Associated Press
These two undated photos, provided by the American College of Radiology shows an extremely dense breast, left, and a least dense breast. This image compares mammograms of an extremely dense breast and an extremely fatty breast. According to the American College of Radiology, most women fall somewhere in between.

SALT LAKE CITY — Mammography remains the best screening tool for breast cancer, and doctors believe it is saving lives. In addition to regular screenings, women can also help themselves by knowing their family history of breast-cancer related disease.

The two issues were common among callers to the Deseret News/Intermountain Healthcare Health Hotline on Saturday, which dealt with questions on breast cancer.

"Mammography is the only screening test for breast cancer which has been shown in multiple randomized clinical trials to reduce the risk of dying from breast cancer," said Dr. Brett Parkinson, radiologist and medical director at Intermountain Medical Center's Breast Care Center.

Occasionally, women may need additional screening, and in that case, Parkinson said ultrasound and MRI are used, but those modalities have not yet been proven to impact mortality.

Parkinson said digital mammography, which he estimates is used in 85 percent of health care facilities nationwide, has also been proven to be more accurate in picking up early stages of breast cancer in women with dense breast tissue, those under 50, and premenopausal and perimenopausal women. In cases where digital mammography is not available, "analog mammography is better than nothing," said Dr. Teresa Reading, a surgeon specializing in breast cancer at LDS Hospital.

"A lot of women don't like mammography and they don't want the radiation," she said, adding that alternatives to mammography are being tested across the country.

Parkinson said, however, that the risk of developing breast cancer from mammography is miniscule, and "you have to remember that we treat breast cancer with radiation."

Dozens of callers to the two-hour program had a variety of questions regarding their own cases of breast cancer, including one 83-year-old woman who has been battling multiple bouts of the illness in both breasts for the past 27 years.

"She's surviving and she wanted other patients to know that even if breast cancer comes back, you can fight it," Parkinson, who took the call, said. "She called to offer women hope and to say that you can still be alive and have a good quality of life with breast cancer."

The doctors encouraged various callers to continue annual screenings for breast cancer, beginning after age 40, and 10 years prior to the age of diagnosis of a first- or second-degree family member who had it. Parkinson said, though, that 80 percent of women with breast cancer are the first in their family to have it.

Women who have had reconstructive breast surgery or have implants resulting from breast cancer surgery, Reading said, may be exempt from screening, as there is limited tissue left in the breast, which makes screening more difficult or impossible. Such patients should continue follow-up visits with their oncologists.

The risk of breast cancer increases with every decade of life, Parkinson said, but women who are nearing the end of their life, and are ill or of declining health, who have a less than five- to seven-year life expectancy, can forgo annual screening.

Reading said women with the breast cancer gene (BRCA1 or BRCA2), which is rare and found in one in 400 women, have a significantly higher risk of breast cancer and ovarian cancer. The doctors said that such patients should have mastectomies and consider having their ovaries removed as well.

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A variety of treatment programs are available and can be discussed with patients on an individual basis with doctors from a variety of disciplines within Intermountain Healthcare's statewide network. Parkinson said the multidisciplinary approach helps provide breast cancer patients in Utah "with the very best treatment possible."

The health hotline is offered to readers through a partnership between Intermountain Healthcare and the Deseret News. It covers a different health topic the second Saturday of each month.


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