From the July 2014 issue of HealthCare Business News magazine


Guido says that she has been in the nursing practice for 30 years and has noticed a variety of cycles regarding the standard of care for breast cancer screening. About 10 to 15 years ago, there was a push to standardize care plans and it was important to ensure that everyone was following one set of standards, but that’s not the case anymore.

“I think we’re going away from that again and we’re now doing a more personalized approach based on what a patient’s risk factors are so that we can talk about the ones that are modifiable,” she says.


Measuring density
The reason mammography is the go-to screening tool is because it has been proven effective in catching breast cancers, based on various clinical trial results. But experts are encountering scenarios where mammography isn’t as effective. “I do think [mammography] is a viable option and I think it’s still a very good one, I just think that we’re finding alternative ways to become better,” says Moffitt’s Drukteinis.

One of the scenarios when mammography isn’t as effective at detecting breast cancer is when a woman has dense breasts. Women with dense breasts have a greater amount of connective tissue than fatty tissue and the connective tissue shows up white on mammograms, but tumors do as well.

Breast imagers are offered multiple tools to detect breast cancer; however, they are challenged with how these devices should be used and implemented,” says Jennifer Okken, product manager for the MAMMOMAT Inspiration Prime Edition at Siemens Healthcare. “We need to define — we have five or six technologies for breast imaging — what’s the best for each patient? Although we’ve done a great job so far, more studies need to be done to define clinical use,” she says.

Some doctors urge women to undergo additional screening with another method, but there is still some uncertainty around that. “It’s unclear the best way to screen,” said Dr. Carol Lee, chair of the American College of Radiology’s Communications Committee of the Breast Imaging Commission. “For women whose only additional risk factor is breast density — we really don’t know whether they need to have additional screening or if so, which modality would be best.”

The reason why it’s unclear is because there have not been any prospective, randomized trials conducted for these alternative modalities. But Lee doesn’t think that those types of trials will ever be conducted because of the time and expense involved.

However, she does think that as doctors gain more experience with the supplemental screening and by collecting that information going forward, they will be able to determine what modality is most useful for certain women.

July 2014 Magazine

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