A new alternative to traditional hand-held ultrasounds could compensate for Thailand's lack of radio
While the average age of American women diagnosed with breast cancer is in the late 50s, in Thai women, it's a decade earlier, averaging out at 48.
Screening should thus start earlier and experts now recommend an annual check up from the age of 40.
For Thailand, that means conducting screening of more than 16 million women every year and therein lies a major problem. Radiologists are in short supply in the kingdom, with the current number standing at a meagre 1,332 nationwide.
Dr Poonpit Thongchai of the Thanyarak Breast Centre at Siriraj Hospital’s Faculty of Medicine, notes that Asian women – and that includes Thais – have denser breasts than western women. While there is nothing abnormal about this, a dense breast makes cancer harder to detect.
Breast tissue consists of fatty and fibroglandular tissue. If more than 50-per-cent of your breast is made of fibroglandular tissue, then your breasts are classified as dense.
And dense breasts, Dr Poonpit explains, means more thorough check-ups.
She likens looking for cancer in a dense breast on a mammogram to looking for a snowball in a snowstorm as the denseness can mask a tumour.
For that reason, a breast ultrasound is undertaken after the mammogram and this requires the expertise of a radiologist.
“The duration of the ultrasound varies considerably and is dependent on the doctor’s level of skill and the density and the size of the breast. It is time-consuming as it requires the radiologist to simultaneously check the screen while moving the transducer on the breast and then save the picture to the system,” Dr Poonpit explains, adding the average duration is about 19 minutes though 30 minutes is far from unusual.
“That’s why the new Automated Breast Ultrasound – Abus for short – is a boon, as it helps the radiologist save time while ensuring accuracy.
Rather like a scanner, the handheld transducer has a soft membrane that is pressed on the breast and a 3-D volumetric image of the entire breast is immediately saved to the computer. Each breast is scanned three times to ensure the area is completely covered with each scan lasting just 45 seconds and the entire process being completed in five to 10 minutes.
While the ultrasound pictures are not much different from those obtained with standard handheld ultrasound technology, the time saved allows Thai radiologists to see many more patients.
“Another difference it that we can keep the file on record and examine it when we are not busy with emergency work,” she says.
