Breast Center: Better screening process for earlier detection

In 2002, 110 women died each day from breast cancer. In 2012, 110 women still die each day from breast cancer because it wasn’t detected early enough.

Women with dense breast tissue — some 15 million in the U.S. alone — now have better options for earlier detection of breast cancer than their annual mammogram can provide.

Dr. Kevin Pope, with the Breast Center of Northwest Arkansas, said this technology known as SonoCine, is an automated ultrasound that provides a clearer image of breast tissue and developing cancers in women that have dense, glandular breasts.

The Breast Center in Fayetteville is the only clinic in the state to offer this new screening process that was approved by the FDA in 2008. Pope said it has taken that long for the medical community at large to see the benefits of a screening process that insurance still does not cover.

SonoCine does not replace a mammogram, but is intended as a supplemental test for women over 40 who have dense tissue. Dr. Stacy Smith-Foley, also of the Breast Center, said mammograms can miss about 50% to 60% of the cancers in women with dense breast tissue.

Pope recalls at least local two local women diagnosed in recent months who could have have benefited from earlier detection if there had been affordable access to this new screening.

Chiqueeta Jameson knows too well what that feels like. While she’s not local to Northwest Arkansas her story rings true with many who are. Jameson is a breast cancer survivor on a mission to educate women with dense breast tissue about their options. She is also a spokeswoman for SonoCine and a breast health advocate.

She said “95% of the women who are dense, don’t know it.” By dense, she means the 40% of women in the U.S that have dense breast tissue.

Women like Jameson, are often told they have dense breast tissue after cancer has been detected because they found they lumps themselves.

Jameson said by the time a cancer can become palpable amid dense breast tissue it has likely grown from 5 millimeters to 1 centimeter and can mean the difference between a stage one lumpectomy and a mastectomy with a regimen of chemotherapy.

“Several years ago I had two gynecologists and one breast surgeon tell me I didn’t have cancer based on mammograms taken in the month of April, June and September. But in December of that same year I sought out another opinion from Dr. Kevin Kelly in Venice, Calif., After looking at my mammogram Dr. Kelly said my breast tissue was too dense and he couldn’t see anything conclusively so he ordered an ultrasound because he knew it provided more clarity in dense tissue,” Jameson said.

Long story short, Kelly spotted a suspicious lump. He biopsied it immediately to find invasive ductile carcinoma that was estrogen sensitive in Jameson. Because the cancer had grown to exceed one centimeter and there was minimal lymph involvement the prescribed treatment was that required surgery and 8 rounds of chemotherapy.

She said the cancer was growing aggressively while undetected by trained physicians. 

“If I had known there was a better test for my breast tissue type when I first suspicion the cancer I would have asked for it. That is my mission today is to let women like me know there are better ways to see through dense breasts than mammography,” Jameson said.

Pope and his colleagues at the Breast Center are training with Jameson this week and next to use the new technology which they are leasing from SonoCine. The cost of the machine is $185,000 and as of now, this is the only one being used in the state.

The Breast Center will charge $275 for the examination using the SonoCine ultrasound, and in most cases it’s not covered by insurance.

Pope said women should have their regular mammograms, perform monthly self-check exams and make sure their doctors do breast exams during annual visits. He said this three-prong approach is the best defense for women of all ages.

He encourages women to ask their doctors or technologists if they detect dense breast tissue when viewing a mammogram. If that’s the case, Pope said women over 40 might be a candidate for the SonoCine ultrasound and they should have that option.

The SonoCine ultrasound screens the entire breasts and the lymph areas under both arms and takes about 25 minutes. This technology can detect invasive cancers as small as 5 millimeters in dense tissue, according to two blind studies conducted in 2010 and published in European Radiology. Jameson said dense breast tissues show up white in a mammogram that often camouflages the cancer that also shows up white. That is why cancer is missed 50% of the time in women with dense breast tissue.

“Think of it this way. Try dropping a white pearl into a bowl of snow and see how easy it is to find. That’s what a doctor sees when he’s looking for cancer in dense tissue. In an ultrasound, the cancer registers as black against the white tissue,” she said.

Pope said it’s going to take more time and education of health care insurers before this technology is covered by routine insurance as a screening process. In the meantime Pope expects his team will try and get some grant help that might be able to defray some of the costs for women who could benefit from this new technology but need assistance covering the $275 cost.

The Breast Center will began taking appointments for the new screening process on July 30.

Pope said major strides have been made in treatment protocol once cancer is detected, but the best way to increase survival rates and mitigate treatment costs over the long term is to detect the cancer as early as possible.

Last year there were an estimated 230,480 new cases of invasive breast cancer diagnosed among women, as well as an estimated 57,650 additional cases of in situ breast cancer, according to the American Cancer Society.

“The SonoCine is a great tool to have as we continue to educate women about all their options in the fight,” Pope said.