Breast Cancer
Hemalatha Rao MD

Breast cancer is the most common cancer in women in the US and the second leading cause of cancer death in women. Early breast cancer detection continues to be an unrecognized medical necessity. The routine screening for breast for cancer starts around the age of forty with annual mammograms. Breast cancer detection should start in the early twenties and women should be taught BSE (breast self exam). If detected early, breast cancer can be treated and cured successfully.

BSE is more appealing and an easier way to screen the breasts as person herself performs it. The comfort of examining the breasts in privacy without any anxiety can detect very subtle changes, which could be missed by a physician or a nurse. The women also become aware of a changing feel of the breast with hormonal changes. Any unusual or a new lump detected should be brought to physician's attention.

Mammogram, which is an X-ray of the breast performed with compression for better visualization of the in depth tissue is quite an uncomfortable procedure as perceived by many women. The anxiety, which is eminent in undergoing any kind of test, is multiplied due to the sensitivity of the patient and the mild discomfort of the procedure.

Miraluma: An exciting new test has been approved as a second line diagnostic test after a mammogram for taking a closer look at breast lumps. Patient receives a small injection of very minute amount of a nuclear material into the blood. Pictures of both breasts and the armpits are taken with the patient lying on her belly. The physician and the technologist do not have any physical contact with the patient during the test. This medicine has been used extensively for screening of heart diseases and has been proved to be very safe. There have been no side effects or reactions with this agent at our institution and hence can be used very safely.

Miraluma images are very different from mammograms, as it will only light up areas, which have an abnormal turnover of activity. This usually happens in breast cancer. Areas of calcium, fat, thickness and thinness of breast tissue will not be seen by this test thus avoiding the need for further investigations. Positive images will have a dark area of activity and can easily be detected.

In patients with lumps, which can be felt, the sensitivity is 76%. In non-palpable lesions it is much lower. This test will pick up cancers close to 1cm or larger. Our experience at Coney Island hospital has been very positive. We have performed in excess of 1500 cases on patients with doubtful mammograms with very good correlation for accuracy, in those who had biopsies on our recommendation based on this test.