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This was in NEJM this week. 

"Ten years after treatment, accelerated, hypofractionated whole-breast irradiation was not inferior to standard radiation treatment in women who had undergone breast-conserving surgery for invasive breast cancer with clear surgical margins and negative axillary nodes."

I recently had a health journalist interview me about the new guidelines for mammography under 50.

You may recall a storm of controversy was touched off in December 2009, when the US Preventive Services Task Force recommended that mammography begin at 50.  Sarah Palin went so far as to compare these recommendations to "death panels" under health care reform.  The controversy died down, and health care reform legislation was rewritten to ensure access to mammographic screening.

JNCI is reporting this week a study that questions the safety of mammograms in young women at high risk for breast cancer. Carriers of the BRCA gene mutation are at very high risk for breast cancer and routinely are offered mammographic screening from a young age. The problem is that mammograms use radiation and there are risks of taking radiation exposures on a routine basis. The big question is where does the risk of radiation-induced breast cancer fall to the point where mammo is of greater benefit than harm.

A recent study carried out at the Mayo Clinic in Rochester MN reveals that small breast tumors of less than 2 cm in size can easily be detected by a dual-headed gamma camera set up for molecular breast imaging (MBI). The study is published in the December issue of the American Journal of Roentgenology. Lead author of the study Carrie B. Hruska MD and his colleagues have developed a dual-head MBI system using 2 cadmium zinc telluride detectors to concurrently attain opposing breast views and reduce lesion-to-detector distance.

Breast feeding is now being linked to  diminished behavioural problems in young children according to new research. Parents of children who were breast-fed as babies were found to be less likely to report that their young child had psychiatric illness or behavioural problems in their first five years according to the study. The probability of mental health problems developing were also linked to the duration of breast-feeding. Thus the longer the infant was breast-fed the less likely that such problems would occur.

Malignant breast masses often show evidence of increased blood flow compared to normal tissue or benign masses. Using 3-D power Doppler ultrasound radiologists are able to identify vessels with higher flow speeds which likely designate cancer. Lead author Dr. LeCarpentier Ph.D. assistant professor in the Department of Radiology at University of Michigan in Ann Arbor and colleagues took out a study on 78 women between the ages of 26 and 70 who where scheduled for biopsy of a suspicious breast mass.

A study expected to be unveiled at the American Society of Clinical Oncology Breast Cancer Symposium says that women who receive an MRI after an initial diagnosis of breast cancer are delaying their treatment and are more likely to require a mastectomy rather than some other type of breast conserving surgical intervention. In spite of this very clear evidence regarding the benefits of MRI the authors of the study say that the use of the MRI is definitely on the rise. "There was no rhyme or reason as to when MRIs are being used " said the author of the study Dr. Richard J.

Breast impedance scanning in human trials "EKG of the breast" may offer alternative to mammography

The Cochrane Library publishes a review this month on breast self exam that reiterates findings from prior large studies: women who perform breast self exam are much more likely to have a biopsy for benign disease and there is no clear improvement in breast cancer detection. Having said this I got an education about self breast exam from of all places Facebook. There is a group about breast self exam and one doc (a resident I think) made the bad move of posting a note that breast exam was no longer recommended.