13 July 2009
| Article by TIME
Breast cancer is a global crisis. Once regarded as a disease of the wealthy West, it is now the most common form of cancer for women across the world. This year alone, more than 1.1 million new cases will be diagnosed (up from 500,000 in 1975) and 411,000 patients will die from the disease.
Surprisingly, that soaring caseload is largely a consequence of successful public health campaigns. Thanks to better healthcare, sanitation and food provision, an ever-growing number of women across the world are living to 50-plus—an age when they’re more susceptible to breast cancer.
The threat of breast cancer may be growing, but so is our understanding of how to tackle the disease. Today, 85% of sufferers in the developed world make a successful recovery. That’s partly due to advances in treatment, but also a result of the mass screening programs implemented by many Western nations. In the U.K., women aged 50 to 70 are encouraged to attend a free breast check—which involves an X-ray, or mammogram—every three years. This process can reveal tumors at a pre-clinical stage, when they are too small to be felt by the patient or her doctor.
With early diagnosis and treatment, survival rates soar. The World Health Organization estimates that regular screening reduces breast cancer mortality by up to 45%, while the U.K.’s National Health Service says that its program saves 1,400 lives each year. Developing countries like China—where urban areas have seen a 20-30% rise in breast cancer in the past decade—are now starting their own screening schemes.
But tumors hidden by dense breast tissue, for example, can be diffi cult to detect or assess with ordinary screening techniques. However, new technologies are helping clinicians make earlier diagnoses in more patients. Philips, for instance, has developed the iU22 Ultrasound. This system’s advanced volume breast imaging and tissue aberration correction technology provide clearer images of dense and fatty breast tissue. According to the American Cancer Society, a breast MRI is often recommended to screen dense breasts or high-risk patients due to its high specificity and sensitivity.
Philips is also conscious of the need to make women comfortable during the sometimes-stressful screening process. Normally, patients enter MRI scanners head first, which can cause feelings of claustrophobia. But Philips’ Elite Breast MRI Clinical Solution reduces anxiety by scanning patients feet first.
In some countries, the war on breast cancer cannot be successfully waged with new technology and screening programs alone. Many Middle Eastern women, for instance, are unwilling to let a doctor—male or female—examine their breasts. Others are afraid that the disease will bring shame on their family. This has fatal consequences. Around 70% of breast-cancer cases in Saudi Arabia andJordan are diagnosed in the less-treatable late stages of the disease, compared to 30% in the U.S.
Samia al-Amoudi, a Saudi Arabian obstetrician and gynecologist diagnosed with the disease in 2006, is helping to change breast cancer’s taboo status. In a weekly newspaper column, she chronicled her struggle with the disease, detailing how she discovered her tumor and discussed the disease with her husband and family. Al-Amoudi believes that Muslim women have a religious duty to care for their bodies: “In Islam, we are asked to go and seek medical advice and to go and seek treatment.”
For women across the world, that simple message of breast cancer awareness could be a lifesaver.
- Breast cancer causes 1.6% of all female deaths worldwide
- More than 55% of breast-cancer-related deaths occur in low- and middle-income countries.
- Regular screening can reduce breast cancer mortality by up to 45%
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RSNA 2011: Ultrasound breast cancer screening found to be operator dependent
New data from the ACRIN (American College of Radiology Imaging Network) 6666 study indicate that operator error accounts for missed cancers in about the same proportion of women screened with ultrasound (US) as those screened with mammography or magnetic resonance imaging (MRI). Although the findings do not diminish the importance of US screening for the substantial proportion of cancers missed on mammography, particularly in those with dense breast tissue, these findings are considered important for their ability to alert radiologists about the risks of missing lesions. While computer-assisted detection (CAD) or automated scanning may be helpful in reducing operator error, many of the lesions were identified by observers as abnormalities of interest even though they were not ultimately pursued for biopsy, making them a problem of interpretation rather than documentation. New strategies are needed for reducing false-negative as well as false-positive cancer diagnoses.
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