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The role of OB/GYNs in delivering personalized breast care

July 03, 2019
Ultrasound Women's Health
From the July 2019 issue of HealthCare Business News magazine

By: Dr. Serena Tidwell

As obstetrician-gynecologists (OB/GYN), we play a significant role in the overall health of our patients.
The well-woman examination — an annual health check-up for breast and gynecological diseases — often leads to a broader discussion of a patient’s overall health. For many patients, this may be their only general healthcare exam, so we need to make it count.

There’s no doubt among the medical community that breast health is an important part of wellness. Yet, we often see a lot of confusion around breast screening recommendations from various healthcare authoritative bodies. At what age should we start screening? How often? When to stop? As OB/GYNs, we are frequently looked to as experts to guide our patients, even though there is little focus on breast care in medical school. At my clinic, we’ve taken this responsibility seriously and have created clear guidelines with the objective to personalize breast care for our patients.

I opened Pink Monarch Breast Center in 2012 as a subsidiary of our OB/GYN practice to increase our patient screening rates. I saw too many patients who were not going for annual mammograms. Fortunately, this significantly changed when I was able to conveniently schedule the mammogram at the same time and location as their physical exam.

Early detection of breast cancer is critical. In fact, finding it early reduces a woman’s risk of dying from the disease by 25-30 percent or more. If the cancer is only located in the breast, the five-year survival rate is 99 percent. Even for cancers found at stages one and two, chemotherapy can be avoided in 70% of cases.

We also offer a personalized and multi-modality screening approach because we know that no two women are the same. There are a variety of genetic and lifestyle factors that create a woman’s individual risk of breast cancer.

In recent years, there has been an increased focus on the risks associated with having dense breast tissue. Specifically, there is the risk of masking on a mammogram (both cancer and dense tissue appear white, making cancer hard to spot). In addition, dense breast tissue composition may encourage cancer to grow. Approximately 40% of American women have dense breast tissue, which means almost half of the patients we see daily are women with dense breast tissue. This single risk factor increases the likelihood of these patients being diagnosed with breast cancer.

While mammography remains the gold standard to detect breast cancer, there are supplemental technologies that can improve cancer detection in dense breasts. At Pink Monarch Breast Center, we offer automated breast ultrasound (ABUS), which can help see through dense tissue. I have seen first-hand the benefits that supplemental screening can offer our dense breast patients. Most notably, our cancer detection rates have increased by finding small cancers missed by 2D and 3D mammography.

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