Mammograms are still your breast bet, say surgeons

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Mammograms are still your breast bet, say surgeons

So beware those 'alternative diagnostic techniques', breast cancer experts warn

Journalist


Breast cancer experts have sounded the alarm over alternative diagnostic techniques.
They said women should stick to the tried and tested mammograms and stay away from scientifically unproven alternatives which could place their health at risk.
Writing in the SA Medical Journal, Dr Jenny Edge and Dr Liana Roodt said the absence of a mammographic breast-screening programme in SA has given rise to alternative techniques which sometimes fail to detect tumours.
Their warning was supported by the Breast Health Foundation, which discouraged women from resorting to “cost-effective” alternatives.
Foundation head Louise Turner said many of these devices are making their way into the country since there is no requirement to register them.
“We don’t endorse them as there is no scientific clinical evidence that they work. The little trials these companies conduct are not peer reviewed and published in the medical journals,” said Turner.
But Azista South Africa, which promotes a device called Breast Scan, said many women could not afford mammograms and needed an affordable alternative that was effective in picking up tumours.
Director Kevin Moodaley said: “More women in the public sector do not have access to mammograms as they do not have access to medical insurance. Our device can be used in the private sector and at home.” The company had done clinical trials in India.
Kyara Bergstrom of Pink Parasol, a breast cancer organisation that promotes complementary therapies, said social media was littered with promotional messages from marketers of alternative therapies who scared patients with alarmism about mammograms.
“Some go as far as saying that mammograms pop tumours like pimples. These patients then turn to the screening tools, which often miss tumours or in situ cancers, leading to unnecessary trauma and expense to the patient,” she said.
Edge (head of breast and endocrine surgery at Tygerberg Hospital in Cape Town) and Roodt (a breast cancer surgeon at Busamed Paarlvlei Hospital in Somerset West) said the most common mammogram alternatives in SA were the so-called Breastlight, thermography and breast tactile imaging, or elastography.
Breastlight’s website says it allows women to see inside their breasts by shining a powerful light through the tissue. But Edge and Roodt said there was overwhelming evidence that it had missed cancers that were picked up by a mammogram, while studies had shown it produced false positives and false negatives.
Rob Oosthuizen of Medloyd Healthcare, which imports the R3,000 Breastlight to SA, said it was not intended as an alternative to a mammogram.
“It is in the period between mammograms where the Breastlight plays an important role in assisting women with the early detection of breast abnormalities,” he said. The device was designed to enhance the monthly self-examinations women should be doing.
Breast thermography uses an infrared camera to detect heat patterns and blood flow in breast tissue, and estimates the size of tumours. Edge and Roodt said interpretation of the thermograph was inconsistent and there were large numbers of false positives and false negatives.
Even though breast tactile imaging was promoted as an alternative to the clinical breast examination through its high sensitivity, data on its diagnostic screening potential was limited, said the doctors.
Specialist breast cancer surgeon Justus Apffelstaedt said use of the devices remained limited and manufacturers had struggled to penetrate the public healthcare sector owing to stringent principles of good medical practice.
In the private sector they came up against medical schemes that were reluctant to pay for such procedures.
He said the devices, mainly sourced by people outside the medical field, were often first marketed in the US and Europe.
“Once they fail to obtain the necessary regulatory approval due to lack of clinical trials, they try to recuperate their costs by bringing these devices to less-regulated markets, mainly the developing countries,” he said.
Apffelstaedt said a mammogram costs between R1,500 and R2,000 in the private sector. This was a lot cheaper than the R500,000 it could cost to treat breast cancer.

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