Posts Tagged ‘mammography’

New Mammography Guidelines

mammogramAlthough the American Cancer Society (ACS) confirms that mammography saves lives, the organization issued new breast cancer screening guidelines on Oct. 20 that recommend women at average risk for breast cancer start getting annual mammograms at age 45. The previous recommendation was to start at age 40, and I will continue to recommend that women get yearly screening mammograms starting at age 40.

Evidence shows that the most lives are saved when screening starts at age 40. Although breast cancer is a little less common in women aged 40 to 44, this group receives the same life-saving benefit from screening mammography that older women do. As a radiologist specializing in breast cancer detection and diagnosis, I see this first-hand. My colleagues in the American College of Radiology agree and are also continuing to recommend that yearly screenings begin at age 40.

The new ACS guidelines note that the “harms” associated with screening may outweigh the benefits in women age 40-44. It is vital that women compare the magnitude and implication of the harms versus benefits associated with screening mammography. The harms they identify are about getting false positive readings from mammograms that can result in women being called back in for more imaging or an ultrasound. About 10% of women are recalled for these additional tests and the vast majority are cleared at that point. About 1 – 2% of patients who are recalled receive a needle biopsy using local anesthetic.

The benefits include saving lives and finding cancers smaller and earlier so that less aggressive treatment is required. I believe most women will agree that the drawbacks pale in comparison to the benefits of screening, and will choose to proceed with yearly screening. In fact, the ACS declares that yearly screening is beneficial and something that the majority of women would want, as long as they are healthy and have a 10 year or longer life expectancy. It is vital that we preserve a woman’s access to this life-saving technology so that she may choose to screen.

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About Dr. Newell

Newell_MaryMary S. Newell, MD, began practicing with Emory Healthcare in 2001 where she is a board certified radiologist specializing in breast cancer imaging and diagnosis. Dr. Newell has interests in emerging imaging technologies, teaching, and healthcare policy.

Dr. Newell chairs the American Board of Radiology Maintenance of Certification (MOC) Breast Committee and the American College of Radiology Joint Practice Guidelines and Technical Standards and Appropriateness Committee on Criteria. She is Head of Curriculum Assessment for the Society of Breast Imaging and Special Consulting Editor for CME for the American Journal of Roentgenology. She also serves as the treasurer for the Georgia Radiologicial Society, is a councilor to the American college of radiology representing the state of Georgia, and serves on numerous committees institutionally and nationally.

Dr. Newell earned her medical degree from the University of Michigan Medical School. She then completed her residency in diagnostic radiology and fellowship in body imaging at the St. Francis Hospital in Illinois. Dr. Newell’s research focuses on discovery and evaluation of new imaging modalities for future use in breast cancer screening and detection.

3D Mammography: More Detail in Imaging Can Reduce Call-Backs

According to the American Cancer Society, about 10 percent of women who have mammograms will be called back for additional testing. However, only 8-10 percent of those women will need a biopsy, and 80 percent of the biopsies will turn out to be benign.

While that sounds encouraging, the emotional toll of a call-back can increase a woman’s anxiety about having future mammograms. To help reduce call backs and false positives, three hospitals in the Emory Healthcare system now use an advanced breast imaging technology, called 3D mammography, which provides radiologists with a much more detailed view of a patient’s breast tissue.

Watch CNN’s segment about Ivory Poser’s experience and how Emory Healthcare is using 3D mammography at three of its hospitals to help reduce call-backs and false positives.

“Compared with 2D mammography, a 3D exam allows radiologists to view the breast in small slices providing more detailed pictures of specific areas,” says Michael A. Cohen, MD, director of Breast Imaging for Emory Healthcare. “The state of the art technology is proven to reduce call-backs by 20 to 40 percent and finds more cancers, particularly in women with dense breast tissue.”

In addition, Emory offers this FDA-approved mammography technology, which is typically not covered by insurance, at no additional charge above the cost of a traditional 2D digital mammogram for patients getting their annual screening mammogram.

“Breast tomosynthesis is a real game changer in the early detection of breast cancer,” explains Leonel A. Vasquez, MD, director of Community Radiology and chief of service for Emory Johns Creek Hospital. “The fact that we are offering this advanced technology at no additional cost is both a real value and the best care for our patients.”

The advantages of 3D mammography are:

  • Greater chance for cancer detection
  • Reduction in false-positives
  • Reduction in call-backs (especially for women with dense breasts)
  • Better visualization and confidence for physicians
  • Less anxiety for patients

Mammogram screenings have been shown to detect breast cancer in earlier stages, which can lead to better chances for a cure. According to the American Cancer Society, deaths related to breast cancer have been declining since 1990, partly due to early detection through screenings and advanced treatments. Screening mammograms are recommended for all women at average risk for breast cancer starting at age 40.

3D mammography is currently available at Emory’s breast imaging centers at the Winship Cancer Institute on Emory’s Clifton Campus, Emory University Hospital Midtown and Emory Johns Creek Hospital.

Emory Breast Imaging Center located at
Emory University Hospital Midtown
550 Peachtree Street NE
Atlanta, Georgia 30308

To make an appointment: 404-778-7465

Emory Breast Imaging Center located at
Winship Cancer Institute of Emory University
1365 Clifton Road NE
Building C, 1st Floor
Atlanta, Georgia 30322

To make an appointment: 404-778-7465

Center for Breast Care located at
Emory Johns Creek Hospital
Emory Physicians Plaza
6335 Hospital Parkway, Suite 106
Johns Creek, GA 30097

To make an appointment: 678-474-7465

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3D Mammography: A New View on Breast Cancer Prevention

3D Mammogram vs 2D mammogramBreast cancer ranks as the second leading cause of cancer-related death among women in the U.S., behind lung cancer, according to the American Cancer Society.

However, the ACS also notes that the rate of deaths caused by breast cancer has been declining since the late 80s, with larger decreases in women younger than 50. The trend is attributed to increased awareness, improved treatments and earlier detection through screening.

Mammograms, which were introduced in the 70s and have transitioned from film to digital, are still the only screening tool approved by the Food and Drug Administration (FDA).

No technology is perfect, and mammograms can miss some breast cancer cases. Since research has found that early detection significantly enhances the success of breast cancer treatment, the healthcare industry is in constant pursuit of better ways to see inside the breast.

Enter 3D mammography. Also called breast tomosynthesis, this relatively new breast imaging technology was approved for use in combination with conventional 2D mammography by the FDA in 2011.

“Breast tomosynthesis allows us to see the inside of the breast from many different angles, and it also gives us the ability to view breast tissue layer by layer, in 1 millimeter increments, or slices,” says, Dr. Maria Piraner,  breast imager (radiologist) for the Center for Breast Care at Emory Johns Creek Hospital.

During a 3D mammogram, the X-ray arm of the mammography machine passes over the breast in a slight arc, taking numerous low-dose images at multiple angles. A computer software program then combines those images into a 3D rendering of the entire breast. For patients who have had previous mammograms, the procedure is nearly identical to conventional mammograms, except each compression takes about 4 seconds longer.

3D mammography does not replace conventional 2D mammography; rather, the two procedures are done in combination on the same machine. The addition of the 3D component can help reduce the chance that a patient will need to be called back for additional images. Since conventional 2D mammograms produce single, flat images of the breast, a cancer can sometimes hide in the overlapping tissue, or overlapping tissue can give the appearance of an abnormality that isn’t there.

While women 40 and older should have a screening mammogram every year for as long as they are healthy, the choice to add 3D to their conventional 2D mammogram depends on personal factors, such as:

  • Family history of breast cancer
  • Having a high risk factor for breast cancer
  • Frequency of call backs on previous mammograms
  • Having dense breast tissue

Dr. Piraner says the advantages of the combination 2D/3D mammogram are:

  • Fewer patients need to be called back for additional images
  • Allows radiologists to see cancers when they are smaller and less complicated to treat
  • Is particularly useful for patients with dense breast tissue

Download our FAQ sheet, “3D Mammography and You” for more information.

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