How a high-tech breast scan could save your life…but because of a broken NHS pledge, you’re unlikely to get one
By Dr Will Teh
Breast cancer is the most commonly diagnosed cancer in Britain, with more than 100 women being told they have the disease every day. Yet despite its high incidence rate, survival rates still lag behind those in the U.S., France and Italy. This is partly to do with the more advanced drug treatments available in those countries.
But the charity Breakthrough Breast Cancer also blames this country’s screening process, and the fact that most services continue to use photographic film for X-rays instead of digital photography.
As a radiologist working with digital technology, I have to agree it really does make a difference. Not only does it makes breast screening quicker and more efficient, but it has the power to detect cancer earlier and therefore help to save lives.
Four years ago, the then Government pledged that breast screening units would be digitised by the end of 2010 yet, as revealed last month, fewer than one in three units across the country has fully switched to using the technology. This delay could be costing lives.
In Britain, women aged 47 to 73 are invited for breast screening every three years. They go to a mobile unit or screening clinic where staff take an X-ray, called a mammogram, of the breast to check for any abnormalities, such as lumps.
We used to process these X-rays on photographic film. So what, you might think. Well, look at the image on the left of this page and you will see why this matters. This is a mammogram taken using the old technique.
Our screening clinic, one of the largest in the country, has been fully digital for more than a year. Ask any of the ten consultants there if they would go back to the old days of using photographic film for mammograms and you’d hear the same answer from each: absolutely not.
Remember when we all used film for our own photos? After a three-day wait, you picked up the pictures from the processors and your heart sank: the bundle of photos had relatives with red-eye, out-of-focus shots with fingers over the lens and over-exposed pictures.
Screening using photographic film can be a bit like that, too. First, a mammographer needs to load and unload the photographic plates at the screening centre. Then, once a woman’s X-ray has been taken, it requires up to two days to be processed, checked and matched to previous records and films, before they can be loaded on to a viewer. This holds 120 pictures, each from a different patient, for a doctor to assess.
This is the first time these X-rays have actually been seen by a medic. They notice some problems. Mrs X’s film was taken out too quickly, so there’s a bit of blurring here. And on Miss Y we need to get a better angle because we can’t see all of the breast tissue.
And so a letter gets sent out to Mrs X and Miss Y, asking them to make an appointment for another mammogram — which can take two weeks. But with digital imaging, the mammographer at the clinic can see immediately if the picture — such as the one shown here on the right — is satisfactory.
This doesn’t mean screening clinics using photographic film suffer constant errors. But because we see 50,000 women a year at our centre, even a small percentage of callbacks means unnecessary stress and inconvenience for many women, and wasted appointments. Furthermore, with digital images there is no processing time and no need for X-rays to be loaded on to a viewer.
As a result of this, if we find abnormalities, the time it takes for a woman to receive a letter asking her to attend further tests has dropped from three weeks to just one week. This, of course, means that cancers could be picked up sooner. And that is another great advantage of digital technology: the image is clearer, as you can see by comparing the two images above.
A major study in the U.S. in 2005 compared digital mammograms to film mammograms for detecting breast cancer. Not only did it find that digital was as good as photographic film, it also showed it is better at finding cancers in certain women. The study also found that for women who are pre and post-menopausal, on HRT or have dense breast tissue, digital is better at finding abnormalities and at picking up cancers in younger women with a family history of the disease.
And this has been reflected in our own results. Over the past year, we have picked up more smaller, early stage cancers. This is because the digital images are much clearer, as you can see, allowing us to detect subtle changes.
Detecting these cancers earlier is so important for these women. Not only does it mean less invasive surgery and a smaller risk of mastectomy, but it also means we find cancer before it has spread around the body. It could also mean less chemotherapy and a greater survival rate in the long-run.
The Government says more than 80 per cent of screening units have at least one digital breast screening machine. But the crucial point is that less than 30 per cent are fully digitised. If a screening unit has more than one screening machine — and we have ten — then it doesn’t make sense for them to have a mixture of digital and film.
Indeed, studies show it is less efficient for units to employ both technologies because it increases workload for the screening staff, meaning they have less time for appointments.
Full digital technology is absolutely essential for breast screening units. All women deserve access to this, and it’s why we’re all fighting for it.
Foreign squatters given legal aid to fight eviction from £1million house… as its British owner has to represent himself in court
Squatters who broke into and occupied a £1million house have been given hundreds of pounds of taxpayers’ money in legal aid to fight eviction. The intruders from France, Spain and Poland have been living in the three-storey five-bedroom townhouse for a month.
Meanwhile owner John Hamilton-Brown has been forced to rent a two-bedroom flat for his family while he battles to get the gang out of the house.
Neighbours said the property had just been sold when the 12 squatters broke in during the early hours of the morning after a window was forced open. Since then there has been more damage and endless parties – several of which have culminated in the police being called.
Yesterday, several of the squatters danced, waved flags, sang and played the guitar outside the property. They also bragged about how easy Britain’s laws were in allowing them to take over homes.
A French man who called himself Jean-Claude, said: ‘I came to England seven years ago because this is where the love is. We will speak to other people from all over the world to come here and live because it is so easy. Why can’t we live anywhere we want?’ A French girl with blonde dreadlocked hair added: ‘I love it here. We move around where we want and share our love. You should see the views in there – it’s amazing.’
Mr Hamilton-Brown, 36, applied to the county court last week to seek an interim possession order to enable him to claim the house back. He did not hire a solicitor because of the expense. But when he arrived at Clerkenwell and Shoreditch County Court, in East London, he was amazed to find that two of the squatters had been granted legal aid and were represented by a duty solicitor. Because they were EU citizens and unemployed, they qualified for free legal representation.
Mr Hamilton-Brown had already been to the court four times since his home was invaded on January 21. At Thursday’s hearing, he was not granted the interim order that would have let him remove the squatters within 24 hours because of a legal technicality. He was granted a possession order – meaning he will now have to wait up to six weeks for a warrant that will allow bailiffs to remove them.
‘I was horrified they were given legal representation,’ Mr Hamilton-Brown said. ‘As I work and pay taxes, I’m at a disadvantage. ‘I’ve saved up for ten years to move into this house and this is what I get. It’s remarkable that they can get away with this.’
Mr Hamilton-Brown, a married father of two young daughters who is a director of a financial services company, added that neighbours had indicated that a lot of damage had been done to the property.
The house in Archway, North London, is near the homes of actress Patsy Kensit and comedian Rob Brydon. A legal notice put in the front window by the squatters states that anybody who enters without their permission could face six months in jail and a £5,000 fine.
A neighbour said: ‘They have more rights than we do. ‘They know what they’re doing on the legal side of things as they’ve been in houses before in the area.’
Four British Muslims slashed teacher’s face and left him with fractured skull ‘for teaching other religions to Muslim girls’
Four men launched a horrific attack on a teacher in which they slashed his face and left him with a fractured skull because they did not approve of him teaching religion to Muslim girls.
Akmol Hussein, 26, Sheikh Rashid, 27, Azad Hussain, 25, and Simon Alam, 19, attacked Gary Smith with a Stanley knife, an iron rod and a block of cement. Mr Smith, who is head of religious education at Central Foundation Girls’ School in Bow, east London, also suffered a fractured skull. The four now face a jail sentence.
Detectives made secret recordings of the gang’s plot to attack Mr Smith prior to the brutal assault. The covert audio probe captured the gang condemning Mr Smith for ‘teaching other religions to our sisters’, the court heard.
The RE teacher was targeted as he made his way on foot along Burdett Road in nearby Mile End on July 12 last year, Snaresbrook Crown Court was told.
Prosecutor Sarah Whitehouse told the court: ‘The evidence from what was said on the probe points overwhelmingly to a religious motive for this attack.’
It is believed the gang had made two earlier attempts to get at the teacher. They were due to stand trial for the attack at Snaresbrook Crown Court but pleaded guilty to causing grievous bodily harm with intent.
A fifth defendant, Badruzzuha Uddin, 23, admitted assisting the thugs by hiding blood-stained clothing.
Judge John Hand QC remanded the defendants in custody until sentence on a date yet to be confirmed.
Hussein, of Bethnal Green, east London; Rashid, of Shadwell, east London; Hussain, of Wapping, east London, and Alam, of Whitechapel, east London; have all admitted causing grievous bodily harm with intent. Uddin, of Shadwell, admitted assisting an offender.
Life of crime predictable from age three for some children
At the age of three, most children will want to grow up to be a train driver, astronaut or princess. But according to scientists, some toddlers are already destined for a life of crime. Disturbing evidence has emerged that the psychological seeds of a criminal career can be seen before they even reach nursery school.
Abnormalities in the parts of the brain that handle emotions, guilt and fear are far more common in criminals than in law-abiding members of society, it shows. It is unclear whether these abnormalities are genetic, the result of upbringing or both – but they can be measured at a surprisingly tender age.
The finding means youngsters could potentially be screened to see if they are at risk – and then ‘treated’ to prevent criminal behaviour.
Professor Adrian Raine, a former Home Office criminologist, agreed predictive scans were many years off. But the father-of-two added: ‘If you told me my son had an 80 per cent chance of being a psychopath, but that he could be treated for it, I would have him treated. But it has to be a decision made by individuals, not by scientists.’
Professor Raine, who now works at the University of Pennsylvania, studied brain scans of prisoners. He found that murderers who kill in the heat of the moment are more likely to have a poorly functioning prefrontal cortex – which deals with reasoning and helps suppress base instincts.
Psychopaths who lack remorse, guilt or empathy tend to have smaller amygdalas – a region that handles all three emotions, he told the American Association for the Advancement of Science.
Professor Raine also tested the fear response of three-year-olds by playing them a neutral sound followed by an unpleasant one, until the children learned the nasty sound always followed the neutral tone.
For most, the sound of the first tone was enough to raise their pulse rates and start a sweat. But a few showed no ‘anticipatory fear’ – a possible symptom of an abnormal amygdala, Professor Raine said.
The prospect of scans suggests a serial killer such as Yorkshire Ripper Peter Sutcliffe could be spotted and treated as a child – but it also poses dilemmas. ‘It raises the question to what extent should we develop new biological interventions to reduce crime,’ Professor Raine said.
Psychologists have identified key personality traits in childhood which are linked to poor behaviour later in life.
Seven-year-olds with unemotional and ‘callous’ traits were much more likely to be involved in anti-social behaviour at the age of 12, a study by Dr Nathalie Fontaine, criminal justice expert at Indiana University, Bloomington, showed.
Other signs include not having at least one good friend, being unkind to other children and not being helpful if someone is hurt.
The experts stress that not all youngsters with the traits turn into criminals – and not all criminals had the traits as children, but that they increase the risk of a life of crime.
‘Surprising’ number of British students studying overseas
Fees at Australian universities are complex and hard to work out but seem to average out at around 5,000 British pounds per annum for Australian students. Overseas students are charged a lot more, however
Britain sends a higher percentage of students to foreign universities than many other countries which could be considered its peers, it has been claimed.
At the Westminster Education Forum on higher education in London last week, Vincenzo Raimo, director of Nottingham University’s international office, said that research suggested there were currently around 22,000 British students on degree courses abroad; approximately 1.7 per cent of Britain’s entire student population.
By comparison, he said, in China and India – well-known for having a large number of their students educated abroad – these figures were only 1.4 per cent and one per cent respectively.
British students abroad are spread fairly evenly around the world, but he said there were particularly high numbers in the US (around 8,500), France (around 2,600) and in Germany (around 2,200).
“In discussing international education, we often focus too highly on students coming into the UK, and ignore the fact that there’s a lot of outward mobility,” Mr Raimo told Telegraph Expat. “Of course, in terms of sheer numbers there are far more Indian or Chinese students studying abroad. But in terms of percentages, we have a surprising number of students looking to experience higher education in a different country.”
The figures discussed by Mr Raimo applied only to students enrolled in full degree courses abroad, not students spending a term or year abroad as part of their degree.
Like many education specialists, Mr Raimo believes that the controversial lifting of the cap on tuition fees in Britain from £3,225 to £9,000 is likely to encourage more students to study abroad. “I think the number would have risen anyway as students became more aware of the advantages of studying in a different country, but without a doubt, financial considerations will increasingly influence students’ decisions,” he said.
Lee Miller, general manager of Study Overseas UK, which helps British students find placements in Australian, American and Canadian universities, said that he had already seen a significant rise in the number of enquiries about studying abroad since the announcement of the fees increase in December.
He added however that many students were looking at universities which were not necessarily cheaper, but which offered what students saw as an improved lifestyle and better quality education than that available in Britain for a similar cost.
“Students seem to think that if you’re going to spend £9,000 a year to study in an average British city, you might as well spend the same amount and go somewhere like Perth, where there’s a great beachside lifestye and really good facilities, especially for sport, ” he said. “Students also say they are attracted to the different content of foreign degrees, where they get more of a chance to take modules in a range of subjects.”
Mr Raimo added in the current economic climate, studying abroad was also likely to improve students’ chances in the job market. “Britain’s mass education system makes it difficult for students with degrees to differentiate themselves in a marketplace. If they’ve studied abroad, however, they look much more independent, and have learnt important new skills, like languages.”
There is however one significant disadvantage of studying overseas: whatever it might cost in the long run, British students abroad are unlikely to get a loan from the Student Loans Company. It offers loans only to students based in Britain, or those doing up to a year’s placement in a university abroad.
None the less, many schools have already started to encourage their pupils to look beyond the traditional destinations for British students. Last month, one of Britain’s best-performing state schools, Hockerill Anglo-European College in Bishops Stortford, Hertfordshire, said it had appointed a student counsellor tasked solely with helping students apply for better-value universities overseas.
Why you need to use your ‘environmentally friendly’ cotton carrier bag 131 times to be green
Cotton bags offered by many supermarkets may be less ‘green’ than plastic carriers – and may cause more global warming, according to scientists.
As a greater amount of energy goes into making a cloth carrier than a polythene one, a cotton bag has to be used 131 times before it has the same environmental impact than its plastic counterpart
And if a plastic bag is re-used as a bin liner, a cotton bag has to be used 173 times – nearly every day of the year – before its ecological impact is as low as a plastic bag on a host of factors including greenhouse gas emissions over its lifetime.
But most of us only use the bags around 51 times before they are thrown away, researchers found.
Paper bags – used by some clothes chains such as Primark – need to be used three times to fall below the environmental impact of the thin plastic carrier, while bags for life – made of stronger plastic – have to be used four times to start having less ecological impact.
The government sponsored research, ‘Life Cycle Assessment of Supermarket Carrier Bags’ by Dr Chris Edwards and Jonna Meyhoff Fry looked at the environmental impact of six different types of bags.
Although completed in 2008, it has not yet been published, with plastic bag makers claiming the findings have been suppressed – although the Environment Agency said it is awaiting ‘peer review’ – checks by other scientists.
Using a thin plastic bag – made from a plastic called high-density polyethylene (HDPE) – equates to generating 1.57kg of carbon dioxide, the greenhouse gas that scientist believe leads to global warming according to the report. A cotton bag would have to be re-used 171 times to emit the same level of CO2.
Cotton bags typically made in China have a greater environmental impact because of the water and fertiliser required in their production, as well as their transportation and greater weight.
The researchers concluded: ‘The HDPE bag had the lowest environmental impacts of the single use options in nine of the 10 impact categories. The bag performed well because it was the lightest single use bag considered.’
Plastic bags have also come under fire for using up oil and for littering the countryside and fouling the marine environment for wildlife. However, the research found that biodegradable bags made of starch were not a greener option than HDPE bags as they are less environmentally friendly to make and heavier.
The authors write: ‘In practical terms of global warming potential, eutrophication [a form of river pollution] ozone layer depletion, toxicity and ecotoxicity the current starch polyester blend bag is significantly worse than conventional single-use options due to the high impact of raw material production on those categories.’
The Daily Mail, through its ‘Banish the Bags’ campaign has spearheaded efforts to avoid using plastic bags wherever possible to save the environment and the public are reducing their use of plastic bags.
Figures from WRAP, the government’s Waste and Resources Action Program, show a total decline in all types of carrier bags issued to 4.5 billion (41%) over the years 2006-2010 – effectively saving 39,700 tonnes of material from entering the waste stream
Peter Woodall, speaking on behalf of the Packaging and Films Association, which represents plastic bag makers, said: ‘This analysis shows what we have been saying for years. Plastic bags are a more environmentally friendly option than cotton bags. ‘It comes down to reducing, reusing and recycling.’ He also cited Canadian research that cotton bags can harbour can harbour germs and mould which can be harmful to health – unless they are washed.
An Environment Agency spokesperson said: ‘The report focuses on the greenhouse gas emissions of manufacturing different types of carrier bags. ‘Much of the environmental impact of these bags is associated with the primary resource use and production. ‘The final report due to be published in the next two weeks, will show that all multi-use bags – plastic, cotton or paper – need to be reused on multiple occasions to justify the additional carbon footprint of their production.
‘If they are, then their overall carbon footprint can be less than single use plastic bags.’
There is a new lot of postings by Chris Brand just up — on his usual vastly “incorrect” themes of race, genes, IQ etc.