Have You Had Your Annual Mammogram?
Kim Hwang, MD
Early detection and
treatment is still our number one defense against losing lives to breast
cancer. This means that monthly self-examination and yearly mammograms for
women after the age of 40 save lives. And while the vast majority of breast
cancers occur in women, a small percentage of men are also at risk for this
form of cancer and should periodically check for lumps or alterations in
appearance and follow up with the doctor should any changes occur.
The American Cancer
Society recommends that women obtain a baseline mammogram at 35 years of age,
which provides your radiologist with an image of your healthy breast. This
serves as a basis for comparison in coming years, making it easier to spot
changes in the breast with subsequent mammograms.
What is the advantage of
provides us with better contrast resolution, which helps us see through denser
breast tissue. This gives us an advantage in spotting tiny changes that are
difficult to detect with regular mammography. The digital advantage is doubly
significant because many women under age 50 have dense breast tissue and cancer
in this young age group tends to be more aggressive, so it is best to catch it
in the very earliest stage.
What happens if the
radiologist finds something on my mammogram?
The radiologists at Cayuga
Medical Center and the Ithaca and Cortland Convenient Care Centers review your
mammogram during your appointment. If they find something suspicious, they will
talk with you and recommend one of two follow-ups.
If the spot they see on
your mammogram is palpable (can be felt during manual examination), you will
have an ultrasound and learn the results during the same visit. An ultrasound
tells the radiologist whether the mass is solid or filled with fluid. A
fluid-filled mass is a cyst and no further action is required. However, if the
mass is solid the radiologist will usually recommend a biopsy. Bear in mind
that 80 percent of breast biopsies are not cancerous.
If what the radiologist
sees on your mammogram are tiny calcifications that are not palpable, the next
step may be a breast MRI and stereotactic biopsy. Most calcifications are not
cancerous, but a percentage of these tiny deposits of calcium are the very
earliest signs of cancer. Because a breast MRI produces a thousand images for
the radiologist to examine, you may have to wait 48 hours for these results.
What happens during a
biopsy can be scheduled within a week and is minimally invasive. It is
performed with local anesthetic and a small-core needle making the procedure
more easily tolerated. An MRI-guided biopsy is very similar. The radiologist is
guided to the exact spot using MR imaging and extracts a marble-sized piece of
tissue containing the tiny calcifications. The tissue is then examined by our
pathologist for diagnosis.
Breast MRI screening is
additionally recommended for certain patients who are at high risk due to
family history or who have inherited the high-risk gene for breast cancer. MRI
is also used to ensure the cancer isn’t anywhere else in either breast because
multifocal cancer is not uncommon.
Discovery and intervention
while the cancer is in its earliest stages dramatically increase the chances
for a cure in women diagnosed with breast cancer. Be proactive: schedule your
Dr. Hwang serves on the
medical staff of Cayuga Medical Center and is board certified in radiology. He
is chairman of Imaging Services.