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April 2008 Issue

Mary Mahoney, MD, reviews a digital mammogram.
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University Hospital Adds Digital Unit to Help Detect Early Breast Cancer

By Amanda Harper
Published April 2008

Even though most women over 40 know they should get annual breast screening exams, few get the type that has been scientifically shown to have the most accuracy.

Mary Mahoney, MD, says detecting breast cancer in earlier stages—when it is most treatable—is more likely with a digital mammogram for a large number of women.

The problem is the technology isn’t offered at most breast imaging centers. It is available, however, to Greater Cincinnati women.

The UC Barrett Cancer Center at University Hospital recently opened an all-digital mammography screening center, adding two high-quality digital mammography screening units to its portfolio of technologically advanced
imaging tools.

Now, the breast imaging center includes three digital and three traditional film screening mammography systems.

A mammogram is a low-radiation X-ray used to view the
breast’s internal structures. Unlike traditional film screen mammography—which is stagnant—digital mammography makes an electronic image of the breast that can be enhanced on a computer for further, more precise evaluation.

UC was one of 33 screening centers that participated in the American College of Radiology (ACR) Imaging Network’s
Digital Mammographic Imaging Screening Trial, one the largest screening trials to date for comparing the effectiveness of digital versus film mammography.

The study showed digital mammography detected 28 percent more cancers than screen film mammography in three categories of women: those 50 or younger, who were pre- or perimenopausal and with dense breast tissue (meaning more tissue than fat).

“We are more likely to detect difficult-to-diagnose cancers earlier with digital mammography,” says Mahoney, director of breast imaging services at the Barrett Cancer Center and professor of radiology at UC. “That could translate into more lives saved through early detection.”

Digital mammography is just one component of a larger group of breast imaging services offered by Mahoney’s team, including image-guided breast biopsies using stereotactic ultrasound or magnetic resonance imaging technology.

The breast imaging program at the Barrett Center was among the first in Greater Cincinnati to earn ACR Breast Imaging Center of Excellence distinction.

ACR designation recognizes centers nationwide that successfully achieve accreditation in all of its breast imaging including breast biopsy, ultrasound and mammography.

“Being told you have breast cancer is a complete shock, so naturally most women’s first reaction is usually: ‘Get it out right now,’” explains Mahoney.

“Determining the most streamlined approach to the patient’s care, however, requires multiple diagnostic tests and an entire team of breast health experts—including radiologists, surgeons, and medical and radiation oncologists,” she says. “The process starts with radiologists specifically trained to pinpoint breast problems and perform specialized breast biopsy procedures to determine the extent of disease.”

If a patient’s mammogram shows a suspicious area, the next step is typically an image-guided biopsy. Mahoney’s team recently acquired a new stereotactic breast biopsy table, which is housed in the Barrett Center, to do these procedures.

During the outpatient procedure, the patient lies on a special table that allows the breast to hang down for treatment. After the breast is numbed, the radiologist uses imaging to guide a hollow-point needle into the breast and extract a small portion of the suspect tissue.

A pathologist analyzes the tissue cells to determine if the suspect area is cancerous.

Mahoney says image-guided breast biopsies are as accurate as and more cost-effective than surgical biopsies as a diagnostic tool.

Once a cancer diagnosis is
confirmed, the patient is sent into surgery to have the mass

and a margin of surrounding tissue removed. Any follow-up chemotherapy or radiation treatments are typically started after surgery.

“We work hard to help the patient come to terms with the diagnosis in steps,” adds Mahoney. “By the time most of our patients reach the operating room, they can say: ‘OK, I’m ready to move on. Let’s kick this cancer.’”  

To schedule an appointment at the digital breast imaging center, call (513) 584-1500. The center is located at 222 Piedmont Ave., Suite 1400. Appointments are available from 7:30 a.m. to 4:15 p.m.

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