Mayo Clinic Women's HealthSource - February 15, 2002

Friday, February 15, 2002

Advances in Breast Cancer Screening and Prevention

SCOTTSDALE, Ariz. - Other than skin cancer, breast cancer is the most common cancer among women in the United States. Mayo Clinic Women's HealthSource features a two-part series detailing advances in breast cancer screening, prevention and treatment. This month covers screening and prevention. The March issue will outline advances in breast cancer treatment.

Early detection of breast cancer is the key to survival. Mammography and clinical breast exams are the most commonly used screening tools, but mammograms can miss about 15 percent of cancers, especially in women with dense breast tissue. And three out of four areas that look problematic on mammogram will ultimately prove to be benign. The use of computers to double check mammograms (CAD, or computer-aided detection) has been shown to increase cancer detection by 19.5 percent. Digital mammography, where X-ray images are computerized, can enhance the radiologist's ability to identify subtle differences in breast tissues.

Other advances in screening for women at high risk for breast cancer include the use of magnetic resonance imaging (MRI) and a technique called ductal lavage.

Two main areas of interest for breast cancer prevention are chemoprevention - the use of drugs (Tamoxifen, for example) to reduce cancer risk - and genetic testing, which can assess risk and identify people who may benefit from gene therapy research.

Say Cheese: Taking Advantage of Cosmetic Dentistry

SCOTTSDALE, Ariz. - The field of cosmetic dentistry has become extremely popular in recent years - so much so that almost 85 percent of dentists offer some kind of cosmetic procedures to their patients. There are many options available to people who want to correct dental problems, according to the February issue of Mayo Clinic Women's HealthSource. The prices range from several hundred to several thousand dollars depending on the procedure and the number of teeth involved.

• Bleaching - Bleaching can be done in the dentist's office or at home. It can whiten stains from age, smoking or foods like coffee and tea. Teeth that are stained yellow respond better than teeth that have brown or gray stains.
• Veneers - Porcelain veneers are shells of ceramic material bonded to the front of the teeth. They mask discoloration and brighten teeth. They can correct even severe shade problems, such as tetracycline-stained teeth. Veneers are highly resistant to new stains.
• Bonding, crowns and implants - These procedures are options for more serious problems - such as chipped and cracked teeth or badly shaped teeth or missing teeth.

If you are interested in improving the appearance and health of your teeth, consult with your dentist to choose the procedure that is right for you.

Alternatives to Hysterectomy

SCOTTSDALE, Ariz. - Excessive uterine bleeding (or menorrhagia) is the cause of more than 20 percent of the 600,000 hysterectomies performed in the United States each year. Mayo Clinic Women's Healthsource reports that new surgical procedures are making hysterectomy unnecessary for some women with menorrhagia. The procedures are typically performed in outpatient settings, and patients often can return to normal activity within 48 hours.

Surgical alternatives to hysterectomy for menorrhagia involve removing or destroying the uterine lining. There are three procedures that are most commonly performed:

• Ablation with laser therapy uses a laser or electrical current to destroy the uterine lining. Complications include possible uterine perforation or fluid imbalances resulting from the procedure.
• Rollerball diathermy uses a device that applies heat as it rolls across the surface of the uterine lining. It is less likely to cause complications, but still carries some of the same risks as standard ablation.
• Thermal balloon ablation is the preferred therapy. A heated, fluid-filled balloon is inflated in the uterus and is left in contact with the uterine lining for about eight minutes. The procedure is less likely to cause uterine perforation than the other two options.

Researchers also are evaluating several other procedures that, for example, use microwave radiation or I.V. medications. All of the procedures mentioned here are only available to women who have no chance of becoming pregnant. Although the uterus is left intact, the destroyed lining cannot support a pregnancy.

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