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Breast Density Awareness: What Every Woman Should Know

POSTED ON TUESDAY, OCTOBER 22, 2013 AT 12:09 PM by Dr. Marc Liebeskind

October is Breast Cancer Awareness Month. All month long we are reminded of the strides we have taken as a nation towards improving detection and treatment of this disease. More survivors are among us than ever before, and early diagnosis is still the best protection in the battle against breast cancer.

Park Avenue Radiologists, P.C., we offer an array of breast imaging services in NYC including screening and diagnostic mammography, breast MRI, ultrasound, and image guided biopsies. These diagnostic tools are used to successfully find breast cancer in its earliest stages, giving the patient more effective treatment options. Raising awareness of the importance of screening and women being diligent about their breast health has contributed to a 34% decrease in death rates from breast cancer in the US since 1990, according to a new report from the American Cancer Society. In July of 2012, NYS Governor Andrew Cuomo signed a piece of legislation designed “to help improve breast cancer detection and prevention” by requiring that mammography patients in New York State be informed if dense breast tissue is found during their examination. In recent news, there is a push towards creating a national law requiring all states to inform patients if dense tissue is found during a mammogram. US Rep. Rosa DeLauro will introduce a breast density inform bill in the House later this month.[1]

  • Why is it important to know if I have dense breast tissue?

A mammogram uses X-ray technology to image the breast tissue and detect tumors. Dense breasts have a relatively high proportion of glandular or connective tissue, which can obstruct the X-ray increasing the odds that a tumor or other abnormality exists which may not be visible by mammography alone. Non-dense breasts have more fat, which X-rays penetrate easily. Dense breast tissue also may be associated with an increased risk of breast cancer.

  • Is it abnormal to have dense breasts?

No. It is not abnormal to have dense breasts. Approximately 40 percent of women who have mammograms have dense breast tissue. Younger women are more likely to have dense tissue, but as many as 25 percent of older women do, too.[2] The American College of Radiology has a 1-to-4 density grading scale. But only 10 percent of women have extremely dense breasts, and 10 percent have fatty breasts. The remaining 80 percent have a mixture.[3]

  • How can I tell if I have dense breasts?

Your breast density cannot be judged by touch, but is evident on the images acquired during a mammogram. If you have dense breasts, following your mammogram at Park Avenue Radiologists, P.C. you will receive a letter stating:

"Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal. However, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with an increased risk of breast cancer. This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician."

  • Are there other screening options if I have dense breast tissue?

Breast MRI and Ultrasound are commonly used in conjunction with mammography. Your provider and you can discuss your risk of breast cancer and decide if additional screening is appropriate for you. Whether or not you have dense breast tissue, mammography is not a perfect study. Five to 10 percent of all screening mammography result in a "false positive finding". This means that results appear abnormal and additional studies are required (ultrasound, fine needle aspiration and biopsy) with the subsequent testing proving no cancer. Normal breast tissue appears different in each woman and the slightest movement or trace of deodorant, powder, lotion can compromise the image. Prior breast surgery, the presence of implants (silicone or saline) can block the view of tissue.

Breast MRI may be an appropriate test in addition to mammography for patients with a strong family history of breast cancer (i.e., mother/ sister with breast cancer before age 50).

Breast MRI may also be helpful in patients recently diagnosed with breast cancer who desire breast conservation therapy or where there is concern for tumor recurrence versus scar. Non contrast breast MRI is also the best test to evaluate breast implant integrity.

 

  • What advances are being made in dense breast screening tools?

Breast MRI is a possible alternative and, according to AuntiMinnie.com, a Michigan breast specialist believes he has changed the equation with a streamlined breast MRI screening exam that could be ready for widespread clinical use.[4]

Park Avenue Radiologists offers our patients state of the art Open 1.5 Tesla MRI’s in New York. The ultra-short bore on the machine provides for the maximum openness and patient comfort without compromising clinical results. Our MRIs are continually upgraded and are enabled for multiple specialized applications including Breast Imaging and MRI Breast Biopsy, Peripheral MRA and Cardiac Imaging. We provide MRI guidance for core biopsy of lesions only visualized on breast MRI, which is something very few outpatient facilities are able to provide.

At Park Avenue, continuing education is stressed to keep abreast of new developments in technology and medical research. We welcome you to contact our knowledgeable personnel with any questions or concerns regarding your imaging needs at info@parkavenueradiologists.com or 212-888-1000. Stay Connected. Join our discussions with patients on Facebook, Twitter, and Google+.

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[1] Seegert, Liz . “A Push For A National Law On Breast Density Notification.” The Courant. 14 Oct. 2013. http://articles.courant.com/2013-10-14/health/hc-breast-density-20131014_1_dense-breast-tissue-breast-cancer-screening-cancer-detection. Retrieved 18 Oct. 2013.

[2] Grady, Denise. “New Laws Add a Divisive Component to Breast Screening.” New York Times. 24 Oct. 2012. http://mobile.nytimes.com/2012/10/25/health/laws-tell-mammogram-clinics-to-address-breast-density.html?f=19. Retrieved 18 Oct. 2013.

[3] McCullough, Marie. “States want patients to know breast tissue density for breast cancer screenings, but is that a good thing?” Med City News. 13 Oct. 2013. http://medcitynews.com/2013/10/latest-breast-cancer-screening-trend-states-want-patients-know-breast-tissue-density-good-thing/#ixzz2i6VmuQDb. Retrieved 18 Oct. 2013.

[4] Yee, Kate Madden. “New breast MRI exam ready to screen women with dense breasts.”  Aunt Minnie. 16 Oct. 2013. http://www.auntminnie.com/index.aspx?sec=sup&sub=mri&pag=dis&ItemID=105131. Retrieved 18 Oct. 2013.

 

Park Avenue Radiologists Welcomes Our Newest Physician, Renu Chundru, MD

POSTED ON MONDAY, SEPTEMBER 30, 2013 AT 6:13 PM by Dr. Marc Liebeskind

The doctors and staff at Park Avenue Radiologists, P.C. are pleased to welcome Renu Chundru, M.D. to our team of Board Certified radiologists! Dr. Chundru joins our specialists with an impressive background of educational and clinical expertise.

After graduating with highest honors from the University of Pennsylvania, Dr. Chundru earned her M.D. from Yale University School of Medicine. Dr. Chundru continued her clinical education following medical school by serving as an internal medicine intern, clinical ophthalmology resident, clinical radiology resident, and neuroradiology fellow.

Dr. Chundru has published original articles in peer reviewed journals including the European journal of radiology and the Yale Journal of Biology and Medicine, and has presented at meetings of the American Society of Neuroradiology, Pediatric Academic Society, as well as the Radiological Society of North America. Dr. Chundru continues to keep abreast of new developments in technology and medical research, having contributed to clinical research at Yale University School of Medicine, The Children's Hospital of Philadelphia, and University of California San Francisco. Learn more about Dr. Chundru:

 

At Park Avenue Radiologists, we strive to provide patients with unparalleled imaging services. Patient care is the utmost importance to our teams of dedicated physicians and staff members. Our private radiology facility has been accredited by the American College of Radiology and is fully licensed by the state of New York, meaning we are held to the highest standards of care. We offer advanced radiology in New York including, Open MRIPET-CT Scan, Cat ScanBone Density Scan, Biopsy and Breast Imaging.

We look forward to working with Dr. Chundru and welcome our patients to come and meet our newest expert! Our team of compassionate personnel is ready to assist you regarding any questions you may have concerning your radiology needs in Manhattan. To contact our office today, call 212-888-1000, email info@parkavenueradiologists.com, or request your appointment online.

 

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Expanded Breast Cancer Screening Compliance Needed for Younger Women: Mammography in NYC

POSTED ON MONDAY, SEPTEMBER 09, 2013 AT 6:30 PM by Dr. Marc Liebeskind

A new study published online September 9 in the journal  Cancer indicates that regular mammography screening significantly reduces breast cancer deaths- particularly in the 40-49 year age group.

Mammography plays a critical role in the early detection of breast cancer. The American Cancer SocietyAmerican Congress of Obstetricians and Gynecologists(ACOG), American College of Radiology and Society of Breast Imaging recommend annual screening mammography for women beginning at age 40. 

In the study, researchers tracked invasive breast cancers diagnosed between 1990 and 1999 and followed the patient cases through 2007 using failure analysis to investigate the value of mammography screening. Failure analysis is an analytical tool that examines a 'failure'- in this case a death from breast cancer- and why it occurred in order to discover correlations between the patients who died and whether they received breast screening. 

The study concluded that most deaths from breast cancer occur in unscreened women. To maximize mortality reduction and life-years gained, initiation of regular screening before age 50 years should be encouraged.

According to a statement released by the American College of Radiology (ACR) in conjunction with the Society of Breast Imaging (SBI), "the study, which involved 7,301 patients, found that 71 percent of confirmed breast cancer deaths occurred in the 20 percent of the study population that did not receive regular mammograms. The majority of those who died from breast cancer never had a mammogram prior to diagnosis. If treatment were the primary survival factor, deaths would not have been so prevalent among the non-screened group."

Among 609 confirmed breast cancer deaths, 29% were among women who had been screened with mammography, while 71% were among women who were not screened. Also, the women who died of breast cancer were younger: Of all breast cancer deaths, only 13% occurred in women age 70 or older, but 50% occurred in women younger than 50, according to AuntMinnie.com.

"'This study should effectively end confusion over when, and particularly if, women need to begin screening. Every year, breast cancer takes too many of our mothers, wives, sisters and friends. While these findings cannot bring back those already lost, they clearly demonstrate that mammography saves lives, and many more deaths can be avoided through regular screening,' said Murray Rebner, MD, FACR, president of the Society of Breast Imaging," -ACR, SBI Statement on Cancer Study: More Breast Cancer Screening Needed in Younger Women

All women should also perform monthly self breast examinations and have a clinical breast exam performed by their Gynecologist or Primary care Physician annually. 

To schedule your annual mammography in NYC with our expert radiologists at our Upper East Side facility, please contact our courteous personnel at 212-888-1000, scheduling@parkavenueradiologists.com, or schedule your exam online

  • Mammography should be scheduled after your period.
  • On the day of you procedure, do not wear any deodorant, talcum powder or lotion in the breast or underarm area.
  • Bring any prior mammography films you may have and give them to the technologists before your study begins.
  • Tell the technologist if you have implants or any pain, lumps, nipple discharge etc.
  • A letter will be sent to you informing you of your results and any necessary follow-up. Allow a week's time and contact your referring physician for instruction. 

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Conquering Fears Surrounding Early Detection: Screening and Diagnostic Imaging in NYC

POSTED ON MONDAY, AUGUST 26, 2013 AT 10:45 AM by Dr. Marc Liebeskind

Take a moment to consider the long term benefit of certain tests and screenings.

At Park Avenue Radiologists, P.C., your health is of the utmost importance to us. Our knowledgeable team encourages our patients and our New York City community to make informed health decisions that are most beneficial to them, as recommended by a healthcare professional.

We understand that the first step in taking control of your health is knowing. Your health is what motivates our dedicated Board Certified radiologists to vigilantly examine the images captured during your exam and promptly report their precise findings back to your doctor.

 

In a recent article, New York Times Wellness blogger Jan Hoffman explores a new study on the psychology behind our healthcare decisions. According to the article, “When researchers ask people why they resist getting tested, reasons like cost, ignorance of the disease’s facts and intrusiveness of the procedure are often cited. But one of the most common barriers to being tested — or finding out the test results — is fear.” To read the full article visit:

At Manhattan’s Premier Radiology Practice, we understand that some of our patients come to us with real uncertainties regarding their diagnostic exam. Our knowledgeable team works hard to reduce any stress that may be associated with a particular exam. The diagnostic and screening exams offered at Park Avenue Radiologists, P.C. are an important part of your healthcare journey. They aide your referring physician in making appropriate suggestions for treatment planning, surgical options, and mapping a plan of care with you.

 

From our Open MRI studies to Mammography, PET-CT and Cat Scans, to Ultrasounds and Biopsy, the report that is dictated by our team of doctors and sent to your doctor should be looked at as empowering, not fearsome. Once an accurate diagnosis is made, you are then able to make informed decisions with your doctor, taking the appropriate steps to relieve the symptoms that caused a need for an examination.

Accurate diagnosis and preventative screening exams are linked to an increased lifespan, greater treatment options, and less invasive surgeries to name a few benefits.

At Park Avenue Radiologists, P.C., we are aware of the importance of moving past the apprehension of the unknown, of being persistent with check-ups, and of seeing a specialist when recommended based on symptoms to greatly increase the chances of being accurately diagnosed and cured. The survival rates of cancer, for example, have significantly increased in the past 30 years, with earlier diagnosis playing an important role. Proper, speedy, and accurate diagnosis is our responsibility. Our service to you is to aide in your longevity.

To speak with one of our representatives regarding your radiological examination in our New York City facility, please contact our personnel at info@parkavenueradiologists.com or 212-888-1000. 

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“Afraid to Get Tested? Slow Down and Think About It” by Jan Hoffman Retrieved 2013-8-20.

 

Lung Cancer Screening Criteria Examined: CT Screening in NYC

POSTED ON MONDAY, JULY 22, 2013 AT 11:26 AM by Dr. Marc Liebeskind

According to a study published in the July 18th issue of the New England Journal of Medicine, when the criteria for Lung Cancer screening with Computed Tomography (CT) is refined using additional patient risk factors, the screening exam is even more effective. By dividing the 26,604 CT-screened individuals from the original National Lung Screening Trial (NLST) into five risk categories, the new study found that the screening exam prevented far more deaths in the patients in higher risk categories. From this study, researchers hope to develop a risk calculator that could be used to better target lung screening in the future.

Lung cancer is the leading cancer killer in both men and women in the United States. In 1987, it surpassed breast cancer to become the leading cause of cancer deaths in women. Lung cancer screenings in New York City with low-dose CT, available at Park Avenue Radiologists, P.C., have been proven effective in reducing lung cancer mortality by 20% in patients that met the NLST criteria.

When comparing the effectiveness of lung screenings in preventing lung cancer deaths with that of other screening exams, the low-dose CT screening exam fares positively. The new study shows that the number of people needed to be screened to prevent one lung cancer death was 161 for individuals in the highest-risk category of the study. To compare mammography, which is widely proven effective in the prevention of breast cancer deaths, has a number of 740-2,000 (depending on the analysis used) individual screenings needed to prevent one breast cancer death.

Low-dose CT screening should be recommended for those people who meet NLST criteria:

  • Current or former smokers aged 55 to 74 years
  • A smoking history of at least 30 pack-years
  • No history of lung cancer

If you meet the above criteria, or know someone who does, speak to your doctor to decide if a lung screening exam at Manhattan’s Premier Radiology Practice, Park Avenue Radiologists, P.C., is suitable for you. If you are not in this group but have concerns over your lung health, talk to your doctor about your concerns. A lung cancer screening may save your life or the life of a loved one. The risk for lung cancer varies by the individual.

Patients undergoing a screening exam should be referred to a facility, like Park Avenue Radiologists, P.C., that is committed to “best practices” for safety and employs knowledgeable expertly trained radiologists. Park Avenue Radiologists is fully licensed by the state and accredited by the American College of Radiology (ACR) in all modalities including MRI, CT, Ultrasound and Mammography. The ACR awards accreditation to facilities for the achievement of high practice standards after a peer-review evaluation of image quality and procedures.

Park Avenue Radiologists continues to install the latest multidetector CT technology on an ongoing basis to provide the highest quality CT scans in NYC with advanced applications for angiography and cardiac studies, virtual colonoscopy and other 3D applications. The doctors and staff of Park Avenue Radiologists, P.C. take every precaution against overexposure to radiation and provide the latest, highest quality technology to all patients. Click here to learn more about the most recent developments in technology used to secure our commitment to patient safety.

The American Cancer Society’s estimates for lung cancer in the United States for 2013 are approximately 228,190 new cases of lung cancer and an estimated 159,480 deaths from lung cancer, accounting for about 27% of all cancer deaths. The best way to prevent lung cancer is to never smoke or to stop smoking now. If you are still smoking, talk to your doctor about ways to help you quit smoking.

For more information on Lung Cancer Screening with low-dose CT, contact us at info@parkavenueradiologists.com or call 212-888-1000.

Visit ParkAvenueRadiologists.com for expedited scheduling, bill pay, additional information, and directions. Stay connected. Follow us on social media: Facebook, Twitter, Google+. You can now sign up for our email newsletter to receive your health related news directly!

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Original Article, as published in the July 18th issue of the New England Journal of Medicine:

AuntMinnie.com: NEJM: Refining lung cancer screening criteria boosts CT efficacy 

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