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Weider Publications

Although you might be doing everything right--eating healthfully, exercising regularly, saying no to cigarettes--there are no guarantees that breast cancer won't strike. "In fact, 75% of breast cancers occur in otherwise healthy women with no apparent risk factors," says Mark Novick, MD, a radiologist and the medical director of the Manhattan East Breast Imaging clinic in New York City.

When breast cancer is caught in the early stages, it's highly treatable; if discovered when localized, there's a 96% five-year survival rate. Until now, the most commonly used screening test for breast cancer has been mammography, but since reading these tests leaves room for human error, early indicators of cancer may be missed.


Enter a new high-tech diagnostic tool that greatly improves the chances of early detection. Computer-aided detection, or CAD, works by scanning a mammogram for signs of cancer and marking suspicious areas, CAD results can be made available in as little as two minutes, by the simple touch of a button. This gives radiologists the ability to review results immediately rather than waiting hours or even days for conventional film-based mammography results to be processed.

CAD is being used with greater frequency by radiologists as a second review of conventional mammograms. And with good reason: According to a study published in the journal Radiology, when compared with mammograms read only by a physician, the CAD technology can lead to a 20% increase in earlier breast cancer detection.


A new CAD system, called CAD stream, has just been introduced. It works to analyze breast Magnetic Resonance Imaging (MRI), another technology that augments mammography. CADstream may help promote the use of breast MRI by automating the analysis of the hundreds of images the MRI generates, thus freeing physicians and radiologists from hours of manual analysis. Since MRI is a much more sensitive diagnostic tool than the mammogram, it's also superior at picking up cancers too small to be detected by mammography.

However, Novick, who uses both CAD and MRIs, cautions that a breast MRI is an augmentation, not a replacement, for mammography. For one thing, MRIs are much more expensive. A mammogram might cost from $350-$400, while an MRI will run from $1,500-$3,000. Because of the expense, MRIs have generally been reserved for women already diagnosed with breast cancer (they can help chart the cancer's progression and help doctors devise the best treatment plan). However, women who are at an increased risk--for example, those who have a mother, sister or daughter with diagnosed breast cancer, women who have tested positive for BRCA1 or BRCA2, the gene mutation associated with breast cancer, or those who have had other cancers--may choose to have a breast MRI for their own peace of mind.


Women between the ages of 20 and 40 are in what Novick calls the "dilemma group." Because of the low incidence of occurrence of this disease in this age group, young women's concerns about breast cancer may be dismissed by medical professionals, and mammograms are not routinely prescribed for women under 40. Consequently, young women with breast cancer are often diagnosed after the disease has progressed and their treatment options have become limited.

No matter what your age, you can increase your chances of early breast cancer detection by being vigilant about protecting your good health. Do frequent self breast exams, and know your family history and risk factors. Don't skip your annual visit to the gynecologist and begin scheduling a yearly mammography after age 40. "Know your body. Know when things are changing," Novick says. "And, if you feel that you're not being taken seriously, get a second opinion."

--Alexa K. Apallas

COPYRIGHT 2003 Weider Publications

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