By: Dr. Ashley Chauvin ND
It is It is estimated that about 1 in 8 Canadian women will develop breast cancer during their
lifetime. However, the 5 year survival rate for breast cancer is now up to 92%. This has
increased approximately 30% in less than 50 years. The reason for increased survivorship rate
is early detection.
The gold standard for breast cancer detection is a mammogram. A mammogram is an X-ray
picture of the breast taken of each breast from 2 different angles. It detects abnormal changes
in the breast, even when they may be too small to see or feel.
Some people can have concerns about the radiation exposure from a mammogram, but in fact, the dose of radiation from a mammogram is less than half of the yearly public dose limit. In studies, we have found the the ratio of lives saved from a mammogram to induced cancer from the radiation is 62:1. Therefore the benefit truly outweighs the risk.
Different countries have different recommendations when it comes to recommending when
mammograms should begin. In the United States and Europe, it is suggested to begin
screening as early as age 40 or 45 or average risk. The Canadian Task Force on Preventative
Health recommends getting mammograms every other year starting at age 50 if you are of
average risk.
You might be high risk if you:
- Have a personal history of breast cancer
- Have the BRCA1 or BRCA2 gene
- Have a first-degree relative (parent, child or sibling) with these gene mutations or history of breast cancer
- Have received chest radiation therapy before 30 years of age or within the past eight year
If you are a high risk individual, you will be part of the provincial screening program and will
receive mammograms (and potentially other imaging such as MRI) sooner than age 50 and
more frequently.
In the most recent years, there has been more awareness about dense breasts and the risk of
breast cancer. Breast density is not related to breast size, it means there is a higher amounts of
glandular tissue compared to fatty tissue. Dense breasts make it difficult to see cancerous
changes on screening mammograms. Therefore, further imaging and additional screening
should be discussed between you and your provider. Thanks to advocacy groups, it is
mandated 9 provinces (including Ontario) as well as 38 states that patients are notified if they
have dense breasts and are recommended further imaging – like diagnostic mammograms or
ultrasounds.
What about Thermography?
Thermography is when a heat-sensing infrared camera is used to record the surface heat produced by different parts of the body. The theory is abnormal tissue growth can cause temperature changes, which may show up on the thermogram. It can seem like a good option because it is non invasive and there is no radiation exposure (the two main patient complaints about mammograms).
However, it difficult to distinguish the cause of the increase in heat, so there is also an increase
in what’s called a false positive. A false positive is when a test flags for the disease, but nothing is actually there. It is not more accurate than a mammogram and unfortunately has not been shown to make a difference in a patient’s overall prognosis if they were flagged.
“Currently there is not sufficient evidence to support the use of thermography in breast cancer
screening, nor is there sufficient evidence to show that thermography provides benefit to
patients as an adjunctive tool to mammography or to suspicious clinical findings in diagnosing
breast cancer”
Self Breast Exams
Breast self awareness can be also be useful in detection of cancer. You use your eyes and
hands to determine if there are any changes to the look and feel of your breasts. If you notice
new breast changes such as a change in size or shape, swelling in your armpit or around your
collar bone, nipple inversion or discharge, change in skin texture or a lump or thickening, it is
important to discuss these with your doctor.
Practicing breast self awareness, advocating if you notice changes and getting screening as
recommended by public health is the best option in catching a potential cancer early.
If you have questions or concerns about mammograms or breast health, let’s chat!
Dr. Ashley Chauvin is our Naturopathic Doctor who focuses her practice on both supporting patients through menopause and when experiencing breast cancer. In addition to her role at Clarity, she provides education for her peers through various education platforms to support their development in evidence based care for their patients experiencing menopause and breast cancer.
Dr. Ashley currently accepts new patients at Clarity Health. You can submit a web inquiry to request a call back to book with Ashley to support your own health journey.
References:
Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al.. Current and future
burden of breast cancer: global statistics for 2020 and 2040. Breast, Published online 2
September 2022; https://doi.org/10.1016/j.breast.2022.08.010
Hooshmand S, Reed WM, Suleiman ME, Brennan PC. A review of screening mammography:
The benefits and radiation risks put into perspective. J Med Imaging Radiat Sci. 2022
Mar;53(1):147-158. doi: 10.1016/j.jmir.2021.12.002. Epub 2021 Dec 27. PMID: 34969620.
https://nuclearsafety.gc.ca/eng/
https://densebreastscanada.ca/
Fitzgerald A, Berentson-Shaw J. Thermography as a screening and diagnostic tool: a
systematic review. N Z Med J. 2012 Mar 9;125(1351):80-91. PMID: 22426613.
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