Ultrasound improves cancer detection

Ultrasound improves cancer detection

Debbie A. Lubis, The Jakarta Post, Jakarta

Women who are at high risk of breast cancer and under 35 years
old should be examined using ultrasound to detect breast cancer
early on, a radiologist says.

Daniel Makes, radiologist at Cipto Mangunkusumo General
Hospital (RSCM), said on Friday that ultrasound could detect
breast lesions with a diameter of less than one centimeter.

"Ultrasound breast-imaging is used primarily to evaluate any
small lesion that could not be detected by mammography so the
potential to 'miss' signs of cancer can be minimized," he said.

Speaking at the seminar titled Update on Multidisciplinary
Management of Cancer, Daniel said conventional mammography
remained the best screening technique to detect breast cancer,
but it is unable to detect tiny lesions in breasts of women aged
below 35 years old.

Breast cancer is the second most common cancer among
Indonesian women after cervical cancer.

Color Doppler and Power Doppler Imaging, Harmonic Imaging, 3-D
Breast Ultrasound, and contrast enhancement Color Doppler Flow
Imaging (CDFI) are recent advances in breast ultrasound
techniques that could improve the accuracy of the diagnosis.

Daniel said that sometimes a mammography identifies oval-
shaped lesions with a clear margin as being benign even though
they were in fact malignant.

On the other hand, Daniel said, mammographies sometimes
identify radialscar, an abnormality of the benign lesion, as
cancerous.

"Ultrasound can evaluate cancerous blood vessels in the lesion
areas or at its periphery. Ninety-five percent of patients with
lesions who have the sonographic characteristics of a classic
simple cyst require no further evaluation," he said.

However, Daniel added that a small complex cyst should be
further evaluated because a benign solid lesion was potentially
cancerous.

He added that Ultrasound would also be useful if the results
of a mammography did not quite fit either of these categories:
circumscribed benign, circumscribed malignant, speculated
malignant, or speculated benign.

Meanwhile, Muchlis Ramli, an oncologist at RSCM said that lack
of education and information meant many Indonesian women remain
unaware of how to detect early signs of breast cancer.

"They trust traditional healers (dukun) more than doctors if
they find something abnormal with their breasts," he said, adding
that 80 percent of breast cancer patients only consulted doctors
when they were at an advanced stage of the cancer, when it is too
late to cure.