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Advances in MammographyAdvances in Mammography

Dr. Jill Steinkeler, Director of Breast Imaging at Lowell General Hospital, discusses the latest advances in digital mammography, including 3D mammography (tomosynthesis) and the importance of early detection. (Health Styles episode 119)

Advances in breast cancer detection and treatment

"If there's one thing I want women to know, it's that mammography works," says Jill Steinkeler, MD, board-certified diagnostic radiologist at Lowell General Hospital. "Its role is to detect breast cancer at an early stage, when it's still curable, which is why regular screening is so important."

Jill SteinkelerDr. Steinkeler and her colleagues follow the American Cancer Society's guidelines for screening, which recommend that women have a baseline mammogram between the ages of 35 and 40, and routine annual mammograms after age 40. Women should also do breast self-exams monthly, and have a clinical breast exam as part of their regular physical.

"Some women at higher risk – those with a strong family history of breast or ovarian cancer or other genetic factors, or who've undergone chest radiation – might start regular screening before age 40," she adds.

To make breast cancer screening convenient and accessible, Lowell General offers mammography at multiple sites with today's most advanced imaging technology.

"All our mammography is digital," Dr. Steinkeler notes, a technology that's been shown to be better than traditional film mammograms in detecting breast cancer in women under age 50 and with dense breasts.

Lowell General Hospital also offers 3D mammography, or tomosynthesis. "This technology gives us three-dimensional images of the breast that can help us see lumps that are otherwise hidden by overlapping breast tissue," Dr. Steinkeler explains. "This is helpful for all women, but especially for those with dense breast tissue. It's been shown to increase the detection rate of breast cancer and minimize false-positive exams."

In addition, Lowell General offers breast ultrasound, ultrasound-guided breast biopsies and cyst aspirations, breast MRI, and stereotactic and MRI breast biopsies.

When breast cancer is detected, Lowell General Hospital also offers a comprehensive array of today's most advanced treatment options.

"Today we know that not all breast cancer is created equal," says Murat A. Anamur, MD, a board-certified medical oncologist and medical director of cancer services at Lowell General. "With this understanding we can tailor treatment to the individual patient."

With advanced testing now available, he explains, doctors can analyze the genes in breast tissue to understand the exact type of cancer a patient has, determine what drugs or treatment approach will hit that target most effectively, and even predict if a recurrence is likely.

"This field is growing fast, and there are new drugs being developed and approved and new concepts emerging all the time," he notes.

When is surgery to prevent breast cancer, like actress Angelina Jolie had, something to consider? "This is one option for risk reduction in carefully selected cases where there is a genetic component," Dr. Anamur says. "If you have a family history of breast cancer – especially if it occurs in younger relatives – this is a red flag that it may have a genetic origin. We also look at how many other family members not only have breast cancer but also ovarian, prostate and colon cancer. Also, if you have cancer in both breasts, or if breast and ovarian cancer occur in the same person.

"In these situations, we refer you to our geneticist for testing," he continues. "If you test positive for the BRCA gene mutation, we then do counseling regarding risk reduction, and removing both breasts is one option." Also removing the ovaries is another. For post-menopausal women, there are three drug options."

"Breast cancer today is more and more treatable, with options expanding all the time," he adds. "But early detection through regular physical exams and mammography remains one of the most important things women can do to improve survival."

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