This year alone 297,790 women will be diagnosed with breast cancer in the United States. It is the most common form of cancer for American women. It is also the second leading cause of death from cancer among women following lung cancer. Innovations in both screenings and treatment are turning the tide in the battle against breast cancer.
Doctors from Hackensack Meridian Health and the John Theurer Cancer Center are available to talk about the significance screenings and treatments this October, breast cancer awareness month on a variety of topics including:
- New Mammogram Screening Guidelines and importance of screenings - Earlier this year a new draft guidance from the United States Preventive Services Task Force changed the timeline of when most women should get their first mammogram from age 50, to 40 years of age, shifting up the time they advise women to begin regular mammograms by ten years. Previously, the United States Preventive Services Task Force did not advise women to begin regular mammograms until age 50, advising women in their 40s who were concerned to talk to their doctor about the possible need for a mammogram. Now the US Preventive Services Task Force says the shift to regular mammograms at age 40 could save 19% more lives. Breast cancer makes up nearly 30% of new cancers in U.S. women each year, and it’s estimated that 1 in 8 women will develop breast cancer in the course of their lives. The median age for diagnosis across all women is 62, but that can vary by racial group.
Other organizations have long pushed for regular mammograms beginning at age 40 including, American College of Radiology, the American Society of Breast Surgeons, and the American College of Obstetricians and Gynecologists. But the task force is the official body that many primary care doctors follow for preventive testing. Despite the change in guidelines, Hackensack Meridian Health has long recommended patients begin yearly mammograms at age 40.
Additionally, starting this year all women getting mammograms will now receive information about the density of their breast tissue. Dense breast tissue can make spotting breast cancer on a mammogram more difficult. That tissue appears white on X-rays, the same color as growths in the breast, making mammograms harder to read.
About half of women over age 40 have dense breasts, with less fatty tissue and more connective and glandular tissue. Dense breast tissue is one of the factors that can increase a woman’s chances of developing cancer. Under the new guidelines women with dense breasts will receive a memo alerting them to this status, and the risks associated with it. Patients will be encouraged to speak with the doctor about results and in some instances will be encouraged to pursue further testing including ultrasounds and MRIs.
- Mammogram & other screening innovations - Advances in mammography technology has made spotting cancer easier, and the tests more comfortable, hopefully encouraging more women to be screened regularly.
Contrast Enhanced Mammography (CEM) an emerging advanced technology that uniquely combines the exceptional high-resolution imaging of Digital Mammography and 3D Mammography with functional imaging provided by contrast. CEM is a fast and safe, diagnostic mammogram with contrast. It can be completed in less than 15 minutes after consulting with your physician. Approved by the FDA, this technology highlights areas of unusual blood flow patterns that can indicate malignancy. Early studies of CEM in screening women with dense breasts have shown the potential benefit of CEM in the detection of breast cancer. Other instances here CEM are beneficial include as an alternative to MRI, as a screening tool for those at a higher risk to breast cancer due to dense breasts, family history or prior biopsy results, to clarify findings from a traditional mammogram, to determine the extent of cancer within a breast and to monitor the response to chemotherapy treatment.
3D Mammography also offers a more comprehensive view of a woman's breast tissue. 3D-Mammography, also known as Digital Breast Tomosynthesis, is an advancement of Digital Mammography that utilizes multiple exposures as the X-ray tube moves in an arc of the compressed breast. The data acquired is then reformatted by the computer to show thin slices through the breast, improving overall resolution, accuracy and detection, all at the same radiation dose and time.
SmartCurve™ Mammography Paddles. SmartCurve mammography paddles come in various sizes and are contoured to conform to the shape of the breast rather than the typical flat panels. The contours provide more even compression, with greater comfort, encouraging women who fear mammograms to get the screenings they need, by offering a more comfortable exam.
A recent poll found one of the major reasons women skip regular mammograms is they find them uncomfortable. Making mammograms more comfortable through technology like SmartCurve, can be a significant piece in getting patients to schedule their regular exams.
- Cold Cap Allows Chemotherapy Patients to Maintain Hair - One of the biggest fears among patients undergoing chemotherapy is losing their hair, especially for women undergoing chemotherapy for breast cancer. Hair is a significant part of their identity, so innovations that allow patients to maintain their hair during treatment, have a significant impact on encouraging patients to pursue the chemotherapy they may need. “I had two patients almost refuse chemotherapy treatment because of the stigma of losing their hair so this has been such an amazing tool,” said Dr. Donna McNamara, Medical Oncologist, Division of Breast Oncology at Hackensack University Medical Center’s John Theurer Cancer Center.
Video of cold capping available here courtesy of Hackensack Meridian Health, more available upon request.
- Breakthroughs in Specific Breast Cancer Types - With regard to treatment, JTCC doctors are exploring a new classification of anticancer drugs to successfully treat women with HER2-low, an advanced form of breast cancer. The drug combination includes antibody drug conjugates (ADC) which research shows can be a more successful treatment for those with this disease.
An upcoming JTCC clinical trial will explore decreasing the use of chemotherapy in younger and premenopausal patients diagnosed with hormone positive breast cancer. An additional study is looking at decreasing cognitive changes that can occur in breast cancer patients.
- Changes To Mastectomy and Lumpectomy procedures - Advances in breast surgery are also giving women more options to remove cancerous tissue without compromising the look and feel of their breasts. Hackensack Meridian Health offers nipple sparing mastectomies for women that qualify, giving them an excellent cosmetic result in which they get to keep all their skin, nipple and areola. The breast looks essentially the same before and after surgery with reconstruction.
HMH surgeons can use hidden scar techniques and tissue rearrangement to ensure the best cosmetic results for our patients undergoing breast conservation and mastectomy. We also work closely with plastic surgeons to give patients excellent cosmetic outcomes.
For breast lumpectomies, breast conserving surgeries, Hackensack Meridian Health surgeons use wireless technology, a clip placed in the breast that gives off an infrared signal that we can detect and find. This is more convenient, comfortable, and efficient for patients as they no longer need to have a metal wire placed into the breast the morning of surgery that sticks out of the skin. The SAVI scout can be put in any time before surgery.
Hackensack Meridian Health physicians and patients are available for stories on the above topics and more this October, breast cancer awareness month.
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