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Jan retired from a long and successful administrative career in late 2016 and the 61-year-old mother of three was looking forward to spending more time with family and friends. Her kids were all grown and scattered across the country, and she had plans to go see them.
But before she got on the plane, she had a few things on her to-do list. One of them involved an annual screening of her breasts to make sure they were cancer-free. Jan, who asked to keep her last name private, had been getting annual mammograms since the age of 40, and in March 2017, she went for her regular 3D mammogram (tomosynthesis) at the Ft. Jesse Imaging & Gale Keeran Center for Women in Bloomington, Illinois, just a short drive from her home.
As usual, the procedure went ahead without a hitch, but when she got her results she learned something new. The radiologist told her that she was among the 40 percent of women who have dense breasts.
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Top image: A breast image from an ABUS exam. Above: Breast density is reported as one of four levels ranging from “almost entirely fatty” to “extremely dense.” As breast density increases, the ability to find cancers hiding in the white, fibrous tissue decreases. Jan’s 3D mammogram revealed that she had heterogeneously dense breasts. Therefore, it was recommended that she have additional imaging with 3D ABUS. Image credits: GE Healthcare.
Breast density is a measurement of the amount of fatty tissue versus the amount of fibrous, connective tissue in the breast. Connective tissue looks white on a mammogram, just like cancer, and may sometimes make it invisible to doctors. Some healthcare professionals say that looking for tumors in women with dense breasts can be like searching for a snowball in a snowstorm.
Because of Jan’s high breast density, her radiologist ordered a type of screening called an automated breast ultrasound (ABUS) exam to be sure he wasn’t missing anything. ABUS has been proven to find a 37.5 percent improvement in detection when doctors used it alongside a mammogram. “ABUS is a great option for patients with dense breasts, in conjunction with mammography,” says Marie Stork, lead mammography technologist at Fort Jesse. “As technologists, we do our best to explain the benefits of the technology.”
In the U.S., there’s only one FDA-approved ultrasound technology for screening women with dense breasts, the Invenia ABUS from GE Healthcare, designed specifically for that purpose. The exam takes about 15 minutes, and the machine generates 3D images of the entire breast to help clearly differentiate between cancer and dense tissue.
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The ABUS exam demonstrated a .7cm lesion in the right breast. The lesion was not seen in her screening 3D mammogram, as it was likely obscured by dense breast tissue. Photo Credit: Fort Jesse Imaging’s Gale Keeran Center for Women
The team at Ft. Jesse Imaging & Gale Keeran Center for Women performs approximately 25 ABUS exams every week. Mammography may miss cancers in dense breasts; however, the Invenia ABUS machine has been proven to find more invasive cancers after a normal or benign mammographic finding.
Jan received the results within a week: She had stage one breast cancer. “I had never heard about dense breast tissue,” she says. “It came as a complete shock, but I was glad that there was technology available that could see through it and find my cancer early.”
Her doctor agrees. “ABUS looks at the breast in a different way than the screening mammogram,” says Dr. Daniel Ha, Jan’s radiologist. “In Jan’s case, the ABUS could see through the density and detect a cancer that was not seen on her 3D mammogram. Even with the best mammogram available today, 3D mammography is still challenged in high breast density. For Jan, ABUS provided a more comprehensive way to look at the breast.”
Jan’s treatment plan included a lumpectomy, 33 radiation treatments, and oral chemotherapy drugs. Fortunately, she is doing well today. She will continue to get annual mammograms and ABUS exams.
“ABUS and screening mammograms are complementary to each other and when combined help us attain the best patient outcome,” Ha says. “If Jan hadn’t had the ABUS exam, her cancer would not have been detected until it was a palpable lesion found during a clinical exam or had become apparent on a mammogram. It might have been at a more advanced stage with fewer treatment options available.”
Jan celebrated Mother’s Day with her family in May. “Following my cancer diagnosis, my mind went crazy thinking about whether my children would even have a mother, and whether I would get to meet my future grandchildren,” Jan says. “Mother’s Day was always a special occasion for me, but it’s become even more special in the last year, and I feel truly blessed.”
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Jan and her family.
A version of this article originally appeared on The Pulse, GE Healthcare’s newsroom.