Advances in Mammography: CADx System

with Chris Both, Director of Imaging Services at Advanced Healthcare

Last Updated: Nov. 1, 2003

For women 40 and older, a mammogram is an annual event – or it should be. A specific imaging procedure that takes a detailed picture of a woman’s breast, a mammogram uses low-dose X-rays and high-contrast, high-resolution film.

The resulting images can help medical professionals identify breast cancer up to two years sooner than was possible before the procedure. The reason? A mass on camera might be so minuscule that manual detection – by a woman doing breast self-exam or a doctor doing the same during a routine physical – wouldn’t notice it.

Chris Both, Director of Imaging Services at Advanced Healthcare "The benefits, as we see them, are really to provide a 'second opinion,' and the way it does that is it highlights the area on a mammogram that may look suspicious."

Now doctors at Advanced Healthcare may be able to detect cancers even earlier, thanks to a Second Look, a computer-aided detection (CAD) system. The software system, online since July 2003, uses breakthroughs in artificial intelligence and enhanced image processing to provide a digitized readout of every mammogram, said Chris Both, Director of Imaging Services at Advanced Healthcare.

Mammography and breast cancer
The technology could, for some women, literally mean the difference between life and death. In 2001, the American Cancer Society (ACS) reported that 192,200 new cases of breast cancer were expected in the U.S. with approximately 40,200 deaths, and lists the disease as the leading cause of death among women between the ages of 35 and 54.

As the baby boomers continue to age, early detection and treatment will become increasingly valuable. According to ACS research, the five-year survival rate for breast cancer patients decreases from 96% for those whose cancers are caught early, to 20% for late-stage cancers that have spread to other organs.

Women with a family history of breast cancer should begin scheduling mammograms before their 40th birthdays, in consultation with their doctors. Some doctors also advise that sometime around their 35th year, women have baseline mammograms.

The procedure is generally done in a breast imaging center and is performed by specially trained staff. The radiologist reviews the results of mammograms, then sends the results to the primary care doctor. Imaging center personnel also notify patients of the results.

For women who have had multiple mammograms, radiologists’ diagnoses are based not only on the current set of pictures, but by comparison with past mammograms. The Second Look technology will, in subsequent years, provide an additional basis for comparison.

Using Second Look
Advanced Healthcare is using Second Look at all its breast imaging centers. The software, which works with the mammography equipment, takes no additional time for patients.

Radiologists read the mammogram as if the system didn’t exist, Both explained, and record their findings. Only then do they examine the digitized readout provided by the Second Look system.

“It’s like having another radiologist looking at it, and comparing the findings,” she said.

Both said it’s a little early to know conclusively how many extra irregularities the doctors are finding as a result of the new technology. But, she said, industry studies show that the system can be effective in helping find cancers at an earlier stage than they might without the added software.

There’s a small extra cost per-patient for the system, which, Both said, is picked up by insurance carriers.

Women scheduling their first mammogram should make sure their doctors are aware of prior surgeries, hormone use and family or personal history of breast cancer. For women with regular menstrual cycles, the best time to schedule the procedure is during the week after their periods. Women who are pregnant or who have had implants need to make sure that imaging center personnel are aware of their circumstances.

We Have Answers Do you have medical questions or need help finding a doctor? The experts at Columbia St. Mary's and Advanced Healthcare can help. Click here.