Fighting the good fight
Author: Sara Rider

According to the American Cancer Society (ACS), nearly 300,000 women will face a diagnosis of breast cancer during 2012. And during 2012, ACS estimates that about 39,510 women will die from breast cancer.

Those aren’t numbers we like to hear. For the sad truth is that breast cancer is the second leading cause of cancer death in women according to ACS – second only to lung cancer. The good news is that the incidence of breast cancer began declining in 2000, dropping by about seven percent between 2000 and 2003. While ACS says the rate of incidence has remained steady since 2003, the death rate from breast cancer has also dropped since 2000. And now there is hope that a new technology may prove a vital tool in the fight against breast cancer for women with a certain risk factor for the disease.

According to ACS, women with denser breast tissue “have a higher risk of breast cancer.” The American Cancer Society defines denser breast tissue as having more glandular tissue and less fatty tissue. Why does this ratio matter? Because women with dense breast tissue not only face a higher risk of breast cancer, “dense breast tissue can also make it harder for doctors to spot problems on mammograms,” according to the ACS website.

But now a new technology has come to Central Texas that can help with detection in women with dense breast tissue: molecular breast imaging.

According to Dr. Sarah Avery, a fellowship-trained breast imager and board-certified diagnostic radiologist at Austin Radiological Association (ARA), “Imaging is the best means of [breast cancer] detection.” And now with molecular breast imaging, or MBI, “There is a new level of improvement that is going to make another leap forward.”

MBI, when combined with mammography, “will improve the detection rate three to four times, versus the rate with mammography alone,” explains Dr. Avery. MBI works by “looking at energy use. It looks at metabolism. It turns out that cancers tend to be more active, more metabolic,” says Dr. Avery. “A cancer is growing – it’s not static.”

“No matter how dense the breast tissue is, it’s still going to have low metabolism in most cases, and tumors are going to have high metabolism,” continues Dr. Avery.

Until the introduction of MBI, finding a suspicious mass in women with dense breast tissue could be “like trying to find a snowball in a blizzard,” she states. Because on a typical scan, both the mass and the dense breast tissue “are the same color.”

“You can find a snowball if it’s sitting in the middle of the grass on a summer’s day, but it’s very hard to find in a blizzard.” With MBI, a suspicious area is now more like that snowball on green grass.

But the improved rate of detection with MBI doesn’t mean that all women should rush out and demand the test.

“Mammography is the foundation and should continue to be the cornerstone of breast cancer detection,” emphasizes Dr. Avery.

“This is another jump forward, but it’s a supplement to mammography for the small group of women for whom mammography provides less-than-optimal benefit.”

With the passage of Henda’s Law in 2011 in Texas, mammography facilities are required to make patients aware of the density of their breast tissue and inform them that dense breast tissue could increase their risk of breast cancer. Armed with that information, women can then discuss with their physicians whether MBI is a good idea for them.

The appropriateness of MBI depends not only on whether a woman has dense breasts, but also on her individual risk of breast cancer.

MBI is suitable for women with dense breast tissue and a higher than average individual risk of developing breast cancer. Women can determine their individual risk through discussions with their physicians or by using online risk calculators. ARA’s website ( contains a link to a National Institute of Health breast cancer risk calculator.

If the physician and patient decide that MBI is a good idea, the actual procedure is very simple and much like a mammogram. Women are given an intravenous dose of a radiopharmaceutical before positioning the breast in a way similar to that used in mammography. Unlike mammography, however, the test only requires stabilization of the breast, not compression.

“Finding out what their density is and then finding out if they are at risk” is important for all women, urges Dr. Avery, “because early detection improves survivability.”

And improved survivability is one of the major goals in the fight against a disease that claims far too many lives.

Sara Rider is a native Austinite who has worked with physicians and hospitals throughout Texas. She frequently writes freelance articles on health topics for newspapers and magazines.

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