Not Your Mother’s Mammogram

April 25, 2014
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By Judy O’Gorman Alvarez

Michele Fee of Jersey Shore Radiology helps patients who have had a suspicious finding in their mammography navigate subsequent testing.

Michele Fee of Jersey Shore Radiology helps patients who have had a suspicious finding in their mammography navigate subsequent testing. Photo by Scott Longfield

For years women have been reminded of the importance of mammograms and told how yearly detection of breast cancer has saved countless lives. But the technology and the procedure – as we know it now – hasn’t been around that long.

Although breast x-rays have been performed for more than 70 years, according to the American Cancer Society (ACS), modern mammography has only been around for 45 years. It wasn’t until 1969 that the first x-ray units were dedicated to breast imaging.

The mammogram results of our mothers  ­– or grandmothers ­– are nothing like the high-quality, low-level radiation procedures that women now undergo each year. With an estimated 232,340 new cases of invasive breast cancers the ACS says will be diagnosed among women in the U.S. this year, the great improvements made in accuracy, safety and even comfort of mammography, are crucial.

Most women, without a family history of breast cancer and who are experiencing no symptoms, are advised to get yearly mammograms after age 40. Screening involves x-ray pictures taken from different angles of each breast. The results are kept on file for radiologists to compare with subsequent screenings.

In the case of an unusual or suspicious result, such as a lump, a thickening or some sort of or change in the breast, a woman may be sent for a diagnostic mammogram which entails additional pictures and magnifications. Abnormal results could mean anything including dense breast tissue, cysts or cancer.

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Michele Fee, breast-imaging navigator at Jersey Shore Imaging and Jersey Shore Radiology in Neptune, often sees patients after an unusual finding during a routine screening mammogram who are in need of additional testing or biopsies.

“It’s a scary time for them,” she said. “I try to help.”

Fee offers knowledge, skills and support to patients through their breast imaging process and helps coordinate any follow-up care.

“I love the interaction with patients,” said Fee, who, although her role as navigator is a newly created one, has been working with mammography patients for 20 years.  “I love helping them,” she said, especially “the ones who are diagnosed. I want to make sure they get the care they need.”

At this location of Jersey Shore Radiology  – there are three others within the practice ­–about 1,000 mammograms are performed each month. Fee said she sees women of all ages, ethnic and socioeconomic groups.

“The ages of women are all over,” Fee said. “There’s no rhyme or reason. We have patients from their late 20s and all the way up to people in their 90s.

“Breast cancer does not discriminate,” she said.

Your grandmother’s mammogram – if she ever had one – was diagnostic and was probably called for only after she or her doctor felt a lump in the breast, according to Dr. Beth Deutch, founder and medical director of HerSpace Breast Imaging and Biopsy Specialists in Eatontown. And, that primitive piece of equipment dealt a very high dose of radiation.

“There have been parallel changes in the mammography and in the oncology and clinical expertise that we have nurtured in the breast cancer screening world,” Deutch said.

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Over the years, developments in mammography have grown. During the ‘60s and ‘70s, according to Deutch, the radiation “dose was about 10 times what a current mammogram is … and the resolution was much poorer.”

Over time, however, gradations of improvements were made in films and equipment and mammography results began to convince people that mammography saves lives.

It wasn’t until a little more than a decade ago that full-field digital mammography came into play. “Before that we had the ability to do small-field but not the full breast,” Deutch said.

In addition, there were other benefits to digital mammography, including diminishing false-positive mammography results and  improved and efficient storage.

At the same time, another important aspect to the changes in mammography is the increased recognition and respect for the field.

“Beginning in the 1980s, breast imaging was finally recognized at a subspecialty of mammography,” Deutch said. “It took a while for specialty radiology to recognize it as a specialty,” and as a result, “invest in better equipment.” Now there is a “great improvement in the quality of people who are doing the screening.”

All the more reason, Deutch, Fee and others in the breast care industry agree, that women ­– regardless of their financial situation – could benefit from mammogram.

Fee has been amazed and impressed by the number of people who have benefited from the funds raised for the Paint the Town Pink campaign.

“I get phone calls each week from people who don’t have insurance,” she said. “This is a great campaign.”

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