Dr. Arthy Saravanan Discusses Early Breast Cancer Detection with ARA’s Mammography


Anchor: Welcome back to We Are Austin. This month we wear pink for Breast Cancer Awareness but, unfortunately, it’s something that affects people every day of the year.

Dr. Arthy Saravanan, a breast imaging radiologist with ARA, is here to share some very important information about women’s health. I’m always happy when you’re here because I learn a lot and you help people be really proactive with their own health. So, what would you say is the most important thing that women know when it comes to breast cancer?

Doctor: Well, I think the most important thing to remember is that breast cancer today is more survivable than it has ever been.

Anchor: Good.

Doctor: And the reason for this is because of early detection by mammography.

Anchor: Mmmhmm.

Doctor: We can sometimes find masses that are very small, years before a lump can actually be felt by the patient.

Anchor: Wow, and that’s exactly the kind of thing you want to hear, that there is hope. So, what is the chance a woman will get breast cancer in her lifetime?

Doctor: Yeah. So, a woman will be diagnosed, 1 in 8 women actually will be diagnosed with breast cancer in her lifetime. The good thing is that 98% of breast cancers that are detected early by mammography are actually survivable.

Anchor: Good, that’s good to hear. So, then when do you start to getting mammograms?

Doctor: So, according to American College of Radiology, you should start getting a mammogram at the age of 40 and yearly thereafter.

Anchor: Okay.

Doctor: Sometimes if you’re high-risk, the screening may begin even earlier. So, I recommend that you speak with your doctor if you need to have additional genetic testing for high-risk factors that may require you to start earlier.

Anchor: So, let’s say that you get a mammogram and then you get a call back. I’m sure there’s a lot fear that happens for people after that. What do you do? What does that mean?

Doctor: Yeah, so callbacks are not uncommon. Let me give you a statistic. Out of every 1,000 women who get a screening mammogram, approximately 100 will be called back for additional imaging.

Anchor: Okay.

Doctor: That’s 10%. So, out of the 100 that are called back, 20 will have biopsies recommended to them and out of the 20, 5 will have cancers detected. So, that’s 5 women in 1,000 that are called back¬ .5 to 1%. Now what are some of the reasons for a callback?

Anchor: Yeah.

Doctor: So, we usually interpret the imaging and determine if something looks suspicious or abnormal. So, four reasons for a callback. Number one is if we see a suspicious mass or a tumor or maybe some architectural distortion in the breast.

Anchor: Mmmhmm.

Doctor: Another reason is if there’s calcifications in your breast. Now calcifications are dense deposits of calcium that are seen in the breast. Most of the time they’re benign. We see them very commonly in women of all ages.

Anchor: Okay, good to know.

Doctor: But sometimes they can reflect a precursor to malignancy. So, in this case the radiologist will call you back and do additional magnification views. We can characterize these calcifications better to see if they’re actually suspicious for cancer.

Anchor: Mmmhmm.

Doctor: Another reason is if we see an asymmetry, which just means that the tissue we are looking at looks different from the surrounding breast tissue and also looks different from the other breast.

Anchor: Okay.

Doctor: Now the last reason is not a true reason, but it has to do with your breast tissue density.

Anchor: Mmmhmm. And can you speak a little bit more. What is dense breast tissue?

Doctor: Yeah, so breast tissue density just means that the composition of your breast tissue is made more of connective and glandular tissue than fat.

Anchor: Okay.

Doctor: It doesn’t necessarily increase the chance or risk of breast cancer, but it does make it a little more difficult to detect breast cancer in mammography.

Anchor: And so, how would someone know, how would a woman know she has dense breast tissue?

Doctor: So, when you come to ARA and our radiologists review your mammograms, you will be sent home with a letter. And the letter will indicate where your breast tissue density in which category it falls into.

Anchor: Okay.

Doctor: There are four categories of breast tissue density: Fatty, scattered fibroglandular, heterogeneously dense, and extremely dense. Fat is generally dark or black on mammograms and connective where glandular tissue is whiter. So, you can see that as we progress in tissue density, the mammograms look whiter.

Anchor: Yeah.

Doctor: So that’s essentially what it means. And we do recommend that once you have extremely dense or heterogeneously dense breast tissue, you may be considered for adjunctive screening either with ultrasound or MRI.

Anchor: Gotcha, okay. Really good to know. What about, what are some of the other things that you typically see? Because you’re doing this day in and day out.

Doctor: Yes.

Anchor: With so many patients. Yeah.

Doctor: So, I’ve just brought a few examples to show you what I typically see. So, many people wonder what a cyst is. A cyst is essentially a benign lesion that we see in the breast.

Anchor: Okay.

Doctor: Ultrasound is a great tool to diagnose that and here on ultrasound imaging, you can see that the cyst is black. It’s fluid-filled.

Anchor: That’s what’s happening here? Okay.

Doctor: Yes, and you can see that the margins are very circumscribed.

Anchor: Yeah.

Doctor: As opposed to a cancer there on that side, where the margins are quite irregular, it’s a very solid mass and if we put on Doppler evaluation or color flow, you can see that it has some vascularity.

Anchor: How interesting.

Doctor: Here’s another example. This is actually a fibroadenoma which is also a benign tumor that we see very frequently in young women.

Anchor: Oh, okay.

Doctor: When we compare that to a cancer as well, you can see how well defined these margins are.

Anchor: Wow.

Doctor: Where the cancer is very irregular.

Anchor: Yeah, so you can get a lot of information from these screenings.

Doctor: Yes. Most definitely. And this is just some additional imaging that we do. This is actually an example of a spiculated mass or a cancer. And you can see how it can hide behind the dense breast tissue.

Anchor: Mmmhmm.

Doctor: But when we do an MRI, the cancer, over there to the right, really lights up.

Anchor: Yeah.

Doctor: So, it causes enhancement.

Anchor: So, do you find that women are getting screened?

Doctor: It is, it’s alarming how many women over the age of 40 don’t actually have their screening mammogram scheduled in Austin.

Anchor: Yeah.

Doctor: I really suggest that if you know a woman over the age of 40 you really encourage her to have her mammogram scheduled.

Anchor: Mmmhmm.

Doctor: You know, early detection does really save lives. We make it pretty easy here at ARA. You can schedule online at ausrad.com. You can go to one of our 13 locations across central Austin.

Anchor: Great, and you do, you make it so easy and you make the information digestible. Which I’m sure is really comforting cause that can be a scary environment for anyone just to go in for a test like that.

Doctor: Absolutely.

Anchor: Thank you so much, you mentioned 13 locations all over Austin, so that no matter where you live in the city, you guys re ready to serve. You can head to the website ausrad.com

Thank you for being here.

Doctor: Thank you for having me.

Anchor: And for all that great info.

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