By Deborah Bostock-Kelley
Special to The Laker/Lutz News
In 2019, an estimated 268,000 new cases of invasive breast cancerwill be diagnosed in women living in the U.S. To reduce this sobering statistic, AdventHealth Wesley Chapel is using innovative diagnosis and advanced treatment options with state-of-the-art technology.
All patients at the hospital receive noninvasive, 3D mammography that helps the radiologist see issues that were hidden in its predecessor, 2D mammography.
“Three-dimensional mammography allows for better visualization of the breast tissue, and is becoming the new standard of care,” said Dr. Jahnavi Pastore, director of breast imaging at AdventHealth Wesley Chapel. “It is our standard practice to perform mammograms as a three-dimensional study because it offers a more precise evaluation of the breast tissue, and is particularly helpful in imaging dense breasts.”
Dense breasts are more challenging for the radiologist to read in a mammogram, because dense tissue appears white in a black-and-white mammogram, as do tumors.
For patients with dense breasts, Dr. Pastore recommends a 3D mammogram, even if a patient has had a recent 2D mammogram. A 3D mammogram allows the radiologist to review the study, and if any concern arises, allows the patient to quickly do a follow-up mammogram with contrast, or an ultrasound.
Contrast-enhanced mammography uses an injection into the vein to increase the ability to see any abnormal breast tissue in the 3D mammogram. Using contrast makes any areas of concern light up in the mammogram, and helps the radiologist diagnose potential concerns.
“The contrast is injected a couple of minutes before having a mammogram. If a tumor is sitting in the breast, it will take up the contrast and jump out on the mammogram against normal background breast tissue,” says Dr. Pastore.
“This is not a routine study, but if we see something on the 3D mammogram for someone with dense breasts, a contrast mammogram may be recommended after a breast ultrasound. In addition, it can serve as an alternative for a breast MRI for patients with pacemakers or severe claustrophobia, who are unable to have a breast MRI,” she said.
A third advancement at AdventHealth Wesley Chapel is elastography — a tool used as part of breast ultrasound imaging to measure the stiffness of a breast lesion.
“If something is particularly stiff compared to the surrounding tissue, it is of greater suspicion and could warrant a biopsy,” says Dr. Pastore. “Sometimes, cysts can be complicated in their appearance, and elastography can be a helpful diagnosis tool, plus it is noninvasive with zero radiation.”
If a tumor is considered high-risk, or is determined to be cancerous and tissue removal is required, the hospital features new SCOUT technology. This technology places an infrared radar reflector the size of a grain of rice into the tumor before the surgery. The reflector emits a radar signal, which allows the surgeon to precisely locate and remove cancerous tissue during a lumpectomy or surgical biopsy using a probe hand piece.
Dr. Pastore relays the story of a young woman who had a family history of breast cancer. She started traditional mammogram screening in her early 30s, and then tried 3D imaging with Dr. Pastore, which led to the discovery of a distortion in the breast.
“There wasn’t an ugly mass. It was relatively small and subtle. We quickly got her in for a diagnostic mammogram, and with compression, the area stood out even more,” she explains. I did an ultrasound of that area and sitting in that tissue, exactly where it was on the mammogram, I saw a mass that was not visible on the 2D mammogram. I got her in the day after and did a breast biopsy, and it was positive for cancer.
“She had a breast MRI to ensure there weren’t any other areas of cancer, and then went on to a breast surgeon who did a lumpectomy and removed that area. The 3D imaging allowed a young cancer patient to have a relatively simple course of treatment. If this had not been detected with 3D mammography, eventually it would have turned into a true mass, and could have required a more extensive and prolonged treatment.”
Dr. Pastore says, “I am grateful to have the technology to do my job to the best of my ability. Radiologists know what to look for, but we are only as good as the tools that we have. To have this type of technology at my fingertips is fantastic.”
For more information: AHWesleyChapel.com, or Facebook.com/AdventHealthWesleyChapel