New technology improves early breast cancer detection
October 14, 2018
STEAMBOAT SPRINGS — A new technology being utilized at the UCHealth Gloria Gossard Breast Care Center now gives doctors another tool to detect breast cancer.
"It's all about finding it early," said Dr. Terese Kaske, breast radiologist and the medical director of the Breast Care Center.
The Automated Breast Ultrasound (ABUS) has been in operation in the cancer center since July and was provided by the Yampa Valley Medical Center Foundation, purchased with $180,000 in unrestricted donor funds.
By the numbers
- Routt County had the highest incident rate of female breast cancer in the state between 2011 and 2015. According to State Cancer Profiles, a website based on data from the CDC and the National Cancer Institute, there were 143.8 cases per 100,000 with an annual count of 19.
- In 2017, UCHealth Gloria Gossard Breast Care Center diagnosed 35 cases of breast cancer in total, with 28 breast cancer diagnoses thus far in 2018. On average, over the last four years, they've diagnosed just over 30 cases per year.
- 1 in 8 women in the United States will be diagnosed with breast cancer during her lifetime — 1 in 7 for Colorado.
- Breast cancer is the most common cancer among women in the world.
- 40,610 women in the United States died of breast cancer in 2016.
- Most major professional groups recommend women have a mammogram every year starting at age 40.
The machine uses ultrasound (sound wave) technology and a square-shaped, slightly curved transducer to produce three-dimensional data of the entire breast.
Pointing to black and white images on the numerous monitors in her office, Kaske described the limitations of mammography, which uses a low dose x-ray to see inside of the breast.
The challenges are particularly pronounced when it comes to women with dense breast tissue, Kaske explained, indicating the images with more breast tissue than fat. The more dense the breast tissue, the more white a mammogram appears, which easily hides suspicious lumps or masses — also white. The fatty tissue shows up gray, and there is a much higher chance of detecting cancer in less-dense breast tissue. In extremely dense tissue, “You don’t have a chance” with a mammogram, said Kaske. It’s been described as "looking for a snowball in a snowstorm."
ABUS has shown about a 35 percent improvement detecting cancer in women with dense breasts.
There's also tomosynthesis, a form of advanced three-dimensional mammography, which Kaske called "a little better, but not the answer to everything."
Every pair of breasts is different, she emphasized, and density can't be determined by feel or size.
In 2017, Colorado passed a law under which women must be notified if they have dense breast tissue, due to the difficulty detecting tumors with a mammogram. Those with dense tissue also have a four to six times higher risk of developing breast cancer.
The intent of the law, now passed in 34 states, is to inform women in making decisions about further action. Its critics say the law causes increased anxiety and additional medical procedures. Dense breast tissue is not uncommon — 40 percent of women have it.
But the goal with any early screening technology, said Kaske, is to find the cancer before it even becomes an observable lump.
And with improvements in technology, there is that risk versus benefit element, she acknowledged, in that suspicious spots calling for a follow-up visit, additional diagnostic screening and/or biopsies may reveal it not to be cancerous.
"There is no perfect test," Kaske said. "I tell people that all the time."
Screenings can show suspicious areas, but they can't tell exactly what it is, she said.
But, there are a number of advantages to the ABUS, Kaske said, in addition to the increased level of detection. For the patient, there is no exposure to ionizing radiation, it is non-invasive, expedient and comfortable — with minimal compression.
For doctors, it is reproducible and standardized, she said. And a technologist can perform the procedure, thus reducing cost compared to a radiologist.
It can do more than a mammogram, but doesn't require the cost of an MRI, which would be used for high risk patients.
But cost is always an issue, acknowledged Kaske. Most insurance will cover a preventative screening mammogram, but few cover an ABUS. There are financing options, she said, encouraging people to contact the hospital’s financial assistance services: Patients with last name A-L can call 970-870-1137, and patients with last name M-Z can call 970-871-2487.
The BUST of Steamboat also will provide $500 per patient toward the cost of any procedure related to breast cancer screening and diagnosis.
Breast Care Center Nurse Navigator Frannie Johnson is another resource for questions regarding breast cancer prevention and treatment and financial assistance and can be reached at 970-875-2623.