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Mammography Still the 'Gold Standard' for Breast Cancer

Is Mammography still the best?


"The hopeful part is that there are other technologies emerging that haven't been proved to the extent that standard mammography has, but they're certainly worthy of continued study and may replace mammography," says Kramer, who's also the senior medical scientist at the National Cancer Institute (NCI).

Among the existing alternatives is digital mammography. It uses equipment similar to the old machines, except that the images can be displayed and manipulated on a computer. Backers of the high-tech device point out that the greater detail in the image may reduce the need for additional screenings in some cases and that new software could more clearly reveal potentially worrisome changes in the breast like calcifications.

"Many consider [digital mammography] to be a major technical advance over traditional mammography, but studies to date have not demonstrated a meaningful improvement in screening accuracy," the report says. The FDA approved one digital mammography device last year.

Panel member Janet Baum, MD, associate professor of radiology at Harvard Medical School, says the jury's still out on digital mammography.

"It may be better information to some patients [with dense breasts]," Baum tells WebMD.

There also are other alternatives that may prove effective as screening tools, such as high-frequency ultrasound waves that bounce off the tissue and can then be assembled into a map. A new 3-D ultrasound displays tissue in depth, not just a single slice.

Magnetic Resonance Imaging, or MRI, has been used to look inside the body with great accuracy since the mid-80s. Now it might be used to seek out breast tumors that require minimal surgery. Still, this approach may not be as effective in separating out nonmalignant vs. malignant tumors.

For decades, researchers have thought it would be possible to illuminate cancers by shining a light source against the breast and looking at the differences in wave transmission through the tissue. The latest effort involves using techniques that can measure the chemical and molecular components of the breast.

Another option, this one being developed at Harvard, is a handheld scanner that contains pressure scanners that can be moved gently across the breast. The image is generated in as little as 20 seconds without painful compression of the tissue.

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