by Nick Jacobs

False security is something that typically comes from a lack of information or, conversely, an abundance of misinformation. As a young college student, we were taught about semantics, the study of the relationship between words and meanings. If you ever doubt that various national media outlets present things differently, watch the contrasts between the same news stories as presented on the numerous cable news networks and then watch the same story on the international news network. It is sometimes amazing how convoluted the actual facts can become from the interpretation of the stories by the different media sources.

Sometimes we just need to determine what the connection is behind the scenes. For example, I recently saw a newsletter called Environment & Climate News that was published by the Heartland Institute. The first article that caught my eye was entitled, Hybrid Vehicle Owners Report Adverse Health Effects. Because my family has two hybrid vehicles, I immediately immersed myself in this article. After paragraphs of fear mongering (my use of semantics to make a somewhat opinionated and prejudiced point), it quoted H. Sterling Burnett, senior fellow at the National Center for Policy Analysis who said, “There is no research definitively linking hybrid batteries to adverse human health effects.” When I googled the Heartland Institute, this is what I found, “The database contains 22,000 documents from 350 U.S. right-wing think tanks and advocacy groups.” Title vs. facts? Your call.

This article, however, is about at risk women and the various modalities that should be considered for ascertaining their risk levels. As a disclaimer, both local hospitals have MRI’s and will be performing MRI breast exams at centers near you. With that knowledge in mind, read this and decide for yourself.

Anne Wilde Mathews in the Personal Journal Section of the Wall Street Journal wrote a persuasive article that should be required reading for any woman at risk for breast cancer. The basic thrust of the article is a very clear revelation that mammography alone is absolutely not foolproof. Not unlike the accuracy or lack thereof of cardiac stress tests, mammograms can miss as high as 30 percent of malignancies, and, if you happen to be one of those unlucky, high risk patients, a clean bill of health after a mammogram is not always a reason for celebration.

As new and more refined modalities come to the forefront, the efficacy of these diagnostic tests is also continuously being substantiated. Ms. Matthews writes, “For those women whose family background, genetic, or other factors signal a high level of concern, a growing number of physicians are suggesting that MRI breast screening be recommended as the most sensitive form of screening.”

Some physicians regularly recommend ultrasound as well. Although ultrasound is much less sensitive; it still helps to identify sometimes missed lesions. According to the article, “MRI could detect cancers missed by mammography.” In higher risk patients, MRI’s detected over 70 percent of breast cancers while mammograms detect only about 40 percent.” The combination of mammography, physician examinations, and MRI resulted in a 90+ percent find rate.

One of the cautions expressed in the article from a study that appeared in the Journal of the American Medical Association, JAMA, was that both ultrasound and MRI’s can lead to false positive findings which, although disconcerting, are far better than false negatives which can be lethal.

One physician quoted in the article, Wendie Berg, a radiologist, said, “It’s a judgment call. The denser the breast, the more difficult the mammogram is to read, the more likely I am to recommend ultrasound.” Another physician, Constance Lehman, said that she never advises ultrasound for patients. “It’s not even in the same ballpark” as MRI.

My objective take on this one is, if you or your family member is an at risk patient from either family history or genetic propensity, seek further diagnostics. What you don’t know can kill you.

(Mr. Jacobs is not a medical profession - this blog is for educational purposes only and should not be construed as medical advice in any way. Please consult your medical professional)