Kane Co Chronicle -- By Jonathan Bilyk
October 25, 2011
Advances in detection, treatment lead to better prognosis
As the woman known as "Dr. Jay" sees it, 3-D is about to make current technology obsolete.
But Sharmishtha Jayachandra, a radiologist and medical director of the Delnor Center for Breast Health, isn't talking about televisions.
Rather, "Dr. Jay," as she is known at Delnor Hospital in Geneva, believes that, just as better technology is revolutionizing virtually every facet of life, so too will up-and-coming devices displace even the tried and true standards in the fight against breast cancer.
"I am sure 3-D (mammography) will replace traditional mammograms very soon," said Jayachandra. "Once the public sees the benefits, there will be a push for everybody to have it."
For generations, women desiring to know whether their breasts are healthy and the medical professionals who diagnose and treat the dread disease have relied on the mammogram as one of their scanning best tools.
However, traditional mammography has always suffered from various deficiencies, said Jayachandra.
Traditional mammography, for instance, can deliver a less than clear image of the breast, leading to uncertainty and, in many cases, the need for a patient to go back for another scan.
Jayachandra placed the rate of "callbacks" at about 10 percent.
"For women, there can be a lot of anxiety involved here," said Jayachandra. "They immediately think, 'Oh my God, I have breast cancer,' and it may not be the case at all."
However, new imaging techniques can greatly reduce the need for such needless suffering.
Jayachandra pointed particularly to 3-D mammography, known as breast tomosynthesis.
The technique uses X-rays to take overlapping images of each breast, producing a 3-D image, greatly reducing uncertainty and the need for further scans.
While Delnor does not yet have a 3-D mammography device, Jayachandra said the hospital intends to purchase one soon.
Women – and young women, especially – can also benefit from other advances, such as the use of magnetic resonance imaging and ultrasound imaging, to detect breast cancers that may have been difficult to find using traditional techniques.
Jayachandra said women with dense breasts could particularly benefit from the use of breast MRIs and ultrasounds. Whether a woman has dense breasts is determined medically, and has nothing to do with the size of a woman's breasts, she said.
Also, she noted that MRIs are not needed in every case, as the exams can be costly and may not be covered by health insurance.
But she said in many cases, the MRIs have proven invaluable.
"We're catching breast cancer earlier on," she said.
Jayachandra and Rachel Baer, a surgeon and co-director of the Center for Breast Cancer at Sherman Hospital in Elgin, also praised the use of ultrasounds in some cases.
Baer said the ultrasound exams, which last 30-40 minutes on each breast and use no radiation, can "detect things that are abnormal, and they can do it at a higher resolution" than can mammograms.
Future imaging techniques will include technology to see breast cancer at the molecular level, Jayachandra said.
And genetic testing for use in breast cancer screenings continues to gain in use, particularly among women with a family history of cancer.
However, technological advances in the breast cancer fight are not limited to detection.
Once cancers have been detected, Baer said doctors are increasingly relying on more precise diagnostic tests like Oncotype DX to more accurately assess the risk of long term cancer recurrence.
And, from there, doctors can more precisely tailor system chemotherapy to reduce the risk of cancer returning, but in a different part of the body.
"Now we're able to better answer the question: 'What treatment is best for each case?'" Baer said.
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