50 Percent of Breast Cancer Deaths Occurred in Women Under 50 Years Old

An ounce of prevention equals a pound of cure. Cliche, right? Maybe. But it’s really common sense. And there’s some truth behind this and other timeworn aphorisms like it. Two recent studies confirm that early detection can be a big plus, especially for women between 40 and 49.

The journal, Cancer, published a study just last September illustrating how important early detection through mammograms can be. Previous studies show a range of benefits, but this one, involving 7,301 patients, discovered that 71 percent of confirmed breast cancer deaths happened in the 20 percent of the women who didn't get regular mammograms. In fact, 50 percent of breast cancer deaths occurred in women under 50. Most who died from breast cancer never had a mammogram.

http://onlinelibrary.wiley.com/doi/10.1002/cncr.28199/abstract

These findings were reinforced earlier this month when researchers from University Hospitals Case Medical Center and Case Western Reserve University School of Medicine published findings in the American Journal of Roentgenology comparing two groups of women between 40 and 49: those being screened and women with symptoms. After reviewing 230 primary breast cancers, the study concluded that women between 40 and 49 who underwent routine screening mammography were diagnosed earlier with smaller tumors. They were also less likely to require chemotherapy.

http://www.medimaging.net/radiography/articles/294750653/for_younger_women_study_
reveals_mammography_saves_lives.html

Being careful and proactive about screening for breast cancer isn’t about paranoia, nor is it something to put off. Mammograms, which take so little time, can give you the chance to have and spend so much more of it with your friends and loved ones.

Zwanger-Pesiri Radiology is the leading breast imaging facility on Long Island, featuring 3D mammography, groundbreaking technology that generates 3D images of the breast that gives physicians better views through overlapping breast tissue. Studies demonstrate that 3D mammography is superior to conventional mammography in detecting cancer and lowering the risk of false-positives. ZPR is the only radiology practice using all Hologic 3D machines -- the gold standard in 3D mammography -- in every location.

Paving the Way: Patient Access to Radiology Results

A recent article in DiagnosticImaging asked the question "should patients have access to images and reports?" The answer, according to Zwanger-Pesiri Radiology's CEO and Medical Director, Steven L. Mendelsohn, MD, is a resounding "yes!"

Zwanger-Pesiri Radiology was an early adopter of the patient portal idea. ZPR's portal, launched almost two years ago, allows patients to access their exam results via their own computer. Patients can now view and print their reports. But patient portals have been met with some concern by doctors who worry that patients will get results online rather than from their referring physician. Mendelsohn, quoted in DiagnosticImaging, laid those fears to rest. "It's such an overwhelming benefit to give patients the results. I cannot think of a practical downside, whether the results are good or bad," he said. Plus, he added that an extra set of eyes is always a good thing. "The patients may pick up on stuff in their report that the referring doctor didn't notice," said Mendelsohn.

According to Mendelsohn, some referring physicians have even called to thank him for providing the reports online to patients. It ensures that patients get their results without delay, and speeds the whole process. Best of all, it gives patients a feeling of control, and the ability to be involved in their own health care.

Patients have greeted the portal with great enthusiasm. "Thank you for instituting the use of the patient portal," wrote one patient. "It is so wonderful to be able to access a record of all procedures and reports, appointments, etc. So much better than asking doctors for copies or to fax results. Having this kind of record at our fingertips is invaluable on so many levels. I will be sure to have all procedures done at Zwanger-Pesiri in the future."

Have you tried Zwanger-Pesiri's patient portal yet?

Zwanger-Periri Radiology is the leading Long Island provider of diagnostic imaging, with 12 offices throughout Nassau and Suffolk counties.

it’s such an overwhelming benefit to give patients the results. I cannot think of a practical downside, whether the results are good or bad, - See more at: http://www.diagnosticimaging.com/pacs-and-informatics/patient-portals-should-patients-have-access-images-reports?GUID=D19C12D8-83B1-4869-969F-926B0ADB9D75&rememberme=1&ts=15112013#sthash.jmseAhuq.4PQSCKgQ.dpuf

it’s such an overwhelming benefit to give patients the results. I cannot think of a practical downside, whether the results are good or bad, - See more at: http://www.diagnosticimaging.com/pacs-and-informatics/patient-portals-should-patients-have-access-images-reports?GUID=D19C12D8-83B1-4869-969F-926B0ADB9D75&rememberme=1&ts=15112013#sthash.jmseAhuq.4PQSCKgQ.dpuf he said.

“If I estimate one to two calls per week per radiologist, I may be overestimating it, - See more at: http://www.diagnosticimaging.com/pacs-and-informatics/patient-portals-should-patients-have-access-images-reports?GUID=D19C12D8-83B1-4869-969F-926B0ADB9D75&rememberme=1&ts=15112013#sthash.jmseAhuq.4PQSCKgQ.dpuf

Two are better than one: Adding tomosynthesis decreases recall rates

Patients undergoing conventional mammography paired with tomosynthesis had significantly lower screening recall rates than those receiving mammography alone, according to a study published in the December issue of Radiology.

The impact on recall rates was particularly strong for those younger than 50 and those with dense breasts, reflecting tomosynthesis’ ability to reduce false-positives in that patient population.

“Recent work has evaluated the performance of tomosynthesis in a variety of observer performance studies, which collectively have established that the combination of digital breast tomosynthesis with conventional digital mammography can decrease screening mammography recall rates without having a negative effect on sensitivity in the detection of malignancy,” wrote Brian M. Haas, MD, of Yale University School of Medicine in New Haven, Conn., and colleagues.

Haas and colleagues created a study to evaluate the performance of breast tomosynthesis in clinical practice by identifying which patients experienced the greatest reduction in screening mammography recall rates and to assess the cancer detection rate.

Participants were selected from patients presenting for screening mammography in a one year period between October 2011 and September 2012 at four clinical sites. These sites all used digital mammography and included breast imaging clinics in an academic tertiary care hospital, two outpatient radiology centers, and a mobile van-based mammography unit. Tomosynthesis was the preferred method of screening when available, and was performed in combination with mammography when feasible.

Eight breast imaging radiologists interpreted the exams. Recall rates were calculated for the two groups and stratified by breast density and age. During the study, 13,158 patients underwent screening mammography, 6,100 underwent tomosynthesis plus mammography, and 7,058 underwent digital mammography alone.

The overall recall rates for patients in the tomosynthesis group were 8.4 percent and 12 percent for the conventional imaging group. When the recall rates were stratified according to breast density, results demonstrated reduced recall rates for the combination compared with mammography alone for all breast density groups. Significant differences were found for scattered fibroglandular breast density, heterogeneously dense breasts, and extremely dense breasts.

When stratified according to patient age, reduced recall rates were evident with tomosynthesis plus mammography for all age groups. Significant differences were found in patients younger than 40, patients 40 to 40 years old, and patients 60 to 69 years old.

Both younger age and greater breast density were significantly associated with higher risk of recall.

There was a 9.5 percent increase in the cancer detection rate with tomosynthesis; 2,018 women would need to be screened with tomosynthesis to detect one additional cancer beyond that detected by mammography individually. 

“When adopted, tomosynthesis promises to alter the mammography workflow by decreasing screening rates and to subsequently improve the mammography experience for many women,” wrote Haas and colleagues. 

Steere, Anna. "Two are better than one: Adding tomosynthesis decreases recall rates." HealthImaging. 24 November 2013.

Web. 3 December 2013. <http://www.healthimaging.com/topics/womens-health>. 

ABC News’ Amy Robach’s Mammogram: Much More than Public Service

 It was supposed to be a routine Good Morning America segment for Breast Cancer Awareness Month. Amy Robach, the ABC News journalist, who had never had a mammogram, reluctantly agreed after some prodding by colleagues, to have one. But it was not to be the sort of private affair that other women share with their physician. Instead, she had been asked to perform the first live television mammogram. 

In a taped piece before the procedure, she said she’d agreed to the unusual public demonstration because, “If I’ve put it off, how many other people have put it off as well?” Still, as Robach explained to viewers, she had little reason to expect anything but a clean bill of health.

By delaying her mammogram until now, she knew she had been taking a risk, but was not overly concerned. Like many women, she calculated that her risk was low. Her work and family schedule was more hectic than most and –taking everything into account -- the test could wait. “I work out, I eat right, I take care of myself and I have very little family history; in fact all of my grandparents are still alive.”
 

But she yielded to arguments from her producers and was persuaded to undergo the procedure on national TV on October 1st because, she told her audience, “If even one life is saved through early detection, it’s all worth it.” She didn’t dream that the person whose life may have been saved through early detection would be her own.

After several subsequent tests a few weeks later, she was given a diagnosis of breast cancer. In November, she received a bilateral mastectomy and reconstructive surgery, and is currently recovering. Ms. Robach’s experience is a powerful argument for early detection. The oddsmaker in every woman’s mind will want to take the journalist’s lesson to heart.
 

Zwanger-Pesiri Radiology is the leading breast imaging facility in Long Island, featuring 3D mammography, a new groundbreaking technology that generates 3D images of the breast and gives physicians a clearer look through overlapping breast tissue. Studies have demonstrated that 3D mammography is far superior to conventional mammography in detecting cancer and lowering the risk of false-positives. ZPR is the only radiology practice using all Hologic 3D machines -- the gold standard in 3D mammography -- not just in a few locations, but in every location.  
 

Recent Zwanger-Pesiri articles on mammography:

·      Women in Their 40s Still Want Breast Cancer Screening

·      Adding 3D Tomography to Mammography Aids in Cancer Detection, Reduces False-Positives 

·      Earlier Mammograms Urged for African American Women

·      What is 3D Mammography?
x
      ZPR also offers digital mammography, breast ultrasound, breast MRI and breast biopies in a caring and compassionate environment.
 

Using an MRI to “See” What Man’s Best Friend Feels

What if it were possible to know what a dog feels?

Fascinating research made possible by MRI technology has uncovered a partial answer to this baffling question. Since man’s best friend can’t speak to us directly, we must rely on indirect information – barking, or tail-wagging, for instance. But do sick or confused dogs show the same behavior? Does a dog that doesn't bark or wag its tail still feel something when it sees a familiar person? And is it the same thing a dog feels when it sees another familiar dog? Some of these questions were answered.

Emory University Professor Gregory Berns believed that neuroscience could offer some clues. He reasoned that knowing more about how dogs react neurologically could affect the way we treat them. In a recent article in The New York Times, Berns describes training his dog, and others, to remain still in MRI machines to be scanned for a study.

Findings are preliminary – studies are ongoing – but one part of a dog’s brain is already demonstrating a remarkable similarity to a human brain: the caudate nucleus. The caudate nucleus is a part of the human brain whose activity can, with some consistency, predict a person’s preference for food or music. So it was with dogs in the study: their caudate nuclei responded to “hand signals indicating food,” the odor of familiar humans, and perhaps the return of an owner who had just disappeared from view.

A remarkable aspect of the research is that dogs are trained to remain completely still inside the MRI unit. Berns notes that vets usually anesthetize dogs for scans like this, but an anesthetized dog would not be able to display emotional reactions. The ability of dogs in the study to remain motionless when requested, made possible by positive training by investigators, allowed the MRI scanner to capture images of brain activity -- and thus, to study dogs’ reactions to stimuli. The team was able to train twelve dogs to obtain MRI scans in this way.

It turns out that dogs are like us in ways that we could never have “seen.” Perhaps one day Berns' team will be able to know when dogs are impatient, worried, or just wanting a little more attention.

Zwanger-Periri Radiology is the leading Long Island provider of diagnostic imaging, including MRI scanning, using the most advanced 3T Wide-Bore MRI (Siemens Skyra) units on the market today.

Earlier Mammograms Urged for African American Women

It’s a cruel paradox: If you are a black woman, you are less likely to get breast cancer than a white woman, but you are 41 percent more likely to die from it.

Research has shown that there are multiple factors at work. Black women tend to request medical attention later, have reduced access to health insurance, participate less in wellness care initiatives, and tend to have poorer overall health at the time they are afflicted with breast cancer.


Recent evidence for this group’s disproportionately poor breast cancer outcome comes from several sources:

• Black women are 50 percent more likely to die within three years of a breast cancer diagnosis than white women (American Association for Cancer Research, October 2012)
• Black women are less likely to survive a breast cancer diagnosis within five years (JAMA, June 2013)
• While white women have historically had higher rates of breast cancer, the number of black women diagnosed with breast cancer has increased, while diagnoses for other ethnic groups remained the same or declined (American Cancer Society, October 2013)

In 2013, more than 6,000 black women are expected to die from breast cancer. Experts believe earlier mammograms for black women (starting at age 40) would save lives.

Zwanger-Pesiri Radiology is committed to providing diagnostic imaging services for those who need them, including those who are uninsured. We are proud of our Give Back Sundays program, which provides radiology services for the disadvantaged and uninsured at no charge. It is one of the many ways that Zwanger-Pesiri Radiology gives back to the community. 

Zwanger-Pesiri Radiology High School Essay Contest

Zwanger-Pesiri Radiology is proud to award ten distinct $1,000 scholarships to eligible high school seniors who reside on Long Island.

We are looking for a well-thought-out essay that can have an impact on all of our lives today and in the future! We want to hear from YOU!!

Criteria

• The essay should be between 1,000 and 1,500 words, submitted electronically as a PDF or Word file.

• The student must be active in community and charitable organizations. This needs to be documented and verified by the school’s guidance department.

• The student must have a GPA of 85 or higher, and be in their senior year.

• Deadline is May 1, 2014.

Topics (choose one)

• How does radiology help you and your family?

• Advances in technology drive innovations in medicine.  How do you see technology advancing radiology?

• How will the Patient Protection and Affordable Care Act have an impact on the field of radiology?

Please e-mail essay submissions to essays@zprad.com. 

Winners and guidance departments will be notified by e-mail by June 1, 2014.