https://www.bizjournals.com/buffalo/news
By Dr. Markus Holzhauer – Windsong Radiologist
Sep 23, 2019
1. The breast is the most heavily guarded and protected part of a woman’s body. This means there is good reason to worry less. Did you know that a mammogram is one of only two imaging tests (the other being a low-dose lung cancer screening for former or current heavy smokers) paid for by insurance companies in the U.S. for asymptomatic patients without any risk factors? It is the only part of a woman’s body which gets scrutinized every year. Finding breast cancer early (stage 1: less than 3 cm in diameter) makes the diagnosis of breast cancer much less frightening and makes for a very curable disease.
2. Old pictures are more than important. A mass on a picture could have a completely different consequence if it is new verses if it has been stable for two years. Know where you had your last mammogram and make certain the radiologist has access to your older images to ensure a more accurate diagnosis.
3. Breast cancer screening is a very unusual job. Since there are only three to five cancers in 1,000 screening mammograms, 995 to 997 times (out of 1,000) patients will ultimately receive good news.
Breast cancer screening is like mining for gold in the Klondike River in Alaska. You have to go through a lot of sand to find a little gold nugget. What does that mean? The breast imaging specialist may have to call the patient back to further investigate if there is an area of concern. Some facilities can do that in a way that reduces anxiety by conducting the exam and providing results on the same day.
If a woman is asked to come back or to stay for the extra imaging, the likelihood that it results in finding a cancer is rather low. It is important to understand that on average about 100 out of every 1,000 breast cancer screening patients will be called back for diagnostic workup (meaning ultrasound or a repeat mammogram). Of these 100 patients, 85 will get assurance of a normal exam after their workup. Only 15 of the 100 patients will end up with a biopsy of which only three to five will result in the presence of a cancer.
4. A woman’s safety net depends on breast density and personal risk. Identifying a patients risk starts with the mammogram. The value of the mammogram is very different based on the density. Patients might benefit from an additional ultrasound or MRI depending on their family history.
Personal risk of getting breast cancer depends on many factors. One way to calculate risk can be found at The National Cancer Institute’s risk assessment tool https://www.cancer.gov/bcrisktool/.
The average lifetime risk of developing breast cancer for a female in the U.S. is 12%. This means that 1 out of 8 women over their entire life will get breast cancer. However there are some factors, including genetic mutations, which could result in a lifetime risk of almost 50%, meaning that 1 out of 2 women would get breast cancer.
A risk assessment determines if a patient could benefit from a consultation with a genetic counselor. The counseling results in a more thorough evaluation and may reveal that genetic testing of the BRCA marker or one of more than 17 genes that have been identified as genetic indicators for breast and affiliated cancers is warranted.
5. Second opinions can be very beneficial. Patients should never be embarrassed to ask for a second opinion.
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https://www.bizjournals.com/buffalo/news/2019/09/23/the-6-secrets-of-breast-cancer-screening.html