (CBS) ―
Mammography can help save lives, but it is not a perfect test. Other screening techniques could be life-saving for millions of women. But should your doctor use them? And if so, when?
Mammograms are very good at finding early breast cancer in older women, especially after menopause when most breast cancer occurs.
But for younger women with denser breast tissue, mammography is not as effective. That is where MRI's, sonograms or ultrasound, and a very new test called a PET scan, can play a role.
Donna Spence is a survivor; ten years ago she had breast cancer, then came a 2 year tour of duty in Iraq, and now breast cancer again.
"I had a recurrence of cancer… it was the same breast, almost the same spot. I found the lump on both occasions and I went for a mammogram," said Spence.
Mammograms are still the best way to find early breast cancer, but because of Ms. Spence's history, she also had a test that looks like a mammogram but is actually something called a PEM scan, for positron emission mammogram.
It's a variation on total body pet scans which look for hot spots that are more metabolically active, a hallmark of cancer.
"We can actually look and see if there are more than one tumor, whether or not there is a tumor in the other breast, whether or not some of the lymph nodes are involved," said Dr Craig Sherman of Manhattan Diagnostic Radiology.
But PEM scans are expensive, require an experienced center and specialized equipment.
That's why if a mammogram turns up something suspicious, the first step is often an ultrasound of the breast. A sonogram is good at telling the difference between a fluid filled cyst and a solid mass, which could be cancer.
Another technology that helps find cancer is a breast MRI. Although it is also an expensive and specialized option, it is effective in finding tumors that may be missed with mammograms.
"Clearly if you are dealing with more than one tumor, it will determine weather or not you have lumpectomy, mastectomy or even bilateral surgery," said Dr. Sherman.
So why not do PET scans or MRI's on everyone?
Because the healthcare system would go bankrupt. Both require expensive, specialized equipment and staff so the tests can run upwards of a $1,000, compared to a couple of hundred for mammograms.
Yet if a lump is felt, but can't be seen on a mammogram or when a cancer has already been found, then the other scans make sense to ensure there's nothing else.
(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)
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