A number of years ago my breast cancer doctor (I had breast cancer 22 years ago) was very excited about a better way to image the breasts, especially for women like myself with what they call, denser breasts. This upgraded form of mammography is called computer-aided detection (CAD). That’s what I was getting when I did go in for follow up imaging.
But a new study now shows that CAD doesn’t improve accuracy of detecting cancer at all. And in fact, what’s even more concerning, the new study has found that radiologists tended to miss more cancers when they interpret films made by this method. Ugh.
This study comes from the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital, Boston. This study was published online September 28, 2015 in JAMA Internal Medicine.
These finding are in sync with two earlier studies saying CAD wasn’t all it was talked up to be. And in fact, those studies found that CAD had little, if any, impact on breast cancer detection. And again concerning, these studies raised concerns that CAD may increase recall and biopsy rates when they weren’t called for.
What a mess.
So what’s a gal with breasts to do? I used to think, perhaps MRIs would fit the bill, as they have no radiation at all, which is the worrisome side of mammography as it is, in fact, ionizing radiation.
But MRI’s are now not without concern either. The contrast, gadolinium, has been found to travel and lodge in the brain. What this means is not exactly known, but it is not a comforting set of now reproduced findings.
How to monitor and image one’s breasts is not a set of easy carefree options. My cancer was not found by mammography (30% of breast cancers aren’t found by it, but that means 70% are). I was using CAD, and was told by my breast specialist it was the best way for me to do. Well, that hasn’t panned out.
I have one kidney so I don’t get MRIs due to the contrast, as it is not gentle on renal tissue. And, oh yes, I also have only one brain.
So what do I do?
• I do monthly, if not weekly, breast exams in the shower with soap.
• I want to intimately know what my breasts feel like to be able to tell if there are changes and if they are cyclical or not.
• I do ultrasounds every 6 months and monitor changes and have all my records in one chart so these changes are tracked.
• I have designed my own special estrogen metabolism formula that I take but haven’t found a company to sponsor… yet.
• I take strategic hormone replacement that balances my hormones and tamps down my “bad” carcinogenic estrogens and “revs” up my “anti-carcinogenic” metabolites, plus upregulates my critical tumor suppressor genes.
• I take nutraceutical aromatase inhibitors.
• I do regular receptor detoxes that I have designed with my years in writing Hormone Deception and working as an estrogen scholar at Tulane.
• I take supplements to promote lymph flow and protect DNA (cancer often starts with DNA damage).
• I mostly avoid foods and lifestyle actions that are known to damage DNA (like blackened meats and non-filtered home air and water).
• I don’t do thermography as I took a course by a number of docs three years ago who had pictures of patients up on the slides that were missed by thermography (when they used to do it and now don’t) and were now no longer alive.
• I live in as immuno-supportive way as I can, including healthy sleep hygiene, robust exercise, passion, repose and community.
• I am a big believer that Vitamin F—fun—is not frivolous but mandatory for the soul and the health of all tissues including our breasts.
• The breasts, I believe, are intimately linked to our mental health. The happier we are, the more balanced our hormones, and vice versa.
• I can’t avoid stress but I invite it in for tea and try to make friends with it.
• I do mammograms about every 5 years to get a different look-see.
Every case is different
I did not have a typical cancer, if I did my to-dos might be different. I might do mammography more often. I might not. Right after the cancer I was prescribed mammograms every 6 months and I was scared into thinking this was the only correct path to take. I was a good little girl back then with this. But I wish now I hadn’t. But that’s what I did back then. There are no set answers and no set safe ways. The literature and science are not straightforward.
In 2014, the Swiss Medical Board, an independent health technology assessment initiative, scrutinized mammography screening. The experts on the board for the review were: a medical ethicist, a clinical epidemiologist, a pharmacologist, an oncologic surgeon, a nurse scientist, a lawyer, and a health economist.
Mammography appeared to prevent only one death for every 1,000 women screened, while causing harm to more. But if you are the woman whose life it saves, well then, it was worth it. But the Swiss now feel each case should be monitored on an individual basis keeping all these complex issues in mind.
But if you are a woman and you own breasts… you must care take them.
• You must do something.
• You can’t stick your heads or breasts in the sand.
• You must work out an individual program based on your personal medical history.
• But with today’s complexities, the truth is, you can’t just listen to one expert. The facts are changing fast and furious even for them.
• All of us today must be our own health advocates.
• The time of Dr. Marcus Welby always being right are long gone.
• But part of your health program for yourself must include breast monitoring of some sensible kind, merged with a healthy breast life conscious style.
• No smoking.
• No second hand smoking.
• No drinking to excess.
• No continuous use of underwire bras.
• No eating a junk food diet deficient in plant foods.
* No protective nutrient deficiencies.
• No couch potatoes.
• No ignored on-going anger and depression or terror.
And there you have at least my opinion on the subject.