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New, more aggressive tests detect cancer

Dr. Ruthane Reginella, director at Butler Health System's Women's Imaging Center at the Crossroads Campus on Oneida Valley Road, said breast ultrasound and MRI are being offered to certain patients in addition to mammograms
MRI, ultrasound offered at BHS

SUMMIT TWP — Two new tests for the 40 percent to 50 percent of women with very dense breasts could detect cancer earlier and make a full recovery more possible.

Dr. Ruthane Reginella, the director at Butler Health System's Women's Imaging Center at the Crossroads Campus on Oneida Valley Road, said breast ultrasound and MRI are being offered to certain patients in addition to mammograms.

She explained that breast density is rated in four categories, 0 to 25, 26 to 50, 51 to 75, and 76 to 100.

Women who fall into the two highest categories are now offered ultrasound or MRI imaging, depending on Reginella's or another doctor's recommendation.

She said women with dense breast tissue have a greater chance of being diagnosed with cancer in the tumor's later stages because mammography does not always catch small tumors.

Even with 3-D mammograms, some small tumors can be missed in women with very dense breast tissue, Reginella said.

“There is an increased risk of breast cancer if a woman has dense breasts, especially that extremely dense category,” Reginella said.

She said screening mammography, or the tests all women have once per year, detects cancer in seven or eight of every 1,000 women screened.

With breast ultrasound, an additional three cancers can be detected. A breast MRI can find 10 more per 1,000, Reginella said.

But she cautions women to continue to schedule their regular mammograms, which can detect calcification that can mean cancer, while the new tests might not.

“Mammography is still the starting point to screen the breast,” Reginella said.

Breast ultrasound testing was not included in the Affordable Care Act, which requires insurance companies to pay for mammograms.But a bill is currently before the state Legislature that would require insurance companies to pay for breast ultrasound testing.“It's up for a vote ... which is nice because October is Breast Cancer Month,” Reginella said.Regarding breast MRI, insurance companies will pay in certain circumstances, such as a breast cancer history, a new diagnosis or implant integrity issues, Reginella said.But an MRI is not covered if the answers on a breast cancer questionnaire determine a woman has less than a 20 percent lifetime risk of developing breast cancer.So, the Women's Imaging Center is offering an abbreviated version of a breast MRI for an out-of-pocket cost of $250.“This is a shorter, more simple exam than the fullblown breast MRI because it is for screening purposes,” Reginella said.

Genetic testing is also offered at the time of the mammogram, and a questionnaire asks women about their family history regarding all women's cancers.The questionnaire is given to women at the registration desk. If a woman qualifies based on her answers, she is offered a phone conversation with a geneticist to determine whether she should have a blood or saliva test.Those tests can find markers for particular cancers that the woman could have inherited.“That's how we educate our patients and identify not only breast, but other cancers as well,” Reginella said.The Women's Imaging Center added 3-D mammography in 2015 to increase breast cancer detection, and has now heightened the facility's capabilities even further with the addition of breast ultrasound and MRI.“It's so exciting with all the new technologies we are rolling out,” Reginella said. “I think it is really going to help our community and detect more cancers earlier that can be curable.”

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