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MRH radiologist: ‘Mammography does save lives’

 

One in eight women will be diagnosed with breast cancer. Annual mammograms and other screenings can help catch cancer early.

Breast cancer awareness matters most when it leads to lives being saved.

That’s why in October, long marked as Breast Cancer Awareness month in the United States, the healthcare workers who work to preserve lives are pushing to make their neighbors aware of something besides the fact that breast cancer exists.

“This month, we’re trying to raise awareness that mammography does save lives,” said Dr. Michael Holt, a radiologist who works out of Memorial Regional Health. “We find cancer early, when it’s most treatable, and those people do better in the long run than getting found later.”



Holt’s job is to help make diagnoses of breast cancer through mammograms, CT scans, MRIs and other means.

“If a suspicious mass is identified in the breast, I can use imaging tools, like ultrasound, to guide a needle into the abnormality to shave out tissue samples to check on and see what’s causing the mass,” he said.



He also is often the one who shares concerns that a woman might have breast cancer with the patient first.

“Those are serious conversations,” Holt said. “Things are much more successful in terms of finding and treating, but it’s still not something we have completely corralled. It’s not like antibiotics and infections — it’s a serious thing, though, and many women die from breast cancer that has spread. Many women know someone who’s had breast cancer that’s spread. A lot of awareness among women is that it can still be a serious thing, but we try to anticipate what can happen and let women know.”

The relatively recent advent of widespread regular yearly testing — Holt said women ages 40 and up should get tested once a year, and those with family history of breast cancer should start as young as 30 years old — has drastically changed outcomes.

“I’m of the vintage that screening mammograms hadn’t been well established as a routine for women,” Holt said. “Breast cancer, we knew the mortality at that time, and since screening mammography got in there, cancer rates have halved. Discoveries have increased, but death rates related to them have approximately halved. It’s been successful over the decades.”

Cancers found earlier, Holt reiterated, are substantially more treatable and can require much less aggressive treatments and lead to better overall outcomes.

“Over the decades, we’ve started finding smaller cancers,” he said. “If we didn’t have as many mammograms, the cancers we found were big, and treatment was not optimal. We don’t see as many larger cancers unless you’re ignoring mammograms. Surgeons and medical radiation oncology have smaller cancers to operate on and treat, on average, and the results are better.”

Treatment has improved, too, as science has developed more precise and effective interventions, Holt said.

“We’re still not so good at treating that we want to ignore getting there early,” he said. “They do much better found earlier than later.”

To a woman who might not want to go through the hassle of a doctor’s appointment — much less a somewhat uncomfortable ordeal during the visit (though Holt points out the procedure has gotten a bit less uncomfortable over the years) — Holt has a message.

“It’s an important thing,” he said. “Breast cancer can be detected early. People do better if it’s detected early. We’re trying to preach to those who aren’t as regular about mammograms to encourage them to come in once a year for the screening mammogram. And look for physical signs (in between yearly mammograms): a lump, color change on the skin of the breast, a kind of puckering of the skin surface, things like that. Talk to your doctor.”

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