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.