A story in today’s Globe Magazine story describes the new Hologic/MGH 3-D mammogram at MGH. The headline uses a word we try to avoid in reporting on cancer: “Breakthrough?” The question mark – and the entire story – attempt to qualify that message.
Here’s the lead:
Dr. Elizabeth Rafferty is trying not to lapse into rhapsodic cliches. “I don’t want to call it a magic bullet, because that would oversell,” she says. “It’s not a panacea.” Then, five minutes later: “I don’t want to say it’s catching on like wildfire.” After a few minutes more, though, Rafferty can’t help herself. She lets her enthusiasm loose. “People have been waiting for it for a long time,” she says. “It’s a step, but it’s a step by a person who has a stride of 7 feet.” “It” is a 3-D mammography machine, the Selenia Dimensions system, one of which sits in the breast imagingclinic at Massachusetts General Hospital that Rafferty, a radiologist, runs. The machine, which is made by the Bedford company Hologic and developed partly at MGH under Rafferty’s supervision, produces images that are so vivid and clear they seem to speak out loud: “Hey, right here! This is a tumor!”
The benefit? In an FDA application, the company “…reported a 7 percent improvement in their ability to distinguish cancerous from noncancerous cases when they used the new system.” In other words, seven percent fewer women will have to come in for a repeat mammogram or follow-up surgery.
But the company, and the rest of us, should be careful not to overhype 3-D mammography. As Rafferty says, it’s not a panacea. The technology does come with costs, financial and medical. A fully equipped 3-D machine runs on average $474,541, not including the annual service fee Hologic charges for maintenance, and even hospitals that already own an upgradeable 2-D system made by Hologic have to pay about $125,000 to get it adapted for 3-D use. There are also costs in the sense of risks: Women who get a combo 2-D and 3-D mammogram, the protocol that confers the most dramatic jump in benefits, are exposed to twice as much X-ray radiation as the norm (albeit still an amount that’s under the FDA’s permitted limit). And no one yet knows if the new technique will actually save lives.
The story goes on to quote MGH docs and Otis Brawly of the ACS dismissing the US Preventive Services Task Force recommendation to limit screening mammography to women over 50. Old data, they say.
No comments yet on the story But with the question of screening at 40 v. 50 still the subject of a raging debate in some circles, we expect to see a few.
If you prefer the “Sex and the City” take on cancer, see the NYTimes story on Kris Carr, the woman behind the “Crazy Sexy Cancer” franchise. (She was treated at Dana-Farber.) We appreciate the diet/prevention/watch and wait approach; but we’ll skip the burning hot pink.
“I wanted to say this isn’t your grandma’s cancer,” she says. “And at the bookstore, all I could find was all this old, sad, pass-the-tissues Hallmark stuff.” So she developed a style that’s a mash-up of “Eat, Pray, Love” and the expletive-laced pro-vegan “Skinny Bitch” books, her voice frilled with easy intimacy and bedecked with hot-pink chick-to-chick flourishes. Carr’s cancer world is a place where prostheses are for “boobies,” medical binders are “bitchin’ ” and patients are encouraged to become “ ‘Prevention Is Hot’
To each her own. We prefer our cancer news from the straight-talking-but-not- at-all-humourless Breast Cancer Action.