What’s the story with Thermography?

Although thermograms are entirely safe with no contrast or radiation of any sort, they are worthless as an early predictor of breast cancer. A study at Dartmouth around 1980 showed identification of some relatively large cancers with thermography. The principle of thermography is based on minute changes of the skin temperature by an underlying breast cancer generating heat because of the high metabolism of the tumor. In order to be detected by thermography the cancers usually have to be at least two cm (⅔ of an inch), unless they are very close to the skin. In the past 35 years this technology has been surpassed by other imaging. Because the procedure is safe and since it was in use by 1975 it was grand-fathered in as an allowed medical procedure by the FDA....

What age should women find out about their breast density and screening for breast cancer?

Breast cancer kills more women between the ages 35-54 than automobile accidents, diabetes, heart attacks, stroke, murder, alcoholism, drug overdose or any other cause.  Almost 8,000 women in this age group die each year in the United States alone.  There has been a concerted effort to convince women and their physicians that it is unnecessary to screen for breast cancer during three quarters of these two decades.  The United States Preventative Services Task Force (U.S.P.S.T.F.) has decided that it is not worth the effort or expense to screen women before the age of 50. Part of that reasoning was that, since most young women have dense breasts, many cancers would be missed by screening mammography anyway. My own feeling is that women with dense breasts, who...

Heather Reimer, A Story of Inspiration and Hope

Part of the goal of this blog is to not only include valuable breast health information that’s useful for women and medical professionals alike, but to also provide stories of inspiration and hope.  Many of these stories will come from women who have experienced receiving a breast cancer diagnosis that was earlier missed because of dense breast tissue, or found their cancer early due to mammography coupled with an ultrasound examination.  We hear these stories all the time, and we want to impress upon all women the importance of knowing their breast tissue density and how to proactively seek the care they need if they find they have dense breast tissue.  Today’s story is from Heather Reimer, an incredible survivor located in Reno, Nevada.  To...

Great News about Genetic Testing!

The genetic test that Angelina Jolie had done that normally runs between $3000 or $4000 will become much cheaper very soon.  The United States Supreme Court has ruled that human genes are not patentable.  This means that the BRCA 1 and BRCA 2 genes that predispose to breast cancer will no longer be monopolized by one company who can charge thousands of dollars for the test, but rather it will be open to competition from other genetic marker companies. You can expect over the next few months that the price will descend thousands of dollars to a few hundred dollars for this test.  At the same time, other less known genetic defects will be tested for in a panel of genetic abnormalities. If you are worried that you have a genetic predisposition for breast cancer...

Is Angelina Jolie’s double mastectomy the best option when you have the BRCA 1 genetic defect?

This is a complex issue. On the one hand, removing both breasts with simple mastectomies and reconstructions will probably reduce the chances of getting breast cancer in woman with this defect from somewhere between 50% and 80% to about 5%.  However, the timing of the occurrence of breast cancer may be many years down the road.  For instance, if you are 35 years old and have this defect, the chances of getting cancer by 70 may be very high, but the chances in the next 15 years are much less.  By doing frequent testing of the breasts using ultrasound or MRI there’s a high likelihood of finding the cancer when it is small, if it were to occur.  For a woman who has an MRI once a year and a breast ultrasound six months later, the chances of having invasive...

What are the survival rates of women who have implants as part of reconstruction after a breast cancer diagnosis? Are their survival rates impacted?

First of all, the incidence (occurrence) of breast cancer in women with implants is virtually the same for women without implants at any given age.  In fact there is some evidence that the occurrence might be slightly less for those with implants. So, having an implant even after having breast cancer will not increase the chance of recurrence or generation of a new cancer. However, in women with cosmetic implants, chance of dying from breast cancer increases 38% compared to women without implants according to a recent article in the British Medical Journal (BMJ 2013; 346:f2399). This article is open-source (free to anyone with internet). Presumably, the increased mortality associated with implants is a result of later discovery of the cancers because of the...

Tell me what to expect when examining my breasts

The most common type of screening for breast cancer is the physical examination done by your healthcare provider or by yourself.  Although self-examinations are now not recommended by the United States Preventative Services Task Force (U.S.P.S.T.F.), they can be useful when done in the right way.  It is important to know your breasts, because a certain amount of lumpiness is expected. This drawing shows where tenderness and thickening will be caused by an over-the-shoulder purse, or the shoulder strap of the seat belt, especially in women who are under 5’5” and who have a full ‘B’ cup or larger. If there is a difference in the size of your breasts, the bra wire will cause disproportional irritation of the outer edge of the larger breast.  If the one...