Making Breast Health a Priority

One in eight women will be diagnosed with breast cancer at some point in their lives. Hearing the words, “you have cancer,” can be shocking, frightening and emotional. Just ask Cooper Clinic radiologist and breast imaging subspecialist R. Vance Dell, MD, MBA, MHCM, FACR, whose wife was diagnosed with breast cancer more than two decades ago.

“Her doctor called me in and said, ‘Vance, I’ve never seen a faster growing cancer,’” says Dell. “I was scared to death.” 

It was that diagnosis that led Dell to specialize in breast cancer mammography, a career he’s poured his heart into ever since. Here, he discusses when women should begin undergoing annual mammograms and how 3D mammography can help with early detection and diagnosis.

When to Get Screened 

When should women start having annual mammograms? 

“The rule Cooper Clinic recommends and follows is to get a mammogram at the age of 40 and continue every year,” says Dell. 

If breast cancer runs in your family, Dell says the rules change a bit. Then, he recommends starting annual mammograms 10 years earlier than the first degree relative was diagnosed. 

“For example, if a woman was diagnosed at the age of 45 and she has daughters, then they should start receiving annual mammograms at age 35,” explains Dell.

The Power of 3D Mammography

The best way to detect breast cancer early on is with 3D mammography. 

“It’s been proven to find cancer smaller and on average, 15 months earlier than with normal mammography,” explains Dell. 

How does it work? Genius™ 3D Mammography takes a series of detailed images of the breast. This allows breast tissue to be evaluated layer by layer in more detail, helping to screen for cancer as small as the size of a tic-tac. 

“A tic-tac is exactly 10 millimeters from one end to the other,” explains Dell. “When we catch breast cancer in women that size or smaller, 99% are alive five years later and more than 96% are alive 20 years later.”

Unfortunately, Dell says cancer is usually double that size, about 20 mm in length, before it can be felt by a woman or her physician. 

“By this size, 20 to 60% of the cancers have already spread to the lymph nodes,” says Dell.

 Only about one third of facilities in the country have 3D equipment, including Cooper Clinic. That’s something Dell’s patients are willing to travel for.

“I’ve had several patients who live in another state and have felt a lump in their breast, called me and chose to fly back to Cooper to see me because we have such advanced technology,” says Dell. He says in one of those cases, the patient’s mammogram depicted cancer.

Preparing for a Mammography

There are a few things Dr. Dell says women should know when preparing for a mammogram. First, the procedure can be uncomfortable, but this is only because of the need to get a clear picture of the breast. The clearer the picture, the better opportunity to identify any potential problems.

Secondly, 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 35%. Dr. Dell explains, “for every 1,000 women screened, we can expect to find three to six cancers.”

Who’s at Risk?

While having a family history of breast cancer can increase your risk, no family history does not necessarily decreases your risk of breast cancer. “Actually, three out of four new cancers found are in women with no family history of breast cancer,” says Dr. Dell. No matter the risk, an annual mammogram reduces the chance of dying from the disease.

A factor that women should be aware of when it comes to their own breast health is breast density. About 50% of women above the age of 40 have dense breasts, which means their ratio of fibroglandular tissue (which includes milk ducts) to breast fat is increased. Because 97 percent of breast cancer originates in the milk ducts, women with more fibroglandular tissue (denser breasts) have a slightly increased chance of developing breast cancer. Though cancers can be harder to find in dense breasts, Dr. Dell notes that ultrasound technology can be used in addition to mammography to provide the most thorough screening possible. The increased use of ultrasound in breast screening is now a national trend.

Breast cancer also affects men—about 1,800 men die of breast cancer each year. The disease can be much more lethal in men. Due to smaller breast size, the cancer can spread more rapidly from the breast to other parts of the body.

Why You Should Never Skip

Women in their 40s have a lot on their plate and while some items can be put on the back burner, Dell says mammograms shouldn’t be one of them.

“Many women might think it’s just skipping a mammogram,” says Dell. “But really, they’re just giving possible undetected cancers time to grow.”

Dell says many women are also fearful of mammograms due to radiation. While radiation in high doses can cause cancer, Dell says a woman can have a mammogram every year from the age of 40 until she’s 100 with no impact to her health. “That amount of radiation she would receive is less than if she would have lived in Denver, Colorado, for 60 years,” says Dell. 

Making sure women come in annually for their mammograms is personal to Dell. Why? It was just days before his wife’s first mammography, at the age of 40, she felt a lump in her breast. Because they caught the cancer early and acted quickly, she’s alive and thriving today. 

For more information about breast imaging and 3D mammography at Cooper Clinic, visit cooper-clinic.com or call 972.560.2651.