Dear Dr. Roach: Recently, I read about a possible tragic consequence of traditional mammography. The article to which I refer states that there is the possibility of rupture of a tumor present in breast tissue during compression of the breast required for the mammogram, thus spilling any malignant cells into the system to take up residence in remote parts of the body.
The article further expounds a “new” type technology, not widely available yet, that needs not compress the breast, but that also has the additional capability to detect tissue changes before a mammogram is able to do so.
Can you enlighten your female readers?
Dear C.K.: I believe the “new” technology you refer to is thermography, which is actually an old technology, with recent attempts to improve it.
Let’s start with an important point: To my knowledge, there has never been a cancer “ruptured” by mammography. Breast cancers do not normally have a capsule that can rupture.
More importantly, in the many studies on mammography, there has never been good evidence that mammography could increase cancer risk.
The controversy about mammograms is mostly around the fact that mammograms are more likely to find slower-growing tumors, some of which would never become problems even if untreated.
Unfortunately, even the pathologists can’t really tell that, so anything that looks like a cancer is removed, causing some women to be treated unnecessarily.
That being said, mammograms save lives.
The old studies on thermography dating back to the 1970s were disappointing. Unfortunately, a review in 2012 showed that thermography detects only about a quarter of the cancers detected by mammogram.
MRI is used in women who already have had cancer or who are at very high risk due to genetics.
MRI is very sensitive, but can’t always differentiate between cancer and benign lesions.
Mammograms aren’t perfect, but they remain the best screening test for breast cancer for most women.
Dr. Roach writes: In August, I wrote about essential tremor, and several people who suffer from this condition, as well as several clinicians, wrote to tell me about a product called Liftware that helps many (but not all) people with hand tremor eat with less difficulty.
It’s a handle that you can attach a fork or spoon to, and it reduces the amount of shaking.
It’s available at liftlabsdesign.com.
Email questions to ToYourGoodHealth@med.cornell.edu.