New Scan Almost 100% Accurate in Diagnosing Breast Cancer



A new type of scan is almost 100 percent accurate in diagnosing breast cancer.


 

NEW SCAN ALMOST 100% ACCURATE IN IDENTIFYING BREAST CANCER

An estimated 1.4 million women undergo breast biopsies every year in the United States for abnormal findings on their mammograms, and approximately 85 percent of these suspicious mammographic findings will turn out to be benign following biopsy.

At the present time, breast imaging technology has not advanced enough to replace biopsy for most women with suspicious abnormalities noted on mammograms, or for women who develop palpable breast lumps. For example, MRI scans can detect 95 to 98 percent of early breast cancers, but MRI is also associated with a very high “false-positive” rate, in which as many as 25 percent of identified abnormalities turn out, after biopsy, to be benign. In an ideal world, a “perfect” breast scan would accurately identify 100 percent of cancers and 100 percent of benign breast lesions, but such a scan does not exist at this time. However, a new technology for scanning small cores of breast tissue removed during a needle biopsy may bring us closer to that “perfect” breast scan.

A newly published study suggests that a novel imaging technology may be able to accurately distinguish benign from cancerous breast cells within core needle breast biopsy specimens with almost 100 percent accuracy. This study appears in the current issue of the journal Cancer Research.

In this study, a device known as a spectroscope was used to scan core needle breast biopsy tissue specimens from 33 women. Pathologists then evaluated these same biopsy specimens and compared their microscopic diagnoses with the findings of the spectroscopic examination.

Using an analytic method known as the Raman algorithm, spectroscopic evaluation of these needle biopsy breast tissue specimens was shown to be almost as accurate as the pathologists’ diagnoses. Among the biopsy tissue samples that were identified as having cancer by Raman spectroscopy, 100 percent turned out to be cancer. Among the biopsy tissue samples that were identified as being benign (i.e., no cancer) by Raman spectroscopy, 96 percent turned out to be benign, while 4 percent contained cancer, based upon the pathologists’ findings

This new noninvasive imaging technology offers a number of potentially important benefits to patients with abnormal mammogram findings, as well as, potentially, women who are undergoing breast-conserving surgery (i.e., lumpectomy) for confirmed breast cancer.

For women who are undergoing needle biopsy of their breast following an abnormal mammogram, Raman spectroscopy of core needle biopsy specimens may allow the Radiologist performing the biopsy to determine, in real time, the results of such biopsies, rather than waiting for a week or longer for the Pathologist to report a formal diagnosis. Raman spectroscopy may also assist the Radiologist in determining whether or not the core needle biopsy has been accurately and adequately performed, based upon the spectroscopic “signature” of the breast tissue recovered from the needle biopsy.

There is also great interest in using Raman spectroscopy to more accurately determine the adequacy of lumpectomy when performing breast-conserving surgery for confirmed breast cancer. At the present time, 25 to 40 percent of patients with very small breast cancers have to undergo repeat lumpectomy due to the presence of cancer cells at (or close to) the edges of the lumpectomy breast tissue specimen, as seen under the microscope by the Pathologist. There is, at this time, preliminary data suggesting that Raman spectroscopy may be useful, in the operating room, to identify areas (“margins”) on the lumpectomy breast tissue specimen where tumor cells are too close to the surface of the specimen, thus allowing the surgeon to take additional breast tissue in these suspect areas at the time of the original lumpectomy surgery. In the best case, this novel approach to breast-conserving surgery may spare many women with breast cancer the need for a second (or third) breast lumpectomy.

As a cancer surgeon who cares for a large number of breast cancer patients, I find this novel and noninvasive imaging technology to be very exciting, and full of potential promise and benefit to patients with abnormal mammograms, as well as patients who have already been diagnosed with breast cancer.

 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.com Top 100 New Book Releases in Cancer” list.

 

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Dr. Wascher Discusses Signs & Symptoms of Skin Cancer

Profile of Dr. Wascher by Oncology Times

Bio of Dr. Wascher at Cancer Treatment Centers of America

Dr. Wascher Discusses Predictions of Decreased Cancer Risk on azfamily.com

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Dr. Wascher Answers Questions About Cancer on talkabouthealth.com

Dr. Wascher Discusses Cancer Prevention Strategies on LIVESTRONG

Dr. Wascher Discusses Cancer Prevention on Newsmax

Dr. Wascher Answers Questions About Cancer Risk & Cancer Prevention on The Doctors Radio Show

Dr. Wascher Discusses Lymphedema After Breast Surgery on cancerlynx.com

Dr. Wascher Discusses Hormone Replacement Therapy & Breast Cancer Risk on cancerlynx.com

Dr. Wascher Discusses Chronic Pain After Mastectomy for Breast Cancer on cancerlynx.com

Dr. Wascher Discusses Sentinel Lymph Node Biopsy for Cancer on cancersupportivecare.com

Dr. Wascher Discusses the Role of Exercise in Cancer Prevention on Open Salon

Dr. Wascher Discusses Aspirin as a Potential Preventive Agent for Pancreatic Cancer on eHealth Forum

Dr. Wascher Discusses Obesity & Cancer Risk on eHealth Forum

Dr. Wascher Discusses the Role of Radiation Therapy in the Treatment of Breast Cancer on Sharecare

Dr. Wascher Discusses the Treatment of Stomach Cancer on Sharecare

Dr. Wascher Discusses the Management of Metastatic Cancer of the Liver on Sharecare

Dr. Wascher Discusses Obesity & Cancer Risk on hopenavigators.com

Dr. Wascher Discusses Hormone Replacement Therapy & Breast Cancer Risk on interactmd.com

Dr. Wascher Discusses Thyroid Cancer on health2fit.com

 

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Dr. Wascher’s Home Page



According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, 3.2 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Women in their 40s May Benefit from Annual Mammograms



A new study finds that women in their 40s with dense breasts benefit from annual mammograms.


 

WOMEN IN THEIR 40s MAY BENEFIT FROM ANNUAL MAMMOGRAMS

The U.S. Preventive Services Task Force (USPSTF) ignited a firestorm of controversy in 2009 when the government agency recommended that most women between the ages of 50 and 74 should undergo screening mammograms every other year,instead of every year. Even more controversial was the USPSTF’s recommendation that most healthy women between the ages and 40 and 49 should no longer undergo routine screening mammograms. Numerous cancer advocacy groups, including the American Cancer Society, subsequently recommended that the USPSTF’s revised guidelines for screening mammograms should, essentially, be ignored, and that women with an average risk of developing breast cancer should continue to undergo annual screening mammograms starting at age 40.

In 2010, following the USPSTF’s controversial recommendations, a significant drop in the number of annual screening mammograms performed on women in their 40s was observed, leading to concern among some breast cancer experts that many cases of breast cancer might go undiagnosed among 40 to 49 year-old women.

Now, a newly published study, which appears in the online edition of JAMA Internal Medicine, provides important new data regarding the potential impact of switching from annual screening mammograms to every-other-year (biennial) mammograms.

In this very large study, researchers analyzed prospectively collected data from mammography facilities throughout the United States that participated in the Breast Cancer Surveillance Consortium. Data was prospectively collected on 11,474 women who had been diagnosed with breast cancer and 922,624 women without breast cancer.

The findings of this enormous public health study strongly suggest that the USPSTF’s recommendations that women between the ages of 50 and 74 undergo every-other-year mammograms may actually be reasonable and safe. When compared to women in this age range who underwent screening mammograms every year, the women who underwent biennial mammograms did not have a higher incidence of advanced-stage breast cancers. An additional important finding was that even women aged 50 or older with very dense breast tissue, or women above 50 who had taken hormone replacement therapy, appeared not to experience any harm by undergoing biennial mammograms instead of annual mammograms. As both of these factors increase a woman’s lifetime risk of developing breast cancer, the finding of this study that women between 50 and 74 years of age can safely undergo screening mammograms every other year (instead of every year) is of particular significance.

In contrast to women between the ages of 50 and 74, this research study’s findings regarding women between the ages of 40 and 49 call into question the USPSTF’s recommendation that women in this age range need not undergo regular screening mammograms. Among the women in this study between the ages of 40 and 49, every-other-year screening mammograms (rather than every year) resulted in a significant increase in the incidence of more advanced-stage breast cancers. In fact, women in this age range, who often have very dense breast tissue, were 89 percent more likely to be diagnosed with advanced-stage breast cancers if they underwent every-other-year mammograms when compared to comparably aged women with dense breast tissue who underwent annual screening mammograms.

I consider this to be a very important clinical research study, and its findings may well lead to changes in the current recommendations regarding screening mammograms. At the same time, it will be important to follow the nearly one million women who participated in this public health study, to see if breast long-term cancer survival rates are impacted by the timing of screening mammograms (i.e., annual versus biennial mammograms).

It is critically important to avoid the multiple lifestyle and dietary factors known to increase the risk of breast cancer. For more research-based information on this important topic, please read the extended chapter on breast cancer in my bestselling book, A Cancer Prevention Guide for the Human Race.

 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!


Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.com Top 100 New Book Releases in Cancer” list.


Join Dr. Wascher on Facebook


Additional Links for Robert A. Wascher, MD, FACS

Profile of Dr. Wascher by Oncology Times

Bio of Dr. Wascher at Cancer Treatment Centers of America

Dr. Wascher Discusses Predictions of Decreased Cancer Risk on azfamily.com

Dr. Wascher Discusses Environmental Risk Factors for Breast Cancer on Sharecare

Dr. Wascher Answers Questions About Cancer on talkabouthealth.com

Dr. Wascher Discusses Cancer Prevention Strategies on LIVESTRONG

Dr. Wascher Discusses Cancer Prevention on Newsmax

Dr. Wascher Answers Questions About Cancer Risk & Cancer Prevention on The Doctors Radio Show

Dr. Wascher Discusses Lymphedema After Breast Surgery on cancerlynx.com

Dr. Wascher Discusses Hormone Replacement Therapy & Breast Cancer Risk on cancerlynx.com

Dr. Wascher Discusses Chronic Pain After Mastectomy for Breast Cancer on cancerlynx.com

Dr. Wascher Discusses Sentinel Lymph Node Biopsy for Cancer on cancersupportivecare.com

Dr. Wascher Discusses the Role of Exercise in Cancer Prevention on Open Salon

Dr. Wascher Discusses Aspirin as a Potential Preventive Agent for Pancreatic Cancer on eHealth Forum

Dr. Wascher Discusses Obesity & Cancer Risk on eHealth Forum

Dr. Wascher Discusses the Role of Radiation Therapy in the Treatment of Breast Cancer on Sharecare

Dr. Wascher Discusses the Treatment of Stomach Cancer on Sharecare

Dr. Wascher Discusses the Management of Metastatic Cancer of the Liver on Sharecare

Dr. Wascher Discusses Obesity & Cancer Risk on hopenavigators.com

Dr. Wascher Discusses Hormone Replacement Therapy & Breast Cancer Risk on interactmd.com

Dr. Wascher Discusses Thyroid Cancer on health2fit.com

 

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Coffee May Reduce Crash Risk for Long-Distance Drivers

Tiny Implant Tells Your Smart Phone When You Are Having A Heart Attack

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Resistant Bacteria are on the Rise

High Levels of Stress Linked to an Increase in Heart Disease Risk

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Poor Sleep May Increase the Risk of Heart Failure

Ancient Mummies Found to Have Heart Disease by CT Scan

Physically Fit Kids Do Better on Math & Reading Tests

How Melanoma Skin Cancer Evades the Immune System

Possible Link Between BPA and Asthma

Baby Boomers Appear Less Healthy Than Their Parents

The Biology of Love in the Brain

Millennials May be the Most Stressed-Out Generation

Even Modest Alcohol Intake Raises Cancer Risk

Why Do Boys Receive Lower Grades than Girls?

Negative Emotions and Feelings Can Damage Your Health

Canker Sore Drug Cures Obesity (At Least in Mice…)

How Technology is Changing the Practice of Medicine

New Salt Intake Guidelines for Children

High Levels of Distress in Childhood May Increase Risk of Heart Disease in Adulthood

Quitting Tobacco by Age 40 Restores a Normal Lifespan in Smokers

Cancer Death Rates Continue to Fall

Self-Help Books Improve Depression

Marines Try Mindfulness and Meditation to Reduce PTSD

Dying Nurse Volunteers Herself to Teach Nursing Students about the Dying

Regular Walks Cut Stroke Risk

Falling Asleep While Driving More Common than Previously Thought

Celebrity Health Fads Debunked

Obesity Among Young Children May Be Declining

Fresh Fruits & Vegetables May Reduce Breast Cancer Risk

Satisfaction with Life May Actually Increase with Age

Brain Changes in the Elderly May Increase Susceptibility to Being Scammed

 



Dr. Wascher’s Home Page



According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, more than 3.1 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Addition of MRI to Mammogram and Ultrasound Increases Breast Cancer Detection






 

New research shows that adding MRI to mammogram and ultrasound increases breast cancer detection rate, but with a high rate of false positive results.


 

 

ADDITION OF MRI TO MAMMOGRAM AND ULTRASOUND INCREASES BREAST CANCER DETECTION

Currently, women who are at an average risk of developing breast cancer are advised to undergo annual screening mammograms beginning at 40 to 45 years of age.  Mammography, like any medical test, is not perfect (at least 10 to 20 percent of breast cancers will not show up on a mammogram among women who are at average risk for this type of cancer).  Moreover, mammography, which relies upon low-powered x-rays to form images of the breasts, is especially challenged by women with dense breast tissue, which is, by itself, a known risk factor for breast cancer.

In many cases, the addition of ultrasound to mammography can help to form more accurate images of dense breast tissue, and is also useful for further evaluation of indeterminate breast abnormalities identified by mammography.  (Also, both the lobular sub-type of breast cancer and small “low-grade” breast cancers tend to show up better on ultrasound than they do on mammograms.)  Together, the combination of mammography and ultrasound can accurately detect approximately 85 to 90 percent of breast cancers in women with normal-density breast tissue; but, once again, in women with dense breast tissue (including most women under the age of 40), the sensitivity and overall accuracy of mammography plus ultrasound is often considerably decreased.

Magnetic resonance imaging, or MRI, has become a popular tool for breast imaging, although, like mammography and ultrasound, MRI of the breast has its downsides as well.  MRI is known to be much more sensitive than either mammography or ultrasound in identifying breast cancers, with most studies showing a 95 percent or greater sensitivity associated with MRI.  However, this exquisite sensitivity of breast MRI, as I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, is also associated with poor specificity (i.e., a high false-positive rate).  Because of its poor specificity, MRI scans of the breast will be wrong, or falsely-positive, in 15 to 35 percent of cases where an abnormality is detected.  Although there are other reasons as well, this high false-positive rate is the primary reason that MRI scans are not routinely used to screen for breast cancer.

As I have noted, none of these three common breast cancer screening tests are perfect, and each of them will miss some cancers that the other types of scans might pick up. With this information in mind, a newly published study, which appears in the current issue of the Journal of the American Medical Association, examines the potential role of ultrasound and MRI scans as supplements to screening mammograms in women who are at an increased risk for developing breast cancer.

In this prospective clinical research study, 612 women deemed to be at increased risk for breast cancer underwent three years of annual breast cancer screening exams with mammography and ultrasound.  After completing these three years of annual screening with mammography and ultrasound, these women additionally underwent MRI scans of their breasts.  Abnormalities suspicious for cancer, based upon any of these three diagnostic tests, were further evaluated by biopsy.  This cohort of women volunteers was then followed for an additional 12 months, to monitor them for any signs of interval development of breast cancer.

The 612 women who underwent mammography, ultrasound and MRI screening were also part of a larger group of 2,662 high-risk women (54 percent of whom had a personal history of a prior breast cancer) who enrolled in this study, and who underwent annual breast cancer screening with both mammography and ultrasound.  Altogether, 110 of these 2,662 women were diagnosed with a new breast cancer during the course of this prospective clinical research study.

The results of this study clearly illustrate the limitations of currently available breast cancer screening tests, particularly among high-risk women.  Following three years of annual screening, only 52 percent of the breast cancers that arose were detected by mammography alone in these high-risk women, although the false-positive rate of mammography was very low, at 9 percent.  The addition of ultrasound to mammography improved the sensitivity, or detection rate, to 76 percent, with a false-positive rate of 16 percent.  When MRI was added to mammography and ultrasound, the detection rate (sensitivity) for breast cancer improved, significantly, to 100 percent, although the false-positive rate increased greatly due to the poor specificity of MRI and, to a lesser extent, ultrasound.  When these three breast imaging modalities were combined, 35 percent of the abnormalities identified turned out to be benign lesions, and not cancer, following biopsy or other confirmatory diagnostic procedures.

This study confirms that essentially 100 percent of detectable breast cancers can be identified using a combination of mammography, ultrasound and MRI.  However, this high level of sensitivity comes at a significant cost in that more than one-third of the abnormalities identified by the combined use of these three breast imaging modalities will, upon further testing, including biopsy, turn out to be completely benign.  Therefore, this high false-positive rate, particularly associated with breast MRI, is the Achilles heel of this combined imaging approach to breast cancer screening.

Fortunately, there are emerging new breast imaging technologies that appear to have the same very high sensitivity rate as MRI, while maintaining the high specificity (i.e., low false-positive) rate of mammography.  Among these promising technologies are Breast-Specific Gamma Imaging and Positron Emission (PET) Mammography (also known as “PEM”).  Ultimately, these newer technologies, as well as even newer technologies, will most likely someday replace the use MRI to screen for breast cancer.



For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.



Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 






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