Mam­mog­ra­phy still the gold stan­dard for early de­tec­tion

The Star Early Edition - - LETTERS - Dr Paul Snei­der

I WAS very dis­ap­pointed that The Star, a paper of re­pute, could pub­lish an ar­ti­cle per­tain­ing to a par­tic­u­larly im­por­tant, highly emo­tional sub­ject and of­ten with re­gret­table con­se­quences on a sci­en­tific mat­ter, on Wed­nes­day June 21, with so many er­rors and mis­rep­re­sen­ta­tion with­out any ob­vi­ous at­tempt to ver­ify the per­ti­nent facts.

First, mam­mog­ra­phy should never be painful. That is an abuse caused by in­ad­e­quate train­ing of the tech­ni­cians and ob­so­lete equip­ment. It should ex­ert pres­sure not dis­sim­i­lar to that (felt) when hav­ing a blood pres­sure ex­am­i­na­tion and nowa­days it is com­puter-con­trolled and lasts only a few sec­onds.

The breast is never “squeezed be­tween two X-ray plates” (sic). The mam­mo­gram has been used since about the 1970s and has ac­com­plished re­mark­able im­prove­ments to women’s qual­ity of life.

Mam­mog­ra­phy is still the gold stan­dard for early recog­ni­tion of breast can­cer and that is why so many coun­tries of­fer this fa­cil­ity as a free ser­vice, re­sult­ing in over­all death rate from breast can­cer de­creas­ing de­spite an aver­age world­wide in­crease in can­cer de­tec­tion of about 3.2% com­pounded.

Did your writer ver­ify the missed di­ag­no­sis in­ci­dence of 1 in 6? That is far too ex­ces­sive and does not match the pub­lished ev­i­dence of “false pos­i­tive” di­ag­noses.

The bot­tom line and very im­por­tant fact is that ul­tra­sound and X-ray gen­er­ated mam­mo­grams pro­duce very dif­fer­ent re­sults. Ul­tra­sound can­not di­ag­nose mi­cro­cal­ci­fi­ca­tion and X-rays can­not di­ag­nose cysts for ex­am­ple.

Be­cause of their dif­fer­ent speci­fici­ties, a mam­mo­gram ex­am­i­na­tion is not com­plete with­out do­ing both X-ray and ul­tra­sound ex­am­i­na­tions.

Ly­ing flat face down on a bed with cutouts for the breasts to pro­trude through has been found to be un­com­fort­able and the ap­pa­ra­tus re­quired to sus­pend them in a bath of warm wa­ter would be ex­pen­sive to pro­duce and cum­ber­some to use. The X-ray dose for mod­ern mam­mog­ra­phy is extremely low and matches the back­ground ra­di­a­tion and is of no con­se­quence. Tens of mil­lions of mam­mo­grams are done daily world­wide and no harm from X-rays has ever been re­ported from their use in mam­mog­ra­phy. If ul­tra­sound only is used for mam­mog­ra­phy the to­tal yield of cor­rect di­ag­no­sis would be low and a great num­ber of breast can­cers would be missed be­cause, for ex­am­ple, many of them present with mi­cro­cal­ci­fi­ca­tion only.

Be­sides, you state that this “new method” will be tried on 20-39 vol­un­teers. No sci­en­tist would ac­cept that as an ad­e­quate num­ber of cases to be sta­tis­ti­cally rel­e­vant. Ul­tra­sound us­age for breast dis­ease has been used now since about 1975, so it is not new.

I am ap­peal­ing to you to please pub­lish ver­i­fi­able and ac­cu­rate facts when print­ing sci­en­tific ar­ti­cles. I am de­spair­ing at the way breast can­cer is pre­sented to the public by the me­dia. If the cor­rect pro­to­cols are fol­lowed, breast can­cer be­comes an in­ci­dent, not a life-threat­en­ing sen­tence.

As breast can­cer is so com­mon and the life­time risk in the Western world is ap­proach­ing 1:7 please en­cour­age women to have reg­u­lar mam­mo­grams.

Early di­ag­no­sis and reg­u­lar mam­mog­ra­phy re­sults in a cure rate for breast can­cer of up to 90% with­out de­form­ing and ex­ten­sive surgery.

Pub­lish true facts which would be a good news story that is ver­i­fi­able. It is time to stop ter­ri­fy­ing women with old-fash­ioned ideas and in­cor­rect facts.

New “cures” and fads oc­cur daily such as ther­mog­ra­phy, special ex­am­i­na­tion gloves, iri­dol­ogy etc etc but as of now, mam­mog­ra­phy by well-trained med­i­cal pro­fes­sion­als re­main the best that is avail­able for the ul­ti­mate cure of breast can­cer.

Mam­mog­ra­phy and early di­ag­no­sis save lives… so far there is noth­ing bet­ter.

‘Please pub­lish ver­i­fi­able and ac­cu­rate facts on sci­en­tific ar­ti­cles’

Park­town North Mam­mo­gram and Bone Den­sity Cen­tre

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