Host: Dr. Linda Austin – Psychiatry
Dr. Linda Austin: I’m Dr. Linda Austin. I’m interviewing Dr. Thomas Pope who is Professor of Radiology here at the Medical University of South Carolina. Dr. Pope, you’ve been very involved and active in the area of mammography or many years now. Let’s talk about the examination of the breast, radiographically.
Dr. Thomas Pope: Okay. There are multiple techniques that can be used to examine the breast. The primary one is mammography. And the standard, up until a few years ago, five years ago or so, was film-screen mammography (FSM), which was a very good technique. It replaced xerography, back in the 80s. So, I’m old enough to have lived through almost all of these techniques.
The digital mammography, however, has a few advantages. One is that it’s been proven to be better in dense breasts. Dense breasts are breasts that have a lot of glandular tissue, usually seen in younger women. And that was the rub on film-screen mammography. It wasn’t as sensitive or specific in women with dense breast tissue.
Dr. Linda Austin: Now, do you mean dense as opposed to fibrocystic?
Dr. Thomas Pope: Dense and fibrocystic are equal terms when we’re talking about this.
Dr. Linda Austin: I see.
Dr. Thomas Pope: So, it’s a woman that has a lot of glandular tissue left in her breast. What happens with aging, generally, is that the glandular tissue recedes and the breasts become fatty replaced, and that’s a perfect scenario for mammography. If you’ve got nothing but totally fatty replaced breasts then a small breast cancer growing can be seen much earlier.
If you have dense breasts and you have a lot of tissue, density, within the breast then the best way, and almost the only way, for the cancer to be seen on mammography is if it’s producing calcifications. And those calcifications are somewhat specific for certain types of tumors. If it’s just a mass without calcification, it’s silhouetted out by the glandular tissue that’s in the breast itself. So, digital mammography not only offers an advantage to women with dense breasts, younger women, it’s also a more contrasty examination. The calcifications are better seen better with digital.
When we migrated to digital, about three or four years ago, we found ourselves bringing many more people back than we