A New Computerized Technique To Detect Breast Cancer
27 Jul 2009
What would I do if I were a woman and worried about breast cancer? I would hope that someone would devise a way to improve the accuracy of mammography. Now, a new computerized ultrasound technique can help to determine what breast lumps are benign or malignant. The result? Fewer sleepless nights waiting for biopsy results.
Mammography has always been a questionable procedure. Dr. Peter Gotzsche, a leading Danish researcher, claims there is no convincing evidence that annual mammograms decrease the risk of death from breast cancer. To reach this conclusion Gotzsche and his colleagues analyzed international studies of half a million women.
The cruel truth is that the benefits of mammography are modest. Experts say that 2,000 women have to be screened for 10 years to gain one benefit. So why expose them to radiation.
Dr Michael Baum, professor of surgery at University College, London, England, says, “The latest evidence shifts the balance towards harm and away from benefits.”
Dr. Joel Grey, an expert on radiation formerly at The Mayo Clinic, has expressed his concern about the radiation risk of mammography. And Dr. John Gofman,a well-known critic of excessive radiation exposure, says, “The serious effects from minimal radiation doses are not imaginary, they are real.”
What about the anxiety they cause? Too often I’ve seen extreme anxiety when mammography results in a questionable report. Fear grows when a second report cannot separate the benign from a malignant one. Sleepless nights follow while waiting for a biopsy to be done and through further delay for the result. Then, there’s the false sense of security associated with mammography. Studies show this technology misses 30 percent of cancers in women 40 to 49 years of age.
These reports of mine are close to heresy. They are not taken kindly by advocates of mammography. It’s akin to damning motherhood and apple pie. Besides many people make a lot of money from mammography.
So what’s the new alternative? I’ve recently interviewed several experts who use ultrasound, along with sophisticated software to examine breasts. Jeff Collins, a computer expert, developed this software after his aunt was advised of a normal mammogram. Several months later she died of breast cancer.
Collins clams mammography along with computerized U.S will help to eliminate human error. As he put it, “It’s like the check list that a pilot goes through before landing the plane. He has to be sure the landing gear are down.”
I talked with Dr. Tom Stavros in Denver Colorado and Dr. Kevin Kelly in California, two of the top U. S. experts on computerized ultrasound. They say that every year two million breast biopsies are done in the U.S and they find cancers 10 percent of the time. This means 1,800,000 women did not need the biopsy or the worry! And this does not include the huge expense.
Stavros and Kelly say that ultrasound will not replace mammography at the present time as mammography is still the best way to pick up tiny areas of calcification which may be cancerous. But that computerized ultrasound is superior to mammography in detecting small cancers in women with dense breasts. And that using this technique there will be less need for breast biopsies.
Collins says that it will remain the doctor’s decision whether or not to do a biopsy on questionable lesions in North America. But what will be done in other countries? China has ordered a supply of Collins’ software. But authorities have one proviso for Chinese physicians. They are so convinced of the software’s accuracy that software rather than the doctor, will determine whether a biopsy is done.
So what is happening in Canada and the U.S.? Hospitals are purchasing digital mammography equipment that costs $300,000 versus $100,000 for mammography. Others are going the next step using 3-D tommography equipment costing $700,000 which also delivers 12 to 15 times the amount of radiation. All this when software ultrasound costs $20,000 and exposes patients to no radiation. But it has always been a mad, mad world.
Currently in Canada there are only two centers providing software ultrasound. In the U.S. there are 45.
