Motor neurone disease 'gene clue'

A gene linked to a type of motor neurone disease that runs in families has been found after a 10-year search.

Along with a related gene reported last year, it opens up an unexplored area of research into the condition, investigators said.

The finding will also help doctors screen and counsel families at risk of the disease, the US and UK team wrote in Science.

Up to 10% of cases are inherited within families because of genetic mutations.

Motor neurone disease (MND) involves the progressive wasting of the muscles, while usually leaving the mind unaffected.

It affects some 5,000 people in the UK.

The first MND gene - SOD1 - was found in 1993 and it has been a major focus of research.

But then researchers found a protein called TDP-43 is deposited in the neurons of 90% of people with the condition.

However, it was not apparent in animal models with the SOD1 mutation, suggesting that the first gene found is not linked with the major underlying biology of the disease.

For the past decade the UK and US team have been looking for a gene believed to be located on chromosome 16.

They eventually found a mutation in the FUS gene in one family with inherited MND - also known as amyotrophic lateral sclerosis.

Further studies showed that 4% of all families had FUS mutations.

The FUS gene is related to TDP-43, the gene for which was found by the same researchers last year.

'Accelerating research'

Professor Christopher Shaw, from the Institute of Psychiatry at Kings College London, said the FUS gene was a very important clue as to what causes motor neurons to degenerate.

"It's very interesting, we really have wrung SOD1 out. We have looked at cells and mice endlessly, but the major pathways are not SOD pathways.

"The genetic pieces of the jigsaw puzzle are beginning to fit together, leading us in new and exciting directions of research."

He said the research would have immediate implications for genetic testing of families affected and also for reassuring those with sporadic cases that their relatives were not at risk.

Dr Belinda Cupid, research manager at the MND Association, said the fact that two genes had been discovered in 12 months reflected the "accelerating pace" of such research.

"Not only will it open up an entirely new avenue of scientific investigation, it will also allow researchers to compare the different known causes of MND and start to home in on the main biochemical events that cause motor neurones to die."

Lung Cancer

Cancer of the lung, like all cancers, results from an abnormality in the body's basic unit of life, the cell. Normally, the body maintains a system of checks and balances on cell growth so that cells divide to produce new cells only when needed. Disruption of this system of checks and balances on cell growth results in an uncontrolled division and proliferation of cells that eventually forms a mass known as a tumor.

Tumors can be benign or malignant; when we speak of "cancer," we refer to those tumors that are considered malignant. Benign tumors can usually be removed and do not spread to other parts of the body. Malignant tumors, on the other hand, grow aggressively and invade other tissues of the body, allowing entry of tumor cells into the bloodstream or lymphatic system and then to other sites in the body. This process of spread is termed metastasis; the areas of tumor growth at these distant sites are called metastases. Since lung cancer tends to spread or metastasize very early in its course, it is a very life-threatening cancer and one of the most difficult cancers to treat. While lung cancer can spread to any organ in the body, certain organs -- particularly the adrenal glands, liver, brain, and bone -- are the most common sites for lung-cancer metastasis.

The lung is also a very common site for metastasis from tumors in other parts of the body. Tumor metastases are made up of the same type of cells as the original, or primary, tumor. For example, if prostate cancer spreads via the bloodstream to the lungs, it is metastatic prostate cancer in the lung and is not lung cancer.

The principal function of the lungs is the exchange of gases between the air we breathe and the blood. Through the lung, carbon dioxide is removed from the bloodstream and oxygen from inspired air enters the bloodstream. The right lung has three lobes, while the left lung is divided into two lobes and a small structure called the lingula that is the equivalent of the middle lobe. The major airways entering the lungs are the bronchi, which arise from the trachea. The bronchi branch into progressively smaller airways called bronchioles that end in tiny sacs known as alveoli where gas exchange occurs. The lungs and chest wall are covered with a thin layer of tissue called the pleura.

Lung cancers can arise in any part of the lung, but 90%-95% of cancers of the lung are thought to arise from the epithelial, or lining cells of the larger and smaller airways (bronchi and bronchioles); for this reason, lung cancers are sometimes called bronchogenic carcinomas or bronchogenic cancers. Cancers can also arise from the pleura (the thin layer of tissue that surrounds the lungs), called mesotheliomas, or rarely from supporting tissues within the lungs, for example, blood vessels.

UK docs to use 'Cyberknife' to treat cancer

Doctors in Britain will for the first time use a robotic radiotherapy machine to treat cancer this week.

The machine called Cyberknife is said to be worth 2.5 million pounds.

It maps the movement of a patient's breathing so that tumours can be targeted with greater accuracy than is currently possible.

The novel device uses a robotic arm to deliver multiple beams of high-dose radiation from a wide variety of angles

The patient's breathing is monitored with the aid of X-ray cameras, and the radiotherapy beam is repositioned accordingly to minimise damage to surrounding tissues.

This, in turn, makes the therapy so accurate that even tumours in difficult positions and dangerous to operate on, such as near the spinal chord, can be treated safely.

Ten people are lined up for treatment in the Harley Street Clinic in London, at a cost per patient of 15,000 to 20,000 pounds.

Dr. Nick Plowman, a consultant oncologist at St Bartholomew's hospital, who will oversee the treatment.

"If you get a discreet little tumour in an awkward place, under the liver or next to the kidney, then there's really nothing better than the Cyberknife," the Telegraph quoted him as saying.

Health Benefits of Gelatin

Gelatin is a colorless, odorless, and tasteless thickening agent, which when dissolved in hot water and cooled, forms a jelly. Gelatin is a mixture of proteins extracted from animal collagen by a process known as hydrolysis. Collagen actually makes up almost a third of all the protein in the human body. It is a big, fibrous molecule that makes skin, bones, and tendons both strong and elastic. The collagen use for making gelatin usually comes from beef and veal bones, cartilage, tendons and other tissue. Much of the commercial gelatin today is made from pig skin. Recently, gelatin has entered the nutritional supplement marketplace for use in bone and joint health. Gelatin is usually found in combination with other supplements such as vitamin C, calcium, glucosamine, chondroitin sulfate, and willow bark.

Commercial Making of Gelatin: To make gelatin, manufacturers grind up the various animal parts and pre-treat them with either a strong acid or a strong base to break down cellular structures and release proteins like collagen. After pre-treatment, the resulting mixture is boiled. During this process, the large collagen protein ends up being partially broken down, and the resulting product is called gelatin.

Health Benefits:

    * Gelatin appears to be beneficial to athletes for muscle growth and metabolism.

    * Gelatin promotes a feeling of fullness.

    * Gelatin helps maintain regularity

    * Gelatin's high collagen protein content helps keep your skin smooth and firm. Many creams contain collagen to moisturize the skin but it is more effective when taken through food.

    * Gelatin strengthens the hair, keeping it looking shiny and healthy.

    * Gelatin is also excellent for the nails because it makes them stronger, so they do not break easily.

    * Gelatin is excellent for your bones because of its high concentration of glycoprotein and proline amino acids

      . If you have a deficiency in both amino acids, you can have joint pain. When it is taken orally, it travels directly to your blood and from there; it goes to its destination, the connective tissue. By adding at least 10 grams of gelatin to your regular diet, your joints will quickly regenerate in case you overexert yourself.

Nutrient in Gelatin: The gelatin is rich in the amino acids found in collagen, including L-proline, L-hydroxyproline, and glycine. It contains no fat, cholesterol or carbohydrates, is free of any additives and easy to digest. Gelatin makes a nutritious addition to your everyday diet.

Culinary uses: Gelatin is used mostly as a stabilizer and thickening agent in desserts, ice cream, jellies and yogurt, cream cheese, marshmallows, gummy bears, aspic and margarine. Gelatin is also used now in cosmetics and pharmaceuticals

Important note: Don't pour gelatin directly onto a boiling liquid, as it loses its gelatinous property. 

Breast Cancer

Breast cancer is cancer arising in breast tissue. Cancer is simply a group of abnormal cells that have abnormal growth patterns.

Although breast cancer is primarily a disease of women, almost 1% of breast cancers occur in men. In 2007, it is estimated that 2,030 men in the U.S. will develop invasive breast cancer.

Breast cancer is the most common type of cancer in women with the exception of nonmelanoma skin cancers. It is the second leading cause of death by cancer in women, following only lung cancer.

In 2007, the American Cancer Society estimated that 178,480 new cases of invasive breast cancer would be diagnosed among women in the United States, and that a further 62,030 new cases of in-situ (noninvasive) breast cancer would be diagnosed.

A woman has a lifetime risk of developing invasive breast cancer of about one in eight, or 13%.

Death rates from breast cancer have been gradually declining and continue to decline. These decreases are likely due both to increased awareness and screening and improved treatment methods.

Breast Cancer Causes

Many women who develop breast cancer have no risk factors other than age and sex.

Gender is the biggest risk because breast cancer occurs mostly in women.

Age is another critical factor. Breast cancer may occur at any age, though the risk of breast cancer increases with age. The average woman at age 30 years has one chance in 280 of developing breast cancer in the next 10 years. This chance increases to one in 70 for a woman aged 40 years, and to one in 40 at age 50 years. A 60-year-old woman has a one in 30 chance of developing breast cancer in the next 10 years.

White women are slightly more likely to develop breast cancer than African American women in the U.S.

A woman with a personal history of cancer in one breast has a three- to fourfold greater risk of developing a new cancer in the other breast or in another part of the same breast. This refers to the risk for developing a new tumor and not a recurrence (return) of the first cancer.

Breast Cancer Symptoms

Early breast cancer has no symptoms. It is usually not painful.Most breast cancer is discovered before symptoms are present, either by finding an abnormality on mammography or feeling a breast lump. A lump in the armpit or above the collarbone that does not go away may be a sign of cancer. Other possible symptoms are breast discharge, nipple inversion, or changes in the skin overlying the breast.

Most breast lumps are not cancerous. All breast lumps, however, need to be evaluated by a doctor.

Breast discharge is a common problem and is rarely a symptom of cancer. Discharge is most concerning if it is from only one breast or if it is bloody. In any case, all breast discharge should be evaluated.

Cancer

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.

Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.

Cancer types can be grouped into broader categories. The main categories of cancer include:

Carcinoma - cancer that begins in the skin or in tissues that line or cover internal organs.

Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

Lymphoma and myeloma - cancers that begin in the cells of the immune system.

Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.

Origins of Cancer

All cancers begin in cells, the body's basic unit of life. To understand cancer, it's helpful to know what happens when normal cells become cancer cells.

The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.

However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.

Not all tumors are cancerous; tumors can be benign or malignant.

Benign tumors aren't cancerous. They can often be removed, and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body.

Malignant tumors are cancerous. Cells in these tumors can invade nearby tissues and spread to other parts of the body. The spread of cancer from one part of the body to another is called metastasis.Some cancers do not form tumors. For example, leukemia is a cancer of the bone marrow and blood.

Cancer Statistics

A new report from the nation's leading cancer organizations shows that, for the first time since the report was first issued in 1998, both incidence and death rates for all cancers combined are decreasing for both men and women, driven largely by declines in some of the most common types of cancer.

Cancer Causes

Diet and lifestyle

There are over 200 different types of cancer. We don't know the causes for each one of these cancers, but we do know about some. It is important to note that for many cancers, there may be more than one cause.

One of the biggest risks is increasing age. Cancer can occur at any age but the risk of developing it increases with age. Nearly two thirds (64%) of people who get cancer are over the age of 65, and more than a third are over 75.

We make lifestyle choices everyday - some we know increase our risk of developing cancer, others may have an influence on our risk. For example, smoking is a major cause of lung cancer and is a factor in other cancers, such as bladder cancer and cancers of the head and neck. Other factors that can influence our risk of developing cancer include heavy alcohol consumption and exposure to sunlight.

It is also thought that diet can influence the development of some cancers, although the evidence is less clear. Diets high in animal fats have been linked with breast cancer, bowel cancer and prostate cancer. A diet that is low in fresh fruit and vegetables may also increase your risk of developing some types of cancer. Obesity has been linked to some cancers, such as cancer of the breast or kidney.

Environmental and occupational causes

Contact with certain harmful substances in the environment or workplace can cause cancer. Substances that are known to cause cancer are called carcinogens.

We know, for example, that 9 out of 10 people who develop mesothelioma (a rare type of cancer affecting the linings of the lung and abdomen) have had contact with asbestos. People who have worked in industries such as ship-building and construction may have come into contact with asbestos. Its use is now banned in the UK.

Certain chemicals used in dye factories, rubber production, gas works and other chemical industries have all been linked to bladder cancer. Fortunately these chemicals have now been banned.

Environmental causes include natural radiation, for example, from the sun. We know that most skin cancers, including melanoma, are caused because of prolonged exposure to the sun. Naturally occurring radon gas has also been linked to some types of cancer, namely lung cancer.

Viruses

It is important to remember cancers are not infectious and cannot be caught from someone. However, there are a number of different viruses that are thought to be contributing factors in the development of cancer.

For example, exposure to HPV (human papilloma virus) is known to increase the risk of developing some types of cancer. For further information about this, see the section about HPV.

Other viruses include the Epstein-Barr virus, which is linked to some types of lymphoma.

There is also a bacterial infection known as H-pylori which is linked to a rare type of stomach cancer.

Malignant Mesiothelioma

Mesothelioma is a rare cancer. It is more common in men, which is due in most part to work-related exposure to asbestos. Risk also increases with age. The biggest risk factor for developing the disease is exposure to asbestos, accounting for 70 to 80 percent of all cases. Asbestos has been used in many products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. Particles can be released from these products, particularly during the manufacturing process, and inhaled. Prior to knowing the dangers, asbestos miners and other workers exposed to asbestos worked without wearing any protection. Smoking does not seem to increase the risk of developing the disease.

Signs

The symptoms of mesothelioma are caused by a build-up of tumor tissue surrounding the lung and fluid in the pleural space that prevents the lung from expanding fully. This causes pressure on the lung, leading to pain and shortness of breath. As the disease progresses, patients may lose weight and have a dry, hacking cough. In the abdomen, this fluid and tumor tissue causes abdominal swelling, pain and weight loss.

Diagnosis

Patients who present with symptoms worrisome for mesothelioma may have a chest x-ray done, indicating a build-up of fluid in the lining of the lung. These patients would then undergo CT scan to further evaluate the cancer. In the case of abdominal mesothelioma, a CT scan . Advance tests include a PET-CT SCAN which would indicate the presence of active disease. Patients would then undergo a biopsy to have the diagnosis confirmed. In the lung, a thoracoscope is used to go through the chest wall, between the ribs to obtain a sample of the tissue. A peritoneoscope is used to enter the abdomen to obtain a tissue sample in abdominal mesothelioma. Staging refers to determining the extent of the disease and this dictates the treatment. Physicians use the TNM system (also called tumor - node - metastasis system). This describes the size of the tumor (T), if the lymph nodes are involved (N), and if it has spread to other areas of the body (M). This is then interpreted to a stage between one and four. Patients with earlier stage tumors tend to live longer and respond better to available treatments.

Cancer Prevention

Cancer occurs when the cells in the body grow out of control. Healthy cells divide and grow in an organized manner. Cancer cells, on the other hand, continue to divide until they form a large mass called a tumor. This uncontrollable cell division occurs when a cell's DNA, which directs all of the cell’s activities, sustains unrepaired damage.There are many different types of cancer, which typically begins in one part of the body, such as an organ (e.g., prostate) or tissue (e.g., breast). If the disease is not detected and treated in its early stages, it can spread (metastasize) to other tissues and organs in the body. According to the American Cancer Society (ACS), cancer will affect about one out of every two men and one out of every three women in the United States at some point in their lives.Though scientists do not understand exactly why DNA sustains damage, various factors have been identified that can increase an individual’s likelihood of developing cancer. These are called risk factors. Individuals who are aware of the risk factors associated with cancer can often prevent the disease by exercising certain cautionary measures, such as avoiding known carcinogens (cancer-causing agents).Several elements can be examined to help identify a person’s risk of cancer. It is important to note that such measures do not mean an individual will develop cancer, only that there is greater susceptibility. Knowing the information can allow individuals to take preventive measures and be monitored by a physician. These factors include:An individual’s medical history. For example, hepatitis or cirrhosis may lead to liver cancer. Dialysis increases the risk of kidney cancer. Having an undescended testicle (cryptorchidism) raises a man’s chance of getting testicular cancer.Family history of hereditary cancer or syndromes. Certain cancers have stronger genetic links than others. Women who have a mother, sister or daughter with breast cancer have a greater risk for developing the disease. Also, certain syndromes can increase a person’s risk, such as familial adenomatous polyposis (FAP). Individuals with this condition are prone to colorectal cancer.Genetic testing. For example, having mutations of BRCA genes increases the risk of breast cancer in women and prostate cancer in men.Preventive measures recommended by a physician depend on how much of an increased risk exists. For example, without treatment, people with FAP almost always develop colorectal cancer by age 40. Many of them undergo preventive removal of the colon (colectomy) to minimize this risk. Some women at high risk of breast cancer choose to have prophylactic mastectomy. In addition, women with breast cancer may be at increased risk to develop ovarian cancer. Breast cancer patients may choose to have their ovaries removed (oophorectomy) to prevent development of cancer there.A physician may recommend increased monitoring rather than preventive treatments for people who face only a moderately increased risk of cancer. For example, a man susceptible to prostate cancer could undergo increased screenings with the digital rectal exam and blood test for the tumor marker prostate-specific antigen. A woman susceptible to breast cancer could undergo mammograms with increased frequency at an earlier age or with increased frequency. The methods to monitor at-risk individuals for cancer are best determined by the patient’s physicians.

Biological Theraphy

Biological therapy is a form of treatment that uses the body’s own immune system to fight cancer. This type of cancer treatment can work either directly or indirectly to enhance, repair or stimulate the immune system’s response to cancer. There are also certain types of biological therapy that may be used to reduce the side effects of cancer treatments such as chemotherapy.

Biological therapy uses specific drugs, known as biological response modifiers (BRMs). Each BRM works differently with the body to fight the cancer or improve the health of the patient undergoing cancer treatment. These drugs are substances found in the immune system, such as antibodies and cytokines, but they are produced in a laboratory when they function as BRMs.

The BRMs used in biological therapy include:

Interferons (IFNs). Interferons are part of the immune system that belong to a class of substances called cytokines. Interferons are usually associated with viral infections, although they are also produced in response to bacteria and other foreign invaders.

Interleukins (ILs). Interleukins are also cytokines. These chemicals are produced by a variety of cells in the immune system to regulate and mediate the white blood cells. In cancer treatment, interleukins are used experimentally to destroy cancer cells.

Monoclonal antibodies (MOABs). Natural antibodies are proteins that fights off infections. Monoclonal antibodies are created artificially and can be targeted against specific areas of cancer cells. MOABs help the body recognize cancer cells so they can be destroyed by the immune system.

Colony-stimulating factors (CSFs). Sometimes called hematopoietic growth factors, these drugs stimulate bone marrow stem cells to divide and develop into white blood cells, red blood cells and platelets. Cancer treatments such as chemotherapy can lower the counts of these blood cells. CSFs can help replace the cells.

Nonspecific immunomodulating agents. Substances that stimulate and indirectly augment the immune system.

Anti-angiogenesis substances or vascular endothelial growth factor (VEGF) inhibitors.A new biological therapy that shows promise in fighting cancer. This strategy prevents tumors from generating new, small blood vessels necessary for the tumor to sustain itself.

Gene therapy. This treatment is based on altering a cell's genetic material to fight or prevent disease. IGene therapy is still experimental in cancer treatment, Researchers are using gene therapy to sensitize the immune system to kill cancer cells, make cancer cells more sensitive to chemotherapy and deliver special drugs on genetic material.

Cancer vaccines. Researchers are developing vaccines that either prevent the development of cancer or treat existing cancers by helping the patient’s body to recognize and fight cancer, and keep it from recurring.

Epithelial growth factor receptor (EGFR) inhibitors. EGFR has been associated with aggressive cancer cell growth in tumors. EGFR inhibitors are drugs that may help prevent the development and progression of cancer in certain tumors.

Biological therapy drugs are administered in various ways, depending on the type of treatment. Oral and some injection treatments may be taken at home, while intravenous administration may require visits to a clinic or hospital. Treatment doses and schedules vary and can range from daily to once every few months.

The medications may be taken alone or in combination with other treatments, such as chemotherapy or radiation. Many of the therapies may be available only through clinical trials. A patient’s medical oncologist can best determine if biological therapy is a viable treatment option.

As with other cancer treatments, biological therapy can cause side effects. The most common side effects include rashes or swelling at the injection site and flu-like symptoms.

Thermography

Thermography is a tool for identifying breast cancer that uses super-sensitive infrared cameras and computer technology to detect heat on the surface of a patient’s breast. The presence of such heat is sometimes the result of intensive chemical and blood vessel activity that is characteristic of precancerous or cancerous tissue.

Although some health professionals support the use of thermography (also known as digital infrared imaging), organizations such as the American Cancer Society (ACS) maintain that there is no proof that this procedure is effective in detecting breast cancer in its early stages. In addition, it may not detect small cancers or tumors deeper in the breast and it cannot pinpoint the location of a tumor.

Two factors cause cancerous cells to generate heat that theoretically can be detected during thermography:

Higher metabolic activity of cancer tissue compared to normal tissue. Cancer cells have higher rates of metabolism (physical and chemical processes in the body) than normal tissues. This higher metabolism registers as an increase in the surface temperature of the breast near the cancerous tissue. This is detected by the infrared camera.

Angiogenesis. A cancerous tumor produces a chemical that promotes the development of blood vessels that supply the tumor with the nutrients it needs to keep growing. In addition, the cancer causes normal blood vessels to dilate (open) to provide even more blood to the forming tumor. Both of these activities produce additional heat which may be detected by the infrared camera.

The infrared camera used during thermography converts infrared radiation emitted from the skin into electrical impulses and feeds the information into a computer. The computer analyzes the temperature and vascular (blood vessel) changes and produces high-resolution images known as thermograms. These images can be displayed on a monitor for analysis, with areas of raised temperature appearing red and areas of normal temperature appearing blue. They can also be printed or sent to another physician electronically.

Thermography has been tested and researched since the 1950s. It originally involved the use of contact plates that measured the heat emitting from the breasts, although thermograms are now produced digitally. In 1982, the U.S. Food and Drug Administration (FDA) approved the use of thermography to help detect breast cancer and some circulation disorders, such as deep vein thrombosis and conditions relating to blood flow in the head and neck.

Proponents of thermography claim that the technique can detect signs of precancerous or cancerous cells far earlier than other imaging techniques. For example, mammography technology cannot detect cancer until a tumor has actually begun to form, which may take several years. Thermography is designed to detect the formation of new blood vessels and chemical changes that occur very early in a tumor’s development. Some experts contend that thermography can identify signs of the formation of breast cancer up to 10 years before any other technique can detect them.

In addition, thermography is touted as having certain advantages over traditional mammography procedures. During thermography, the machine does not touch the breast, in contrast to the squeezing of the breast that occurs during mammography. In addition, patients are not exposed to the potentially harmful radiation used in mammography.

However, many experts have expressed doubts about the effectiveness of thermography in diagnosing breast cancer. For example, the American Cancer Society (ACS) maintains that thermography is not a reliable diagnostic tool because it misses some cancers and has a high rate of false positives. The ACS warns that thermography should never be used as a replacement for mammograms.

Other experts have also criticized thermography for producing too many false results, and have argued that the technique cannot detect the heat of cancers located deep in the breast or under fatty areas. It has also been noted that not all cancers emit heat, and thus would not be revealed by a thermogram.

Still, some experts support thermography as a valuable tool in detecting breast cancers. Experts generally agree that thermography should not be used as a stand-alone diagnostic tool, but rather should be used with other diagnostic tools, such as mammograms, ultrasounds and physical examinations.