TEDWomen 2010
Deborah Rhodes: A test that finds 3x more breast tumors, and why it's not available to you
Deborah Rhodes: Pomagalo koje pronalazi trostruko više tumora dojki te zašto nije dostupno vama
Filmed:
Readability: 5.2
1,021,722 views
Radeći s timom psihologa, dr. Deborah Rhodes razvila je novo pomagalo za detekciju tumora koji je trostruko učinkovitiji od tradicionalnih mamografa za žene sa zbijenim tkivom dojke. Domašaji spašavanja života su zapanjujući. Pa zašto za to nismo čuli? Rhodes daje pozadinsku priču stvaranja pomagala te političku i ekonomsku mrežu koja je dijeli od glavnog korištenja.
Deborah Rhodes - Physician, cancer researcher
Deborah Rhodes is an expert at managing breast-cancer risk. The director of the Mayo Clinic’s Executive Health Program is now testing a gamma camera that can see tumors that get missed by mammography. Full bio
Deborah Rhodes is an expert at managing breast-cancer risk. The director of the Mayo Clinic’s Executive Health Program is now testing a gamma camera that can see tumors that get missed by mammography. Full bio
Double-click the English transcript below to play the video.
00:15
There are two groups of women
0
0
3000
Postoje dvije grupe žena
00:18
when it comes to screening mammography --
1
3000
2000
kad se govori o probirnoj mamografiji --
00:20
women in whom mammography works very well
2
5000
3000
žene kod kojih mamografija veoma dobro djeluje
00:23
and has saved thousands of lives
3
8000
2000
i spasila je tisuće života
00:25
and women in whom it doesn't work well at all.
4
10000
4000
i žene kod kojih uopće dobro ne djeluje.
00:29
Do you know which group you're in?
5
14000
3000
Znate li vi u kojoj ste skupini?
00:32
If you don't, you're not alone.
6
17000
2000
Ako ne znate, niste same.
00:34
Because the breast has become
7
19000
2000
To je stoga što su grudi postale
00:36
are very political organ.
8
21000
3000
veoma politički organ.
00:39
The truth has become lost
9
24000
2000
Istina se izgubila
00:41
in all the rhetoric
10
26000
2000
među retoričkim
00:43
coming from the press, politicians,
11
28000
2000
dolaskom novinara, političara,
00:45
radiologists
12
30000
2000
radiologa
00:47
and medical imaging companies.
13
32000
2000
i tvrtki za medicinska snimanja.
00:49
I will do my best this morning
14
34000
2000
Dat ću sve od sebe
00:51
to tell you what I think is the truth.
15
36000
3000
da vam ispričam što smatram istinom.
00:54
But first, my disclosures.
16
39000
3000
Ali prvo da vam se predstavim.
00:57
I am not a breast cancer survivor.
17
42000
2000
Nisam preživjela rak dojke.
00:59
I'm not a radiologist.
18
44000
2000
Nisam radiolog.
01:01
I don't have any patents,
19
46000
2000
Ne posjedujem nikakve izume
01:03
and I've never received any money from a medical imaging company,
20
48000
3000
i nikada nisam primila novac od bilo kakve tvrtke za medicinska snimanja.
01:06
and I am not seeking your vote.
21
51000
3000
I ne tražim vaš glas.
01:09
(Laughter)
22
54000
2000
(Smijeh)
01:11
What I am
23
56000
2000
Doktorica sam
01:13
is a doctor of internal medicine
24
58000
2000
interne medicine
01:15
who became passionately interested in this topic
25
60000
2000
koja se strastveno zainteresirala za ovu temu
01:17
about 10 years ago
26
62000
2000
prije 10 godina
01:19
when a patient asked me a question.
27
64000
3000
kada mi je pacijentica postavila pitanje.
01:23
She came to see me
28
68000
2000
Došla je k meni
01:25
after discovering a breast lump.
29
70000
2000
nakon što je otkrila kvržicu na dojci.
01:27
Her sister had been diagnosed with breast cancer
30
72000
3000
Njenoj sestri je dijagnosticiran rak dojke
01:30
in her 40s.
31
75000
2000
u četrdesetima.
01:32
She and I were both very pregnant at that time,
32
77000
3000
Ona i ja smo u to vrijeme bile u visokom stupnju trudnoće
01:35
and my heart just ached for her,
33
80000
2000
i bila sam tužna zbog nje,
01:37
imagining how afraid she must be.
34
82000
3000
zamišljajući koliko se vjerojatno boji.
01:40
Fortunately, her lump proved to be benign.
35
85000
3000
Srećom, dokazalo se da je njena kvržica benigna.
01:43
But she asked me a question:
36
88000
2000
Ali postavila mi je pitanje:
01:45
how confident was I
37
90000
2000
koliko sam sigurna
01:47
that I would find a tumor early on her mammogram
38
92000
2000
da bih pronašla tumor rano na njenom mamogramu,
01:49
if she developed one?
39
94000
2000
da ga je razvila?
01:51
So I studied her mammogram,
40
96000
2000
Pa sam proučila njezin mamogram
01:53
and I reviewed the radiology literature,
41
98000
2000
i pregledala radiološku literaturu
01:55
and I was shocked to discover
42
100000
2000
te sam bila šokirana
01:57
that, in her case,
43
102000
2000
kad sam otkrila
01:59
our chances of finding a tumor early on the mammogram
44
104000
2000
da je u njenom slučaju vjerojatnost ranog otkrivanja tumora na mamogramu
02:01
were less than the toss of a coin.
45
106000
3000
bila veoma malena.
02:04
You may recall a year ago
46
109000
2000
Možda ćete se sjetiti stihije
02:06
when a firestorm erupted
47
111000
2000
koja je prije godinu dana nastala
02:08
after the United States Preventive Services Task Force
48
113000
4000
nakon što je Operativna Grupa Preventivnih Usluga SAD-a
02:12
reviewed the world's mammography screening literature
49
117000
3000
prikazala svjetsku literaturu mamografskog probira
02:15
and issued a guideline
50
120000
2000
i izdala direktivu
02:17
recommending against screening mammograms
51
122000
3000
protiv probirujućih mamograma
02:20
in women in their 40s.
52
125000
2000
žena u četrdesetima.
02:22
Now everybody rushed to criticize the Task Force,
53
127000
3000
Svi su krenuli kritizirati operativnu grupu
02:25
even though most of them weren't in anyway familiar
54
130000
2000
iako ih većina uopće nije bila upoznata
02:27
with the mammography studies.
55
132000
3000
s mamografskim studijama.
02:30
It took the Senate just 17 days
56
135000
2000
Senatu je trebalo samo 17 dana
02:32
to ban the use of the guidelines
57
137000
2000
da zabrani upotrebu direktive
02:34
in determining insurance coverage.
58
139000
3000
u određivanju osiguranja.
02:38
Radiologists were outraged
59
143000
2000
Radiolozi su bili uvrijeđeni
02:40
by the guidelines.
60
145000
2000
direktivama.
02:42
The pre-eminent mammographer in the United States
61
147000
2000
Eminentni mamografer u Sjedinjenim Američkim Državama
02:44
issued the following quote
62
149000
2000
poslao je pismo
02:46
to the Washington Post.
63
151000
3000
Washington Postu.
02:49
The radiologists were, in turn, criticized
64
154000
3000
Radiolozi su bili kritizirani
02:52
for protecting their own financial self-interest.
65
157000
3000
zbog toga što su štitili vlastite financijske interese.
02:55
But in my view,
66
160000
2000
Ali s mog stajališta,
02:57
the radiologists are heroes.
67
162000
2000
radiolozi su junaci.
02:59
There's a shortage of radiologists
68
164000
2000
Imamo nedostatak radiologa
03:01
qualified to read mammograms,
69
166000
2000
koji su osposobljeni za čitanje mamograma
03:03
and that's because mammograms are one of the most complex
70
168000
3000
i to je zato što su mamogrami
03:06
of all radiology studies to interpret,
71
171000
3000
od svih radioloških studija najsloženiji za tumačenje
03:09
and because radiologists
72
174000
2000
i zato što su radiolozi
03:11
are sued more often
73
176000
2000
češće tuženi
03:13
over missed breast cancer
74
178000
2000
zbog promaknutog raka dojke
03:15
than any other cause.
75
180000
2000
nego u bilo kojem drugom slučaju.
03:17
But that very fact is telling.
76
182000
3000
Ali ta činjenica govori sama za sebe.
03:20
Where there is this much legal smoke,
77
185000
3000
Gdje je mnogo pravnog dima,
03:23
there is likely to be some fire.
78
188000
3000
vjerojatno će biti i nešto vatre.
03:26
The factor most responsible for that fire
79
191000
3000
Faktor koji je najodgovorniji za tu vatru
03:29
is breast density.
80
194000
2000
je gustoća dojke.
03:33
Breast density refers to the relative amount of fat --
81
198000
2000
Gustoća dojke se odnosi na relativnu količinu masti --
03:35
pictured here in yellow --
82
200000
2000
ovdje obojano žuto --
03:37
versus connective and epithelial tissues --
83
202000
2000
naspram vezivnog i epitelnog tkiva --
03:39
pictured in pink.
84
204000
2000
obojano rozo.
03:41
And that proportion
85
206000
2000
I taj razmjer je
03:43
is primarily genetically determined.
86
208000
2000
primarno genetički određen.
03:45
Two-thirds of women in their 40s
87
210000
2000
Dvije trećine žena u četrdesetima
03:47
have dense breast tissue,
88
212000
2000
imaju gusto tkivo dojke,
03:49
which is why mammography doesn't work as well in them.
89
214000
3000
što je razlog zbog kojeg mamografija za njih ne radi kako treba.
03:52
And although breast density generally declines with age,
90
217000
3000
I unatoč tome što gustoća dojke pada s godinama,
03:55
up to a third of women
91
220000
2000
trećina žena
03:57
retain dense breast tissue
92
222000
2000
zadržava gusto tkivo dojke
03:59
for years after menopause.
93
224000
3000
godinama nakon menopauze.
04:03
So how do you know if your breasts are dense?
94
228000
3000
Dakle, kako znate da su vam dojke guste?
04:06
Well, you need to read the details
95
231000
2000
Pa, trebate pročitati detalje
04:08
of your mammography report.
96
233000
2000
vaše mamografije.
04:10
Radiologists classify breast density
97
235000
2000
Radiolozi grupiraju gustoću dojke
04:12
into four categories
98
237000
2000
u četiri kategorije
04:14
based on the appearance of the tissue on a mammogram.
99
239000
3000
bazirane na pojavi tkiva na mamogramu.
04:17
If the breast is less than 25 percent dense,
100
242000
3000
Ako u dojci ima manje od 25% gustoće,
04:20
that's called fatty-replaced.
101
245000
2000
to se zove masna zamijena.
04:22
The next category
102
247000
2000
Sljedeća kategorija je
04:24
is scattered fibroglandular densities,
103
249000
2000
raspršena vlaknastožljezdana gustoća,
04:26
followed by heterogeneously dense
104
251000
2000
koju slijedi heterogena gustoća
04:28
and extremely dense.
105
253000
2000
i ekstremna gustoća.
04:30
And breasts that fall into these two categories
106
255000
2000
Dojke koje spadaju u ove dvije kategorije
04:32
are considered dense.
107
257000
2000
smatraju se gustima.
04:34
The problem with breast density
108
259000
2000
Problem s gustoćom dojke
04:36
is that it's truly the wolf in sheep's clothing.
109
261000
3000
je to što je to doista vuk u janjećoj koži.
04:39
Both tumors and dense breast tissue
110
264000
2000
I tumori i gusto tkivo dojke
04:41
appear white on a mammogram,
111
266000
3000
se javljaju kao bijela pojava na mamogramu
04:44
and the X-ray often can't distinguish between the two.
112
269000
3000
i rendgenske zrake često ne mogu razlikovati to dvoje.
04:47
So it's easy to see this tumor
113
272000
2000
Dakle, jednostavno je vidjeti ovaj tumor
04:49
in the upper part of this fatty breast.
114
274000
3000
u gornjem dijelu ove masne dojke.
04:52
But imagine how difficult it would be
115
277000
2000
Ali zamislite kako bi bilo teško
04:54
to find that tumor in this dense breast.
116
279000
3000
pronaći taj tumor u ovoj gustoj dojci.
04:57
That's why mammograms find
117
282000
2000
Zato mamogrami pronalaze
04:59
over 80 percent of tumors in fatty breasts,
118
284000
3000
više od 80% tumora u masnim dojkama,
05:02
but as few as 40 percent in extremely dense breasts.
119
287000
3000
ali manje od 40% u ekstremno gustim dojkama.
05:05
Now it's bad enough that breast density
120
290000
2000
Dovoljno je loše što gustoća dojke
05:07
makes it hard to find a cancer,
121
292000
2000
otežava pronalazak karcinoma,
05:09
but it turns out
122
294000
2000
ali čini se da
05:11
that it's also a powerful predictor
123
296000
2000
je to također veoma moćan pokazatelj
05:13
of your risk for breast cancer.
124
298000
2000
vašeg rizika za karcinom dojke.
05:15
It's a stronger risk factor
125
300000
2000
To je jači faktor rizika
05:17
than having a mother or a sister with breast cancer.
126
302000
3000
od toga da imate majku ili sestru s karcinomom dojke.
05:20
At the time my patient posed this question to me,
127
305000
3000
U vrijeme kad mi je pacijentica postavila ovo pitanje,
05:23
breast density was an obscure topic
128
308000
2000
gustoća dojke je bila nepoznata tema
05:25
in the radiology literature,
129
310000
2000
u radiološkoj literaturi
05:27
and very few women having mammograms,
130
312000
2000
i jako je malo žena koje su obavljale mamografiju
05:29
or the physicians ordering them,
131
314000
2000
ili doktora koji su ih tražili
05:31
knew about this.
132
316000
2000
znalo za to.
05:33
But what else could I offer her?
133
318000
2000
Ali što sam joj drugo mogla ponuditi?
05:36
Mammograms have been around since the 1960's,
134
321000
3000
Mamografija postoji negdje od 1960. godine.
05:39
and it's changed very little.
135
324000
2000
I veoma malo se promijenila.
05:41
There have been surprisingly few innovations,
136
326000
3000
Imamo iznenađujuće malo inovacija
05:44
until digital mammography was approved
137
329000
2000
sve dok 2000. nije odobrena
05:46
in 2000.
138
331000
2000
digitalna mamografija.
05:48
Digital mammography is still an X-ray of the breast,
139
333000
3000
Digitalna mamografija je još uvijek rendgenska snimka dojke,
05:51
but the images
140
336000
2000
ali se slike
05:53
can be stored and manipulated digitally,
141
338000
2000
mogu pohraniti i obraditi digitalno,
05:55
just like we can with a digital camera.
142
340000
3000
kao što mi možemo digitalnom kamerom.
05:58
The U.S. has invested
143
343000
2000
SAD je uložio
06:00
four billion dollars
144
345000
2000
4 milijarde dolara
06:02
converting to digital mammography equipment,
145
347000
3000
prilikom prelaska na digitalnu mamografsku opremu.
06:05
and what have we gained from that investment?
146
350000
3000
I što smo dobili tim ulaganjem?
06:08
In a study funded by over 25 million taxpayer dollars,
147
353000
4000
U studiji koju je financiralo 25 milijuna dolara poreznih obveznika,
06:12
digital mammography was found
148
357000
2000
ustanovljeno je da digitalna mamografija
06:14
to be no better over all
149
359000
2000
nije ništa bolja
06:16
than traditional mammography,
150
361000
2000
od klasične mamografije.
06:18
and in fact, it was worse in older women.
151
363000
3000
I zapravo, bila je gora kod starijih žena.
06:21
But it was better in one group,
152
366000
3000
Ali je bila bolja u jednoj skupini,
06:24
and that was women under 50
153
369000
2000
a to su žene ispod 50 godina
06:26
who were pre-menopausal and had dense breasts,
154
371000
3000
koje su bile pred menopauzom i imale guste dojke.
06:29
and in those women,
155
374000
2000
I kod tih žena
06:31
digital mammography found twice as many cancers,
156
376000
3000
digitalna je mamografija pronašla duplo manje karcinoma,
06:34
but it still only found 60 percent.
157
379000
3000
ali je još uvijek pronalazila 60%.
06:37
So digital mammography
158
382000
2000
Dakle, digitalna je mamografija
06:39
has been a giant leap forward
159
384000
2000
bila ogroman skok naprijed
06:41
for manufacturers
160
386000
2000
za proizvođače
06:43
of digital mammography equipment,
161
388000
2000
opreme za digitalnu mamografiju,
06:45
but it's been a very small step forward for
162
390000
2000
ali je bio veoma mali korak naprijed
06:47
womankind.
163
392000
2000
za ženski rod.
06:50
What about ultrasound?
164
395000
2000
Što je s ultrazvukom?
06:52
Ultrasound generates more biopsies
165
397000
2000
Ultrazvuk zahtijeva više biopsija
06:54
that are unnecessary relative to other technologies,
166
399000
2000
koje su nepotrebne u odnosu na druge tehnologije,
06:56
so it's not widely used.
167
401000
3000
pa nije mnogo korištena.
06:59
And MRI is exquisitely sensitive for finding tumors,
168
404000
3000
A magnetna rezonanca je veoma osjetljiva za pronalazak tumora,
07:02
but it's also very expensive.
169
407000
3000
ali je također veoma skupa.
07:06
If we think about disruptive technology,
170
411000
3000
Ako razmišljamo o tehnologiji koja remeti,
07:09
we see an almost ubiquitous pattern
171
414000
2000
vidimo gotovo sveprisutni obrazac
07:11
of the technology getting smaller and less expensive.
172
416000
3000
tehnologije koja postaje sve manja i jeftinija.
07:14
Think about iPods compared to stereos.
173
419000
3000
Razmislite o iPodovima u usporedbi sa stereo uređajima.
07:17
But it's the exact opposite in health care.
174
422000
3000
Ali potpuno je suprotno u zdravstvu.
07:20
The machines get ever bigger
175
425000
2000
Uređaji postaju sve veći
07:22
and ever more expensive.
176
427000
2000
i sve skuplji.
07:26
Screening the average young woman with an MRI
177
431000
3000
Snimanje prosječne mlade žene magnetnom rezonancom
07:29
is kind of like driving to the grocery store in a Hummer.
178
434000
3000
je poput ulaska u trgovinu mješovitom robom u Hummeru.
07:33
It's just way too much equipment.
179
438000
2000
To je jedostavno previše opreme.
07:35
One MRI scan
180
440000
2000
Jedna magnetna rezonanca
07:37
costs 10 times what a digital mammogram costs.
181
442000
3000
košta deset puta više no što košta digitalna mamografija.
07:40
And sooner or later, we're going to have to accept the fact
182
445000
2000
I prije ili kasnije morat ćemo prihvatiti činjenicu
07:42
that health care innovation
183
447000
2000
da inovacije u zdravstvu
07:44
can't always come at a much higher price.
184
449000
3000
ne mogu uvijek biti skuplje.
07:49
Malcolm Gladwell wrote an article in the New Yorker
185
454000
2000
Malcolm Gladwell napisao je članak u New Yorkeru
07:51
on innovation,
186
456000
2000
o inovacijama
07:53
and he made the case that scientific discoveries
187
458000
3000
i objasnio je da su znanstvena otkrića
07:56
are rarely the product of one individual's genius.
188
461000
4000
rijetko proizvod jednog jedinog genija.
08:00
Rather, big ideas can be orchestrated,
189
465000
3000
Točnije, velike ideje mogu biti izvedene
08:03
if you can simply gather
190
468000
2000
ako jednostavno skupite ljude
08:05
people with different perspectives in a room
191
470000
2000
s različitim perspektivama u prostoriju
08:07
and get them to talk about things
192
472000
2000
i date im da razgovaraju o stvarima
08:09
that they don't ordinarily talk about.
193
474000
2000
o kojima inače ne razgovaraju.
08:11
It's like the essence of TED.
194
476000
3000
To je kao srž TED-a.
08:14
He quotes one innovator who says,
195
479000
2000
Gladwell citira jednog inovatora koji kaže,
08:16
"The only time a physician and a physicist get together
196
481000
4000
„Jedini put kada se liječnik i fizičar nađu
08:20
is when the physicist gets sick."
197
485000
2000
je kada se fizičar razboli.“
08:22
(Laughter)
198
487000
2000
(Smijeh)
08:24
This makes no sense,
199
489000
2000
To nema smisla
08:26
because physicians have all kinds of problems
200
491000
2000
zato što liječnici imaju raznovrsne probleme
08:28
that they don't realize have solutions.
201
493000
3000
za koje nemaju rješenje.
08:31
And physicists have all kinds of solutions for things
202
496000
2000
A fizičari imaju razna rješenja za stvari
08:33
that they don't realize are problems.
203
498000
3000
za koje ne shvaćaju da su problemi.
08:36
Now, take a look at this cartoon
204
501000
3000
A sada, pogledajmo ovu karikaturu
08:39
that accompanied Gladwell's article,
205
504000
2000
vezanu za Gladwellov članak
08:41
and tell me if you see something disturbing
206
506000
2000
i recite mi vidite li nešto uznemirujuće
08:43
about this depiction of innovative thinkers.
207
508000
3000
u ovom prikazu inovativnih mislioca.
08:46
(Laughter)
208
511000
2000
(Smijeh)
08:48
So if you will allow me a little creative license,
209
513000
4000
Dakle, dozvolite mi sada malo kreativne slobode,
08:52
I will tell you the story
210
517000
2000
ispričat ću vam priču
08:54
of the serendipitous collision
211
519000
2000
o slučajnom otkrivanju zavjere
08:56
of my patient's problem
212
521000
2000
problema mojih pacijenata
08:58
with a physicist's solution.
213
523000
2000
s rješenjem fizičara.
09:00
Shortly after her visit,
214
525000
2000
Ubrzo nakon njenog posjeta,
09:02
I was introduced to a nuclear physicist
215
527000
2000
upoznata sam s nuklearnim fizičarom
09:04
at Mayo
216
529000
2000
u Mayo klinici
09:06
named Michael O'Conner,
217
531000
2000
pod imenom Michael O'Conner,
09:08
who was a specialist in cardiac imaging,
218
533000
2000
koji je specijalist u snimanju srca,
09:10
something I had nothing to do with.
219
535000
2000
nečemu s čim uopće nemam veze.
09:12
And he happened to tell me
220
537000
2000
I on mi je pričao o
09:14
about a conference he'd just returned from in Israel,
221
539000
3000
skupu s kojeg se baš vratio iz Izraela
09:17
where they were talking about a new type of gamma detector.
222
542000
3000
gdje su pričali o novom obliku gama detektora.
09:20
Now gamma imaging has been around for a long time
223
545000
2000
Gama snimanje je u uporabi već duže vrijeme
09:22
to image the heart,
224
547000
2000
što se tiče snimanja srca
09:24
and it had even been tried to image the breast.
225
549000
3000
i čak se njime pokušavalo snimiti dojku.
09:27
But the problem was
226
552000
2000
Ali problem je bio u tome
09:29
that the gamma detectors
227
554000
2000
što su gama detektori
09:31
were these huge, bulky tubes,
228
556000
2000
velike, teške cijevi
09:33
and they were filled with these scintillating crystals,
229
558000
2000
i punjene su svjetlucavim kristalima
09:35
and you just couldn't get them close enough around the breast
230
560000
3000
i jednostavno ih nismo mogli dovoljno približiti dojkama
09:38
to find small tumors.
231
563000
2000
da bismo pronašli male tumore.
09:40
But the potential advantage was
232
565000
2000
Potencijalna prednost je bila ta
09:42
that gamma rays, unlike X-rays,
233
567000
2000
da na gama zrake, za razliku od rendgenskih zraka
09:44
are not influenced by breast density.
234
569000
3000
ne utječe gustoća dojke.
09:47
But this technology
235
572000
2000
Ali ta tehnologija
09:49
could not find tumors when they're small,
236
574000
2000
nije mogla pronaći tumore kada su bili mali.
09:51
and finding a small tumor is critical for survival.
237
576000
3000
A pronalazak malog tumora je kritičan za preživljavanje.
09:54
If you can find a tumor
238
579000
2000
Ako možete pronaći tumor
09:56
when it's less than a centimeter,
239
581000
2000
dok je manji od centimetra,
09:58
survival exceeds 90 percent,
240
583000
2000
preživljavanje iznosi 90%,
10:00
but drops off rapidly
241
585000
2000
ali brzo pada
10:02
as tumor size increases.
242
587000
2000
kako se veličina tumora povećava.
10:05
But Michael told me about
243
590000
2000
Ali Michael mi je pričao o
10:07
a new type of gamma detector that he'd seen,
244
592000
2000
novom tipu gama detektora koji je vidio
10:09
and this is it.
245
594000
2000
i to je upravo ovo.
10:11
It's made
246
596000
2000
Napravljeno je,
10:13
not of a bulky tube,
247
598000
2000
ne od teške cijevi,
10:15
but of a thin layer of a semiconductor material
248
600000
3000
već od tankog sloja poluprovodnog materijala
10:18
that serves as the gamma detector.
249
603000
2000
koji služi kao gama detektor.
10:20
And I started talking to him
250
605000
2000
Počela sam s njim razgovarati
10:22
about this problem with breast density,
251
607000
2000
o problemu gustoće dojke
10:24
and we realized that we might be able to get this detector
252
609000
3000
i shvatili smo da bismo mogli biti u mogućnosti
10:27
close enough around the breast
253
612000
2000
dovesti ovaj detektor dovoljno blizu dojke
10:29
to actually find small tumors.
254
614000
2000
da bi zapravo našli male tumore.
10:31
So after putting together
255
616000
2000
Dakle, nakon što smo skupili
10:33
a grid of these cubes with tape --
256
618000
3000
ovu mrežu kocki s trakom --
10:36
(Laughter)
257
621000
3000
(Smijeh)
10:39
-- Michael hacked off the X-ray plate
258
624000
3000
-- Michael je isjekao rendgensku ploču
10:42
of a mammography machine
259
627000
2000
iz mamografskog aparata
10:44
that was about to be thrown out,
260
629000
2000
koji je trebao biti bačen.
10:46
and we attached the new detector,
261
631000
3000
I pričvrstili smo novi detektor
10:49
and we decided to call this machine
262
634000
2000
i odlučili nazvati ovaj aparat
10:51
Molecular Breast Imaging, or MBI.
263
636000
3000
Molekularno Snimanje Dojke ili MSD.
10:55
This is an image from our first patient.
264
640000
2000
Ovo je slika naše prve pacijentice.
10:57
And you can see, using the old gamma technology,
265
642000
2000
I možete vidjeti, koristeći staru gama tehnologiju,
10:59
that it just looked like noise.
266
644000
2000
da je to izgledalo kao šum.
11:01
But using our new detector,
267
646000
2000
Ali koristeći naš novi detektor,
11:03
we could begin to see the outline of a tumor.
268
648000
3000
mogli smo vidjeti obris tumora.
11:06
So here we were, a nuclear physicist,
269
651000
2000
Dakle, evo nas, nuklearni fizičar
11:08
an internist,
270
653000
2000
i internist
11:10
soon joined by Carrie Hruska, a biomedical engineer,
271
655000
3000
kojem će se uskoro pridružiti Carrie Hruska, biomedicinski inženjer
11:13
and two radiologists,
272
658000
2000
i dva radiologa
11:15
and we were trying to take on
273
660000
2000
i pokušavamo promijeniti
11:17
the entrenched world of mammography
274
662000
2000
ukorijenjeni svijet mamografije
11:19
with a machine that was held together by duct tape.
275
664000
3000
s aparatom kojeg drži ljepljiva traka.
11:23
To say that we faced
276
668000
2000
Reći da smo se susreli
11:25
high doses of skepticism
277
670000
2000
s velikom dozom sumnjičavosti
11:27
in those early years
278
672000
2000
u tim ranim godinama
11:29
is just a huge understatement,
279
674000
2000
je eufemizam.
11:31
but we were so convinced that we might be able to make this work
280
676000
3000
Ali također smo bili uvjereni da bismo mogli ovo osposobiti
11:34
that we chipped away with incremental modifications
281
679000
3000
kada bismo uklonili neke dijelove dodane
11:37
to this system.
282
682000
2000
ovom sistemu.
11:39
This is our current detector.
283
684000
2000
Ovo je naš trenutni detektor.
11:41
And you can see that it looks a lot different.
284
686000
2000
Možete vidjeti da izgleda dosta drugačije.
11:43
The duct tape is gone,
285
688000
4000
Nema više ljepljive trake
11:47
and we added a second detector on top of the breast,
286
692000
2000
i dodali smo drugi detektor na vrh dojke
11:49
which has further improved our tumor detection.
287
694000
3000
koji je dodatno unaprijedio detekciju tumora.
11:52
So how does this work?
288
697000
2000
Dakle, kako ovo radi?
11:54
The patient receives an injection of a radio tracer
289
699000
3000
Pacijentu se ubrizga radio tragač
11:57
that's taken up by rapidly proliferating tumor cells,
290
702000
3000
kojeg primaju brzorastuće tumorske stanice,
12:00
but not by normal cells,
291
705000
2000
ali ne i normalne stanice.
12:02
and this is the key difference from mammography.
292
707000
3000
I ovo je ključna razlika od mamografije.
12:05
Mammography relies on differences
293
710000
2000
Mamografija se oslanja na razlici
12:07
in the appearance of the tumor from the background tissue,
294
712000
3000
u izgledu tumora od pozadinskog tkiva,
12:10
and we've seen that those differences
295
715000
2000
a vidjeli smo da te razlike
12:12
can be obscured in a dense breast.
296
717000
3000
mogu biti nejasne u gustoj dojci.
12:15
But MBI exploits
297
720000
2000
Ali MSD koristi
12:17
the different molecular behavior of tumors,
298
722000
3000
drugačije molekularno ponašanje tumora
12:20
and therefore, it's impervious to breast density.
299
725000
3000
i zato je neprohodno za gustoću dojke.
12:24
After the injection,
300
729000
2000
Nakon ubrizgavanja
12:26
the patient's breast is placed between the detectors.
301
731000
2000
dojke pacijentice se smještaju između detektora.
12:28
And if you've ever had a mammogram --
302
733000
2000
I ako ste ikada išli na mamografiju --
12:30
if you're old enough to have had a mammogram --
303
735000
2000
ako ste dovoljno stari da bi išli na mamografiju --
12:32
you know what comes next:
304
737000
2000
znate što je sljedeće:
12:34
pain.
305
739000
2000
bol.
12:36
You may be surprised to know
306
741000
2000
Iznenadit ćete se kad čujete
12:38
that mammography is the only radiologic study
307
743000
3000
da je mamografija jedina radiološka studija
12:41
that's regulated by federal law,
308
746000
2000
koja je regulirana saveznim zakonom
12:43
and the law requires
309
748000
2000
i zakon zahtijeva
12:45
that the equivalent of a 40-pound car battery
310
750000
3000
ekvivalent od 18 kilograma automobilske baterije
12:48
come down on your breast during this study.
311
753000
3000
da vam se spusti na dojke tijekom ove studije.
12:52
But with MBI,
312
757000
2000
Ali s MSD-om,
12:54
we use just light, pain-free compression.
313
759000
3000
koristimo samo laganu, bezbolnu kompresiju.
12:57
(Applause)
314
762000
6000
(Pljesak)
13:03
And the detector
315
768000
2000
I nakon toga detektor
13:05
then transmits the image to the computer.
316
770000
2000
šalje sliku na računalo.
13:07
So here's an example.
317
772000
2000
Ovdje je primjer.
13:09
You can see, on the right, a mammogram
318
774000
2000
Desno možete vidjeti mamografiju
13:11
showing a faint tumor,
319
776000
2000
koja pokazuje nejasan tumor,
13:13
the edges of which are blurred by the dense tissue.
320
778000
2000
čiji su rubovi nejasni zbog gustog tkiva.
13:15
But the MBI image shows that tumor much more clearly,
321
780000
3000
Ali MSD slika nam jasnije pokazuje tumor,
13:18
as well as a second tumor,
322
783000
2000
baš kao i drugi tumor
13:20
which profoundly influence that patient's surgical options.
323
785000
3000
koji veoma utječe na kirurške opcije te pacijentice.
13:24
In this example, although the mammogram found one tumor,
324
789000
3000
U ovom primjeru, iako je mamograf pronašao jedan tumor,
13:27
we were able to demonstrate three discrete tumors --
325
792000
3000
možemo demonstrirati tri diskretna tumora --
13:30
one is small as three millimeters.
326
795000
2000
jedan je velik svega tri milimetra.
13:33
Our big break came in 2004.
327
798000
3000
Naš se veliki uspjeh dogodio 2004.
13:38
After we had demonstrated that we could find small tumors,
328
803000
3000
Nakon što smo demonstrirali da možemo pronaći male tumore,
13:41
we used these images
329
806000
2000
upotrijebili smo ove slike
13:43
to submit a grant to the Susan G. Komen Foundation.
330
808000
3000
da podnesemo subvenciju za Zakladu Susan G. Komen.
13:46
And we were elated when they took a chance
331
811000
3000
Bili smo ushićeni kada su riskirali
13:49
on a team of completely unknown investigators
332
814000
2000
i uzeli ekipu potpuno nepoznatih istraživača
13:51
and funded us to study
333
816000
2000
i osnovali nas da proučimo
13:53
1,000 women with dense breasts,
334
818000
2000
1.000 žena s gustim dojkama,
13:55
comparing a screening mammogram to an MBI.
335
820000
3000
uspoređujući probir mamografa i MSD-a.
13:58
Of the tumors that we found,
336
823000
2000
Od tumora koje smo pronašli,
14:00
mammography found
337
825000
2000
mamografija je pronašla
14:02
only 25 percent of those tumors.
338
827000
3000
samo 25% tih tumora.
14:05
MBI found 83 percent.
339
830000
3000
MSD je pronašao 83%.
14:08
Here's an example from that screening study.
340
833000
3000
Evo primjera te probirne studije.
14:11
The digital mammogram was read as normal
341
836000
2000
Digitalna mamografija je pročitana kao normalna
14:13
and shows lots of dense tissue,
342
838000
2000
i pokazuje nam mnogo gustog tkiva,
14:15
but the MBI shows an area of intense uptake,
343
840000
3000
ali MSD pokazuje područje intenzivnog obuhvaćanja,
14:18
which correlated with a two-centimeter tumor.
344
843000
3000
što korelira s tumorom od dva centimetra.
14:21
In this case, a one-centimeter tumor.
345
846000
3000
U ovom slučaju, tumor od jednog centimetra.
14:24
And in this case,
346
849000
2000
A u ovom slučaju,
14:26
a 45-year-old medical secretary at Mayo,
347
851000
3000
45-ogodišnja medicinska tajnica u Mayo klinici
14:29
who had lost her mother to breast cancer when she was very young,
348
854000
3000
koja je izgubila majku zbog karcinoma dojke kada je bila veoma mlada,
14:32
wanted to enroll in our study.
349
857000
2000
željela je sudjelovati u našoj studiji.
14:34
And her mammogram showed an area of very dense tissue,
350
859000
3000
Njena mamografija je pokazala područje veoma gustog tkiva,
14:37
but her MBI showed an area
351
862000
2000
ali njen MSD je pokazao područje
14:39
of worrisome uptake,
352
864000
2000
zabrinjavajućeg obuhvaćanja
14:41
which we can also see on a color image.
353
866000
3000
koji također vidimo i na slici u boji.
14:44
And this corresponded
354
869000
2000
A to korelira
14:46
to a tumor the size of a golf ball.
355
871000
2000
s tumorom veličine loptice za golf.
14:48
But fortunately it was removed
356
873000
2000
Ali srećom,
14:50
before it had spread to her lymph nodes.
357
875000
3000
odstranjen je prije no što se proširio na njene limfne čvorove.
14:54
So now that we knew that this technology
358
879000
2000
Dakle, sada kada smo znali da ova tehnologija
14:56
could find three times more tumors in a dense breast,
359
881000
3000
može pronaći tri puta više tumora u gustoj dojci,
14:59
we had to solve one very important problem.
360
884000
3000
morali smo riješiti jedan veoma važan problem.
15:02
We had to figure out how to lower the radiation dose,
361
887000
3000
Morali smo smisliti kako smanjiti dozu zračenja.
15:05
and we have spent the last three years
362
890000
3000
I proveli smo posljednje tri godine
15:08
making modifications to every aspect of the imaging system
363
893000
3000
praveći modifikacije svakog aspekta u sustavu snimanja
15:11
to allow this.
364
896000
2000
da bi ovo dozvolili.
15:13
And I'm very happy to report that we're now using a dose of radiation
365
898000
3000
I veoma sam sretna što vam mogu priopćiti da sada koristimo dozu zračenja
15:16
that is equivalent to the effective dose
366
901000
2000
koja je jednaka efektivnoj dozi
15:18
from one digital mammogram.
367
903000
2000
jedne digitalne mamografije.
15:20
And at this low dose, we're continuing this screening study,
368
905000
3000
I u ovoj niskoj dozi, nastavljamo probirnu studiju,
15:23
and this image from three weeks ago
369
908000
3000
a ovo je slika od prije tri tjedna
15:26
in a 67-year-old woman
370
911000
2000
koja pokazuje normalnu digitalnu mamografiju
15:28
shows a normal digital mammogram,
371
913000
2000
kod 67-ogodišnje žene,
15:30
but an MBI image
372
915000
2000
ali MSD slika
15:32
showing an uptake that proved to be a large cancer.
373
917000
3000
pokazuje mjesto za koje se dokazalo da je veliki karcinom.
15:35
So this is not just young women that it's benefiting.
374
920000
3000
Dakle, ovo ne koristi samo mladim ženama.
15:38
It's also older women with dense tissue.
375
923000
3000
Već također i starijim ženama s gustim tkivom.
15:41
And we're now routinely using one-fifth the radiation dose
376
926000
3000
Sada rutinski koristimo petinu doze zračenja
15:44
that's used in any other type of gamma technology.
377
929000
3000
koja se koristi u bilo kojoj drugoj vrsti gama tehnologije.
15:48
MBI generates four images per breast.
378
933000
3000
MSD daje četiri slike po dojci.
15:51
MRI generates over a thousand.
379
936000
3000
Magnetna rezonanca ih daje više od tisuću.
15:54
It takes a radiologist
380
939000
2000
Radiologu trebaju
15:56
years of specialty training
381
941000
2000
godine posebne obuke
15:58
to become expert in differentiating
382
943000
2000
da bi postao stručnjak u diferencijaciji
16:00
the normal anatomic detail
383
945000
2000
normalnog anatomskog detalja
16:02
from the worrisome finding.
384
947000
2000
od zabrinjavajućeg.
16:04
But I suspect even the non-radiologists in the room
385
949000
3000
Ali slutim da čak i ne-radiolozi u sobi
16:07
can find the tumor on the MBI image.
386
952000
3000
mogu naći tumor na MSD slici.
16:10
But this is why MBI
387
955000
2000
Ali ovo je razlog zašto je MSD
16:12
is so potentially disruptive --
388
957000
2000
tako potencijalno poremećen.
16:14
it's as accurate as MRI,
389
959000
2000
Precizan je poput magnetne rezonance,
16:16
it's far less complex to interpret,
390
961000
3000
mnogo je jednostavniji za interpretaciju
16:19
and it's a fraction of the cost.
391
964000
2000
i manje košta.
16:21
But you can understand why there may be
392
966000
2000
Ali možete razumijeti zašto mogu postojati
16:23
forces in the breast-imaging world
393
968000
2000
snage u svijetu snimanja dojke
16:25
who prefer the status quo.
394
970000
3000
koje preferiraju status quo.
16:29
After achieving what we felt were remarkable results,
395
974000
3000
Nakon što smo postigli sjajne rezultate,
16:32
our manuscript was rejected
396
977000
3000
četiri časopisa odbila su
16:35
by four journals.
397
980000
2000
naš rukopis.
16:37
After the fourth rejection,
398
982000
2000
Nakon četvrte odbijenice,
16:39
we requested reconsideration of the manuscript,
399
984000
2000
zatražili smo ponovno razmatranje rukopisa
16:41
because we strongly suspected
400
986000
2000
jer smo sumnjali
16:43
that one of the reviewers who had rejected it
401
988000
2000
da je jedan od recenzenata koji nas je odbio
16:45
had a financial conflict of interest
402
990000
2000
imao financijski sukob interesa
16:47
in a competing technology.
403
992000
3000
s konkurirajućom tehnologijom.
16:50
Our manuscript was then accepted
404
995000
2000
Naš rukopis je tada prihvaćen
16:52
and will be published later this month
405
997000
3000
i bit će objavljen kasnije ovog mjeseca
16:55
in the journal Radiology.
406
1000000
2000
u časopisu Radiologija.
16:57
(Applause)
407
1002000
8000
(Pljesak)
17:05
We still need to complete the screening study using the low dose,
408
1010000
3000
Još trebamo dovršiti probirnu studiju upotrebljavajući nisku dozu
17:08
and then our findings will need to be replicated
409
1013000
2000
i onda će naši nalazi biti ponovljeni
17:10
at other institutions,
410
1015000
2000
u drugim ustanovama.
17:12
and this could take five or more years.
411
1017000
3000
I to bi moglo potrajati pet godina ili više.
17:15
If this technology is widely adopted,
412
1020000
3000
Ako ova tehnologija bude širom prihvaćena,
17:18
I will not benefit financially in any way,
413
1023000
3000
neću imati nikakve financijske koristi od nje na ikoji način.
17:21
and that is very important to me,
414
1026000
3000
A to mi je veoma važno
17:24
because it allows me to continue to tell you the truth.
415
1029000
3000
zato što mi dopušta da vam nastavim govoriti istinu.
17:28
But I recognize --
416
1033000
2000
Ali prepoznajem --
17:30
(Applause)
417
1035000
4000
(Pljesak)
17:34
I recognize that the adoption of this technology
418
1039000
3000
Prepoznajem da će usvajanje ove tehnologije
17:37
will depend as much on economic
419
1042000
2000
ovisiti o ekonomskim
17:39
and political forces
420
1044000
2000
i političkim snagama
17:41
as it will on the soundness of the science.
421
1046000
3000
kao i o čvrstoći znanosti.
17:44
The MBI unit has now been FDA approved,
422
1049000
3000
MSD zajednica je sada odobrena od strane FDA,
17:47
but it's not yet widely available.
423
1052000
3000
ali još nije naširoko dostupna.
17:50
So until something is available
424
1055000
2000
Dakle dok nešto ne bude dostupno
17:52
for women with dense breasts,
425
1057000
2000
za žene s gustim dojkama,
17:54
there are things that you should know
426
1059000
2000
postoje stvari koje trebate znati
17:56
to protect yourself.
427
1061000
2000
da bi se zaštitili.
17:58
First, know your density.
428
1063000
2000
Prvo, znajte svoju gustoću.
18:00
Ninety percent of women don't,
429
1065000
2000
90% žena ne zna,
18:02
and 95 percent of women don't know
430
1067000
2000
a 95% žena ne zna
18:04
that it increases your breast cancer risk.
431
1069000
3000
da povećava rizik od karcinoma dojke.
18:07
The State of Connecticut became the first and only state
432
1072000
3000
Država Connecticut je postala prva i jedina država
18:10
to mandate that women receive notification
433
1075000
2000
koja zahtijeva da žene dobiju obavijest
18:12
of their breast density
434
1077000
2000
o gustoći dojke
18:14
after a mammogram.
435
1079000
3000
nakon mamografije.
18:17
I was at a conference of 60,000 people in breast-imaging
436
1082000
3000
Bila sam na konferenciji sa 60.000 ljudi u vezi snimanja dojki,
18:20
last week in Chicago,
437
1085000
2000
prošlog tjedna u Chicagu.
18:22
and I was stunned that there was a heated debate
438
1087000
3000
I bila sam zapanjena da je tamo bila užarena rasprava
18:25
as to whether we should be telling women
439
1090000
2000
o tome da li ženama treba govoriti
18:27
what their breast density is.
440
1092000
2000
kakva im je gustoća dojki.
18:29
Of course we should.
441
1094000
2000
Naravno da treba.
18:31
And if you don't know, please ask your doctor
442
1096000
3000
A ako ne znate, molim vas, pitajte svog doktora
18:34
or read the details of your mammography report.
443
1099000
3000
da vam pročita detalje vaše mamografije.
18:37
Second, if you're pre-menopausal,
444
1102000
2000
Drugo, ako ste pred menopauzom,
18:39
try to schedule your mammogram
445
1104000
2000
pokušajte zakazati svoju mamografiju
18:41
in the first two weeks of your menstrual cycle,
446
1106000
2000
u prva dva tjedna menstrualnog ciklusa
18:43
when breast density is relatively lower.
447
1108000
3000
kada je gustoća dojke relativno niža.
18:46
Third, if you notice a persistent change in your breast,
448
1111000
3000
Treće, ako primijetite ustrajnu promjenu na vašim grudima,
18:49
insist on additional imaging.
449
1114000
3000
inzistirajte na dodatnom snimanju.
18:52
And fourth and most important,
450
1117000
2000
I četvrto i najvažnije,
18:54
the mammography debate will rage on,
451
1119000
3000
debata oko mamografije će i dalje bjesniti,
18:57
but I do believe that all women 40 and older
452
1122000
3000
ali vjerujem da sve žene s 40 i više
19:00
should have an annual mammogram.
453
1125000
2000
trebaju imati godišnju mamografiju.
19:02
Mammography isn't perfect,
454
1127000
2000
Mamografija nije savršena,
19:04
but it's the only test that's been proven
455
1129000
2000
ali je to jedini test kojim je dokazano
19:06
to reduce mortality from breast cancer.
456
1131000
3000
smanjenje smrtnosti od raka dojke.
19:09
But this mortality banner
457
1134000
2000
Ali ova smrtna zastava
19:11
is the very sword
458
1136000
2000
je sami mač
19:13
which mammography's most ardent advocates use
459
1138000
3000
koju mamografski najžešći odvjetnici koriste
19:16
to deter innovation.
460
1141000
2000
da zadrže inovacije.
19:18
Some women who develop breast cancer
461
1143000
3000
Neke žene koje razviju rak dojke
19:21
die from it many years later,
462
1146000
2000
umru mnogo godina kasnije.
19:23
and most women, thankfully, survive.
463
1148000
2000
A većina žena, hvala Bogu, preživi.
19:25
So it takes 10 or more years
464
1150000
2000
Potrebno je 10 ili više godina
19:27
for any screening method
465
1152000
2000
za bilo koju probirnu metodu
19:29
to demonstrate a reduction
466
1154000
2000
da bi dokazala smanjenje
19:31
in mortality from breast cancer.
467
1156000
2000
smrtnosti od raka dojke.
19:33
Mammography's the only one that's been around long enough
468
1158000
2000
Mamografija je jedina koja je tu negdje dovoljno dugo
19:35
to have a chance of making that claim.
469
1160000
3000
da bi imala priliku napraviti takav zahtjev.
19:38
It is time for us to accept
470
1163000
3000
Vrijeme nam je da prihvatimo
19:41
both the extraordinary successes of mammography
471
1166000
2000
i izvanredne uspjehe mamografije
19:43
and the limitations.
472
1168000
2000
i ograničenja.
19:45
We need to individualize screening
473
1170000
2000
Trebamo individualizirati probir
19:47
based on density.
474
1172000
2000
ovisno o gustoći.
19:49
For women without dense breasts,
475
1174000
2000
Za žene bez gustih dojki,
19:51
mammography is the best choice.
476
1176000
3000
mamografija je najbolji odabir.
19:54
But for women with dense breasts;
477
1179000
2000
Ali za žene s gustim dojkama
19:56
we shouldn't abandon screening altogether,
478
1181000
2000
ne bismo svi skupa trebali napustiti probir,
19:58
we need to offer them something better.
479
1183000
3000
trebamo ponuditi nešto bolje.
20:03
The babies that we were carrying
480
1188000
2000
Djeca koju smo nosile
20:05
when my patient first asked me this question
481
1190000
3000
kada me pacijentica upitala pitanje
20:08
are now both in middle school,
482
1193000
3000
su sada u srednjoj školi,
20:11
and the answer has been so slow to come.
483
1196000
3000
a odgovor presporo dolazi.
20:16
She's given me her blessing
484
1201000
2000
Dala mi je svoj blagoslov
20:18
to share this story with you.
485
1203000
3000
da podijelim ovu priču s vama.
20:21
After undergoing biopsies
486
1206000
2000
Nakon biopsija koje su u tijeku
20:23
that further increased her risk for cancer
487
1208000
3000
i kasnije povećale njen rizik od raka
20:26
and losing her sister to cancer,
488
1211000
2000
i toga što je izgubila sestru od raka,
20:28
she made the difficult decision
489
1213000
2000
donijela je tešku odluku
20:30
to have a prophylactic mastectomy.
490
1215000
3000
da napravi profilaktičnu mastektomiju.
20:34
We can and must do better,
491
1219000
3000
Možemo i moramo bolje,
20:37
not just in time for her granddaughters
492
1222000
3000
ne samo na vrijeme za njene unuke
20:40
and my daughters,
493
1225000
2000
i moje kćeri,
20:42
but in time for you.
494
1227000
2000
već na vrijeme za vas.
20:44
Thank you.
495
1229000
2000
Hvala vam.
20:46
(Applause)
496
1231000
16000
(Pljesak)
ABOUT THE SPEAKER
Deborah Rhodes - Physician, cancer researcherDeborah Rhodes is an expert at managing breast-cancer risk. The director of the Mayo Clinic’s Executive Health Program is now testing a gamma camera that can see tumors that get missed by mammography.
Why you should listen
For all of the lives it saves, mammography still cannot detect the early onset of breast cancer in as many as one of every four women ages 40 to 49. And women with dense breast tissue are four to six times more likely to develop cancer than others. Deborah Rhodes and her colleagues at the Mayo Clinic in Minnesota think they’ve found an effective way to screen these high-risk patients: molecular imaging.
Rhodes, who specializes in evaluating and managing breast cancer, is collaborating with a nuclear physicist and various radiologists on a dual-head “gamma camera” that can capture the tiny tumors in dense tissue. The new technique, which would complement (not replace) mammography, is sensitive enough to pick up a mass two-fifths of an inch in diameter. Molecular breast imaging requires patients to be injected with a radioactive drug, but it is much more comfortable than the vise-grip mammogram and is expected to cost only slightly more.
Deborah Rhodes | Speaker | TED.com