Category: News

The American College of Radiology (ACR) and Society of Breast Imaging (SBI) jointly published updated breast cancer screening guidelines in June 2021 in the Journal of the American College of Radiology (JACR). The updated guidelines have a few main points. The guidelines state that all women should have a risk assessment by age 30 – especially minority women. It also emphasizes the importance of screening in overlooked or underserved populations, including transgender individuals and Black women. The ACR and SBI continue to recommend annual screening beginning at age 40 for women of average risk.

The new guidelines point out that certain factors such as sex assigned at birth, hormone use, and surgical histories place transgender individuals at increased risk for breast cancer, and describe that “due to hormone use, biological males transitioning to female are at increased risk for breast cancer compared to other males.” Further, biological females transitioning to a male who does not undergo mastectomy remain at their previous risk for breast cancer – this is important to note as many transgender individuals are less likely to undergo routine checkups and screening. This is true, too, for many minority women, “said Dr. Emily Conant, one of the authors of the guidelines. Minority women are 72% more likely to be diagnosed with breast cancer before age 50, 58% are more likely to be diagnosed with the advanced-stage disease before 50, and 12% more likely to die from the disease, compared with white women.” Therefore, it is vital that all women undergo a risk assessment by age 30 and start screening at age 40 – delaying screening until 50 will result in unnecessary loss of life to breast cancer, particularly in minority women.

Since the 1980s, when annual screening mammography became widespread, it has been proven to decrease breast cancer mortality by 40%. To maximize the benefits of screening mammography, annual screening should be followed without an upper age limit. Dr. Stamatia Destounis, one of our very own Elizabeth Wende Breast Care (EWBC) physicians, and author of the new guidelines, and the Chief of the ACR Breast Imaging Commission said, “new evidence continues to support annual screening starting at age 40, with closer attention given to minority women in underserved populations…. mounting data and more inclusive screening recommendations should remove any thought that regular screening is controversial.”

Reference: Monticciolo DL, Malak SF, Friedewald SM, Eby PR, Newell MS, Moy L, Destounis S, Leung J, Hendrick RE, Smetherman D. Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging. J Am Coll Radiol 2021, article in press.

Read the full article (abstract)

It is important to develop a lifelong relationship with your breast imaging specialists dedicated to the early detection of breast cancer.

Most women of average risk will begin having annual screening mammograms at the age of 40. Current guidelines from the Society of Breast Imaging and the American College of Radiology state that patients should continue having annual screening mammograms as long as they are in good health, which for many could be well into their late 70-80s. This potentially means patients could have a 40-year relationship with EWBC! Every year for 40 years! But, WHY?

What is so important about coming to EWBC compared to going to another facility that also does mammograms?  Aren’t all mammograms and radiologists the same? From the first time you call our office to schedule an appointment and step into one of our seven locations, you can tell why EWBC is different. Our professional and supportive staff is led by a team of highly trained breast imaging radiologists who double read every screening mammogram. All EWBC technologists are specifically focused on mammography, and our sonographers are specialized in breast ultrasound.

Our goal is to provide the type of care for our patients that we would expect our loved ones to receive. We take time to explain every step along the way and make sure you are as comfortable as possible. If you have an unexpected problem or concern, we can typically see you within 24-48 hours. Most importantly, we’ve invested in the latest technology to provide you with quick and accurate results. Our doctors go the extra mile to answer questions, review results and provide support. Whenever patients have a biopsy, they leave the office with the doctor’s cell phone number and are encouraged to call if needed.  If you have a diagnosis that requires surgery or treatment, we are always available to answer questions.

We adhere to the recommended screening intervals set forth by the Society of Breast Imaging and the American College of Radiology. Their guidance allows us to remain focused on our patients and provide the most appropriate care for each patient. Our experience of opening the first dedicated breast clinic in the nation sets us apart.

Call one of our many offices located throughout the Rochester, NY area at (585) 442-2190 to request an appointment today!

Stamatia V. Destounis, MD, FACR, FSBI  | Elizabeth Wende Breast Care

The emergence of COVID-19 in the winter of 2020, and the subsequent shut-down in many areas of the country, led to the cancellation of many routine screening examinations, screening mammography included.

At the peak of the pandemic, the Centers for Disease Control and Prevention (CDC) [1], along with individual institutions, and societies such as the American Cancer Society (ACS) and American College of Radiology (ACR) [2], recommended women postpone attending screening to not expose themselves unnecessarily to the virus. At the time, reports showed that screening rates for breast, colon, prostate, and lung cancer were already declining, ultimately revealing a significantly lower attendance rate than the baseline rates of previous years [3].  Specifically, the report from the Epic Health Research Network showed that between March 15 and June 16 an estimated 285,000 breast cancer screenings were missed [3].

As the intensity of the virus subsided, many communities were able to re-open screening services, yet apprehension over visiting doctors’ offices persisted for many, and women have continued to be faced with the decision of whether to attend their annual mammogram appointment or to further delay screening to avoid potential exposure to the virus.

Breast cancer is the most common cancer in American women (except for skin cancers), with an estimated 276,480 new cases of invasive breast cancer expected to be diagnosed in women in the U.S. in 2020 [4]– but because of the reduced volume attending screening, there was nearly a 50% drop in new breast cancer diagnoses, according to a recent study published in the Journal of the American Medical Association (JAMA) [5]. Data from the National Cancer Institute (NCI) estimates that reduced screening for six months due to COVID-19 and the resulting delays in diagnosis and treatment could lead to nearly 10,000 extra deaths from breast and colorectal cancer alone in the next decade [6].

Detecting breast cancer at routine annual screening mammography is vital to diagnose breast cancer early, when it is in its most treatable form; small, and has not spread to the lymph nodes or other parts of the body, providing the highest chance of survival. Delays in screening attendance ultimately can lead to delays in diagnoses, contributing to larger, advanced cancers being diagnosed, requiring more invasive and taxing treatment.

Understanding all the facts is crucial when deciding to attend screening or delaying screening attendance further. While postponing was prudent at one time, continued delays in routine screening does pose health risks. The risk of developing cancer does not go away just because there is a pandemic. While many women rightfully decided to put off mammograms due to immediate COVID-related concerns, it is important to be aware that medical imaging centers have safely resumed offering screening mammograms. The future spread, duration, and peaks of COVID-19 remain unclear, however, getting back in for screenings is so important for early detection. Remember, early detection saves lives.

References

1. Coronavirus Disease 2019 (COVID-19). (2020). Available at https://www.cdc.gov/coronavirus/2019-ncov/index.html. Accessed November 2020.
2. ACR COVID-19 Clinical Resources for Radiologists. (2020). Available at  https://www.acr.org/Clinical-Resources/COVID-19-Radiology-Resources. Accessed November 2020.
3. Epic Health Research Network: Preventive cancer screenings during COVID-19 pandemic. Available at www.ehrn.org/wp-content/uploads/Preventive-Cancer-Screenings-during-COVID-19-Pandemic.pdf. Accessed November 2020.
4. American Cancer Society. Breast Cancer Facts & Figures 2019-2020. Atlanta: American Cancer Society, Inc. 2019.
5. Kaufman HW, Chen Z, Niles J, et al. Changes in the Number of US Patients With Newly Identified Cancer Before and During the Coronavirus Disease 2019 (COVID-19) Pandemic. JAMA Netw Open. 2020; 3(8): e2017267.
6. Sharpless NE. COVID-19 and Cancer. Science 2020; 368(6497): 1290.

About the Author

Stamatia Destounis, MD is a practicing radiologist at Elizabeth Wende Breast Care and Clinical Professor of Imaging Sciences at the University of Rochester School of Medicine and Dentistry.

Dr. Destounis is an ACR ultrasound and MRI accreditation reviewer and the chair of the ACR Breast MRI Quality Committee and Breast Economics Committee. She serves as chair on the SBI Patient Care and Delivery Committee and is the chair of the RSNA Breast Educational Exhibits Committee. Dr. Destounis serves as a reviewer for several peer-review journals.

Dr. Destounis is actively involved with research, acting as the principal investigator on several clinical trials conducted at her practice. Dr. Destounis’s personal research interests include digital breast tomosynthesis, screening mammography, breast ultrasound, and breast MRI, and she has published numerous peer-reviewed articles and book chapters throughout her career on these topics.