Staying watchful for health issues related to the breast, and taking the optimal and most timely care steps in breast health, is important for a woman and can mean the difference in a woman's health. Just as important as understanding the latest age-related recommendations for preventive breast x-rays and other screening steps is finding a center for imaging that maintains advanced digital equipment and provides a service with the highest quality standards.
Kathleen Greatrex, MD, discusses the latest breast cancer screening guidelines and clears up the confusion for women wondering whether to have an annual mammogram.
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Clearing up the Confusion Surrounding Breast Cancer Screening Guidelines
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Learn more about Dr. Kathleen Greatrex
Kathleen Greatrex, MD
Kathleen V. Greatrex, M.D. is one of the nation’s leading experts on breast imaging and dedicates a great deal of time educating women about breast cancer. Dr. Greatrex graduated from Temple University School of Medicine. She was elected to membership in the Epsilon Chapter of the Alpha Omega Alpha Medical Honor Society. She completed her Residency at Temple University Hospital and her Fellowship training in Breast and Body Imaging at Memorial Sloan-Kettering Cancer Center in New York. Dr. Greatrex is President of Lourdes Imaging Associates, and serves as Chair of the Department of Radiology and Nuclear Medicine, as well as Division Chief of Breast Imaging for the Lourdes Health System. She holds the distinction of being the first female President of the Medical Staff in the 60 year history of the medical center. She has served as a board member of the Lourdes Health Foundation and in 2013 she was appointed to the Board of Trustees for the Lourdes Health System and just recently Dr. Greatrex was appointed to the Board of Trustees for Immaculata University. Dr. Greatrex has been named the first female President of the Medical Staff at Lourdes Medical Center of Burlington County with her term beginning in 2015.Learn more about Dr. Kathleen Greatrex
Transcription:
Melanie Cole (Host): Well there seems to be a lot of confusion about breast cancer screening guidelines and you’re hearing things in the media and nobody knows quite what to make of it or when they are supposed to start breast cancer screening. My guest, to clear this up for us today, is Dr. Kathleen Greatrex. She’s the chief of breast imaging at Lourdes Health System. Dr. Greatrex, explain a little bit about breast cancer. What are you seeing as far as incidents and awareness and are more women getting screened?
Dr. Kathleen Greatrex (Guest): Well breast cancer incidents still remains at one in eight in this country but it’s interesting how women do want to get screened every year with mammography for potentially God forbid finding that they have breast cancer. They did a study actually in Philadelphia and they found that 70% of the women that they – that they talked to want to get screened every year, but again there’s a lot of confusion around annual breast cancer screening with mammography after the age of 40 and every year after that. There has been no other screening, study, or test in this country or in the world that has been as important in decreasing the incidents and death rate from this disease, and I think that we have to keep that in mind and we have to know that it’s still important for women to get a mammogram every year after the age of 40, and this is what we mandate through the American College of Radiology and it’s extremely important overall.
Melanie: So then let’s dissect the screening guidelines. Who should get screened? Because some people say 40, some people say 45, does family history play a role in this? Why is there such confusion over the current recommendations?
Dr. Greatrex: Well I think as far as who should get screened, how they should get screened, screening should begin at the age of 40 and every year after that. Now if you have a first degree relative – say for example your mother or your sister had contracted breast cancer, then they should be screened 10 years prior to the time or the age that they were diagnosed. In other words, if your mother got breast cancer at the age of 40, you should begin getting screened at the age of 30. So for women who have a strong family history like that, screening should occur earlier. For women who have a genetic predisposition to breast cancer, the BRCA 1 and 2, genetic markers, then those women should be getting screened earlier as well. But remember one thing, breast cancer in and of itself is very rare when it comes to genetics. It’s only about 5% to 6% of all breast cancers that we diagnose in women have a genetic marker, so for the most part, the two most important markers or risk factors I should say for breast cancer is things that we can’t do anything about and that is age – increasing age and being a women. So those two things we can’t do anything about. We can though be vigilant about our bodies, our fat intake, our weight, making sure we get regular exercise, refrain from alcohol, at least keep it to a mild to moderate level. You don’t want to overdo that because that in and of itself can damage things like the liver and the liver is important in breaking down estrogen which naturally occurs in our bodies, even after the menopause so it’s very important to be mindful of your weight, be mindful of your alcohol consumption, be mindful of your family history. Talk to your relatives. See who has had breast cancer in your family. It may be a cue to you that there could be – that you could have an increased chance of getting the disease. It’s also important to do self breast exams. I recommend women do their self breast exams every month, especially the week after your period ends. If you don’t know how to do an exam, please ask your gynecology, ask your primary care physician because women are picking up breast lumps which can be potentially malignant and it’s important for us to be educated about the disease. I don’t think anybody knows our bodies like we do, so it’s important to keep on top of things and if you have a question, if you have concern, if you have a fear, that’s why you have a physician to help you through it, and by all means, you should also inquire with your radiologist too. The one who’s reading your mammogram. Ask questions. Say you would like to go over your mammogram with the radiologist. They’re available to you. They have the knowledge that you would need to go forward and to feel safe and secure about your mammogram.
Melanie: Dr. Greatrex, clear up a little bit of the confusion about digital mammography, 3D tomosynthesis, conventional mammography, the ultrasound, you know a whole breast ultrasound now, which is covered by insurance in some cases if you have dense breasts. Clear up some of this. Explain it all for us.
Dr. Greatrex: Well I’ll tell you digital mammography is now the standard of care for looking at the breast tissue and conventional imaging does not have the sensitivity that digital imaging has and now we’ve developed this new way called 3D tomosynthesis where actually you’re looking at the breast tissue in 3 dimensions and it’s absolutely amazing because we are able to pick up breast cancers that we otherwise miss on digital imaging. You have to understand something, 10% of all breast cancers are going to be missing on a mammogram for whatever reason but the beauty about digital tomosynthesis, this 3D imaging is that we’re able to pickup 27% more cancers. It’s more sensitive. It’s more specific when it comes to picking up these tumors. Breast density has also played a big role and it’s been in the news about how breast density can predispose you to cancers of the breast. They have found that those patients who have increased density within their breasts have a 3 to 4 times increased risk of getting or having breast cancer. So having this increase in breast density makes it more difficult to read a mammogram. That’s the beauty of 3D breast tomosynthesis. For those patients who do not have the ability to get 3D breast tomosynthesis, there’s ultrasound which is used as another name with which to screen those breasts which are of increased density on the mammogram. We can pick up cancers that otherwise would be missed. So the modalities are out there. The treatment is out there and certainly if we can get this tumor at a stage that we can find it so small enough, we can cure it. You know the size of the tumor is a direct correlate to the degree of survival. The smaller the tumor, the better odds we have of curing it, so this is why it’s so important to get a yearly mammogram. They have found that those women who have gotten yearly mammograms after the age of 40, that there’s been a nearly 40% reduction of breast cancer specific deaths in those women that have gotten them, and this just came out in August in the Journal of Cancer. So the research is out there, the findings are out there that annual screening mammograms can reduce the breast cancer specific death rate in this country and it’s about getting your mammogram at the age of 40 and every year after that, and of course remember starting earlier if you have a strong family history or a genetic predisposition to the disease. I would also like to say too that they found that those women that got screening mammograms every year after the age of 40 had a higher rate of getting other screening tests for colorectal cancer, so getting their colonoscopy, for pap smears for cervical cancers, so it’s important for us to be vigilant about our health, to be vigilant about taking care of ourselves. So that’s what we try to do, that’s what I do every day at Lourdes and you know I just want to be able to say if you take care of your body, it will take care of you.
Melanie: What a great wrap up. I don’t even have to ask you for one because that was absolutely perfect. Thank you Dr. Greatrex for really clearing that up and explaining to us about the age that we should be looking to get our mammograms, what family history is involved, and 3D tomosynthesis. Thank you so much for joining us today Dr. Greatrex. This is Lourdes Health Talk. For more information, please visit lourdesnet.org, that’s lourdesnet.org. This is Melanie Cole, thanks so much for tuning in.
Melanie Cole (Host): Well there seems to be a lot of confusion about breast cancer screening guidelines and you’re hearing things in the media and nobody knows quite what to make of it or when they are supposed to start breast cancer screening. My guest, to clear this up for us today, is Dr. Kathleen Greatrex. She’s the chief of breast imaging at Lourdes Health System. Dr. Greatrex, explain a little bit about breast cancer. What are you seeing as far as incidents and awareness and are more women getting screened?
Dr. Kathleen Greatrex (Guest): Well breast cancer incidents still remains at one in eight in this country but it’s interesting how women do want to get screened every year with mammography for potentially God forbid finding that they have breast cancer. They did a study actually in Philadelphia and they found that 70% of the women that they – that they talked to want to get screened every year, but again there’s a lot of confusion around annual breast cancer screening with mammography after the age of 40 and every year after that. There has been no other screening, study, or test in this country or in the world that has been as important in decreasing the incidents and death rate from this disease, and I think that we have to keep that in mind and we have to know that it’s still important for women to get a mammogram every year after the age of 40, and this is what we mandate through the American College of Radiology and it’s extremely important overall.
Melanie: So then let’s dissect the screening guidelines. Who should get screened? Because some people say 40, some people say 45, does family history play a role in this? Why is there such confusion over the current recommendations?
Dr. Greatrex: Well I think as far as who should get screened, how they should get screened, screening should begin at the age of 40 and every year after that. Now if you have a first degree relative – say for example your mother or your sister had contracted breast cancer, then they should be screened 10 years prior to the time or the age that they were diagnosed. In other words, if your mother got breast cancer at the age of 40, you should begin getting screened at the age of 30. So for women who have a strong family history like that, screening should occur earlier. For women who have a genetic predisposition to breast cancer, the BRCA 1 and 2, genetic markers, then those women should be getting screened earlier as well. But remember one thing, breast cancer in and of itself is very rare when it comes to genetics. It’s only about 5% to 6% of all breast cancers that we diagnose in women have a genetic marker, so for the most part, the two most important markers or risk factors I should say for breast cancer is things that we can’t do anything about and that is age – increasing age and being a women. So those two things we can’t do anything about. We can though be vigilant about our bodies, our fat intake, our weight, making sure we get regular exercise, refrain from alcohol, at least keep it to a mild to moderate level. You don’t want to overdo that because that in and of itself can damage things like the liver and the liver is important in breaking down estrogen which naturally occurs in our bodies, even after the menopause so it’s very important to be mindful of your weight, be mindful of your alcohol consumption, be mindful of your family history. Talk to your relatives. See who has had breast cancer in your family. It may be a cue to you that there could be – that you could have an increased chance of getting the disease. It’s also important to do self breast exams. I recommend women do their self breast exams every month, especially the week after your period ends. If you don’t know how to do an exam, please ask your gynecology, ask your primary care physician because women are picking up breast lumps which can be potentially malignant and it’s important for us to be educated about the disease. I don’t think anybody knows our bodies like we do, so it’s important to keep on top of things and if you have a question, if you have concern, if you have a fear, that’s why you have a physician to help you through it, and by all means, you should also inquire with your radiologist too. The one who’s reading your mammogram. Ask questions. Say you would like to go over your mammogram with the radiologist. They’re available to you. They have the knowledge that you would need to go forward and to feel safe and secure about your mammogram.
Melanie: Dr. Greatrex, clear up a little bit of the confusion about digital mammography, 3D tomosynthesis, conventional mammography, the ultrasound, you know a whole breast ultrasound now, which is covered by insurance in some cases if you have dense breasts. Clear up some of this. Explain it all for us.
Dr. Greatrex: Well I’ll tell you digital mammography is now the standard of care for looking at the breast tissue and conventional imaging does not have the sensitivity that digital imaging has and now we’ve developed this new way called 3D tomosynthesis where actually you’re looking at the breast tissue in 3 dimensions and it’s absolutely amazing because we are able to pick up breast cancers that we otherwise miss on digital imaging. You have to understand something, 10% of all breast cancers are going to be missing on a mammogram for whatever reason but the beauty about digital tomosynthesis, this 3D imaging is that we’re able to pickup 27% more cancers. It’s more sensitive. It’s more specific when it comes to picking up these tumors. Breast density has also played a big role and it’s been in the news about how breast density can predispose you to cancers of the breast. They have found that those patients who have increased density within their breasts have a 3 to 4 times increased risk of getting or having breast cancer. So having this increase in breast density makes it more difficult to read a mammogram. That’s the beauty of 3D breast tomosynthesis. For those patients who do not have the ability to get 3D breast tomosynthesis, there’s ultrasound which is used as another name with which to screen those breasts which are of increased density on the mammogram. We can pick up cancers that otherwise would be missed. So the modalities are out there. The treatment is out there and certainly if we can get this tumor at a stage that we can find it so small enough, we can cure it. You know the size of the tumor is a direct correlate to the degree of survival. The smaller the tumor, the better odds we have of curing it, so this is why it’s so important to get a yearly mammogram. They have found that those women who have gotten yearly mammograms after the age of 40, that there’s been a nearly 40% reduction of breast cancer specific deaths in those women that have gotten them, and this just came out in August in the Journal of Cancer. So the research is out there, the findings are out there that annual screening mammograms can reduce the breast cancer specific death rate in this country and it’s about getting your mammogram at the age of 40 and every year after that, and of course remember starting earlier if you have a strong family history or a genetic predisposition to the disease. I would also like to say too that they found that those women that got screening mammograms every year after the age of 40 had a higher rate of getting other screening tests for colorectal cancer, so getting their colonoscopy, for pap smears for cervical cancers, so it’s important for us to be vigilant about our health, to be vigilant about taking care of ourselves. So that’s what we try to do, that’s what I do every day at Lourdes and you know I just want to be able to say if you take care of your body, it will take care of you.
Melanie: What a great wrap up. I don’t even have to ask you for one because that was absolutely perfect. Thank you Dr. Greatrex for really clearing that up and explaining to us about the age that we should be looking to get our mammograms, what family history is involved, and 3D tomosynthesis. Thank you so much for joining us today Dr. Greatrex. This is Lourdes Health Talk. For more information, please visit lourdesnet.org, that’s lourdesnet.org. This is Melanie Cole, thanks so much for tuning in.
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