Mammograms and Ultrasounds Aid in Breast Cancer Detection

with Patrick McWey, M.D., Radiologist, Columbia St. Mary’s

Posted: Oct. 1, 2005

The importance of mammograms and ultrasounds in the detection of breast cancer can’t be understated, said Patrick McWey, M.D. He cited the significant fact that about 12 percent of all women in the United States will have breast cancer during their lifetimes.

“The current recommendation from both the American College of Radiology (ACR) and the American College of Surgery (ACS) is for women at age 40 to begin annual mammogram examinations,” explained Dr. McWey, a radiologist at the Van Dyke Haebler Center for Women’s Imaging at Columbia St. Mary’s Columbia campus.

Patrick McWey, M.D., Radiologist, Columbia St. Mary’s "It’s important to encourage women who have breast cancer symptoms and need a biopsy to accurately diagnose their situation, to go to a center that provides all types of biopsies."

“However, if there’s a family history of breast cancer diagnosed at an early age in a first degree relative, it’s recommended that screenings begin approximately 10 years before the breast cancer was diagnosed in that close relative. For example, if a woman’s mother had been diagnosed with the illness at age 45, the daughter should begin screening at age 35.”

Breast self-exams
According to Dr. McWey, all women starting at age 20 should be doing breast self-exams monthly, and continue throughout their lives, along with regular visits to their doctors.

“While breast cancer is uncommon in women under 30, it does occur,” he said.

“Self examination is very important. There have been some studies demonstrating that self-exams are effective in finding lumps in the breast, which may necessitate biopsies. I’ve seen a number of women under age of 30 who have found lumps that have turned out to be cancer. If they hadn’t done self exams, their chances of survival would have been reduced.”

Dr. McWey strongly advises women who feel a new lump or see a spontaneous discharge (either clear or bloody) from their nipples while doing a self-exam to seek the attention of their doctor immediately and get a mammogram and ultrasound screening. Because some cancers are not visible on mammograms, particularly in young women with dense breasts, they need to be evaluated with both mammography and ultrasound, he emphasized.

Detection methods
“People today are very aware of mammography because for the vast majority of women it’s the best screening tool we have,” he said. “But it’s not foolproof. It doesn’t detect all cancers, which is why ultrasound, while not as well known by the general public, is very important.”

Dr. McWey said that the newer technology of magnetic resonance imaging (MRI) today is used more and more frequently to screen women with strong family histories of breast cancer and women who had been diagnosed previously with the disease.

It’s not a screening tool to be used for the general population, he explains, but it is effective for women at high risk — those with BRCA-1 or BRCA-2 gene mutations that predispose to early development of breast cancer.

“It’s important to encourage women who have breast cancer symptoms and need a biopsy to accurately diagnose their situation, to go to a center that provides all types of biopsies,” he said. “Biopsies, in most cases can be done as a minimally invasive biopsy. That’s the best way to diagnose the abnormality. Because roughly 75 percent of all biopsies are benign, we don’t want to do major surgery for everything that’s been found on a mammogram or ultrasound.”

He believes that women should be their own health advocates. “They should come to believe that they can play an important role in their breast care by paying close attention to their bodies and to their symptoms and immediately follow up with their doctors, if necessary.”

Full-field digital mammography
The Van Dyke Haebler Center for Women’s Imaging at Columbia St. Mary’s has four mammogram and two ultrasound machines for breast imaging. It is the first center in Wisconsin to offer full-field digital mammography. This computerized technology provides multi-dimensional views of the breast.

Radiologists can manipulate the image on the computer to aid in detection of an abnormality, enlarge without losing clarity, or zoom in on a suspicious area. These capabilities increase the ease with which radiologists can detect early changes in the breast.

Next-day results are provided for screening mammograms and same-day results are provided for diagnostic mammograms. Other services provided include minimally invasive biopsies using state-of-the-art techniques like ultrasound-guided needle and sterotactic vacuum-assisted biopsies. Women receive results within 24 hours.

Additionally, a breast health clinician provides personal education and counseling for women undergoing biopsies or diagnosed with breast cancer.

Patrick McWey, M.D.
2025 E Newport Ave.
Milwaukee, WI 53211
(414) 961-3841

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