Early detection remains critical | SteamboatToday.com

Early detection remains critical

Advances in screenings, treatment options give breast cancer patients hope

Dr. Malaika Thompson, breast radiologist at UCHealth Gloria Gossard Breast Care Center in Steamboat Springs, reviews an image from a screening mammogram.
UCHealth/Courtesy photo

Ongoing advances in both breast cancer diagnosis and treatments are providing more hope and improved survival rates for the 1 in 8 women who will suffer from breast cancer in their lifetimes.

Medical oncologist Dr. Farrah Datko, who cares for women with breast cancer at UCHealth Cancer Care and Hematology Clinic in Fort Collins, calls recent advancements in breast cancer treatments “exciting, promising and hopeful.”

Radiologist Dr. Malaika Thompson at UCHealth Gloria Gossard Breast Care Center in Steamboat Springs said, “Breast cancer is an extremely common disease that we have really excellent treatment rates and extraordinary results if found early.”

Both physicians stress that early detection is crucial.

“The earlier breast cancer is diagnosed, the higher the cure rate and the less treatment that is needed to achieve cure,” Datko noted.

Breast cancer rates have increased slightly in the past several years due in part to increased screening and improved screening technology, as well as a general increase in risk factors, such as obesity and delayed age of giving birth in American women. However, breast cancer survival rates have improved during this period due to advancing treatment options that provide better outcomes with less side effects, Datko explained.

The oncologist said one of the most notable advances in breast cancer treatment is more women are able to be cured with less toxic treatments.

“Thanks to research teams and brave women who have participated in large research studies, we now know that many women with hormone receptor-positive, early-stage breast cancers can be spared the toxicities of chemotherapy. Tests like Oncotype DX and Mammaprint can be used to determine which cancers respond so well to endocrine therapy pills that chemotherapy no longer adds benefit,” Datko said.

In explaining just a few advances in breast cancer treatments in the past several years, Datko noted that for some women with triple-negative breast cancers, immunotherapy may now be used along with chemotherapy to improve outcomes.

“For women with HER2 positive breast cancers, there are now two antibody-drug conjugates approved,” Datko said. “This is a clever new type of therapy that brings the chemotherapy directly to the cancer cell, reducing side effects. For women with advanced hormone receptor positive breast cancers, the class of oral drugs called CDK inhibitors has significantly extended the time that cancer can be controlled, typically with much less side effects than intravenous chemotherapy.”

In 2020, the staff at Gloria Gossard Breast Care Center performed 2,388 screening mammograms and 187 follow-up screening breast ultrasounds on women with dense breast tissue and diagnosed 38 cases of breast cancer. Of those diagnosed last year, 23 were from Routt County, six from Moffat County and nine from other counties.

Thompson described some of the improved diagnostic tools the breast care center added last year, including lateral approach stereotactic biopsy for women with small breasts who otherwise had only surgery as an option for diagnosis; updated digital mammography equipment to offer high-resolution tomosynthesis, nearly halving the radiation dose; and curved paddles on mammogram machines to provide equal compression across the entire breast and decrease pinching and discomfort during screenings.

Stereotactic biopsy uses mammography to guide needle biopsy, and the upgrade in 2020 added a lateral arm to the local stereotactic biopsy machine to allow the team to biopsy women with small breasts, “which can be challenging and sometimes impossible on the standard stereotactic biopsy machine without the added equipment,” Thompson explained.

Tomosynthesis, or 3D mammography, obtains images in very high detail at numerous angles to increase cancer detection, which has been used locally since 2016. In spring 2020, the center upgraded to a newer type of technology that takes the thin slice tomosynthesis images and generates a 2D image from the data, instead of having to take a separate 2D image.

Dr. Malaika Thompson, local breast radiologist, reviews an image from a screening mammogram.
UCHealth/Courtesy photo

“By eliminating the need to physically acquire 2D images of each breast in addition to tomosynthesis, the radiation dose is dramatically reduced, and the time of breast compression required for taking the pictures is decreased, making mammography more tolerable,” Thompson said.

With all of these improvements, patients still have the primary role to play by scheduling screening appointments.

“The more often you screen, the earlier we can find it, and the easier it is to cure,” Thompson emphasized.

Finances should never hamper breast cancer screenings

Curved paddles are an option on mammogram machines at UCHealth Gloria Gossard Breast Care Center to provide equal compression and decrease discomfort during screenings. | UCHealth/Courtesy photo

Medicare, Medicaid and most insurance companies cover the cost of mammograms.

According to the Susan G. Komen organization, the Affordable Care Act since September 2010 required all new health insurance plans to cover screening mammograms every one to two years for women age 40 and older with no out-of-pocket costs.

Northwest Colorado Health can help patients who do not have health insurance obtain a free mammogram through the Women’s Wellness Connection. The program provides access to mammograms for women age 40 to 64 who do not have health insurance, have not had a mammogram in the past 12 months and meet income requirements.

Funding also is available through the community supported nonprofit Yampa Valley Breast Cancer Awareness Project, also known as Paint the Town Pink, that is in its 22nd year of raising money for women fighting breast cancer in Routt and Moffat counties. Underinsured or uninsured patients in need can apply to the nonprofit to cover mammogram screenings or pay for costs not covered by high insurance deductibles for follow-up tests and treatments such as screening ultrasounds or biopsies.

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