HOUSE CALL: Diagnosing breast cancer — we've come a long way


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By Dr. Linda Proctor STLtoday.com | Posted: Wednesday, October 26, 2011 6:00 am

The incidence of invasive breast cancer has decreased in recent years in this country as has deaths from breast cancer.

These results suggest that reduced use of hormone replacement, earlier detection by screening mammography and improved treatments are responsible. Breast cancer accounts for nearly 28 percent of cancers diagnosed in women in this country.

We've also done a good job in getting the message out that early detection with annual mammograms beginning at age 40 is important.

Unfortunately, one-in-four of the breast cancers we've diagnosed at Missouri Baptist since 2007 have been in women under age 50. This only reaffirms the importance of starting annual mammogram screening at age 40. When caught early, women have more treatment options and the treatments are often less invasive.

Most of us are aware of the term digital mammography, still many may not fully realize how astounding these advanced technologies are when it comes to saving women's lives.

Less than a dozen years ago, the majority of radiologists read mammogram images on film, searching for any visible signs of breast abnormalities. Today, digital mammograms are reviewed on high-resolution computer monitors with the ability to zoom in on areas of concern.

Digital Images are now stored electronically and may easily be shared with other specialists treating patients with breast cancer.

Digital mammography has improved our ability to detect early breast cancer. Our goal is to find it early, before there is a chance to spread to adjacent tissues or axillary lymph nodes (located in the armpit).

Additional tools for evaluating breast tissue include ultrasound and dynamic breast MRI exams. Radiologists use ultrasound frequently to evaluate a palpable lump or mass seen with mammography. When suspicious, a biopsy is performed for further evaluation.

MRI exams are recommended to further evaluate a known breast cancer after needle core biopsy to define the extent of disease in the breast and axilla as well as assess presence of disease in the opposite breast. It is also used as a screening tool in conjunction with mammography and ultrasound to follow women who are at high risk for developing breast cancer.

We recommend a three-step approach for breast preventative care:

1) Annual mammogram (age 40 or older, unless your physician recommends otherwise)

2) Monthly breast self-examination

3) Annual breast exam by your physician

Linda Proctor is a board-certified radiologist at Missouri Baptist Cancer Center. For referral to a physician on-staff at Missouri Baptist Medical Center, call 314-996-LIFE. For further information: BreastCancer.org.

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