21 March, 2019

Mammography is Still the Best Option for Breast Cancer Screening

The FDA recently issued a stern warning against the use of thermography as a standalone method for detecting, diagnosing, or screening for breast cancer.  The department cleared thermography for use only when combined with another screening method, such as mammography. In accordance, they released the following statement: “Mammography… is the most effective breast cancer screening method and the only method proven to increase the chance of survival through earlier detection.” Yet, many homeopathic clinics, mobile health units and health spas tout thermography as a reliable tool for screening and diagnosing breast cancer.

So, what exactly is thermography? It’s a test that uses an infrared camera to detect heat patterns and blood flow in body tissues. It is said to reveal temperature differences on the surface of the breasts. The theory is that as cancer cells multiply, they need more oxygen-rich blood to grow and when blood flow to the tumor increases, the temperature around it will increase as well. Proponents of thermography promote it as an effective screening test for women under 50 and those with dense breast tissue. It is also said to be beneficial because unlike mammography, there is no radiation associated with thermography.

Thermography has been found, however, not to be very sensitive at finding early stage breast cancer and many cancers have gone undetected. In one case highlighted on ABC’s Good Morning America, the patient, who relied on thermography alone, later died after her cancer was missed by thermography. Furthermore, thermography also has trouble distinguishing the causes of the heat in the breast, leading to a high false-positive rate.

Mammography is still the single most effective method of early detection. A mammogram can often identify cancer several years before physical symptoms develop. And while many people are concerned about radiation exposure, according to the American Cancer Society, the dose required for a mammogram is very small and the risk of harm is minimal.

In 2011, the FDA approved the use of Tomosynthesis, or 3D mammography, which constructs a 3D image of the breast. Recent studies have indicated that the addition of 3D mammography to a traditional 2D mammogram reduces false-positives and also allows for the detection of slightly more invasive cancers.        

Breast ultrasound can be helpful as a supplemental screening tool in certain women. Studies have shown that with the addition of breast ultrasound, more cancers can be detected as compared with mammogram alone for women with dense breast tissue. In patients with dense breast tissue, there are cancers which can be seen on ultrasound but are hidden on mammography.  However, Dr. June Chen, the medical director of Breastlink Newport Beach, reminds us that “it is important to remember that screening breast ultrasound is an adjunctive examination and never a replacement for screening mammography”.

Breast MRI is also used as a supplementary screening tool in women who are at high risk for breast cancer. MRI uses magnetic fields instead of x-ray to produce detailed, cross-sectional images of the breast tissue.

If you feel that you need additional screening, talk to your doctor about the option that is best for you and your health.

21 March, 2019


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