Sonnenalp Breast Center’s new technology increases ability to detect cancer in dense-breasted women
Special to the Daily
By the numbers
Breast density, nationwide:
• 74 percent of women in their 40s.
• 57 percent of women in their 50s.
• 44 percent of women in their 60s.
• 36 percent of women in their 70s (as women age, breast tissue tends to become more fatty).
Source: The American College of Radiology
Women hear a lot about mammograms for early detection of breast cancer, but what they may not know is that mammograms can miss 20 percent of cancer in patients with dense breasts. That’s why Sonnenalp Breast Center at Shaw Regional Cancer Center has obtained the latest technology to detect cancer, particularly in women with dense breasts.
Since opening in 2002, Sonnenalp has continually researched new cancer detection technologies as they evolve. The center recently purchased GE’s Advanced Breast Ultrasound, the leading and only Food & Drug Administration-approved, breast ultrasound for detection of cancer in women with dense breasts.
“This investment is yet another example of how Sonnenalp has stayed on the cutting edge of breast diagnostics,” said Doris Kirchner, president and CEO of the Vail Valley Medical Center, of which Sonnenalp is an outpatient department.
Nationally, approximately 45 percent of women have dense breasts, but in Eagle County, for unknown reasons, more than 60 percent of women have dense breasts, said Colleen Berga, manager of Sonnenalp’s breast imaging. This makes it difficult to detect cancer with traditional or even 3-D mammography. Advanced Breast Ultrasound increases the ability to discover breast cancer from 80 percent with regular mammography to 94 percent to 97 percent.
What are dense breasts?
Breasts consist of fat and fibrogladular tissue. Physicians define breasts as dense when they contain more than 50 percent fibroglandular tissue.
Though dense tissue is not uncommon — and a perfectly normal attribute, like having brown eyes or blonde hair — it is linked to a four to six times higher risk of developing breast cancer than mostly fatty breasts, according to an article in the New England Journal of Medicine.
In addition, mammograms are less effective at showing early cancer tumors in dense-breasted women because both fibrogladular (dense) breast tissue and masses and lumps appear white on mammograms. As a result, dense breast tissue may mask a lump. Some physicians describe it as looking for a snowball in a snowstorm.
Unlike dense breast tissue, fatty tissue appears gray, so radiologists can easily identify a white mass of cancer.
Only mammograms can determine the density of breast tissue; palpation cannot. Younger women, premenopausal women and those who take hormone therapy for menopause are more likely to have dense breasts, according to the Mayo Clinic.
How does the technology work?
Once a mammogram detects dense breasts, Advanced Breast Ultrasound screening uses software to reconstruct breast images in a three-dimensional plane, allowing radiologists to see breasts from all aspects. In comparison, older ultrasound screenings presented 300 to 400 small, square images of the breast.
“We had to scroll through each square of the breast, and it was hard to see where exactly (any abnormalities were),” said Dr. Monique Fox, a board-certified breast radiologist at Sonnenalp. “It wasn’t giving us as much information. (Advanced Breast Ultrasound) screening takes basic information and presents it in three different planes. … We can see if lesions are real or not and see where they are. It helps us with more problem solving.”
Between Sonnenalp’s 3-D mammography and its ultrasounds, detection of Stage 1 cancer (tumors less than 2 centimeters) have increased by 40 percent, and false positives have decreased by a third, Fox said.
“It’s like going from DOS to Microsoft, as far as what the software can look at and view,” Fox said. “It’s much easier to detect cancer with (Advanced Breast Ultrasound).”
However, Advanced Breast Ultrasound does not replace mammograms, which physicians and breast experts still recommend receiving annually. The technology simply complements mammography for women with dense breasts.
“Screening is very important for Eagle County women,” Fox said. “We recommend mammography and ultrasounds every year for women with dense breasts. The population of women diagnosed here is higher than the national average.”
Nationwide, women ages 40 to 44 have a 6 percent incidence of breast cancer, while residents of Eagle County have a 10 percent to 12 percent incidence. In women ages 45 to 54, the percentages are the same nationally and regionally — 10 percent to 12 percent, Fox said.
Physicians aren’t sure why more women in the valley present with breast cancer, but they postulate it could be linked to the higher population of younger women.
The experts at Sonnenalp ensure the most compassionate, gentle care possible. The center provides private changing rooms and waiting rooms with relaxing music, magazines and a selection of tea and coffee. The Advanced Breast Ultrasound procedure is painless, involving lotion and light pressure from the transducer. Patients receive results in one to three days.
“We’ve always tried to make the experience easy and comfortable because we know that breast imaging is accompanied by a lot of anxiety and fear,” Berga said. “All the technologists are super caring.”
With Advanced Breast Ultrasound technology, Sonnenalp has become a pioneer in cancer detection, not only in Eagle County but also along the Front Range; only a couple of clinics in the Denver metro area have acquired Advanced Breast Ultrasound, Berga said.
The purchase was made possible by The Sonnenalp of Vail Foundation, Vail Breast Cancer Awareness Group and Shaw Outreach Team.
“We’ve always been so fortunate to offer the best to our community because of the support of these generous groups,” Berga said.
Kimberly Nicoletti is a paid writer with the Vail Valley Medical Center.