TBO.com - TBO is Tampa Bay Online

For Breast Cancer, Early Detection Is Key

ADVERTISEMENT

By JOE SEELIG

Highlands Today

Published: October 12, 2008

SEBRING - Most patients go in for their mammogram with some anxiety and certainly "nobody wants to have it done," said Tanya Hinskey, a mammography technologist at Highlands Breast and Imaging Center.

"With the new digital mammogram it's not quite as uncomfortable," she added.

But, according to the American Cancer Society, in addition to self-examination mammograms can "detect and evaluate breast abnormalities, both in women who have no breast complaints or symptoms and in women who have breast symptoms (problems such as a lump, pain, or nipple discharge)."

A mammogram is an X-ray technique to visualize the internal structure of the breast, according to the National Cancer Institute's Web site.

"And although strides are being made to develop other imaging technologies to detect, diagnose, and characterize breast cancer, high-quality mammography is the most effective technology presently available for breast cancer screening," the Web site stated.

"For a mammogram, the breast is squeezed between two plastic plates attached to the mammogram machine," the American Cancer Society Web site stated. "This squeezing or compression is needed to spread the tissue apart.

"It also ensures that there will be very little movement, that the image is sharper, and that the exam can be done with a lower X-ray dose."

There are two locations in Highlands County that offer digital mammograms; Seascape Imaging Outpatient Center, owned by Florida Hospital, and the Highlands Breast and Imaging Center, which is privately owned.

Central Florida Imaging, also privately owned, offers the tried and true method of analog (film) mammograms.

"There's really no difference detail-wise between film and digital," said Tina Nelson, manager at Central Florida. "There is only an advantage for storage."

The American Cancer Society, the American College of Radiology, as well as the National Cancer Society recommend yearly mammograms in women beginning at age 40, according to Dr. Patrick Carruthers, owner and radiologist at Highlands Breast and Imaging Center.

"If there is a strong family history of breast cancer, a baseline mammogram at about age 25 is recommended," he said.

For these high-risk women, with a risk factor of 20 percent or greater, annual mammograms, as well as an annual MRI of the breast is now recommended.

"Early detection is very important," said Carruthers. "If a cancer is found early, that is a cancer that is less than 1 cm in size, about the size of a pea; this would represent a Grade 1 cancer. Following surgery and possible radiation, the five-year survival rate in these patients approaches 100 percent."

In 2007, Highlands Breast and Imaging Center diagnosed 54 cases of breast cancer in its patients. Eight of these were presented as palpable lumps and 46 were detected on screening mammograms, Carruthers said.

From the patient's point of view the procedure for a mammogram with a digital system is the same as for conventional mammography. That is to say it is the same type of X-ray.

"Digital mammography may have some advantages over conventional mammography. The images can be stored and retrieved electronically, which makes long-distance consultations with other mammography specialists easier," according to the NCI.

"The images are displayed on a computer monitor and can be enhanced (lightened or darkened) before they are printed on film. Images can also be manipulated; the radiologist can magnify or zoom in on an area."

A diagnostic mammogram is a test done on a patient with symptoms such as feeling a lump, pain or skin changes of the breast. In addition to the mammogram, a physical breast examination may be performed by the radiologist.

Depending on the results of the mammogram or physical exam, an ultrasound of the breast may or may not be done.

Ultrasound imaging of the breast is used to distinguish between solid tumors and fluid-filled cysts, according to the NCI. Ultrasound can also be used to evaluate lumps that are hard to see on a mammogram.

Once a breast cancer is detected the patient may be scheduled to be seen by three different doctors; a surgeon, a radiation oncologist and a medical oncologist.

The key is to see which treatment plan is best for each patient.

"Surgery is usually the first line of attack against breast cancer," according to BreastCancer.org. "Decisions about surgery depend on many factors. You and your doctor will determine the kind of surgery that's most appropriate for you based on the stage of the cancer, the 'personality' of the cancer, and what is acceptable to you in terms of your long-term peace of mind."

Radiation therapy is a highly targeted, very effective way to kill cancer cells in the breast that may remain after the surgeon has finished operating. Radiation therapy can reduce the risk of a recurrence by about 70 percent.

"Despite what many people fear, radiation therapy is relatively easy to tolerate and its side effects are limited to the treated area," the Web site stated.

Radiation treatments will be overseen by a radiation oncologist, a cancer doctor who specializes in radiation therapy, such as Dr. Eric Saunders, of the Heartland Oncology Partners LLC, at the Florida Hospital Cancer Institute.

"The Linear Accelerator is the heart of our clinic," Saunders said. "It generates high energy X-rays and electrons. A conventional X-ray generates 125 keV (kilo electron volts) while the Linear Accelerator generates 6 to 15 MeV (million electron volts). The technology has improved to better target the radiation."

"(The Linear Accelerator) delivers a uniform dose of high-energy Xx-ray to the region of the patient's tumor," according to RadiologyInfo.org. "These X-rays can destroy the cancer cells while sparing the surrounding normal tissue."

Men are not immune from this disease. About one percent of men are likely to develop the disease. And when it is detected it is usually in a more advanced stage, said Saunders.

Saunders said in his 20-plus year career he has treated about 10 male patients for breast cancer.

Carruthers said he sees an average of two men a month.

Many of the men Carruthers has seen had Gynecomastia, an enlargement of the breast; sometimes a side effect of medications.

"Several types of medications cause tenderness of the breast (in men) because it is making new breast tissue," Carruthers said. (As often happens with women in puberty)

"I don't remember diagnosing any men in the last eight years (with breast cancer)," Carruthers said.

However, the American Cancer Society estimates that about 2,000 new cases of invasive breast cancer are diagnosed in men each year and approximately 450 men die from breast cancer annually.

Another step in cancer treatment may be chemotherapy.

Chemotherapy is a "systemic therapy," delivered by the medical oncologist.

"This means it affects the whole body by going through the bloodstream," according to BreastCancer.org. "The purpose of chemotherapy and other systemic treatments is to get rid of any cancer cells that may have spread from where the cancer started to another part of the body.

"Chemotherapy is effective against cancer cells because the drugs love to interfere with rapidly dividing cells. The side effects of chemotherapy come about because cancer cells aren't the only rapidly dividing cells in your body. The cells in your blood, mouth, intestinal tract, nose, nails, vagina, and hair are also undergoing constant, rapid division. This means that the chemotherapy is going to affect them, too.

"Still, chemotherapy is much easier to tolerate today than even a few years ago. And for many women it's an important 'insurance policy' against cancer recurrence."

Joe Seelig can be reached at (863) 386-5834 or jseelig@highlandstoday.com .

Share this:

Loading Comments...

Email Print

ADVERTISEMENT