Hope on the Horizon for Breast Cancer

By Andrews, Linda Wasmer

Except for non-melanoma skin cancer, breast cancer remains the most frequently diagnosed cancer in women. Cancer experts say there is reason to feel encouraged by the current breakthroughs in detection and treatment.

In recent years, researchers have discovered new and better ways to detect and treat breast cancer--and to keep it from coming back, the American Cancer Society (ACS) says. These new developments stem from a vast body of research. Recent advances, along with greater public awareness of the importance of breast exams, have caused a decline in breast cancer deaths in women since 1990.

Here's a roundup of what's on the horizon in the areas of mammography, surgery, and hormonal therapy. Keep in mind that all these advances are not yet widely available and many may not be appropriate for everyone. Any treatment decisions must be made by a woman and her doctor, based on her particular cancer, her medical and physical history, and her doctor's clinical judgment.

Improved mammography

There's no doubt about it: Finding breast cancer early increases treatment options and saves lives. Study after study has shown that regular mammograms play a vital role in early cancer detection.

Thanks to advances in digital technology, mammography may become an even more valuable tool in the future. Currently, standard mammography captures images on film. But research centers around the country are now testing 3D digital mammography or tomosynthesis, which generates images without film much the way a digital camera does.

Both digital and standard mammography use X-rays to take a picture of your breast, but in digital mammography, the image is recorded and stored on a computer, the ACS says. The radiologist can manipulate the digital image, adjusting the size, brightness, or contrast to see it more clearly. Tomosynthesis takes this a step further and allows the breast to be viewed as many thin slices, which can be combined into a 3D picture. It may allow doctors to detect smaller lesions or ones that would otherwise be hidden with standard mammograms. Digital mammography is more expensive than standard mammography.

In the years to come, digital mammography may make it easier to diagnose cancer by using special computer programs that recognize cancerlike patterns in breast images.

Another way to find cancer

An alternative to using X-rays is magnetic resonance imaging (MRI), which uses radio waves and strong magnets to view body tissue, the ACS says. Although MRIs are common in helping to diagnose other diseases, they must be specially adapted to scan the breast. They can be used as a follow-up after mammography has found cancer in the breast, or to screen women at high risk for breast cancer. More research is needed, however, to find out if MRIs are any better than mammography at finding small breast cancers. As of 2007, the ACS recommended new guidelines that include screening MRI with mammography for certain high-risk women.

Advances in biopsies

Before an abnormality on a mammogram is diagnosed as cancer, doctors typically order a biopsy. This is a procedure in which a doctor removes a small tissue sample from the breast and examines it under a microscope. This is the only way to tell if cancer is really present. The sample may be removed using a needle or open surgery. When using a needle to perform the biopsy, the doctor usually guides it into the area by feeling the lump. If a lump is too small to be felt, doctors have used ultrasound or a computer to help guide the needle.

The newest biopsy technique being studied uses MRIs to help doctors get a clearer picture of the tissue being sampled, the ACS says. In this type of biopsy, a doctor can take many tissue samples through one small incision. Researchers say this procedure is being studied in women with a personal or family history of breast cancer, those who have already had breast surgery, and those with dense breast tissue.

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On the day of your mammogram, it's important that you don't wear deodorant.