April 2009 Reader's Digest Article

Kim, what is duct ectasia?  I have never heard the term before....Thank you...Lucy

 After reading what I wrote I realize I had incorrectly typed parts of this post...it needed to be corrected as in some cases I said one thing meaning something else. Sorry for the confusion.

Deidre, I agree about the x-ray risk. At my last bc surgery, they put in wires...before they put in the wires they did a mammogram and after the wires were put into the breast they follow it up with another set of mammogram pictures. After wiring, they realize there were more califications. They did another set of mammogram pictures and wires. The day of my surgery, I had four sets of mammogram pictures of my already sick breast. That is four years worth of mammograms

The mri showed only the larger tumor. It did not show up the multi focal dcis.. But the mammogram right before surgery picked up new califications. As much as I dislike having mammograms, I have to admit the one before surgery showed that there was a larger area of my breast that needed to be taken out. In someways the mammogram I had before surgery saved me from dirty margins. There are pro's and con's to just about everything.

It's gone through my mind...did all the mammo's I had last year cause a recurrence..one year later? If this is true than I'm in real trouble. This year I had several more than last year. I hope not.

I wish I could afford mri's...meanwhile since I'm high risk, I'll have mammograms.

B Barry

A doctor on another thread said that a chest x-ray is worth the same radiation you get with one week of living normally (from sun, etc.). Put it into perspective.

 I found this interesting for high risk women or men.

American Cancer Society Recommends MRIs for High-Risk Breast Cancer Patients

The organization's new guidelines, featured in its journal CA: A Cancer Journal for Clinicians, now recommend that women with an unusually high risk of developing breast cancer should get annual MRIs in addition to their annual mammograms. Click for guidelines. Click for New York Times story.

Because MRIs are more sensitive than mammograms, they are able to detect early indicators of breast cancer in high risk individuals that mammograms cannot. For many women, this could be a life-saving discovery.

"These guidelines are a critical step to help define who should be screened using MRI in addition to mammography, a question of significant importance as we discover women at very high risk of breast cancer can be diagnosed much earlier when combining the two technologies rather than using mammography alone," Christy Russell, MD, chair of the ACS Breast Cancer Advisory Group and co-author of the new guidelines stated.

The guidelines are also, for the first time, recommending MRI for screening women who show no signs of cancer, but possess a breast cancer gene or have a first-degree relative with the gene. 
                 

Reading this stuff can confuse me more.  I mean, the first thing they do when you become a cancer patient is ... cat scan to simply stage you. (Mine did, at least.)  Everytime I turn around it's another scan or some sort.  I have often joked I'm on the way to becoming my own power supply.  I have to go in for another breast MRI this week because my surgeon wants to remove a papiloma.  All this on top of the twelve weeks of RADS I figure at this rate I'm just waiting for the next diagnosis to come through. 

Caryn, this is out of the blue but did you have any pain or tenderness in the nodes?  The ones that they found the recurrance that is.  My MRI did not show axillary nodes in the under arm pit area just in the tops and maybe the sides of the breast.  My mammo's do not show them either.  Or did they specifically look at those nodes and adjusted to see them?  Mine have been sore since September and are getting worse.  Started with the axillary nodes in the pit then the neck and now I can feel some b b's in the clavicle.  I have had testing that did not "see" any cancer...but those tests did not see the nodes that are now all palpable and enlarged.  I have had two rounds of antibiotics in the past three weeks.  The Dr thinks they have gone down a little but they are not gone and more are popping up. 

About the mammo and stuff...I can't tell you how many I have had in the past 6 years.  I finally got an MRI in December I do not really care what the diagnostic tool is.  If it finds cancer earlier than just waiting for a bump then I will be doing it.  I am more scared of my family history and finding it too late than I am of the risk received from diagnostics.

Do we really know if it is the mammo's causing more cancer?  Could it be that now that they are cheaper...more insurances cover them.... more people doing them...so we are finding more cancer?  Would that person have gotten cancer with out doing the mammo?  I do not think we will ever know the whole truth on that one. 

Best advice each individual does what he/ she is comfortable with.

barry,  I may be thinking about it too simplistically, but here's how I see it:  While over one's lifetime the accumulated exposure to radiation may put some people at low risk of cancer, radiation has also been proven very effective at killing cancer.  With breast cancer, radiation reduces recurrence risk by approx. 50%.  So if someone already has breast cancer (even DCIS), the benefit from radiation in terms of helping ensure that the existing cancer is completely eradicated is usually much greater than the small risk that this radiation might cause another cancer sometime in the future.  Curing the known cancer is considered a higher priority than concern about a possible small risk of cancer in the future.  This same logic applies to treating childhood cancers.  It's known that the radiation that some children receive for their childhood cancers puts them at greater risk of cancer as an adult.  But without this treatment, these children might never become adults. 

Of course, this risk/benefit equation has to be determined individually for each of us.  If the risk of recurrence from one's breast cancer is already very low after surgery & other treatments, then the benefit from radiation might be small and not worth the risk of a possible future cancer.  So sometimes radiation isn't recommended after breast cancer surgery.  But most of the time, the benefit from radiation is considerable.   With high grade DCIS, for example, I read about one study yesterday that showed that with surgery only, there was a 50% recurrence rate within 7 years.  Half of these recurrences - i.e. 25% - were invasive cancer.  So if radiation can cut the risk of invasive cancer to 12.5%, that benefit is certainly much greater than the risk from the radiation itself.

Dierdre,

Sorry, my statement on the bottom of my thread was not intended to mean that they cause more cancer.  I was meaning that since more people are doing them (mammo) is why we are finding more cancer...essentially they except in some cases like yours are doing their job.  I was thinking that the increased mammo is not necessarily causing more cancer but finding more.  From what I read I see that the mammo even the digital ones do not find everything that is why other tools such as US and MRI are used in conjunction.  Unfortunately, even though the MRI is very good, not every body can get them.  I have heard about some saying the MRI did not find what they had either.  I remember someone saying above that it is Practicing Medicine...so true. We learn as we go.  Great mind benders here... something for all women to ponder and decide thier course of action.

Vickie