Lance Pysher, MD, Radiologist
Marcus Daly Imaging Department
1200 Westwood Drive
Hamilton. MT 59840
When it comes to screening for breast cancer, there is plenty of confusion
out there. What age to start at? Screen every year or every other year?
What about MRI and ultrasound? Some medical groups recommend one thing
and others another.
Well here are some of the facts:
- Mammography has helped reduce breast cancer mortality in the U.S. by nearly
40% since 1990.
- 3/4 of women diagnosed with breast cancer has no family history of the
disease and are not considered high risk.
- Even for women 50+, skipping a mammogram every other year would miss up
to 30% of cancers.
- 1 in 6 breast cancers occur in women aged 40-49.
- The ten-year risk for breast cancer in a 40 year old woman is 1 in 69.
- Annual mammograms can detect cancer early - when it is most treatable.
In fact, mammograms show changes in the breast up to two years before
a patient or physician can feel them.
- Mammograms can also prevent the need for extensive treatment for advanced
cancers and improve chances of breast conservation.
In general the benefits of mammography are agreed upon. The debate is
over the risks. Mammograms use X-rays which in large doses can cancer.
The doses used for mammograms are low and the associated risk is small,
but not zero. That is why we don't do mammograms on women in their
20s and 30s, because for these women breast cancer is so rare that even
the small risk of X-rays isn't worth it. However, this isn't the
risk that is debated. The groups advocating for mammograms every other
year starting at age 50 are concerned about the anxiety caused by what
are called "false positives." These are people called back for
extra views, an ultrasound, or occasionally a biopsy, but end up not having
cancer. About 1 in 10 women will be asked to come back for a more thorough
evaluation and after taking a few more pictures will be told there is
nothing to worry about. Occasionally, about 10-15% of the time, a biopsy
will be recommended. This means roughly 1 out every 100 women will get
a biopsy, and a third of those will have cancer, and two thirds will have
a biopsy but no cancer.
At Marcus Daly Imaging we strive to minimize this stress and anxiety.
Last year we upgraded our mammography system to a state of the art breast
tomosynthesis system. This new technology not only finds more cancers,
it decreases the number of false positives. It does this by allowing the
radiologist to look through the breast tissue at different depths rather
than as a summation of all the breast tissue. This is especially helpful
in women with dense breasts. What this also means is that rather than
having to get those extra pictures 10% of the time, now we rarely call
anyone back unless they need an ultrasound or a biopsy. In addition, unlike
most hospitals, the vast majority of the mammograms are reviewed while
the women waits allowing us to do any ultrasounds or extra views during
the appointment, further decreasing the anxiety.
With the next breast tomosynthesis equipment we are now able to do stereotactic
biopsies which allow us to perform nearly all the biopsies here in the
Marcus Daly Imaging Center. Whether the biopsy is done with this new equipment
or with ultrasound, these biopsies are all done in radiology with only
the skin needing to be numbed and a small amount of tissue sampled with
a needle. There is no need to visit a surgeon or go to the operating room.
In many cases the biopsy will be done the same week.
Here at Marcus Daly Memorial Hospital we believe mammography and breast
cancer screenings saves lives and continue to recommend yearly mammograms
starting at age 40. For those women concerned about the cost, the Aid
for Mammography fund will pay for your mammogram and other necessary related
procedures available at Marcus Daly Memorial Hospital. Last year together
the community donated over $50,000 and over the past five years 770 women
got their mammogram, as well as other related services through the Aid
for Mammography program and many breast cancers have been found. For information
about the aid for mammography fund, visit
Questions or comments can be addressed to Lance Pysher, MD, Radiologist,
c/o Marcus Daly Memorial Hospital, Imaging Department, 1200 Westwood Drive,
Hamilton, MT 59840.