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Mammograms Decrease Nationwide Due to COVID-19

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stethoscope with breast cancer ribbon

With one in every four women not receiving a mammogram in 2021, due to COVID-19, the number of deaths from breast cancer will spike over the course of the next two to three years. Cooper Clinic radiologist and breast imaging subspecialist R. Vance Dell, MD, shares the necessity of annual mammograms and the impact the recent pandemic has made on women’s chances of survival. These findings are contributed to the breast cancer having more time to grow before detection.

Study proves mammograms save lives
A recent large clinical study, using data dating back to 1992, studied two large groups of women—one receiving mammograms every year and the other going longer than one year in between mammograms. The group who did not receive their mammograms just for one year saw a staggering 30% increase in mortality. This study’s findings reiterate the importance of annual mammograms.

Screening mammography vs. random mammography
A mammogram is a specialized x-ray of the breast that can detect cancers as small as two or three millimeters in size. Dr. Dell is quick to note that screening mammography means having the breast examination every year or every other year. Annual screening saves the most lives with screening every other year still being able to save lives, just not as many. Any other interval in between mammograms is no longer considered screening but random, which shows no improvement in mortality from breast cancer.

Screening mammography, when paired with ultrasound and MRI as needed, has a 92% accuracy rate. “Mammography is a primary screening tool and our first line of preventive medicine when it comes to breast health,” says Dr. Dell.

3D mammography technology
Cooper Clinic uses Hologic’s Genius 3D Mammography in addition to its existing breast health and diagnostic imaging services. Genius 3D Mammography detects 41% more invasive breast cancers, detects 15 months earlier than others and reduces false positives by up to 40%. The machine performs a four-second scan of the breast and is a similar experience to the traditional 2D mammogram. “There’s not a better mammogram machine in the world than what we have at Cooper Clinic right now,” says Dr. Dell.

Different layers in the breast, including blood vessels, milk ducts, fat and ligaments can be challenging to differentiate when viewed in 2D traditional mammogram. However, Genius 3D Mammography uses breast tomosynthesis, in which the scan examines the breast one layer at a time by taking multiple photos of each layer.

“Small cancers often missed by traditional 2D mammograms are found more often with 3D mammography, and the distinction between normal and abnormal breast tissue can be seen more clearly by the physician,” said Dr. Dell. “While traditional 2D mammography is comparable to looking at the cover of an unopened book and trying to determine what’s inside, 3D mammography is likened to actually opening the book and reading it page by page in full detail.”

Why wait to be screened?
Many women wait to get a mammogram once they feel an abnormal lump through self-examination. However, by the time a cancer is large enough to be felt by a woman or her doctor, 20-60% of those cases have already spread to the lymph nodes. These women are more likely to undergo a mastectomy than a lumpectomy after being diagnosed.

The concern of radiation from mammograms has proven to be a common misconception amongst health care providers and patients alike. Some women may also be deterred by fear of overexposure to radiation, but Dr. Dell dispels the myth. “Back in the 1970s and 1980s, levels of radiation in mammography were high, but today’s technology has dropped the levels significantly and mammography is very safe,” he says. “A woman who has an annual mammogram beginning at age 40 will be exposed to less radiation over her lifetime than if she had lived in Denver, Colorado for the same period of time, where the high elevation exposes residents to powerful sun rays.”

The more information a woman has about breast health and breast cancer, the more likely she will be to utilize screening mammography as a preventive measure. “Every woman who leaves Cooper Clinic after a mammogram will have an answer the same day,” explains Dr. Dell. “We will take additional views or an ultrasound if needed, and can order an MRI or biopsy if the situation calls for it.”

The radiologist’s role
Dr. Dell makes it his mission to educate women about their breast health in order to reduce anxiety and fear. He explains breast density and reviews mammogram results with his patients, and if there is a need for MRI or biopsy, he explains his suspicions and works to ease patient fears. “Finding a breast cancer is so far from a death sentence,” he says. “I have gone through the stages of anxiety and fear from breast cancer with my wife, so I understand how difficult the process can be.”

Women should not be afraid to ask questions of the radiologist or technologist performing the exam. Being comfortable with their expertise and trusting their knowledge can help make the procedure a bit more relaxing. Since mammogram screening quality was mandated by law in 1992, breast cancers have been found much earlier and mortality has dropped by 40%.

Mammograms serve as the ultimate tool in saving women’s lives. Statistics determine if a breast cancer the size of 10 millimeters or the size of a Tic Tac mint is detected, 99% of women diagnosed will be alive five years later and 97% will still be alive 20 years later—regardless of how aggressive the cancer is. According to Dr. Dell, breast cancer should be thought of as a curable disease as long as it is found early with the help of mammography.

For more information about breast imaging and mammography at Cooper Clinic, visit the Cooper Clinic website or call 866.906.2667.