The mention of a mammogram is generally met with dread. “Mammogram” means we’ve reached the age where such screening is necessary, and every woman has heard whispered horror stories of the machine that painfully compresses your breasts.
Mammograms are still the gold standard for detection of breast health changes, but women now have options instead of the conventional mammogram. While the process may still be uncomfortable, new technology reduces the need for repeated mammograms and increases the detection rate.
Digital mammograms, a technological advance
Besides the traditional x-ray mammogram that produces images on film, some hospitals offer digital mammograms and/or 3D mammograms (breast tomosynthesis). 3D mammography is reported to detect 41% more invasive breast cancers, often finding these cancers when they are smaller so treatment is more effective. 3D reduces call-backs for additional testing by about half, and readings for women with dense breast tissue are a bit easier.
Digital mammograms are similar to traditional methods but provide higher resolution images that can be stored digitally, reducing the need for retakes and providing less radiation exposure.
When a mammogram reveals something suspicious, doctors may request supplemental screening before resorting to a biopsy, the only method to determine with certainty if a mass is cancerous. Additional breast screening options include thermography, ultrasound, breast MRI, and molecular breast imaging.
Sheri Plocek, certified clinical thermographic technician at ThermApproach, explains, “Thermal Imaging, while it does not replace the mammogram, is an adjunctive [additional] screening to mammography. A mammogram is a test of the structural component of breast tissue (an x-ray); a breast thermogram is a test of the physiology and function of the breast tissue.” In short, she says, “One test cannot replace the other because they look at two different things.”
A thermogram reads the heat being emitted from our bodies, and those readings can help determine overall breast health, point to changes, and indicate other abnormalities.
“Unlike a mammogram, a thermogram is radiation-free, compression-free, [and] pain-free,” Ploceck continues, “and [it] looks at the entire chest from just below the chin to just above the navel–not just the area of tissue compressed between two plates.”
Both mammograms and thermograms are screening procedures—neither test can definitively diagnosis cancer— but when the methods are used together, along with your doctor’s physical examination, you increase your chances detecting early changes in breast health.
Large fibrocystic breasts can pose difficulties for a clear mammogram read, but dense breast tissue is no issue for thermography. Size and density do not affect infrared heat readings.
Age can also play a role. For women over the age of 50, mammograms are 80% sensitive (20% of cancers are not detected), so mammograms are more likely to miss possible changes in breast health.
Thermograms are not adversely affected by age or breast density/size. Ploceck expounds, “Thermography is… a safe screening for breast health changes of women under the age of routine mammography, those with dense breasts, implants, large or small breasts, reconstructive surgery, and any women wanting to add more to their breast health management program for any reason.”
Breast ultrasound is another option for supplemental screening and can be used in conjunction with mammograms to determine breast health. High frequency sound waves are bounced off the breast tissue and collected as an echo to produce an image for a structural readings of the breast, like a mammogram. Additionally, ultrasounds do not require compression or radiation, like a thermogram.
However, ultrasounds have lower spatial resolution and are therefore unable to reveal fine details. Used alongside a mammogram, ultrasounds can help differentiate a solid mass from a fluid-filled cyst.
Other screening techniques
Breast MRI technology uses a computer, radio waves, and a magnetic field to analyze breast changes. This additional screening can help determine the extent of the tumor, evaluate for residual cancer post-surgery, monitor cancer therapy, and detect issues for women with breast implants.
Molecular breast imaging (MBI) is a new FDA-approved technology that is used to screen dense breast tissue or high-risk women who cannot tolerate an MRI. MBI requires minimal prep, is compression-free, and provides results in as little as 30 minutes.
As with mammograms, these additional screening methods cannot diagnose cancer. The findings from breast screenings aid in decreasing or increasing suspicion; the final step is always a biopsy.