GUEST COLUMN: 3-D mammography catches subtle changes, reduces patient anxiety

Each October we hear the clarion call for mammography in fighting the battle against breast cancer. But what exactly is mammography and what exactly is involved in diagnosing breast cancer?

For those unfamiliar with the procedure, an annual screening mammogram is a very powerful and non-invasive tool used to detect breast cancer. It’s very quick and painless, and as long as women maintain their annual trajectory of screenings, patients have been found to have a 40% percent decrease in death rates.

Since the advent of annual screening mammography, it’s also been determined that the quality of life for the patient has also increased significantly because the cancer is discovered a lot earlier. Of course, the sooner cancer is diagnosed, the better it is for the patient. That’s because earlier cancers are generally localized solely in the breast and have not yet spread to other parts of the body. In this manner, the patient can avoid intensive chemotherapy, extended radiation regimes or even radical procedures like a mastectomy. The less intensive treatments of an early diagnosis helps the patient feel better and provides an avenue for a much higher quality of life.

For many years, 2-D mammography was universally utilized. This procedure provides one image of the breast. While this imaging technique is fine and still used today, more subtle findings for more dense breasts could possibly go undetected.

With the advent of 3-D mammography, we are able to get clearer images, and we are able to catch much more subtle things even in dense breasts. With traditional 2-D mammography, sometimes suspicious areas may require an additional scan. However, 3-D scans provide images on multiple layers (or slices) of the breast tissues, which helps the radiologist determine if it is a true finding or just normal breast tissue. This imaging greatly reduces the possibility of callbacks, which in turn, reduces patient anxiety.

How do mammograms detect breast cancer?

As to what to expect with mammography, patients present to the screening site where the medical technologists will take them to the mammography machine. Here the technologist will compress the breast two ways: top to bottom and side to side. The technologists are well trained to provide the appropriate compression without hurting patients. It’s non-invasive, there are no needles, and there is no reason to be afraid. The images are acquired using low-dose radiation, and the entire process takes only about 10 minutes to complete.

If a potential issue is determined through the screening mammogram, a diagnostic mammogram accelerates the surveillance level to determine if there are, in fact, any suspicious findings requiring a biopsy. This procedure provides additional pictures of varying compressions at heightened magnifications. There is also breast ultrasound, which is non-invasive with no radiation allowing radiologists to focus on the suspicious tissue and determine if there is truly any underlying problems.

Additionally, at Telfair Pavilion we have the automated breast ultrasound which is another screening tool in our arsenal. This technology provides a screening of the whole breast that can detect certain subtilties that a mammogram may not find. For those who have been diagnosed with breast cancer, there is Breast MRI which can assist in determining the stage of cancer cells, which then guides the ultimate therapy and treatment of the disease.  This tool also aids in screening for cancerous tissue in those who are younger, may have higher breast density or those who may be at higher risk with personal family history, previous chest wall radiation or those who have implants. It is also noninvasive, involving a contrast dye that aids in determining any suspicious cells.

Should the diagnostic mammogram prove positive, the patient will be recommended for a biopsy. The most common is stereotactic biopsy and ultrasound guided biopsy.  With stereotactic biopsy, the mammogram machine is used to compress the breast, and once the breast is compressed, we can define the specific mass or calcification that needs to be studied further. Then the skin is numbed, and the specimen is taken. The machine itself has a vacuum that assist in removing the sample. The procedure is fairly quick, taking about five minutes to complete.

Ultrasound guided biopsy is very similar, although there is no radiation but rather real-time ultrasound guidance. Again, the skin is numbed, and typically three samples are removed. Similar to stereotactic biopsy, a marker is placed in the area to define the area. After this, the patient will receive one quick mammogram of the affected breast to ensure that the marker is in the correct location. The ultrasound biopsy takes about five minutes.

These advanced technological and diagnostic procedures are available to stop breast cancer in its tracks. While artificial intelligence is rapidly evolving, especially in the field of medical imaging, until we get there, mammography remains the gold standard by which this deadly disease can be identified and hence treated. Early detection remains the key to survival which further underscores the importance of getting this annual screening.

St. Joseph’s/Candler is hosting its annual Mammography Day on Monday, Oct. 28, at six convenient locations throughout the region. Call 819-PINK to schedule your annual mammogram today, and please encourage everyone you know to do the same.

This article originally appeared on Savannah Morning News: GUEST COLUMN: 3-D mammography catches subtle changes, reduces patient anxiety