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Featured Story Written by Breann Lujan-Halcon

Screening and Detection

Starting at 40, women should begin getting annual mammograms.

Angela Weiss has been work­ing at Ivin­son Memo­r­i­al Hospital’s radi­ol­o­gy depart­ment since 2002. She has spent 12 of those years in Ivinson’s Breast Imag­ing Cen­ter work­ing in mammography.

As the Lead Mam­mo­g­ra­ph­er, she has seen the mam­mo­gram process and equip­ment evolve over time. One thing she wants you to know, we are a long way from those hor­ror sto­ries you have heard about mammograms.

We are hear­ing from our old­er gen­er­a­tions about when mam­mo­grams were intim­i­dat­ing and very uncom­fort­able and that is what is being told to the next gen­er­a­tion,” Angela said. We need to get rid of those misconceptions.”

When Angela first joined Ivinson’s radi­ol­o­gy depart­ment, imag­ing was still done on film. The time­ly process demand­ed more man pow­er, longer wait times and less­er qual­i­ty images. 

They had big machines that were called film rollers that they would hang films up for the radi­ol­o­gist and fold film,” Angela said. It was a lot of footwork.”

Leav­ing films and the dark room as a thing of the past, Ivin­son upgrad­ed to a dig­i­tal 2D machine that decreased wait times for patients and allowed radi­ol­o­gists to review images even faster. 

In 2017, Ivinson’s Breast Imag­ing Cen­ter went even fur­ther to improve mam­mo­grams for patients by invest­ing in the Holog­ic 2D/3D mam­mog­ra­phy machine. The advanced tech­nol­o­gy gives radi­ol­o­gists the tools to help iden­ti­fy breast can­cer soon­er, while pro­vid­ing a more com­fort­able and effi­cient patient experience. 

At Ivin­son, we have a state-of-the-art Breast Imag­ing Cen­ter and our equip­ment is the best on the mar­ket. I have patients that have his­tor­i­cal­ly gone down south and they come here now because our equip­ment is top of the line,” Angela said. 

The mam­mo­gram tech­ni­cians at Ivin­son are all licensed and fre­quent­ly trained on new edu­ca­tion and posi­tion­ing tech­niques that pro­vide the best imag­ing and most com­fort to a patient. Mam­mo­grams per­formed on the Holog­ic 2D/3D mam­mo­gram machine use a vari­ety of pad­dles that pro­vide bet­ter breast com­pres­sion while using less force. Stud­ies have found that 3D mam­mo­grams offer bet­ter eval­u­a­tions for patients with dense breast tissue.

It’s more com­fort­able for the patient and it also gives us a bet­ter read-out because we have a bet­ter con­sis­ten­cy of com­pres­sion through­out the whole breast. We also have a foam pad that we can use if you have sen­si­tive skin or are prone to tears.”

In addi­tion to com­fort, Ivinson’s advanced mam­mo­gram machin­ery pro­vides radi­ol­o­gists with enhanced images to review.

Mov­ing from the dig­i­tal machine to the 3D machine, the clar­i­ty is night and day com­pared to now. Then, it was very cloudy white look­ing and now our images are very crisp and clean look­ing. We can see more details in the breast than ever before. With the 3D we are able to see 1 mil­lime­ter thin slices.”

What’s the big deal with 3D? To a radi­ol­o­gist and the patients they see, it’s everything.

Patients used to get call backs because of over­lap­ping tis­sue. The radi­ol­o­gist wouldn’t always be able to dif­fer­en­ti­ate if there was over­lap or if there was some­thing there. Patients would have to come back for addi­tion­al images,” Angela explains of the old process. Now, the radi­ol­o­gist can actu­al­ly scroll through the one mil­lime­ter thin slices and they can see if it is tis­sue lay­ing on top of tis­sue or if it is some­thing lay­ing with­in the tis­sue that we need to be con­cerned about. The res­o­lu­tion of the pic­tures is so good now, that we are pick­ing up micro­cal­ci­fi­ca­tions that we would have nev­er seen before.”

Breast cal­ci­fi­ca­tions are deposits of cal­ci­um that devel­op in breast tis­sue. Cal­ci­fi­ca­tions are cat­e­go­rized as micro­cal­ci­fi­ca­tions or macro­cal­ci­fi­ca­tions. Micro­cal­ci­fi­ca­tions appear on mam­mo­grams as small white specks and can be a pre­cur­sor for cancer. 

They are not always can­cer­ous,” Angela explains. We can have cal­ci­fi­ca­tions that are very benign in our breast but they can be can­cer­ous and those can­not be picked up by any oth­er modal­i­ties. That is why a mam­mo­gram is the gold stan­dard. We are look­ing for cal­ci­fi­ca­tions and those are nev­er going to be seen in ultrasounds.” 

Most clin­i­cal guide­lines rec­om­mend that women of aver­age risk begin breast can­cer screen­ings at age 40 with an annu­al mam­mo­gram. Patients with high­er risks may need to be screened ear­li­er and more often. Screen­ing mam­mo­grams are rou­tine and look for signs of breast can­cer in patients that are not dis­play­ing signs or symp­toms. Patients that are expe­ri­enc­ing symp­toms should not delay in con­tact­ing their health­care provider.

Get your mam­mo­gram,” Angela stress­es. I did not have my own until I worked as a mam­mo­g­ra­ph­er and what made me get a mam­mo­gram was see­ing what I do here at work. If I didn’t work in this field, I don’t know if I would have done it yet, because I didn’t real­ly know the impor­tance of it. Now, I can­not stress it enough.”

Like many women, Angela con­sid­ered her­self healthy, she had no fam­i­ly his­to­ry of breast can­cer and was con­sid­ered at aver­age risk. In the Unit­ed States, one in eight women will devel­op inva­sive breast can­cer in their life­time and 85% of breast can­cers have no fam­i­ly his­to­ry at all.

As an expert in her field, Angela stress­es that there is no good rea­son not to get your mammogram.

98% of the young women that come for their first mam­mo­gram, walk out my door and say, this was noth­ing, and they are super relieved,” Angela said. After a long day of breast can­cer screen­ings, her work does not stop there. Angela works to encour­age aware­ness with not only her patients, but their inner cir­cles as well. I tell them, you know what your job is? Your job is to tell your friends and tell their friends, because breast can­cer can hap­pen to anybody.”

To sched­ule your year­ly mam­mo­gram, ask your health­care provider if they have stand­ing mam­mo­gram orders at Ivinson’s Breast Imag­ing Cen­ter. Sched­ule your screen­ing today at (307) 7554640.

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