\u201cMammograms save lives, period, end of story. But it takes decades to appreciate just how many,\u201d announced ABC News Medical Unit correspondent Courtney Hutchison, reporting June 28, 2011 on a 29 year long mammogram study in Sweden. \u201cThe researchers found that seven years of mammograms made for 30 percent fewer breast cancer deaths years down the road, when compared with women who didn\u2019t receive mammograms.\u201d According to Dr. Laurie Margolies, chief of breast imaging at Mount Sinai Medical Center in New York, the longer follow-up period is essential, because a number of breast cancers are very slow growing, and they take many years to become lethal.<\/p>\n
Therefore, the shorter term studies that have been done previously, can only account for breast cancer deaths due to the more aggressive, fast growing cancers. This study is a wake up call for those who have claimed that mammograms don\u2019t have enough benefit to warrant starting them at age forty, or having yearly exams. \u201cOverall, breast cancer experts believe this study out of Sweden supports the message they\u2019ve been sending all along: Regular mammograms save lives. Period,\u201d concludes Hutchinson.<\/p>\n
Mammograms aren\u2019t a prevention tool, however, they\u2019re a detection tool. When it comes to breast cancer, of course, both are extremely important. Dr. Colin Kopes-Kerr has recently written in these pages of the essential nature of diet, exercise, relaxation, not smoking, and holding to a healthy weight. According to Kopes-Kerr, this \u201cHealthy Lifestyle\u201d plan has been proven in repeated studies by top researchers to reduce the rate of \u201call cancers by 36 to 64 percent.\u201d<\/p>\n
So, if women combine a healthy lifestyle (prevention) with yearly mammograms after the age of 40, beginning earlier if they have certain risk factors (early detection), they should be able to reduce their risk of breast cancer by a very significant amount.<\/p>\n
Breast cancer detection has taken a leap forward with the advent of digital mammography. \u201cDigital is the state of the art modality for early detection of breast cancer used in mammography screening,\u201d according to Michie Russ, mammographer and x-ray technician for the past fifteen years, who works in the imaging department at Eastern Plumas Health Care.<\/p>\n
Russ has spent most of her time as a mammographer utilizing film equipment. She describes the film cassettes that had to be loaded and unloaded. Then, the film had to be processed, including the developer, fixer, and wash. After that, film cassettes had to be cleaned. A small spot of dust could cause what she called an \u201cartifact,\u201d which meant further images would be required. Still, it was a fairly quick process considering all that was involved\u20142 -3 minutes per image as opposed to the approximately 5 seconds per image with digital. Though that may not seem like a lot of time saved, \u201cthe extra time not spent focusing on the mechanics of film,\u201d said Russ, allows her to \u201cspend that time with the patient, answering her questions,\u201d helping her to understand and feel comfortable with the process.<\/p>\n
In film mammography, the mammographer chooses a focus point at the most important part of the breast, which Russ terms \u201cthe optimal density.\u201d This can cause the portion of the breast nearest the chest wall to be underexposed and nearest the nipple to be over exposed, she said. In digital imaging, the digital plate is made of a computer grid, and each small square of that grid receives proper exposure for that particular portion of the breast. This is particularly important, she explained, at the front skin line, which often appears \u201cburned out\u201d in a film image. <\/p>\n
A clear image of this skin line is essential in the diagnosis of Paget\u2019s Disease of the breast, a very aggressive, very deadly form of breast cancer. Its characteristic surface swelling of the skin is often misdiagnosed as Mastitis, said Russ, which is an inflammation of the breast. Early diagnosis is especially important in Paget\u2019s Disease because it is so fast growing and so lethal. In addition, it tends to occur more in younger women.<\/p>\n
Digital mammography is especially good at penetrating dense breast tissue and breasts with implants. Also, the image quality is much higher\u2014\u201cit\u2019s crisp, clean, beautiful,\u201d said Russ\u2014so, problems can be diagnosed more quickly and precisely. And, it\u2019s better able to distinguish between different types of breast tissue\u2014from fibrous to glandular to fatty tissue. <\/p>\n
The detail allowed by digital makes it easier to assess calcifications, as well. Many of these are benign, but small cluster calcifications can indicate the earliest stages of the breast cancer Ductal Carcinoma In Situ. This is one of the most common cancers and it\u2019s non-invasive\u2014confined to the milk duct of the breast. It doesn\u2019t form a lump that can be felt, however; 80% of cases are found by mammograms. Because it\u2019s discovered before it has spread, the prognosis for this form of cancer is excellent. \u201cThat\u2019s when we want to catch [it] before it has invaded anything. That\u2019s when it really saves lives.\u201d Russ cautioned women that \u201cjust because the doctor says it\u2019s calcification doesn\u2019t mean it\u2019s cancer,\u201d however.<\/p>\n
She added that EPHC works with radiologists at North Star Imaging in Reno, who read the image and determine if further images need to be taken. Digital images can be transferred almost immediately, meaning results can be relayed to patients much more quickly, as well.<\/p>\n
A further advantage of digital mammography is that it reduces the already small amount of radiation emitted in film mammography by another 30 \u2013 50 percent. It also affords a higher level of comfort. Newly trained digital mammographer, EPHC\u2019s Nicole Sheldon, emphasized that patients need to understand it\u2019s still just as vital to compress the breast to get a quality image. But, she added that the breast doesn\u2019t need to be compressed for as long. As soon as the button is pressed and the image taken, the compression paddle automatically lifts away from the patient. The whole process takes about 20 seconds, said Sheldon. <\/p>\n
In addition, said Russ, the new paddle design slopes with the breast, which \u201callows for overall compression with less pinching at the chest wall.\u201d EPHC is also experimenting with new \u201cmammo pads,\u201d which cushion the breast and make the whole experience more comfortable. \u201cWe don\u2019t want anyone to turn away because they had a bad experience in the past,\u201d she said. <\/p>\n
Plumas County hospitals routinely offer low cost mammography specials during October, Breast Cancer Awareness Month. Eastern Plumas Health Care is celebrating the arrival of its new digital mammography system with a special during the month of July, as well. And, under the Affordable Care Act, Medicare patients can now have very low or no cost mammograms as part of their Welcome to Medicare and yearly prevention exams.* Now, there\u2019s no excuse for women not to get their potentially lifesaving breast screenings.<\/p>\n
*Your health care provider will help you determine when you qualify for your Medicare mammogram during your Welcome or annual exam.<\/p>\n","protected":false},"excerpt":{"rendered":"
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