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Tuesday, August 20, 2013 - Tomosynthesis Detects Cancer that Mammogram Missed
 
Tomography patient, Melissa Lonas (L), poses with her friend and Parkwest mammography technician, Nean Walker (R), at the Parkwest Comprehensive Breast Center.

To say that the threat of breast cancer was on her mind would be an understatement.  Melissa Lonas, an active, engaging woman in her 60s, knew that she was at risk for developing breast cancer.  In 2005, her older sister, Cindy, passed away after undergoing treatment for the disease.  Her younger sister, Rusti, elected to have a prophylactic (preventative) bilateral mastectomy in 2006 after atypical cells were found in her breast tissue. For these reasons, Lonas was diligent about performing self breast exams and receiving regular mammograms.

The results of Lonas’s routine mammogram in January 2012 came back negative, but because of her family history and the fact that she had more glandular, or “dense,” breast tissue, she was encouraged to have an MRI done to double check for abnormalities.  She attempted to have the scan done at another East Tennessee area hospital, but had to stop mid-procedure because of shoulder pain from a prior injury.  Being unaware of additional detection options, Lonas returned home and reassured herself that she didn’t need another screening. After all, the mammogram had not found any cancer.

One day while shopping, Lonas ran into her friend Nean Walker, who was also her mammogram technician at the Parkwest Comprehensive Breast Center. “I told Nean that I couldn’t follow through with the MRI and I asked her if there was any other option for me,” explained Lonas. “That’s when she told me about tomosynthesis, a new cancer detecting technology that was only available at Parkwest. She encouraged me to have it done just to put my mind at ease.”

‘Tomosynthesis is 3-D digital mammography that gives a clearer picture of the breast, especially for women with dense breast tissue,” explains Parkwest radiologist Amanda Squires, M.D.  On a mammogram, dense tissue appears white, much like a tumor.  This can lead to false positive result, causing unnecessary additional screenings, biopsies and anxiety for the patient.  In contrast, tomosynthesis produces several 3-D images of the breast from different angles, making it easier to detect cancer.

Lonas immediately scheduled the tomosynthesis screening and was surprised that the whole procedure took only a few minutes to complete when she went in on August 12. The results showed that Lonas had a small tumor in one breast.  A biopsy confirmed that the tumor was malignant grade 2 breast cancer located just outside the duct gland. Squires believes that the tumor had been missed by the traditional mammogram earlier that year because of its location and the fact that Lonas had dense breast tissue. The tomosynthesis caught the cancer just in time to being aggressive treatment.

On Sept. 10, 2012, Lonas underwent a bilateral mastectomy followed by nearly two months of radiation therapy to further reduce her chances of redeveloping breast cancer. Today she is grateful that she ran into Nean Walker that fateful day last summer. “I just would have let it go if I hadn’t talked to Nean,” said Lonas. “Had she not encouraged me to try tomosynthesis at Parkwest, the cancer might not have been discovered until it was too late.  I encourage every woman, especially those with a family history of breast cancer or dense breasts, to have tomosynthesis done in addition to a traditional mammogram.”

Dr. Squires is hopeful that 3-D mammography will become the new standard in breast cancer screening and detection, and that may not be too far in the future. The state of Tennessee recently passed legislation (effective July 2014) stating that all breast centers must inform patients if they have dense breast tissue so those patients may seek additional cancer screening options like tomography if they choose. “A recent study confirmed that tomosynthesis increases detection of breast cancer by 35 percent and detection of invasive cancer by 53 percent. It’s hard to argue with results like that,” said Squires.

While it has received FDA approval, 3-D mammography is not yet covered by all insurance plans.  The cost of the procedure is $125. Lonas maintains that “it was the best money [she] ever spent.” For more information or to schedule an appointment, call the Parkwest Comprehensive Breast Center at 865-373-7010.