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An exciting, new high-tech diagnostic tool has just been added to the FCHC Radiology Department, and it will make it easier and more conclusive to detect breast cancer earlier when it is more treatable. The Genius™ 3D Mammography™ system from Hologic® became operational in early May after passing Food & Drug Administration (FDA) approval.  

“Our role in the Radiology Department is all about earlier diagnosis of diseases,” says Michelle Andrews, BAHS, RT(R)(M), FCHC’s Assistant Radiology Manager and the Lead Mammographer. “The 3D Mammography unit is much more accurate than the 2D systems that hospitals have been using. It means patients will be much less likely of having to return for a call back exam due to inconclusive results.” Andrews says 3D Mammography also has a 20% to 65% increase in the detection of invasive breast cancers that have spread from the original site.

“We follow the mammography guidelines of the American College of Radiologists and the U.S. Department of Health and Human Services,” says Andrews. “Both organizations say women should begin having an annual mammogram at age 40, and sooner if they are at higher risk.” Women should get an order from their primary care physician for a routine mammography screening. FCHC recommends that women choose the 3D Mammography exam, but the conventional 2D Mammography unit is still offered as an option. The patient’s health insurance company will be billed for the conventional 2D Mammography exam, which is typically covered by insurance. The insurance company will also be billed for the 3D Mammography exam. If insurance does not cover the 3D Mammogram, then the patient will be counseled regarding the additional cost of the 3D exam.

How it Works

The procedure for the new 3D Mammography™ is the same as what patients have come to expect from the conventional 2D exam. The technologist will position the patient, compress her breast, and take images from different angles. There’s no additional compression required, and it only takes a few extra seconds for the exam, which is proven to be more accurate. The 3D image is low-dose, meaning a patient only receives a small amount of radiation during the exam.

The technologist views the images at the computer workstation before the patient leaves the exam room, to ensure that quality images have been captured. The images are then sent to the radiologist, who examines the images and sends the report to the patient’s primary care physician.

“What makes it so special is that the unit lets doctors examine a woman’s breast tissue layer by layer,” says Andrews. “It gives us slices of images, like the pages of a book, rather than trying to look through the cover of a book to see what’s behind it. It solves the problem of missing a suspicious area because it’s hiding in the clouds, so to speak.”

Reading the Image

Once the mammography images have been obtained and verified by the technologist to be good images, they are electronically sent to a radiologist who reads the images on screen. After the images are read, a report is completed and sent to the referring provider.   

Michael Pole, MD, Medical Director of the FCHC Radiology Department sees the advantages of the 3D Mammography in providing the most accurate diagnoses. Dr. Pole underwent eight hours of advanced training on how to read the new image slices generated by the 3D Mammography™ unit. “I’m a big fan of 3D Mammography™,” says Dr. Pole. “The beauty of this device is that for dense breast tissue that can hide suspicious lesions, I can flip through the 3D images and see the suspicious looking area for what it actually is. That helps to eliminate callbacks to patients to come in for a second, more definitive type of exam.”

What If They Find Something?

If Dr. Pole confirms there is something in the mammography exam that should be investigated, he will schedule and perform a needle biopsy. Part of the process involves inserting a tiny metal marker in the breast to identify where the biopsy occurred. The biopsied tissue then is sent to the medical lab where it is read. The results are then given to Dr. Pole, who forwards them to the patient’s primary care doctor.

“If the biopsy results are negative, then the patient can go about their life,” says Dr. Pole. “If it comes back positive, then we’ll schedule a consultation with one of our surgeons. The tiny metal marker I inserted during the biopsy will help guide the surgeon when removing the affected area.”

Chemo vs. Radiation

Once surgery has been performed, the patient will meet with a medical oncologist to discuss follow-up treatment options. Sometimes only radiation therapy is scheduled, while other times both radiation and chemotherapy are scheduled. Women who have had only a small lump removed will likely be scheduled for radiation therapy that is performed by a radiation oncologist at a radiation treatment center. If a full mastectomy is performed, no radiation treatment is necessary unless the cancer has spread to the lymph nodes. In those cases, both radiation and chemotherapy are recommended. Radiation therapy is typically scheduled for five days a week for five to six weeks.

“Today’s chemotherapy drugs are much more advanced than what we had work with just 10 years ago,” says Leisa Britsch, RN, BSN, OCN, Director of the FCHC Rainbow Hematology/Oncology Unit.  “They are more effective, and there are a dozen options compared with the two we had in the past. Plus, only a quarter of them cause hair loss, and we are able to reduce the side effects of nausea to almost nothing with other pharmaceutical drugs we have.”

Chemotherapy treatments are usually given once every three weeks for three to four months. In addition to chemotherapy drugs, there are antibody treatments that target the tumor and ignore healthy cells. The cancer must, however, express a certain gene in order for patients to receive these antibody treatments.

What Happens After Treatment?

Once chemotherapy and radiation treatments have been completed, the patient will typically visit their oncologist twice a year for follow up. Three years ago FCHC created a Survivor Clinic for patients with all types of cancer. An oncologist and nurse practitioner operate the clinic.

“The clinic will schedule one-on-one meetings with the patient to discuss what to watch for with long-term side effects after surgery and treatment,” says Britsch. “They will make sure a patient is up-to-date on their immunizations, and they will work with the patient to offer exercise and nutritional recommendations. But just because a patient has beaten one type of cancer, it doesn’t mean they shouldn’t have all of their cancer screenings done, and the clinic will encourage that.”

We’re There, From Start to Finish

“Our new 3D Mammography™ system will allow us to capitalize new technology to help us make a more accurate breast cancer diagnosis,” says Patti Finn, FCHC CEO. “But beyond that, if a patient needs a biopsy, surgery, radiation at an area treatment facility, chemotherapy, or antibody therapy,” we can help. “We are also there after treatment to support the patient through our Survivor Clinic. It’s all based part of our mission to serve our community by promoting and providing the means for continued health and wellness.”

For more information about 3D Mammography™at FCHC, contact our Radiology/Mammography Department at 419-330-2651 or email us at info@fulhealth.org.