She’s excited that these machines are now available at Memorial Regional Hospital in Hollywood and Memorial Hospital Miramar in Pembroke Pines. By October, they should be available throughout the Memorial Hospital System. There are about 10 tomosynthesis machines already in use from Coral Gables to Delray Beach.
With tomography, Hayes finds that the false positives (the number of times women are recalled to the office to check on something that ends up being benign) are reduced by 20 percent.
However, it won’t replace the traditional mammogram as the two technologies are complementary.
Hayes explains it this way: If you are planning to drive from Florida to Maine, you look at a large map to see what states you’ll pass through. Then, when you get on the road, you consult local maps for detailed driving directions.
In the same way, a mammogram gives doctors a picture of the overall appearance of the breasts that can be compared from year to year. The 3-D image on the other hand lets them “drill down and look millimeter by millimeter, page by page through that breast,” Hayes says.
After you’ve had a mammogram and perhaps tomosynthesis and if you find out you have dense breasts, your doctor can help you determine your next step based on your age, your family and your medical histories.
If your mother had breast cancer and your sister had it in her 30s or 40s or if you had chest radiation at an early age for Hodgkin’s lymphoma, chances are your doctor will prescribe a chest MRI. For other patients with dense breasts who are at lower risk for developing breast cancer, bilateral ultrasound is often the preferred follow-up to a mammogram. Ultrasound has proven to uncover three to four additional cancers for every 1,000 women screened, according to Yepes.
But the downside to ultrasounds as well as MRIs is that although they detect a multitude of irregularities, they are not very good at showing if these are malignant or benign. This can result in the patient having to go through more follow ups, tests and biopsies.
“It is a balancing act for the patient and the doctor to decide and can get difficult,” Yepes says.
Women are starting groups such as How Dense Are you (areyoudense.org). They are working to pass state and federal legislation requiring that women be given more information about dense breasts in the letter telling them the results of their mammograms.
Almost a dozen states have enacted such laws. Florida had a bill pending but concern about wording from the medical community kept it from gaining momentum and it died.
However, there’s really no need for legislation if you take responsibility for your own health. Initiate that conversation about breast density with your doctor.
“Together we can weigh the pros and cons,” Yepes says.