New Technology in the Fight Against Breast Cancer

by Lori Kunzelman, M.D. and Connie Jones, M.D.

It's the moment a distant fear becomes a reality. Every year, hundreds of thousands of American women cope with it. For some, it's fear of the unknown. For others, it's fear created from having lost someone to this horrible disease. And for others, it's the fear that they might find something ... again.

Yes, we're talking about breast cancer. But the good news is, if detected early, there is a 96 percent chance of survival. Those are favorable odds.Women need to understand and embrace early detection as their best means in the fight against breast cancer.

During Breast Cancer Awareness month, it's important to shine a light on how new technology is allowing doctors to detect breast cancer earlier and with improved accuracy.

DIGITAL MAMMOGRAPHY
Digital mammography, which has essentially replaced traditional film mammograms, converts x-ray images into electronic images which can be viewed, optimized and stored on a computer. Digital mammograms provide radiologists with clearer, more precise images than ever before. Doctors can manipulate images to increase size, zoom and change contrast or brightness.

"Clearer, more precise images result in fewer false positives, call-backs and unnecessary radiation to the patient over time," says Connie Jones,M.D., a breast imaging radiologist at Scottsdale Medical Imaging, Ltd.

Additionally, digital mammography is faster, meaning patients don't have to be compressed or sit still quite as long. Digital mammography has shown significant cancer detection over conventional mammography in women with dense breast tissue who are younger than 50 and women who are about to go through menopause.

Doctors expect digital mammography to improve and grow very rapidly, which will further breast cancer detection capabilities in the near future. Mammograms continue to be the gold standard for the early detection of breast cancer.

BREAST MAGNETIC RESONANCE IMAGING (MRI)
Breast Magnetic Resonance Imaging (MRI) has proven to be a powerful tool in conjunction with mammography. Breast MRI is effective at detecting cancers that may have been missed in a mammogram or even ultrasound. The detection of breast cancer hinges on the fact that malignant tissue shows greater blood flow than surrounding normal breast tissue. Hence, cancer obscured by dense breast tissue on a mammogram may often appear obvious on an MRI.

The American Cancer Society recommends that women who are at risk for breast cancer--those with a family history of breast cancer or the mutated BRCA1 Or BRCA2 gene--receive an annual breast MRI in addition to an annual mammogram. Breast MRI is also the "gold standard" for evaluation of breast implant rupture.

POSITRON EMISSION MAMMOGRAPHY (PEM)
Positron Emission Mammography (PEM) is today's most innovative breast imaging technology that enables physicians to detect tumors as small as a grain of rice (1.5 millimeters).

"Still a new technology, the hope is that PEM will greatly increase the detection of breast cancer in early stages, and in turn, positively improve breast cancer management overall," says Lori Kunzelman,M.D., also a breast-imaging radiologist at Scottsdale Medical Imaging, Ltd.

PEM has several advantages. It uses half the pressure a mammogram does, making for a much more comfortable experience for women. Additionally, PEM has the ability to see through dense breast tissue and implants.

Another advantage is its accurate specificity rate--how well it determines which detections require additional attention. Using the same technology as a positron emission mammography (PET) scan, PEM then takes high-resolution images revealing cancerous areas.

PEMis currently being used in addition to a standard mammogram and an MRI. Patients who have recently been diagnosed with an invasive breast cancer and those who are currently in follow-ups after treatment of an invasive cancer are eligible for PEM with a physician's referral.

At this point, PEM is only available at about 30 locations in the United States--one of which is right here in Arizona at Scottsdale Medical Imaging, Ltd.

BREAST TOMOSYNTHESIS
Another cutting-edge technology is breast tomosynthesis (pronounced "toe-moe-SIN-tha-sis"), a technology that doctors think could eventually replace the traditional mammogram. Currently being used for research purposes, radiologists hope to gain FDA approval quickly.

Tomosynthesis works to overcome the limitations that mammograms have encountered over the years. It requires only enough pressure to keep the breast stable during the procedure. In mammography, the compression can be uncomfortable and may deter some women from getting the test.

Additionally, tomosynthesis offers a three-dimensional view of a breast where a mammogram creates only two-dimensional images. This makes it easier to detect breast cancer that may be hidden in overlapping due to the compression of the breast tissue during a mammogram.

"We are seeing extremely positive results from tomosynthesis," says Jones. "Hopefully, promising results will help tomosynthesis gain FDA approval and then allow it to be used regularly in breast imaging."

Advancing technology is now allowing doctors to detect breast cancer so much earlier than they ever could before. And by detecting the condition early, treatment can be much more successful.Women should embrace this screening process and empower themselves in the fight. After all, early detection is the best protection!

Lori Kunzelman, M.D. and Connie Jones, M.D. are Breast Imaging Radiologists at Scottsdale Medical Imaging, Ltd.