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The Benefits of a Full Service Breast Center
"Mammography is part science, part art and improves with greater degrees of radiologist experience," says Linda M. Sanders, M.D., Medical Director of the Breast Center at the Saint Barnabas Ambulatory Care Center (ACC). "I would compare the search for breast cancer to reading a blackboard that has been written on with black chalk. Cancer is white, and is often superimposed on breast tissue, which is also white. The experience of the radiologist can make all the difference not only in the detection of a subtle cancer, but knowing which patient does not need to get called back for additional imaging." The experience of the radiologist is directly influenced by the patient volume at a breast center. A center that performs a large number of mammograms and other sophisticated diagnostic procedures usually has an experienced technologic staff as well. The largest comprehensive breast care program in the region, The Breast Center performed more than 58,000 breast procedures last year, including screening mammograms, stateof- the-art minimally invasive breast biopsies, and MRI of the breast. The Breast Center is also the only facility in the region offering "triple assurance" to patients having a screening mammogram. Two standard views are taken of each breast as part of the screening mammogram. The images are then processed by a computer aided detection (CAD) system which highlights abnormalities. Studies have shown that this technology assists the radiologist in identifying additional cancers. Two board-certified radiologists review each study independently, and may confer with one another in complicated cases. Breast Screening: Where to Begin Between the ages of 35 and 40, a woman should have her first screening mammogram. (If a woman has a problem at an earlier age, she may require a mammogram earlier than 35). A screening mammogram is a safe, low dose x-ray procedure for women who do not have current breast problems. Two views of each breast are obtained. Dr. Sanders relates that the mammogram is the only test currently shown by medical research to be of value as a screening exam for breast cancer.. Some women may be confused about the use of a mammogram versus ultrasound for screening. A breast ultrasound is required in approximately half of patients who have had an abnormal mammogram. This additional test is used to determine whether an area of concern on a mammogram is a cyst or a solid mass. "Ultrasound is not useful for screening, in my experience, but is invaluable to target a problematic area that was identified by mammography or by physical exam," explains Dr. Sanders. "It may also be used as a follow up to an abnormality seen on breast MRI (magnetic resonance imaging)." Breast MRI uses magnetic pulses and a computer to make detailed images of the breast with excellent tissue contrast. MRI is useful in patients with a newly discovered breast cancer; the scan can evaluate the extent of the cancer, often better than mammography, and can also assess the opposite breast. MRI is also used to show the difference between cancer and scar tissue. In women with a high genetic risk of breast cancer, screening trials of MRI show it has greater sensitivity than mammography in finding breast tumors. "MRI is an essential tool to evaluate the breast in higher risk women," says Dr. Sanders. MRI is more sensitive than mammography, but it may be less specific because so many benign breast abnormalities show up and are difficult to distinguish from early cancer. MRI is best utilized in women with a higher risk of breast cancer, whether it be due to genetic risk, prior personal history of cancer, or newly diagnosed cancer." The Next Step: If Something is Found
Depending on the results, there may be a need for further testing, including minimally invasive breast biopsy. Dr. Sanders has been the chief of the Breast Intervention section at The Breast Center at Saint Barnabas Ambulatory Care Center for over a decade. Dr. Sanders reports that most breast biopsies are benign; less than 20 percent are found to be malignant. If cancer is suspected, Dr. Sanders makes sure that the patient is referred to a breast surgeon before leaving the department and also emphasizes that breast cancer caught early often responds successfully to treatment. "We have a great department and we find things early," she emphasizes. "Our breast center is a great choice for a patient. Our high volumes ensure experienced radiologists to interpret the studies and to perform minimally invasive procedures as indicated. We participate with almost all insurance carriers. We care about our patients, not just our films." For more information or to schedule a mammogram, please call The Breast Center at the Saint Barnabas Ambulatory Care Center in Livingston at (973) 322-7804. For information or to schedule a mammogram at the new Saint Barnabas Breast and Women’s Imaging Center in Bedminster, please call (908) 234-0205.
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Choosing a quality breast center is one of the most significant decisions a woman makes in caring for her health. While most women realize that a mammogram is an important medical test to screen for breast cancer, they may not realize the importance of finding an experienced radiologist to obtain the most accurate test results possible.
