Photo courtesy of Nanette De Bruhl This slide shows an 8 mm mass
not seen in the mammography the previous year. The mass is so small
a doctor would not be able to feel, and therefore, detect it.
By Hemesh Patel
Daily Bruin Senior Staff
Breast cancer is expected to rob the lives of more than 40,000
individuals this year, but technological advances in preventing and
treating the disease have also cured the majority of breast cancer
patients.
And starting next month, the UCLA Iris Cantor Center for Breast
Imaging will participate in a nationwide clinical trial involving
digital mammography.
With digital mammography, images are transferred directly to
computers. Radiologists can then manipulate the images by changing
the contrast of the image and zooming in and out.
With film-screen imaging, the current method of detection,
doctors can only study the image on film.
Previous studies have found that digital mammography is just as
effective in finding cancerous tumors as film-screen imaging.
“The question is, “˜Can it be better?'”
said Dr. Nanette De Bruhl, associate professor of radiological
sciences.
The study aims to answer this question by evaluating all aspects
of digital mammography, including a comparison to film-screen
imaging.
Apart from manipulating images, digital mammography may allow
physicians to transfer images from one city to the next.
De Bruhl said this new imaging technique allows radiologists to
double-check for cancer with the aid of computer programs that
point out possible tumors.
But there are disadvantages to digital mammography, one of which
is cost. The unit can cost up to $400,000, almost three times the
amount for film screen equipment.
According to De Bruhl, radiologists also face the challenge that
the new equipment provides slightly lower resolution of images.
“As technology improves, this will not be a big
issue,” De Bruhl said.
In addition to advances in early detection, scientists with a
better understanding of the disease are developing radiation and
surgical treatments that have less of a hazardous toll on the
body.
Fifty to 60 years ago, those infected with breast cancer had
their entire breast removed. This primitive form of mastectomy also
surgically removed muscle in the chest area.
But improvements started to develop in the 1980s when scientific
studies in the United States showed that removing cancerous lumps,
followed by radiation, were just as effective as a complete
mastectomy.
“People forget that the majority of breast cancer patients
are cured,” said Dr. Guy Juillard, professor of radiation
oncology.
According to the UCLA Jonnson Cancer Center, 90 percent of women
diagnosed in the early stages of cancer five years ago are now
healthy.
Scientists have recently learned that cancerous tissue takes a
longer time to repair than normal tissue after radiation
treatment.
Because of this, Juillard said physicians are now prescribing
gentler amounts of treatment over a longer period of time.
“Medicine that is a little toxic needs to be taken in
smaller amounts,” he said.
While radiation therapy may be the primary way of treating the
disease, researchers are discovering more about the benefits of
chemotherapy ““ taking drugs that fight off cancerous cells
which are still lingering after initial treatment.
“Chemotherapy has changed a lot in the last few years
because the molecular abnormalities of breast cancer are better
understood,” said Dr. John Glaspy, professor of medicine.
“What is happening now is a revolution in science.”
Initially, chemotherapy drugs left patients with toxic side
effects, such as hair loss, a low blood count and even death.
Through trial and error, and a clearer understanding of the
disease, researchers improved the efficiency of the medication.
“The molecular biology explosion occurred 10 years ago,
but it started to bear fruit five years ago,” Glaspy
said.
Researchers are producing “molecularly smart bombs”
that pinpoint and destroy the cancerous cells. And scientists are
beginning to better comprehend the nature of the oncogene ““ a
gene, which if mutated, can lead to cancer development.
Drugs such as herceptin, which works by leaving the oncogene
functionless, became available a few years ago, Glaspy said.
Other revolutionary forms of therapy, involving hormones, are
tailored to prevent breast cancer. According to Glaspy, tamoxifen
is a weak estrogen drug that reduces the risk of developing breast
cancer in half.
While scientists know that hormones have something to do with
increasing the risk of developing breast cancer, the details are
sketchy and poorly understood.