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Awareness to Understanding: Ending the Breast Cancer Confusion

Pinktober_pink_october_breast_cancer_awareness.svgOctober is coming to an end and with it an end to another Breast Cancer Awareness Month. How successful was this 2015 month of pink awareness? Perhaps this year more than most, the results were decidedly mixed.

 

The message that early detection saves lives was out there in many formats and for this we are grateful.

 

  • If we have been successful in convincing one more woman that screening for breast cancer with yearly mammography can lead to successful treatment and improved survival, we are grateful.

 

  • If we have educated women to know their biggest risk for breast cancer is being female and getting older, we are grateful.

 

  • If the message that 75% of women with a new diagnosis of breast cancer will have no high risk factors has been understood, we are grateful.

 

We are grateful for the focus this month brings to a subject that touches all of our lives.

 

Tempering our enthusiasm is the concern that the positive messages of this month may have been overshadowed by confusion- confusion created by the new “guidelines” published by the American Cancer Society.  Did we really gain anything more than confusion from a new conflicting and not universally accepted set of guidelines? Here’s where we stand:

 

  • We stand by the recommendations of the American College of Radiology and direct you to the site: End the Confusion from the Society of Breast Imaging if you have questions.

 

  • We recommend annual screening mammography starting at age 40 for all women unless you have high risk factors for which screening may start earlier or include other studies like breast MRI.

 

  • Please note, the American Cancer Society guidelines also support starting screening at age 40 “if they wish to do so.”  We hope you will all wish to do so in order to save the most lives possible.

 

  • We recommend screening annually because just as science is not yet able to predict who will develop breast cancer, we are also unable to predict the aggressiveness of the cancer. Some grow rapidly, and we have all as breast imagers seen sizable tumors develop in less than 12 months in women of all ages.

 

And so, as another Halloween approaches, we are grateful for the spotlight of October on breast cancer. Our dream is that one day soon there will no longer be a need for this month of awareness, that breast cancer will no longer be a threat to women’s – and men’s- lives. Together we can get there!

 

(Image credit: Pinktober pink october breast cancer awareness” by © Nevit Dilmen. Licensed under CC BY-SA 3.0 via Wikimedia Commons)

Breast Density – What You Need To Know

dense dense notBreast density is in the news a lot these days – just what is all the fuss about? Let’s review the facts about breast density and your breast health:

What is breast density?

  • Breast density is a description of the makeup of your breast tissue and its appearance on mammography.
  • Breasts contain fat (dark gray on a mammogram), varying amounts of glandular tissue (white) and supporting structures (linear white).
  • Breast density may vary based on hormonal changes.

Why does breast density matter?

  • The more glandular tissue, the harder your mammogram is to interpret!
  • Breast cancers often appear as white, star-shaped masses or may appear as tiny flecks of white.
  • It is much harder to find a small white mass or speck of white on a background of white tissue than it is on a background of dark gray.
  • Further, studies have shown that for those women with the densest breast tissue, there is a slight, probably around 4% increase in the risk of breast cancer.

How do I know what my breast density is?

  • Breast density is determined by your radiologist from your breast imaging.
  • You cannot determine breast density from a physical breast exam- either by you or your doctor!
  • Your breast density will be classified on your mammogram report as:
    • Fatty (10% of women)
    • Scattered fibroglandular tissue (40% of women) – meaning a mix with around 25-50% of the breast being glandular or white mammographically
    • Heterogeneously dense (40% of women) – meaning a mix with 50-75% of the breast glandular
    • Extremely dense (10% of women) – meaning over 75% glandular
  • Breasts with density in the last two categories are considered dense.
  • As breast density increases, the mammogram becomes progressively whiter.

Where do I find out my breast density?

  • Many states have passed laws requiring the reports we give to you include information on your breast density.
  • We have been providing information on breast density to our patients for the past few years along with the results we provide before you leave our office.
  • If your facility does not provide this information to you, your doctor’s mammography report should contain a statement on breast density.

What should I do now?

  • Knowledge is power. Breast density is just one factor which influences breast health.
  • If you have no other risk factors for breast cancer other than being female and being over the age of 40, screening with annual mammography and careful clinical breast exams every year will likely be all you need. 3D mammography would be beneficial. Be compulsive and come for that mammogram every 12 months!
  • If you are at higher risk for breast cancer due to family history of breast or ovarian cancer or from other factors like radiation to the chest, additional screening tests may be helpful.
  • Consulting with your doctor or with a genetic counselor can help determine your individual risk for breast cancer.
  • For those with a lifetime risk of over 20%, breast screening should consist of mammography and breast MRI every year, alternating each test every 6 months.
  • If your risk is less than 20% or if you are unable to tolerate MRI, screening with breast ultrasound in addition to mammography is an alternative.

No matter your breast density, remember this: mammography saves lives. Make sure you and all those you love get the screening they need.

Dr. Harrison Will Be Taking Your Calls on Dr. Mirabile’s Radio Show!

LH profile picGreat news! Our very own Dr. Linda Harrison will be the guest on Dr. James Mirabile’s radio show tomorrow, July 25th from 1-2p on KCMO Talk Radio (710 AM / 103.7 FM). We’re very excited about this!

Dr. Harrison will be fielding questions from callers and talking about dense breast tissue and – this is important – 3D mammography, the latest advancement in women’s breast health.

Please tune in! Please ask questions! Please have a wonderful weekend and take good care of yourself!

You can listen live here.

Submit your questions online here.

Improving Mammography to 3D Images – No Special Glasses Required

3D-Glasses by xenmate via FlickrTwo years ago, we reported on the emerging technology of 3D mammography. Research since that time has helped to define the benefits and clarify the role of 3D mammography in breast cancer screening.

If you’re wondering how 3D mammography (also called tomosynthesis) works, we have answers. While the machinery will look much like a traditional mammography machine, you will notice a difference when the images are taken. The upper part of the machine will move in an arc while taking several images of the breast tissue. The latest machines approved for 3D mammography can do a 3D study with the same radiation dose as a conventional 2D mammogram, unlike some earlier versions. This is still a mammogram, and yes, compression is still required.

Computers are used to take the digital data obtained from those multiple mini-exposures and convert it into multiple thin, 1 mm or less slices through the breast tissue. The 3D part is done in the radiologist’s head – no special glasses required! The benefit to the radiologist is that the tissue of the breast can be seen without overlap. Think of trying to look through the pages of a book as a whole, versus looking at one page of a book at a time – this is sort of the difference between a 2D mammogram where all the tissue overlaps versus a 3D mammogram where it can be separated.

So what is gained with 3D mammography? There are two important benefits: first, 3D mammography allows the radiologist to find more cancers. Are we excited to find more cancer? No, but… the benefits of early detection are astounding, skyrocketing survival rates. If we can catch cancer early, we can literally save lives. We don’t dance for joy when we discover cancer, but we dance when we know our patient will live.

The other big benefit is the need for fewer work-up studies, especially diagnostic mammograms following a screening study,  because we are able to view the tissue without overlap. The need for additional testing is reduced, thus saving time, cost and anxiety.

While research has shown consistently positive results in the number of cancers found and the reduction in the need for additional testing, the precise role of 3D mammography is still under investigation. Further, most payors are not covering the additional cost of 3D mammography.

More breast cancers are found in women with all breast densities, but those with dense breast tissue will likely benefit the most. Other groups we think will benefit the most include women with a history of breast cancer, family history of breast cancer, women with previous inconclusive mammograms and women with prior breast cysts or lumps.

In short, 3D mammography is proving to be a very valuable tool for breast cancer screening and detection.

(Image credit: 3D-Glasses by xenmate via Flickr. Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

Introductory Remarks, Pink Promise Brunch 2015

IMG_1648Introductory Remarks, Pink Promise Brunch 2015

by Linda Harrison, MD

Welcome to the 19th Annual Susan G. Komen Greater Kansas City Pink Promise Brunch. Diagnostic Imaging Centers, P.A. proudly presents today’s celebration of breast cancer survivors, and we are thrilled to bring Christine Clifford, our inspirational speaker, to celebrate with us. We extend a grateful welcome to the 2015-2016 Komen grantees who are with us today, thanking them for the work they do to fulfill the Komen mission here in Kansas City. We are a room of survivors, co-survivors, researchers and workers. Together we are Komen.

Diagnostic Imaging Centers has seen a lot of changes over our years of sponsorship – the brunch and Diagnostic Imaging Centers have both grown and changed. The brunch started as a luncheon in a single small room with less than 50 people. Look how we’ve grown! Diagnostic imaging Centers started as a single office on Troost Ave and while we have grown from our one small office to 7 offices across the city, our commitment to the best in women’s imaging has never wavered. We remain a locally owned and run company of 192 people who share the Komen vision of a world without breast cancer.

In 2015, our commitment to the best means we are expanding our women’s imaging by bringing the latest in low dose 3D mammography technology to our offices.  Mammography is still a mainstay in the arsenal against breast cancer, and this latest technology gives us new tools as radiologists, allowing us to do our jobs better. Better is good, but still not perfect.

Our commitment to Komen comes in the form of dollars and time. The physicians and employees of Diagnostic Imaging Centers work with Komen throughout the year as we focus on ways to fulfill that promise of one sister to another. We recognize that commitment is not a one then done proposition.

As Henry Ford said, “Coming together is a beginning; keeping together is progress; working together is success”.  We work together because we want a world without breast cancer; an end to the need to tell one more woman there is something suspicious in your breast; and end to the need for chemotherapy and radiation and surgery; an end to the loss of our sisters and brothers to this disease. These are our common goals.

Today we come together on this beautiful spring morning of renewal as a community. Each of us here has traveled a different path. For our breast cancer survivors, that path has at times been a roller coaster – one in the dark, without sight of the end. The journey at times has left you feeling isolated and alone – even when surrounded by your loved ones.

But we come together today to remember that there is strength and healing in our togetherness.  As Ryunosuke Saturo, a Japanese author, wrote: “Individually, we are one drop. Together, we are an ocean.” One person fighting their breast cancer; one person researching for better ways to treat and maybe one day to prevent breast cancer; one person supporting their loved one in their journey; one person working tirelessly to fulfill the promise of one sister to another. All of you as one are a powerful force of change and good; but together? We are amazing!

Together is what Komen is all about. We are blessed by the amazing staff of our local Komen affiliate. They understand. They know the power of 1 multiplied. Every ribbon, every dollar, every person committed to fulfill a dream is a part of the Komen ocean.

Beautiful, courageous, strong, committed – welcome to the Komen community. Together we will work until there is a time when not one more life is shortened, not one more daughter or sister or brother is lost, not one more.

That’s our dream.

Together, this courageous ocean will make these dreams a reality.

The 19th Annual SGK Pink Promise Brunch: Keeping Our Promise

IMG_0641Anything worth promising is worth saying again. We, Diagnostic Imaging Centers, P.A., along with Susan G. Komen for the Cure of Greater Kansas City, gather for the 19th year with a community of survivors and co-survivors to honor a promise between sisters. A promise to find an end to breast cancer.

More than just a special occasion, the annual Pink Promise Brunch is a celebration – of life and loving people, of renewal and hope. Together this group is a community of commitment to educate, support and find cures for breast cancer. All are welcome – survivors, support givers and anyone with an interest in supporting the Komen mission. If you would like to join us, we’d love to have you!

This year’s uplifting event will be on Saturday, April 18, 2015 from 9am until 1pm at the Overland Park Convention Center Ballroom, located at 6000 College Blvd., Overland Park, KS 66211.

Equally as fun as the eating and camaraderie, conversations and presentations, there is, as always: retail therapy! For everything from health and wellness, to beauty and fashion, to silent auctions, to demos… there’s something for everyone in the special shopping area.

This year’s keynote speaker is humorist and survivor, Christine Clifford. Our very own Dr. Linda Harrison will also be sharing some thoughts on this promising-to-be-wonderful day.

Of all the things we love to celebrate at the Pink Promise Brunch, our favorite person is YOU. Hope to see you there!

Tickets and further details can be found here.

Breast Density: Who Knows? We Do! (And So Should You)

Question Mark by Leo Reynolds via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)As doctors, medical terminology is an integral part of our workday, but we realize not everyone has familiarity with those crazy Latin roots or the phrases that we use and re-use! However, there are some medical words and phrases that it would behoove you to know.

“Breast density” is one such term. Every mammography report includes a statement about it, and all women should have an understanding of what it means. However, according to a new study, nearly half of all women who should be getting mammograms had never heard of breast density. Yikes – there is room for more education here!.

Breast density is not something that can be discovered by a physical breast exam, either your own self-exam or your doctor’s clinical breast exam. Mammography reveals the internal structures of the breast with an image of varying shades of black, gray and white depending on the relative amounts of fat and glandular tissue. Breast density is described on a scale from fatty breasts to dense breasts. A fatty breast is one where most of the tissue has been replaced by fat with the image mostly dark gray. A dense breast on the other hand has mostly glandular tissue and will appear as mostly white. Many breasts fall somewhere in the middle.

Cancers often appear as white on a mammogram, whether a mass or tiny microcalcifications. One of the important reasons you should know about breast density is dense breasts make it harder to find some breast cancers on a mammogram. Simply put, it is harder to find a small white object (a potential cancer) on a background of white seen on a dense mammogram.

The other important reason you should know about your breast density is the small but real increase in the risk of breast cancer in those women with dense breasts. This is on the order of a 3-4% increase.

Here’s what YOU can do:

  • Doctors are only required to disclose if you have dense tissue in a handful of states. If you are not in one of those states you can still find out your breast density from the report or discussion with your doctor and/or radiologist.
  • If you have dense breasts, knowing your other risk factors is important. If this is your only other risk factor for breast cancer (other than being female!), routine annual screening with mammography may be all you need. Getting that mammogram every year is important to assess for changes!
  • If you have other risk factors in addition to dense breasts, supplemental imaging may be a good idea. This can include breast MRI for those with high risk (for example having a mother or sister with premenopausal breast or ovarian cancer) or breast ultrasound if intermediate in risk.

As the saying goes, knowledge is power. And knowing if you have dense breasts (and what to do about it) can save your life – that’s really powerful!

(Image credit: Question Mark by Leo Reynolds via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0))

Breast Cancer: No Room at the Inn

No vancancy. by A National Acrobat via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)Mold loves a musty basement, mosquitoes like standing water and certain bacteria love improperly cooked meats. Given the “right” environment, these buggers flourish. Conversely, if their environments become inhospitable, they don’t live long.

This simple truth got scientists thinking: Is it true for cancer as well? Recently published research in the Journal of the National Cancer Institute (JNCI) suggests that local environment can similarly influence tumor growth.

Breast and prostate cancers were tested in lab mice who were given chemotherapy and two conditions: a sedentary life or one with an exercise wheel. The mice who exercised fared better.

Here’s how: cancer cells (such as breast and prostate) thrive in areas of hypoxia, or low oxygen. That’s their sweet spot. With exercise comes greater oxygen into the tissues of the body and into the tumors. Improvement in number of blood vessels and smaller areas of poor perfusion or hypoxia were seen in the active mice.

So, score one more for exercise! Not only does it reduce the risk of breast cancer, but it may make tumor growth more difficult. Not a bad side effect for something good for your overall health.

(Image credit: No vacancy. by A National Acrobat via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

232,000 Breast Cancer Survivors. Wow. How?

Aviodrome Lelystad Airport 09-08-05 by ArchAngel12 via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)

The statistics for breast cancer get a little overwhelming and hard to appreciate. Two hundred thirty two thousand is the estimated number of women with a new breast cancer diagnosis last year – 232,000 more survivors in just one year. The more familiar statistic of a 1 in 8 chance of developing breast cancer in your lifetime is fairly well known – and this applies even if you have no family history of breast cancer.

This is (for the time being) the reality. However, here’s the good news: early detection saves lives – LOTS of lives. Before a cancer can be seen or felt, it can often be detected by mammography. Thus far, mammography and improved breast cancer treatments have raised the breast cancer survival rate up to 98%. Those new breast cancer survivors last year have the best odds yet of beating their disease.

Because 232,000 is a huge number, here are some ways to imagine it:…..

We could fill Kansas City’s Kauffman Stadium (go Royals!) more than 6 times over with survivors. The new breast cancer survivors could fill the city of Reno, Nevada. We could load 632 jumbo jets with survivors (and wouldn’t THAT be a party!).

Aside from figuring out the logistics of how to cram 632 jets full of people who are conquering their breast cancer, there’s a bigger question:

What does it take to ensure 232,000 is just the beginning? It takes a team. A team dedicated to treating every patient so that they have the best chance of beating the disease. And a team dedicated to finding breast cancers when they are most treatable.

Early detection happens with an effort by you and the rest of your health care team. First, know thyself. Performing monthly self-exams helps you know what’s a slight bumpiness from what’s a new lump. Observing your body for physical changes (rashes, dimpling, aching, etc.) is helpful – tell your doctor about ANY change! There are annual clinical exams by your doctor or healthcare practitioner starting at age 20. Every woman over the age of 40 (or earlier if at high risk) should have an annual mammogram.

Mammograms see into the breast tissue – beyond what can be felt or found even by a careful clinical breast exam. Mammograms are an incredibly powerful tool that allows us, your radiologist, to inspect the structures of the breast to identify good health… and even find bad news. But remember, bad news caught sooner is better than bad news later. The earlier the stage of breast cancer, the better the chances of survival. And the less intense the treatment.

So, until we can figure out how to prevent those 232,000 women from getting breast cancer in the first place, let’s fill more jets, more stadiums, more races for the cure, and more homes with wives, mothers, daughters, sisters and friends who are survivors. Let’s conquer breast cancer!

 

 

(Image credit: Aviodrome Lelystad Airport 09-08-05 by ArchAngel12 via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

1 in 8 Women Will Get Breast Cancer… and Half of Women Aren’t Doing Anything About It

shocked by anthony kelly via flickr copyright creative commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)This just in… one in eight women will get breast cancer in their lifetime. Not new news? Perhaps it needs repeating. Along with this: Early detection saves lives.

 

Why the need to repeat and re-emphasize? Approximately half of all women (half!) aren’t getting their annual screening mammograms. As professionals in women’s health – and breast imaging in particular – we couldn’t be bigger fans of proactive behaviors. Given that 50% of women in our country aren’t getting this potentially life-saving exam is concerning – and frustrating!

 

Mammography, clinical breast exams and monthly self-exams are the way to fight breast cancer. Sounds straightforward, right?

 

So, why the apathy? There are a lot of theories and undoubtedly lots of reasons which influence the action and/or lack of action by women.

 

Time. More than ever, women don’t have time to spare – between family and work, we’re pushed to our limits. There are, however, outpatient facilities that make it possible to walk-in without a doctor’s order for a screening mammogram and leave with results in-hand 20 minutes later. It can be done! Call ahead to find the best facility near you.

 

Cost. But if you have insurance, this should NOT be an issue. Annual screening mammograms are required to be covered by insurance plans under the ACA – without cost to you. There are also programs to assist the uninsured through nonprofits like the Komen Foundation. Money should not come between you and your best possible health!

 

Fear. There are lots of fears associated with that annual mammogram – but none should keep a woman from getting it done. There are fears of pain – who hasn’t heard the horror stories? But we promise you, with a caring technologist who knows your fears, we can get you through the brief seconds of compression and discomfort – promise! And then there are the bigger “what-if” fears. What if we find something? Remember, the vast majority of mammograms will have normal or benign, non-cancerous findings. And further, if we see you every year, it is more likely that your cancer will be found when it is small and treatable. Still fearful? Make that yearly appointment with a friend – life is always better with a friend at your side.

 

Armed with knowledge to conquer fear, money woes and time, you are better prepared to take care of yourself. Share with a friend or loved one – this might be the push they need to get their mammogram. While nearly half of women aren’t getting their annual screenings to ensure their best possible health, you don’t have to be a statistic. Let’s change the ratio!

(Image credit: shocked by anthony kelly via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0))

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!