When it comes to breast health, early detection is your best protection. Mammography is a standard component of the annual checkup for American women over 40. At the Breast Health Center, we recognize that mammograms can be stressful for some women and we strive to make your mammography visit as comfortable and convenient as possible. Beyond diagnostic mammography, the MarinHealth Medical Center Breast Health Center offers a comprehensive range of diagnostic techniques that put us at the forefront of care.
In this segment, Natalya Lvoff, MD, discusses the latest advancements in personalizing breast health screening and how the new Breast Health Center is equipped with the latest in screening technologies in an environment that is patient friendly.
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Advancements in Personalizing Breast Screening
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Learn more about Natalya Lvoff, MD
Natalya Lvoff, MD
Natalya Lvoff, MD is the Medical Director of the Breast Health Center and a Radiologist and a member of the medical staff at MarinHealth Medical Center.Learn more about Natalya Lvoff, MD
Transcription:
Advancements in Personalizing Breast Screening
Bill Klaproth (Host): Marin County has a new breast health center, part of the Marin healthcare district offering spacious, welcoming surroundings along with state of the art technology for comprehensive care. Here to talk with us about the new facility and the latest advancements in personalized screening and treatment is Dr. Natalya Lvoff. She is the medical director of the breast health center, a radiologist and a member of the medical staff at Marin General Hospital. Dr. Lvoff, thanks for your time. As I mentioned, Marin County has a new breast health center offering the latest in screening technology. Can you tell us about the new patient friendly breast health center?
Dr. Natalya Lvoff (Guest): Just a couple weeks ago in June, we relocated our breast center to Drake’s Landing. We have a brand new, state of the art facility that’s 9,000 sq. ft. – that’s almost three times larger than our prior center. We combine large open spaces for patients with private, secluded spaces for individualized private care. We have new electronic registration. We have improved patient parking. We have the newest and best technology that’s available in Marin County. We have four brand new tomosynthesis machines. We have tomosynthesis stereotactic biopsies. We have two ultrasound machines that are dedicated to breast imaging. We have a brand new technology that we’re doing here – bone densitometry – which is new for the breast center.
Bill: That sounds terrific and sounds like a great facility for women. You were talking about some of the latest technology available. Can you explain the different types of diagnostics and screening technologies that are available at the new breast health center, like 2D versus 3D versus MRI, and who do they apply to?
Dr. Lvoff: Sure. Two dimensional tomography is the conventional tomography – it’s what all women have had up until now. It’s a two dimensional flat image that’s produced of the breast, and the problem with it is that there is overlapping breast tissue. The overlapping breast tissue can hide breast cancer or sometimes it can mimic breast cancer. The solution to this is the newest available technology – tomosynthesis – which is a three dimensional mammogram. A tube moves around the breast in a 15-degree arc. It acquires multiple images at different angles. These images are reconstructed for the radiologist into thin slices and it allows the radiologist to see through overlapping breast tissue – kind of like the difference between looking at the cover of the book with a conventional two dimensional mammogram versus flipping through each individual page, which is tomosynthesis, or a three dimensional mammogram – kind of like the different between reading a chest x-ray or a CT scan of the chest. Three dimensional mammography is much more sensitive for detecting breast cancer. It has been shown to have increased detection of breast cancer and also decreased callbacks from screening mammography.
Bill: Do you use that 3D breast imaging in a normal mammogram or is that after you detect something?
Dr. Lvoff: It is used for screening as well as diagnostic mammography. Screening means screening women at average risk for breast cancer or increased risk for breast cancer. We use it in diagnostic mammography for women where we see something on a screening mammogram and they're asked to come back for additional imaging where if the woman feels something – a nodule in her breast - and she would have a diagnostic mammogram. We do this three dimensional mammography in all cases.
Bill: What about MRI? When do you use that?
Dr. Lvoff: MRI is used for problem solving if we see something on a mammogram and we need to examine is further or it’s used for screening women who are at increased risk for breast cancer. It’s always used at a supplement to mammography – never as a substitute for it.
Bill: Dr. Lvoff, how does family history and prior issues and other risk factors – how do those influence screening protocols?
Dr. Lvoff: The screening protocol is the same regardless of a patient’s risk factors. All women are advised to have an annual screening mammography beginning at age 40. Women who are at increased risk for breast cancer may also benefit from annual screening breast MRI or genetic testing.
Bill: When it comes to family history, how important is that?
Dr. Lvoff: Family history is important, so women with a strong family history may benefit from supplemental screenings like an annual breast MRI, but 75% of breast cancers occurred in women with no family history of breast cancer. Screening is extremely important even with women who are not considered at increased risk.
Bill: What about ethnicity and dense breasts? How do those influence your screening protocol decisions?
Dr. Lvoff: Ethnicity does not. Again, all women over the age of 40 should have an annual screening breast MRI. Dense breasts benefit the most from tomosynthesis – this new technology of three dimensional mammography.
Bill: You mentioned that a woman should start getting breast screenings at the age of 40. How frequently after that?
Dr. Lvoff: All women age 40 and above should have annual screening mammography.
Bill: Regardless of risk factors every year?
Dr. Lvoff: Regardless of risk factors. 75% of women with breast cancer do not have a strong family history of breast cancer. Regardless of risk factors, all women beginning at age 40 should have annual screening mammography. Women with increased risk for breast cancer may also benefit from additional screening with breast MRI.
Bill: With the new breast health center right here in Marin, if a woman wanted to start going there, how would she transfer her prior screening history? I imagine that would be important.
Dr. Lvoff: Absolutely. Having all prior mammograms is extremely important. Our front desk will help a patient obtain all prior records and all prior imaging studies.
Bill: The breast health center can help with that as well?
Dr. Lvoff: Yes. Our front desk is staffed with people who will help a woman transfer all of her records to us.
Bill: That sounds great, Dr. Lvoff. Thank you so much for your time today. To learn more about the new breast health center in Marin County, visit breastcentermarin.org. Once again, that’s breastcentermarin.org. This is the healing podcast brought to you by Marin General Hospital. I'm Bill Klaproth. Thanks for listening.
Advancements in Personalizing Breast Screening
Bill Klaproth (Host): Marin County has a new breast health center, part of the Marin healthcare district offering spacious, welcoming surroundings along with state of the art technology for comprehensive care. Here to talk with us about the new facility and the latest advancements in personalized screening and treatment is Dr. Natalya Lvoff. She is the medical director of the breast health center, a radiologist and a member of the medical staff at Marin General Hospital. Dr. Lvoff, thanks for your time. As I mentioned, Marin County has a new breast health center offering the latest in screening technology. Can you tell us about the new patient friendly breast health center?
Dr. Natalya Lvoff (Guest): Just a couple weeks ago in June, we relocated our breast center to Drake’s Landing. We have a brand new, state of the art facility that’s 9,000 sq. ft. – that’s almost three times larger than our prior center. We combine large open spaces for patients with private, secluded spaces for individualized private care. We have new electronic registration. We have improved patient parking. We have the newest and best technology that’s available in Marin County. We have four brand new tomosynthesis machines. We have tomosynthesis stereotactic biopsies. We have two ultrasound machines that are dedicated to breast imaging. We have a brand new technology that we’re doing here – bone densitometry – which is new for the breast center.
Bill: That sounds terrific and sounds like a great facility for women. You were talking about some of the latest technology available. Can you explain the different types of diagnostics and screening technologies that are available at the new breast health center, like 2D versus 3D versus MRI, and who do they apply to?
Dr. Lvoff: Sure. Two dimensional tomography is the conventional tomography – it’s what all women have had up until now. It’s a two dimensional flat image that’s produced of the breast, and the problem with it is that there is overlapping breast tissue. The overlapping breast tissue can hide breast cancer or sometimes it can mimic breast cancer. The solution to this is the newest available technology – tomosynthesis – which is a three dimensional mammogram. A tube moves around the breast in a 15-degree arc. It acquires multiple images at different angles. These images are reconstructed for the radiologist into thin slices and it allows the radiologist to see through overlapping breast tissue – kind of like the difference between looking at the cover of the book with a conventional two dimensional mammogram versus flipping through each individual page, which is tomosynthesis, or a three dimensional mammogram – kind of like the different between reading a chest x-ray or a CT scan of the chest. Three dimensional mammography is much more sensitive for detecting breast cancer. It has been shown to have increased detection of breast cancer and also decreased callbacks from screening mammography.
Bill: Do you use that 3D breast imaging in a normal mammogram or is that after you detect something?
Dr. Lvoff: It is used for screening as well as diagnostic mammography. Screening means screening women at average risk for breast cancer or increased risk for breast cancer. We use it in diagnostic mammography for women where we see something on a screening mammogram and they're asked to come back for additional imaging where if the woman feels something – a nodule in her breast - and she would have a diagnostic mammogram. We do this three dimensional mammography in all cases.
Bill: What about MRI? When do you use that?
Dr. Lvoff: MRI is used for problem solving if we see something on a mammogram and we need to examine is further or it’s used for screening women who are at increased risk for breast cancer. It’s always used at a supplement to mammography – never as a substitute for it.
Bill: Dr. Lvoff, how does family history and prior issues and other risk factors – how do those influence screening protocols?
Dr. Lvoff: The screening protocol is the same regardless of a patient’s risk factors. All women are advised to have an annual screening mammography beginning at age 40. Women who are at increased risk for breast cancer may also benefit from annual screening breast MRI or genetic testing.
Bill: When it comes to family history, how important is that?
Dr. Lvoff: Family history is important, so women with a strong family history may benefit from supplemental screenings like an annual breast MRI, but 75% of breast cancers occurred in women with no family history of breast cancer. Screening is extremely important even with women who are not considered at increased risk.
Bill: What about ethnicity and dense breasts? How do those influence your screening protocol decisions?
Dr. Lvoff: Ethnicity does not. Again, all women over the age of 40 should have an annual screening breast MRI. Dense breasts benefit the most from tomosynthesis – this new technology of three dimensional mammography.
Bill: You mentioned that a woman should start getting breast screenings at the age of 40. How frequently after that?
Dr. Lvoff: All women age 40 and above should have annual screening mammography.
Bill: Regardless of risk factors every year?
Dr. Lvoff: Regardless of risk factors. 75% of women with breast cancer do not have a strong family history of breast cancer. Regardless of risk factors, all women beginning at age 40 should have annual screening mammography. Women with increased risk for breast cancer may also benefit from additional screening with breast MRI.
Bill: With the new breast health center right here in Marin, if a woman wanted to start going there, how would she transfer her prior screening history? I imagine that would be important.
Dr. Lvoff: Absolutely. Having all prior mammograms is extremely important. Our front desk will help a patient obtain all prior records and all prior imaging studies.
Bill: The breast health center can help with that as well?
Dr. Lvoff: Yes. Our front desk is staffed with people who will help a woman transfer all of her records to us.
Bill: That sounds great, Dr. Lvoff. Thank you so much for your time today. To learn more about the new breast health center in Marin County, visit breastcentermarin.org. Once again, that’s breastcentermarin.org. This is the healing podcast brought to you by Marin General Hospital. I'm Bill Klaproth. Thanks for listening.