Posts Tagged ‘thermograms’

3-D Mammograms: Pros & Cons

Wednesday, October 24th, 2012

Note: While on vacation I read about 3D mammograms, which have actually been in the works for sometime, but only recently approved by the FDA. Below is an excerpt by Liz Szabo from USA Today about this procedure. Although it cuts down on the false positives with regular mammograms, it increases the levels of radiation a woman receives. So my question is, why isn’t there more information on thermograms, which are less invasive, less painful, and without any radiation??? (I put in bold some of the important facts.) es

(Photo: Maxine Park, USA TODAY)

 

Q. What is a 3-D mammogram?

A. The technology, called tomosynthesis, provides three-dimensional images of the breast by using a technology similar to CT scans, or computed tomography, says Carol Lee, a radiologist at New York’s Memorial Sloan-Kettering Cancer Center and chair of the American College of Radiology’s breast imaging commission. The imaging machine moves around the breast in an arc, taking multiple X-rays that a computer forms into a 3-D image. The Food and Drug Administration approved tomosynthesis last year and it’s now used in 46 states, according to Hologic, which manufactures the machines.


Q. Why would someone want a 3-D image of the breast?

A. Researchers hope that it will reduce the number of false alarms, in which radiologists call women back for additional mammograms because of uncertainty about their findings, says Constance Lehman, director of imaging at the Seattle Cancer Care Alliance, who is leading a clinical trial on 3-D mammography. About 10% of the 40 million women who get screening mammograms every year receive a “call back,” leading to anxiety and sometimes additional types of tests, such as ultrasounds, says Peter Soltani, Hologic’s senior vice president of breast health. Lehman notes, however, that this benefit has not yet been definitively proven in a rigorously designed study.

There is no data to prove that tomosynthesis finds more cancer or saves lives, says Fran Visco, president of the National Breast Cancer Coalition. “3-D is a new technology that should not be used outside of a clinical trial,” Visco says.

Q. Who could benefit most from 3-D mammograms?

A. Younger women with dense breasts could potentially benefit the most, Lee says. That’s because radiologists have a harder time picking
out cancers in dense breasts, because both cancers and dense tissue appear as white on a mammogram. “It’s like writing a word on a blackboard
and then covering it in scribbles,” Lee says. “By subtracting the scribbles, you can see the word better.” So far, however, studies haven’t proven
that 3-D mammograms find significantly more cancers than traditional mammograms,
Lee says. “I personally have yet to be convinced that it’s
substantially better,” Lee says. “And it doesn’t replace a regular mammogram.”

Q. What are the risks and limitations of 3-D mammograms?

A. Because the tests are new, insurance companies may not cover them and may require patients to pay out of pocket.

More importantly, the procedures give women twice as much radiation as a standard mammogram, notes surgeon Susan Love,
author of Dr. Susan Love’s Breast Book. That’s because women who get 3-D imaging still undergo traditional 2-D mammography, as well.

Radiation is a known cause of breast cancer. Researchers in recent years have become concerned about radiation exposure from medical imaging,
particularly CT scans. A 2009 analysis estimated that CT scans cause about 29,000 cancers and 14,500 deaths a year. Soltani says the total radiation
dose from 3-D mammography is still relatively low, in spite of this increase — from 0.5 millisieverts to 1.0 millisieverts. In comparison, a CT scan
of the head has a radiation dose of about 2.0 millisieverts.

But Lehman says a woman’s total radiation dose may not necessarily increase if she undergoes a 3-D mammogram. That’s because the exam may
help her avoid the radiation from repeat scans.

Love says she’s skeptical about the technology, which she compares to “a new toy,” noting that the most essential questions about its benefits are
likely to remain unanswered. The most important question about a new type of screening, Love says, is not simply how well it finds cancer,
but whether it saves lives. She says she doubts the makers of tomosynthesis are going to perform that sort of large, expensive, long-term study.

Lee asks, “Is it worth radiating everyone to avoid a few false positives?”