Category: News

No Need to Quarantine Screening Mammograms

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 V. Destounis, M.D., FACR

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.

 

The Role of a Genetic Counselor in Your Healthcare

Genetic counselors play a crucial role in people’s healthcare – from helping them navigate the genetic testing process, to identifying key information in their family health history, to supporting them through an important medical decision.

Genetic counseling and cancer risk assessment can help people better understand their health, make informed healthcare decisions, and shape the future of personalized medicine.

EWBC Genetic Counseling

With genetic counseling, individuals and families can become aware of how their genetics can affect their health.

Genetic counselors, trained not only in medical genetics but also counseling, are the experts in helping people interpret these test results and guiding patients in their next steps.

Specifically, at a genetic counseling appointment, a genetic counselor would help:

  • Explore personal and family health history to become aware of genetic risks
  • Decide what, if any, genetic testing is best for patients and families
  • How a test result might not give you all the information you need
  • Discuss the medical and emotional implications of genetic information
  • Discuss genetic test results and next steps
  • How genetic test results may affect other family members

Genetic testing helps you learn if your family history of breast cancer is due to a specific inherited gene mutation. The test itself is simple – it’s done with a blood or saliva sample. Results come back in about a week. Genetic test results are a factor in determining the overall risk. Results can help you understand your risk of getting breast and ovarian cancers and steps you can take to reduce your risk. A positive test result does not mean you will get breast or ovarian cancer. If you test negative for a specific gene mutation, you still may be at an increased risk for breast or ovarian cancer.

You may wonder about purchasing an at-home DNA testing kit. While at-home DNA test kits can help with understanding genealogy, they can also unearth your potential risk of developing some significant health conditions in the future. That’s why a certified genetic counselor is recommended to discuss their potential risk based on family history and whether testing makes sense. Genetic counselors can also help people understand their results and ensure informed health decisions are being made after testing.

Each year, millions of people are undergoing genetic testing to learn more about their risks for certain inherited diseases, whether they’re a carrier for certain conditions or if they have a genetic mutation, like BRCA, which could lead to cancer. These tests aren’t meant to scare you, rather provide you with the tools you need to make informed health decisions.

Knowing your cancer risk and being proactive about your health may help you take steps to lower your risk of getting breast or ovarian cancer or find it at an early stage.  As always, genetic counseling can help you determine the best personal course of action. Questions you may have for a genetic counselor: Am I a candidate for genetic testing? Am I a candidate for an MRI? I was previously tested, do I need a larger panel? Will my insurance cover genetic testing?

Genetic counseling and testing are recommended for men or women whose family medical history has certain patterns of cancer. If you have questions, please reach out to our Cancer Risk Assessment and Genetic Counseling office at Elizabeth Wende Breast Care. Our certified genetic counselor, Jessica Salamone, and her staff would be happy to assist you. (585) 758-7050.

Meet our Genetic Counselor, Jessica Salamone, CGC

 

Breast Cancer Awareness Month in the time of COVID-19

Women Wearing Pink for Breast Cancer Awareness

No Need to Quarantine Your Screening Mammogram

Every October, without fail, we see lots of PINK! For most of us the pink ribbon is synonymous with Breast Cancer Awareness Month (BCAM), but do you know its origins? The first awareness month was in 1985, headed by Betty Ford after her breast cancer diagnosis, although the pink ribbon wasn’t specifically associated with the cause until 1992 when Estee Lauder handed out nearly two million ribbons to draw attention to the importance of breast health.

Awareness month in 2020 will be different, with the walks and events transitioning to virtual activities. Breast Cancer Awareness Month will have the same purpose nonetheless — to encourage involvement in the fight against breast cancer.

Breast Cancer Awareness is as important as it has ever been, but because of the COVID-19 pandemic, some women are postponing their cancer screenings, including breast cancer screening. Women are faced with the decision of postponing annual mammography screening to avoid potential exposure to the virus. While many of us rightfully delay mammograms due to immediate COVID-related concerns, medical imaging centers have resumed offering mammograms and are taking all possible steps to keep patients safe.

Knowing all the facts is crucial when making this decision, as postponing routine screening does pose health risks. Breast cancer is the most common cancer in American women (except for skin cancers) and is one of the most treatable forms of cancer when detected early. Performing routine, annual screening mammography plays an integral role in the early detection of breast cancer, as women diagnosed with early breast cancer (when the cancer is small and has not spread) have a high chance of survival. Delays in screening can lead to delays in diagnoses leading to more advanced cancers and more invasive treatment options. The risk of developing cancer doesn’t go away just because there is a pandemic.

It’s smart to be cautious, but mammography saves lives. Check with your mammogram provider about safety protocols they have in place, but don’t put it off. If you are a woman age 40 or older — National Breast Cancer Awareness Month is a perfect time to schedule your yearly mammogram appointment.

The pink lights are on at Elizabeth Wende Breast Care, so don’t hesitate to keep your appointment, or reschedule one you may have missed. It’s about women making their health a top priority and that means keeping up with annual screenings and taking charge of your breast health.

Elizabeth Wende Breast Care in Rochester, New York

 

Who interprets the images at EWBC?

Our team of experienced breast imaging radiologists! Radiologists are doctors who have continued their education to complete a four-year residency in radiology. At Elizabeth Wende Breast Care (EWBC) we only have specialty-trained breast radiologists (versus general radiologists) who have also completed fellowships in breast imaging focusing on mammography and diagnostic breast procedures. Radiologists at our clinic only read breast imaging studies (versus other radiology studies).All the radiologists at EWBC are board certified by the American Board of Radiology.

At EWBC, two radiologists read your screening mammogram, giving you the advantage of two expert opinions. EWBC breast imaging specialists are dedicated to providing the highest level of quality imaging services to all patients and healthcare providers.

Make sure the most qualified radiologist will read your mammogram. Experience matters for the best breast care.

Meet our radiologists

 

 

Do you need a mammogram but don’t have insurance? Come to a special screening Saturday on May 8!

Elizabeth Wende Breast Care (EWBC) together with Cancer Services Program of the Finger Lakes Region (CSP-FLR) provide free screening mammograms and clinical breast exams for women 40 and over who do not have insurance. The program also pays for follow-up diagnostic exams if there is an abnormal finding during a screening.

EWBC is holding special Saturday screening days on May 8, October 16 and  December 11, 2021 at the Brighton office. To schedule an appointment, call 585-442-2190. At this EWBC appointment expect social distancing and enhanced cleaning. If these special screening dates are not convenient, please call 585-442-2190 for additional dates.

Breast cancer is the most common type of cancer in women and is the second leading cause of cancer death in women (after lung cancer). Yearly mammograms starting at age 40 is the best way to find breast cancer early — when it may be easier to treat. We hope to see you soon.

We are here for your breast care needs

Exceptional care redesigned!

At EWBC you can expect social distancing, enhanced cleaning and same day results in a new way.

Patients are screened prior to and also at the time of their appointment. EWBC staff are screened daily.  Everyone is required to wear a mask.

We have spread out appointment times and furniture to help with social distancing. Companions are asked to wait in their car to reduce the amount of people in the building.

Our team is deep cleaning on a continual basis throughout the day. Imaging equipment and exam rooms are disinfected after each patient as well as all waiting rooms, common areas and frequently touched surfaces.

Elizabeth Wende Breast Care continues to offer same day results. Patients can choose to receive messages by email or text.

Our patients and dedicated staff are adapting well to this new patient experience. One patient recently commented:

“The fact that we are going through COVID-19, the staff were very accommodating, extremely cautious with cleanliness, very friendly, and made the experience as a whole welcoming and comfortable!”

Breast Imaging ⁠— it’s all we do. We hope to see you soon!

 

Genetics appointments via teleconference

During this uncertain time, when a typical face to face consult is not possible, our genetic counselor is available for appointments via teleconference.

You can safely participate in a virtual genetic counseling session from the comfort of your home. If you have a current appointment scheduled, our staff will reach out to you to discuss converting the appointment to a teleconference. If you prefer a more traditional in person consultation, we will certainly reschedule your visit until later this year.

If you have any questions, please call us at (585) 758-7041 or send a secure EWBC portal message to the Genetics/MRI Department and a staff member will reach out to you.

 

EWBC’s research department presents at national radiology meeting in Chicago

EWBC’s research department has been busy preparing to present data from our clinic at the biggest radiological conference of the year; the Radiological Society of North America 2019 Annual Meeting in Chicago December 1–6, 2019.

Dr. Destounis, on behalf of the research team, will proudly be presenting data supporting the benefits of screening breast ultrasound in an oral presentation entitled, “Is there value to screening breast ultrasound as a supplement to mammography in women at average risk in comparison to those with known risk factors?”  The team examined data from screening ultrasound and screening mammogram appointments in women with dense breast tissue over a four-year period, dividing the data by patients with one or more known risk factors (family history, hormone replacement therapy, etc.) and those without known risk factors. The study found screening ultrasound in patients with known risk factors detected a substantial number of cancers not seen on mammography (3.2/1000 additional cancers); 1.4/1000 cancers were detected in patients with no known risk factors.

These results support that goal of screening, and the use of screening ultrasound, in detecting additional malignancies previously undetected by screening mammography. Finding cancer early when it is small allows patients to have less invasive and less intensive treatments with the highest success rates.

Dr. Destounis and the EWBC research team have published past studies and articles which also support the use of screening ultrasound, but this study more clearly expresses that screening breast ultrasound is beneficial for all women with dense breasts, with or without known risk factors. At Elizabeth Wende Breast Care, we give the option of screening ultrasound to all patients who have mammographically dense breast tissue regardless of the presence of additional risk factors, or lack thereof. As a patient here at EWBC, if you are informed that you have dense breast tissue, you are one of the almost 50% of women – ask us today for more information on the benefits of screening ultrasound.

 

Update on our Genetic Counseling Program

The landscape of genetic testing for cancer susceptibility is changing rapidly. Today, testing via a cancer gene panel is commonplace. However, the size and clinical utility of those panels is expanding. It is important for you, with the help of your physician, to carefully consider which option is best for you. Panels can be as small as only including those breast cancer causing genes with associated management guidelines or as large as 80+ genes. The larger panels are often without clear-cut risk information and management guidelines as the data about specific genes is newly emerging.

The year 2020 will likely include dramatic changes both in panel size and technology. It will certainly be the year of new advances in the field of genetic testing. This new technology will improve both detection and interpretation and will be an exciting era for those of us in direct patient care. The soon to be approved testing will provide better sensitivity and clarity for a significant portion of patients with previously identified variants of unknown clinical significance.

Risk assessment models are a tool we use to predict your future risk of breast cancer. One tool has recently been refined and as a result, you will have access to a more personalized medical management plan. Risk assessment models are used on women who have no personal history of breast cancer. One such model, Tyrer-Cuzick version 8, now includes your breast density. A 5-year, 10 year and lifetime risk of breast cancer can be calculated. This provides you and your healthcare team with a valuable tool in navigating the sometimes-complex field of breast imaging and surveillance. If you’re a high risk patient with dense tissue, you are likely eligible for a screening ultrasound and MRI in addition to your yearly screening mammogram.
As always, genetic counseling can help you determine the best personal course of action. Am I candidate for genetic testing? Am I candidate for MRI? I was previously tested, do I need a larger panel? Will my insurance cover genetic testing?

If you have questions, please reach out to our Cancer Risk Assessment and Genetic Counseling office at Elizabeth Wende Breast Care. Our certified genetic counselor, Jessica Salamone and her staff would be happy to assist you. (585) 758-7041.

 

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