New Guidelines, Technologies Update Breast Cancer Screening Protocols
For the first time in 25 years, the breast cancer diagnosis rate among women in the U.S. has stabilized, and the number of deaths per year has declined each year since 1990. Yet, breast cancer is still the most commonly diagnosed non-skin cancer for American women. Pathology expert Dr. George Hollenberg offers a step-by-step screening process for most common women's cancer.
Plainview, NY (PRWEB) December 1, 2006 -- For the first time in 25 years, the breast cancer diagnosis rate among women in the U.S. has stabilized, and the number of deaths per year has declined each year since 1990. Yet, breast cancer is still the most commonly diagnosed non-skin cancer for American women; the National Breast Cancer Coalition (www.natlbcc.org) expects nearly 250,000 women to be diagnosed with the disease this year alone. However, before diagnosis, women must first negotiate the ever-changing process of screening tests, which can sometimes be as daunting as diagnostic and treatment procedures.
"Much of the breast cancer research is focused on early and accurate detection through improved screening protocols, and new guidelines and approaches are being instituted based on recent studies and findings," notes Dr. George Hollenberg, MD, a leading pathology expert and founder of Acupath Laboratories in New York. "When followed, these step-by-step procedures are largely pain-free, take little time, and - if they are complied with regularly - can make a significant difference in the types of diagnostic and treatment protocols that may be needed subsequently," Dr. Hollenberg adds.
Changes reinforce patient's role in her own health care
The first step in screening for breast cancer continues to be the patient's knowledge of her own body. However, the American Cancer Society (www.cancer.org) discontinued its recommendation that women perform monthly breast self-exams, noting that the clinical evidence did not support the contention that this practice lowered the risk of breast cancer death. Instead, the ACS encourages women to know their breasts, and to report any perceived changes to their doctors. However, a "clinical" breast exam, one done manually by a physician or other health care practitioner, is still recommended yearly for women over age 40.
An annual mammogram is also recommended for women over 40, with a "baseline" mammogram taken around age 35. However, the National Institutes of Health (www.nih.gov) recently determined that certain women would benefit from the latest advance in mammography, the digital mammogram. "Digital mammography may be appropriate particularly for women under 50, because their breast tissue tends to be denser, and for women determined to be at high risk for developing the disease," Dr. Hollenberg notes, "because it offers an even higher standard of clarity than traditional X-ray mammography."
When manual exams and mammography aren't enough
While clinical breast exams and annual mammograms together form the gold standard of early breast cancer detection, there are times when these screening tools are not enough. A lump may be felt manually, but fail to show up clearly on a mammogram. Breast tissue may be too dense even for a digital mammogram to analyze. Or a suspicious finding on a mammogram may require a more exacting technique in order to identify the physician's next steps. "A number of new technologies now enable us to scrutinize breast tissue and cells - non-invasively, or with very minimal invasiveness - during the screening process," Dr. Hollenberg points out. "This is more comfortable for the patient and promotes a shorter time to diagnosis, staging and treatment, which we know can help with treatment decisions, peace of mind and quality of life for the patient." According to Dr. Hollenberg, the protocol for post-mammography screening includes:
- Ultrasound is most often used after a mammogram reveals something suspicious. "Ultrasound waves can provide better visual evidence as to whether the lump is a solid mass or a fluid-filled cyst," Dr. Hollenberg points out. However, ultrasound cannot detect microcalcifications in the breast - an early sign of disease - and so it is not used as a first-line diagnostic.
- Computer Aided Detection (CAD) uses lasers to allow radiologists to zoom in on certain suspicious areas of a mammogram film. While the patient needn't be present, it allows technicians to scan, computerize and analyze mammogram films for possible signs of cancer.
- Magnetic Resistance Imaging (MRI) provides a 3-D look at the breast, and it is used most often when mammography and ultrasound fail to provide a comprehensive picture of a suspicious lump in the breast. It is also used post-surgery or radiation to evaluate abnormal areas in women already diagnosed with and/or treated for breast cancer. While it is not a first-line diagnostic, MRI can visualize dense breast tissue better than other methods.
- PET Scans are most often used to identify, position and evaluate large or aggressive tumors that have recurred in women previously diagnosed with breast cancer.
- T-Scanners are handheld, 2D imaging devices that doctors can use to pinpoint the location of a possible tumor. It is a follow-up test that is used when mammography or other tests have failed to confirm or eliminate the need for a biopsy. The T-Scanner is moved across the breast to create an image on the computer screen, and tumors show up as white spots on the image.
- Image Guided Breast Biopsies can be performed during many of the above follow-up screening processes, such as ultrasound, MRI and PET scans. As the doctor is viewing the breast tissue using ultrasound or stereotactic (computer generated 3-D imaging) guidance, she can aspirate tissue or fluid from suspicious areas, enabling a pathologist to evaluates them quickly and determine if cancer cells are present.
About Dr. George Hollenberg
Dr. George Hollenberg, M.D. is an authority in the fields of pathology, clinical pathology and dermatopathology with expertise in the areas of dysplastic nevi, melanoma, prostate and gastrointestinal cancer. Board-certified in Pathology and Dermatopathology, Dr. Hollenberg is a Fellow of the College of American Pathologists, The American Society of Dermatopathology and the AMA. He has published articles on skin, prostate and gastrointestinal cancer, and is the Consultant in Dermatopathology to The North Shore University Hospital Center. As the founding director of Acupath Laboratories, Inc., Dr. Hollenberg supervises the analysis of tens of thousands of biopsies per year, using the latest cutting-edge technology in histology and immunocytochemistry, as well as the latest advances in computerized report preparation.
www.acupath.com.
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