Symptoms

Some warning signs of breast cancer include:

• New lump in the breast or underarm (armpit)
• Thickening or swelling of part of the breast
• Irritation or dimpling of breast skin
• Redness or flaky skin in the nipple area or the breast
• Pulling in of the nipple or pain in the nipple area
• Nipple discharge other than breast milk, including blood
• Any change in the size or the shape of the breast
• Pain in any area of the breast

If symptoms occur contact your doctor immediately and work with them to implement appropriate treatment and monitoring.

For years, the gold standard in breast cancer screening has been 2D mammography. Unfortunately, it doesn’t always deliver clear results. Traditional 2D mammograms suffer from decreasing sensitivity as the density of a woman’s breast tissue increases, or when breast tissue overlaps. This can result in unclear images that leave health providers unsure of what they see, and can lead to cancers being missed.

IPMC Medical Center now offers MAMMOMAT Revelation with wide-angle breast tomosynthesis. It’s state-of-the-art 3D mammogram technology that is proven to detect breast cancer better than traditional 2D mammography alone. We’re using it in our practice to give our patients new confidence in their breast health.

Unlike 2D mammography, 3D wide-angle breast tomosynthesis takes many x-ray pictures of each breast from many angles that are not available in traditional mammography. The x-ray tube moves in a 50-degree arc around the breast, taking 25 images during the exam. Those images are then sent to a computer, where they are assembled into a 3D picture of the breast. The result is a clearer image that helps health providers detect malignant tumors better than standard 2D mammography alone, with fewer recalls.

We introduced wide-angle tomosynthesis as an adjunct to 2D mammography because we want you and your family to be sure. We love its wide-angle imaging and the clarity it offers our doctors. We think it will save lives because it leaves breast cancer no place to hide.

1. Self-examinations

Contribute actively to early detection with self-examinations by examining your breasts one week after your menstrual cycle has begun. Check your breasts carefully and pay attention to changes. Speak to your gynecologist or physician about any findings.

Additionally, your physician will perform a physical breast examination at your annual exam. If the physical examination performed by a physician detects anything suspicious, they will refer you for a mammography, an ultrasound scan, and/or magnetic resonance imaging.

SenoClaire, which was approved by the FDA in 2014, uses a low-dose short X-ray sweep around the positioned breast with nine exposures acquired with a “step-and-shoot” method, removing the potential motion from the tube helping to reduce blur and increase image sharpness.

We are committed to offering the community a complete suite of solutions – from screening and diagnosis through treatment and monitoring. SenoClaire will offer our patients a new solution to help clinicians detect breast cancer with low dose radiation and high image quality.

A key challenge when performing screening mammography is keeping the radiation levels as low as possible. With GE’s SenoClaire, there is no increase in dose from a 2D standard mammogram to a 3D view, which means there is no increased radiation to patients during a SenoClaire breast exam. ­­

SenoClaire marks a significant step forward in helping our clinicians detect breast cancer. At IPMC, our goal is to provide our patients with the most effective ways to battle cancer from every possible angle, with innovative procedures, medicines, and technology.

What is Tomosynthesis

Tomosynthesis is an exciting technology that offers a new way of looking at breast cancer detection with 3-dimensional imaging. It allows a radiologist to take multiple pictures of each breast from various angles, which differentiates it from a traditional mammogram, which takes a single image in two directions. Tomosynthesis has the potential to revolutionize mammography and breast cancer screening because it offers improved sensitivity and specificity at dose levels equivalent to those with 2D mammography.

Mammograms are:

• One of the best ways to identify breast cancer early, when it is most responsive to treatment.
• A low-dose x-ray that uses a small level of radiation to produce high-quality images of breast tissue.
• A 20–30-minute procedure, from checking in to leaving the facility.
• The screening procedure itself tends to run about 10 minutes for most patients.

Mammograms aren’t:

• Dangerous
• Time consuming
• Overly painful

Everyone’s pain threshold is different, but the compression involved in a mammogram is more often described as discomfort, and typically lasts for just a few seconds at a time.

Tips for preparing for your mammogram

• Schedule your mammogram for when your breasts aren’t likely to be tender or swollen, to help reduce discomfort and get good pictures. Avoid the week before your period if possible.
• On the day of the exam, don’t apply deodorant, antiperspirant, powders, lotions, creams, or perfumes under your arms or under your breasts.These can affect the imaging results.
• Instead of a dress, you might find it easier to wear a skirt or pants.

Comfort and confidence await

Because IPMC Medical Center uses Siemens Healthineers mammography solutions, you have access to systems that offer:

• Images captured from more angles in a single exam, giving your doctor a better view of the breast to help detect more abnormalities sooner
• Customized breast compression for each patient
• Comfortable, rounded paddles that warm up quickly
• A unique imaging process so you don’t need to hold your breath during exams
• Calming lighting to help create a more comfortable exam environment

Screening women aged 40 to 49 for breast cancer has additional benefits beyond the proven decrease in mortality rate, according to researchers at Case Western Reserve University. Patients screened with mammography are statistically less likely to undergo chemotherapy, avoiding the associated toxic morbidities. Screening mammography also helps identify a subset of patients at increased risk of breast cancer by diagnosing high- risk lesions.

The majority of high-risk lesions identified in a retrospective chart review were found in screened patients. Identifying patients at high risk may allow for the administration of chemoprevention, decreasing the risk of subsequent breast cancer development. The identification of high-risk lesions also may lead to supplemental screening MRI, which has the added benefit of detecting future mammographically occult malignancies in high-risk patients.

“When the US Preventive Services Task Force guidelines were published in 2009, confusion was created among patients and primary care providers on when and if 40- to 49-year-old women should be screened,” said Nelly Salem, MD, of University Hospitals–Case Western Reserve. “Without screening mammography, these asymptomatic high-risk women would be unaware of their risk and the opportunity to decrease their risk of subsequent breast cancer development with use of chemoprevention.”

Tomosynthesis After Screening Mammography Reduces Need for Ultrasound, Biopsies

Breast tomosynthesis in the diagnostic workup for one- or two- view focal asymmetry detected at screening mammography resulted in less ultrasound use, fewer biopsies, and higher positive predictive value for cancer than when diagnostic exams involved only 2D mammography, according to a study conducted at the University of Virginia.

“Tomosynthesis has been evaluated in screening populations and been shown to decrease recall rates,” said researcher Brandi Nicholson, MD, “but studies in the diagnostic setting are lacking.” The 532 patients who were recalled for a focal asymmetric density discovered at screening were analyzed across three categories: women recalled prior to the availability of tomosynthesis in the practice (PT), those who did not have tomosynthesis at diagnostic evaluation after it was available (NT), and those who had diagnostic tomosynthesis (YT). There were 238 patients in the PT group, 145 in the NT group, and 149 in the YT group.

The researchers found that additional full views and ultra- sound were performed significantly less frequently in the YT group than in both the PT and NT groups. They also found that the positive predictive value was increased for the YT group com- pared with both the PT and NT groups.

Overestimation of Radiation Exposure May Keep Women From Screening

Misinformation and misunderstanding about the risks associated with ionizing radiation create heightened public concern and fear, and may result in avoidance of screening mammography that can detect early cancers.

In a study to determine the baseline understanding of the radiation associated with mammography among patients presenting for initial or follow-up imaging, women were asked to rate the amount of radiation received in a single mammogram as being significantly less, slightly less, about the same, slightly more, or significantly more compared with a series of radiation benchmarks. None of the subjects correctly ordered all six of the benchmarks; on average, they significantly overestimated the amount of radiation associated with a mammogram in comparison with other radiation benchmarks.

“Our findings indicate a need to educate patients about the amount of radiation they are exposed to during a single screening mammogram,” said Jacqueline Hollada, a member of the UCLA research team. “Using everyday sources of radiation exposure as benchmarks can help add perspective and improve patients’ understanding of radiation levels associated with mammography, thereby reducing anxiety related to the examination.”

The authors concluded that medical personnel should make concerted efforts to accurately inform women of the risks and benefits of mammography, specifically highlighting the low dose of mammographic ionizing radiation, and provide objective facts to ensure that women make informed decisions about screening.

Source: Radiology Today