A Duryea woman recently diagnosed with early-stage breast cancer is urging women with certain breast characteristics to undergo testing in addition to a mammogram.
Pauline Reedy, 71, said her cancer was detected as much as one to two years earlier because she heeded her doctor’s recommendations and underwent an ultrasound in addition to an annual mammogram.
A mammogram is an X-ray of the breast performed mostly on women. It is incredibly accurate in finding tumors for most patients, but it has its limitations, particularly for people with dense breast tissue, said Dr. Susan Summerton, a radiologist with Delta Medix Medical Group in Scranton. Breast density refers to the ratio of fatty tissue to glandular tissue.
Cancer in early stages appears as a white speck on a mammogram, she said. In patients with dense breasts, the background of the X-ray image is predominantly white, which makes it difficult for a radiologist to detect cancer.
“When you are trying to distinguish white on top of the white, it is very challenging, like trying to find a polar bear in a snowstorm,” Summerton said. “An ultrasound is extremely helpful in looking through dense tissue because it displays the tissue differently.”
Most recently, a study published in May in the British Journal of Cancer shows the cancer detection rate increased by 40% when patients underwent supplemental ultrasounds compared to a mammogram alone.
The surgical treatment
Delta Medix has seen similar results. On average, cancer is found in four of every 1,000 mammograms, Summerton said. Since January, Delta Medix performed 200 supplemental ultrasounds, which detected five cancers that were not detected by reading the mammogram alone.
While ultrasound is a great supplemental tool, it does not replace the mammogram, Summerton said. Just as the ultrasound detects abnormalities the mammogram can not, the mammogram detects suspicious marks the ultrasound cannot pick up.
Summerton said most insurance companies cover the cost of the ultrasound. Patients should check with their insurers, however, to ensure coverage. Breast cancer is the second most common cancer in women, behind skin cancer. As with all diseases, early detection is crucial.
“It helps if you find it early when the tumor is not as aggressive,” said Dr. Kristine Kelley, a breast surgeon at Delta Medix. “It also gives you more options in the surgical treatment.”
While dense breast tissue itself is not abnormal, it does increase the risk of cancer. Legislation enacted in Pennsylvania in 2014 requires medical providers to notify patients if they have dense breasts and advise them to consult their physician to determine if additional testing is needed.
Most patients are heeding the advice at Delta Medix. About 80 to 90% of patients who get the notice get the ultrasound, officials said. She underwent a lumpectomy, a procedure in which the tumor and some surrounding tissue are removed.
She also underwent radiation treatments but did not need chemotherapy. Had the cancer been detected later, she might have had to undergo a mastectomy, a surgery to remove the entire breast.