Monday Medical: Understanding breast cancer screenings

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Most women’s biggest concerns about breast cancer boil down to a simple question: Do I have it? The answer, however, is not always simple. Depending on risk factors, such as family history and breast density, screening and/or diagnosis may require multiple tests and procedures.

Monday Medical

Monday Medical columns publish weekly in the Steamboat Today's Yampa Valley Health section. Read more columns here.

“There is no exact formula for every woman,” said Dr. Terese Kaske, breast imaging specialist radiologist and medical director of the Gloria Gossard Breast Health Center at Yampa Valley Medical Center.

The center’s specially trained staff and advanced technology have enhanced the hospital’s ability to detect and diagnose early breast cancers.

Breast health specialists and staff at the center work hard to provide comfortable and efficient services — including same-day screening results — but ensuring breast health can take time and diligence, which can be stressful for patients.

With 20 years of experience examining breast images and conducting biopsies, Dr. Kaske understands the angst that can accompany breast cancer screening and diagnosis. She wants to help women better understand important aspects of these processes to keep their anxiety in perspective and prepare them for their visits to the center. Dr. Kaske discussed some of these points at a YVMC women’s health event, Celebrate Women, last week.

For most women, breast screening begins with a mammogram or X-ray of the breasts. The American Cancer Society recommends women receive annual mammograms beginning at age 40. Women who are at high risk for breast cancer because of family history and other factors may need to begin mammography at an earlier age and may be a candidate for annual MRI screenings, which provide additional detail of the breast. Breast MRI is available at the Yampa Valley Medical Center.

Last year, only 65 percent of women 40 and older in Routt County had a mammogram, which is below the state screening rate. Most health plans must cover the cost of mammograms every one to two years for women 40 and older.

During a mammogram, the breast is compressed between two plastic plates, providing two important views of breast tissue. Good compression can be uncomfortable, but it allows the mammogram technologist to get a better image of the breast and use less radiation.

“It’s important to allow us to do a good study,” Dr. Kaske said.

Sometimes doctors need additional mammograms and/or breast ultrasound tests to better understand a potential abnormality. About 10 to 12 percent of women will receive a callback for a second round of imaging. This more often occurs to women who have not had previous mammograms or whose breast images from a different hospital have not been sent to the Breast Health Center.

“Sometimes, the pattern of the fibroglandular tissue in the breasts is different, and if you don’t have anything to compare it to, you have to resolve it,” Dr. Kaske said. “Most of the time, it’s not going to be anything.”

Another factor that can affect screening is breast density. Women whose breasts are composed of more fibrous or glandular tissue than fatty tissue have denser breasts. Higher breast density can mask abnormalities and increase a woman’s risk for breast cancer. Doctors may recommend the addition of a screening breast ultrasound for these women.

If a screening test shows a breast abnormality or a patient feels a lump, doctors may need to conduct a biopsy, or remove tissue from the abnormality, to explain it and determine whether or not it is cancerous. Every imaging test has limitations; understanding the limitations is an important part of every doctor’s job. If the results of a test are not conclusive, then a biopsy may be required.

“Our imaging is very good, but it doesn’t always tell us what something is,” Kaske said, adding that the biopsy process at the Breast Health Center is minimally invasive and results are available within one to two days.

The Breast Health Center is located in the Medical Office Building adjacent to YVMC. For more information, call 970-871-2399 or visit www.yvmc.org/breasthealth.

Tamera Manzanares writes for Yampa Valley Medical Center. She can be reached at tameramanza@gmail.com.

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