New technology saves lives

Staff Writer

Editor’s note: This is part two of a four part series which will showcase different areas of a cancer diagnosis from early detection, to support systems, to those who receive a diagnosis and how such a diagnosis affects not only the person receiving it.
“I think a lot of people don’t understand how important it is to do breast exams, to look in a mirror, to see your breast, to look for discolorations, or abnormalities or [nipples] retracting in because a lot of women find things on their own just by looking and feeling their breasts,” said Lisa Roettger, lead mammographer at the Women’s Imaging Center at Joint Township District Hospital. “And that’s a great thing because we get a lot of women that have already felt something or their doctor felt something.”
Early detection is the message the Women’s Imaging Center (WIC), and many other cancer organizations and hospitals, push for those at risk for breast cancer. After age 40, it is recommended by the American College of Radiology, for women to start receiving annual mammograms, whether they have a family history or not. The cost of screening mammograms are, at least partly, covered by all insurance plans as a requirement from the Affordable Care Act. This includes Medicaid and Medicare.
“Mammogram is the least expensive, and the most accurate for diagnosing most problems,” Roettger said.
Recently, JTDMH purchased a new 3D mammography machine called the Senographe Pristina which not only gives physicians a more detailed look at breast tissue, but also gives patients control over the amount of pressure applied to breast.
“I always start with, ‘compression is the most important part about this test.’ The more compression the more the breast tissue spreads apart and the easier we can see the abnormalities,” Roettger said. “So we want to see the problem, if they’re in your breast, we want to see them, so that’s why we want good compression. It should be snug, but it should not be painful. You shouldn’t be bruised from a mammogram or anything like that.
“That being said, I always say, ‘tell me how you’re doing.’ You have to talk to your mammo-tech, if something is pinching tell me, I can fix that.”
The 3D technology of the new machine gives the physicians more than just a two sided view, she mentioned. She compared the differences to looking at a book. With 2D imaging, physicians can see the top and side view of the a book, but with 3D, individuals can see the top, side and all the pages inside.
“With the new 3D system, it has made things even easier for radiologists to see abnormalities because 3D penetrates the breast tissue a little bit better and it gives a [tomosynthesis] sweep, which is like a moving sweep of different images that the computer calculates into a 3D image,” Roettger said.
Typically, a mammography takes four images of the breast.
While mammograms won’t give a complete “yes” that cancer is present or a complete “no,” it gives doctors an idea if they need to check further and schedule a biopsy for the area in question. Biopsy is the only way to confirm cancer is present.
If a diagnostic screening is scheduled at the WIC, patients will have their exams looked over by a physician who will determine if the results are normal or if they need to conduct more tests before making a decision about the findings. Some of those additional tests may be done that day.
“When you come in with a diagnostic as a problem, the goal is to have the availability to do anything and everything we can do at that time that’s available and have to doctor look at it and have you leave with some type of results,” she said.
Ultrasound testing is something WIC could offer the same day, but extensive testing like Molecular Breast Imaging would be something that would need to be scheduled for a different day. Roettger mentioned if testing needed to be scheduled for a later date, she hopes, at least, patients could find comfort in knowing the next steps of determining what is going on is being taken care of.
While diagnostic screens are one reason individuals may schedule a mammogram, JTDMH offers self-request screenings for individuals as well. Individuals must meet all of the following requirements in order to qualify for scheduling: female age 40 or older, have no current breast complaints, no personal history of breast cancer and no breast implants.
Feeling a lump isn’t necessary for the self-request screenings either, and may not always be noticeable in the very early stages of breast cancer, Roettger mentioned. It’s one of the many reasons mammograms are important for early detection, she added.
“That’s why early detection is so key, because you can’t feel it and you don’t have symptoms so therefore you have your mammogram and we can detect it early,” she said. “The chance of survival and the chance of overcoming it easier is phenomenal. We don’t want to wait until you can feel it because then it’s getting bigger. We want to detect it before it can even be seen.”
One concern Roettger addressed was hearing from some individuals that because they don’t have a history of breast cancer, they don’t feel the need to get regular pre screenings. She mentioned that mammography machines are a tool which can help detect breast cancer early that can likely be easier treated than if someone were to wait.
“People are still scared to get a mammogram, which is disheartening to me because we work to try to make it a very good experience for women,” she said. “And now with the technology improving and the equipment, trying to make it more comfortable, I think if women would just come in and try it their mind would be put at ease because early detection is vital in finding this.”
She discussed some concerns people have about being exposed to radiation, especially on a regular basis; once yearly screenings start. For Roettger, the exposure risk is worth it, if it means early detection. She also acknowledge that many may not realize that radiation is all around us.
The American Cancer Society found that women who receive a mammogram are exposed to the same amount of radiation (0.4 mSv) that any individual would be exposed to over a seven week period from nature.
Additionally, she acknowledged that although there may be a lump, that doesn’t mean someone may have breast cancer. Cysts and hematomas are among some of the other benign abnormalities that may form in the breast tissue.
“Cysts are one of the most common things that women come in with that are a very benign thing so I always tell my patients, ‘just because you’re feeling something doesn’t mean it’s a problem, it could be a very normal thing for you,’” she said.
Receiving a mammogram will help determine if there is a need for further test.
WIC is currently offering self-request screening mammograms throughout the week, including some evening and Saturday appointments. To schedule an appointment, call 419-394-9599.