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3-D Mammography at The Breast Center at St. David’s Medical Center Significantly Increases Cancer Detection

In the June 25, 2014 issue of the Journal of the American Medical Association (JAMA), a groundbreaking study was published that found 3-D mammography (also called breast tomosynthesis) screening technology significantly increased cancer detection while simultaneously reducing the number of false positives.

The study, “Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography,” reviewed close to half a million mammography exams, and was led by Sarah M. Friedewald, MD of the Caldwell Breast Center, Advocate Lutheran General Hospital in Park Ridge, Illinois.1

Researchers found that 3-D mammography finds significantly more invasive/lethal cancers than a traditional 2-D mammogram. According to the study’s results, 3-D mammography also reduces the number of women called back for unnecessary screenings due to false alarms, thereby reducing anxiety AND health care costs.

Other significant findings include:

  • A 41% increase in the detection of invasive breast cancers
  • A 29% increase in the detection of all breast cancers
  • A 15% decrease in women recalled for additional imaging
  • A 49% increase in Positive Predictive Value (PPV) for a recall
  • A 21% increase in PPV for biopsy
  • No significant change in the detection of ductal carcinoma in situ (DCIS)

This study used Hologic 3-D mammography systems and involved 13 U.S. breast screening sites and 139 radiologists.

The Breast Center at St. David’s Medical Center is committed to early identification and the fight against breast cancer. The Breast Center provides 3-D mammography, the latest in breast screening technology. If you would like to schedule a mammogram, or if you have questions about this important breast health procedure, please call 512.544.8800.
Watch KVUE’s coverage of this study, including an interview with The Breast Center at St. David’s Medical Center’s director of imaging, Dr. Elizabeth Moorehead, M.D.

You may also click here to see JAMA’s full study.

1 Friedewald SM, Rafferty EA, Rose SL, Durand MA, Plecha DM, Greenberg JS, Hayes MK, Copit DS, Carlson KL, Cink TM, Barke LD, Greer LN, Miller DP, Conant EF, Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography, JAMA June 25, 2014.

10 Ten Reasons to Receive Care at a Breast Center that is NAPBC Accredited

  1. The National Accreditation Program for Breast Centers (NAPBC) is a consortium of professional organizations dedicated to the improvement of the quality of care and monitoring of outcomes of patients with diseases of the breast. This mission is pursued through standard-setting, scientific validation, and patient and professional education.
  2. The NAPBC Board includes professionals from 20 national organizations that reflect the full spectrum of breast care.
  3. NAPBC accreditation is only given to centers that have voluntarily committed to providing the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance.
  4. The center must demonstrate compliance with standards established by the NAPBC for treating women who are diagnosed with the full spectrum of breast disease. The standards include proficiency in the areas of center leadership, clinical management, research, community outreach, professional education and quality improvement.
  5. Receiving care at a NAPBC-accredited center ensures that you will have access to comprehensive care, including a full range of state-of-the-art services.
  6. A NAPBC-accredited center uses a multidisciplinary team approach to coordinate the best care and treatment options available for you.
  7. At a NAPBC-accredited center, you will have access to breast cancer related information, education, and support.
  8. At a NAPBC-accredited center, you will receive information about clinical trials and new treatment options.
  9. To maintain accreditation, centers must monitor compliance with the NAPBC standards and undergo an on-site review every three years.
  10. The Breast Center at St. David’s Medical Center is the only breast center in Austin to be NAPBC-accredited, so you can receive treatment or care close to home.

To make an appointment at The Breast Center at St. David’s Medical Center, please call 512.544.0080.

For more information about NAPBC, please visit,

Brenda Baumann, RN

Common Questions About Breast Tomosynthesis (3-D Mammography)

The Breast Center at St. David’s Medical Center is pleased to be the first in Austin to offer a revolutionary 3-D digital mammography system known as “breast tomosynthesis” (3-D mammography). With annual volumes exceeding 15,000 mammograms and 1,200 biopsies, The Breast Center is excited to incorporate the latest technology in screening and diagnostic mammography in the care and treatment of our patients.

What is breast tomosynthesis? What are the benefits of breast tomosynthesis?

Breast tomosynthesis is the first and only FDA-approved 3-D digital technology that enables radiologists to see your breast in greater detail than traditional mammography. Breast tomosynthesis produces a 3-D image of your breast tissue in one-millimeter slices, allowing radiologists to see “inside” the breast, minimizing or eliminating ambiguity caused by overlapping tissue, common in women with dense breasts.

An objective research study comparing the use of traditional digital mammography to a 2-D/3-D breast tomosynthesis in 13,856 women revealed that the use of the 2-D/3-D breast tomosynthesis combination resulted in:

  • 35% increase in cancer detection rates
  • 53% increase in detection rates of invasive cancers
  • 38% decline in call backs for additional images
  • 11% decline in biopsy rates

How do I qualify for a 3-D mammogram?

Breast tomosynthesis is available to all patients who are due for their annual screening mammogram. Detection benefits have been demonstrated in all types of breast tissue. Diagnostic exams may also be performed with a physician`s order.

What should I expect during the 3-D mammogram?

A 3-D mammogram is similar to a traditional (2-D) digital mammogram. Our technologist will position you, compress your breast and take images from different angles. The x-ray arms sweep in an arc over your breast taking multiple breast images to produce the 3-D images of your breast. The duration of the exam is similar to that of traditional digital mammography. The technologist will send the images of your breast to the radiologist to be read. The results will be reported to you and your physician.

What is the cost?

The Breast Center at St. David’s Medical Center will bill your insurance company for the 3-D mammogram.

Will I be exposed to more radiation?

The amount of radiation is below the safety standards set forth by the government, and the benefit greatly outweighs any radiation exposure risk. The amount of radiation from a 3-D mammogram is slightly higher than digital mammography and roughly equal to the radiation exposure of traditional mammography on film.


Hours: Monday–Friday, 7:00 a.m. to 6:00 p.m.
Soft foam mammopads used to enhance comfort.
RN Navigator ensures you receive prompt results.

For additional information or to schedule your annual mammogram, please call The Breast Center at St. David’s Medical Center at 512-544-8800 or 512-544-8803.

-Brenda Baumann, RN

Breast Tissue Density and Henda’s Law

Dense breast tissue increases the difficulty in detecting breast cancers on a mammogram thus placing women at greater risk. Breast tissue is composed of a combination of glandular and fatty tissue. Breast density refers to the amount or ratio of these two types of tissues as seen on a mammogram. Younger women (under 40 years of age) generally have very dense breasts. In other words, this is what we expect to see. As a woman ages, the glandular tissue is replaced by an increase in fatty tissue which has the advantage of making breast cancer more readily visualized on mammography. Women using hormone therapy may continue to have denser breasts even after menopause. Dense tissue looks white or gray on a mammogram, and cancer can also appear white or gray.

Henda`s Law

In 2011, the Texas Legislature passed House Bill 2102, which is known informally as “Henda’s Law”―named after Henda Salmeron, a Dallas realtor and breast cancer survivor who was instrumental in organizing the effort to pass the law in Texas. It is based on a similar law in Connecticut, and requires that mammography providers inform women that dense breast tissue can affect the accuracy of mammography in detecting breast cancer, and women with dense breasts plus additional risk factors may benefit from supplemental screening. The mandated language for the notification reads:

Texas H.B. 2102 – Henda’s Law – Breast Density
If your mammogram demonstrates that you have dense breast tissue, which could hide abnormalities, and you have other risk factors for breast cancer that have been identified, you might benefit from supplemental screening tests that may be suggested by your ordering physician.

Dense breast tissue, in and of itself, is a relatively common condition. Therefore, this information is not provided to cause undue concern but rather to raise your awareness and to promote discussion with your physician regarding the presence of other risk factors, in addition to dense breast tissue.

A report of your mammogram results will be sent to you and your physician. You should contact your physician if you have any questions or concerns regarding this report.

For consistency, the American College of Radiology has four grades of breast composition to describe the breast density of all patients using the following patterns:

  • Type 1: fatty (<25% glandular tissue)
  • Type 2: scattered (25-50% scattered fibroglandular tissue)
  • Type 3: heterogeneously dense
  • Type 4: dense (>75% fibroglandular)

Supplemental screening exams include breast ultrasound, Tomosynthesis (3D screening), MRI or molecular breast imaging. There are pros and cons to these exams, and women at high risk (i.e., have a first-degree maternal or paternal relative diagnosed prior to menopause) should discuss their individual risk, breast tissue density and the need for supplemental tests with their healthcare provider or the RN Nurse Navigator at their imaging/mammography center.

For more information, contact Laura Fritz, RN, APRN, Nurse Navigator at The Breast Center at St. David`s Medical Center at 512-544-8800.

**COMING SOON: 2D/3D Tomosynthesis mammography only at The Breast Center at St. David`s Medical Center

Resolution #2 – EXERCISE to Reduce Your Risk of BREAST CANCER

via flickr

via flickr

Losing weight and exercising more are very popular New Year`s resolutions. It is commonly known that exercise has cardiovascular benefits, but there is another great reason to hop on that treadmill in 2013. Research has shown that women who exercise regularly and maintain a healthy weight can decrease their risk of breast cancer. Researchers at the University of North Carolina at Chapel Hill found that women who exercised 30 minutes per day (10-19 hours per week) experienced greater health benefits, with a 30% reduced risk of developing breast cancer, than inactive women who gained a significant amount of weight, particularly after menopause.

Regular exercise is crucial to reap these health benefits, but staying on track all year can be daunting. There are many ways you can become more active.

  • Try to incorporate simple changes such as taking the stairs or selecting a parking spot requiring you to walk further.
  • Other exercise options include: team sports, classes, joining a gym, investing in home exercise equipment, or aerobic activities, like walking, running and dancing. Before exercising, always begin with a warm-up that includes adequate stretching.

Follow this with 20-30 minutes of aerobic activity, and end your session with a cool down combined with more stretching. If you have a medical condition, you should speak with your healthcare provider prior to participating in any vigorous activity.

Stay healthy in 2013! Get moving and reduce your risk of developing breast cancer!

-Brenda Baumann, RN

(Resource: Cancer, online edition, June 21, 2012)

Celery: Merrily Waging a War on Breast Cancer

As you make your way from one holiday celebration to another, you can rejoice in the fact that there may be at least one party food option that it’s alright to indulge in, celery. Apigenin, a natural substance found in celery, parsley, and other fruits and vegetables has been found to slow the progression of cancer cells. Researchers at the University of Missouri reported their findings in the May 2012 online journal, Hormones and Cancer. Apigenin was tested specifically against breast cancer cells that are found to be progesterone – receptor positive and this chemical was found to have a shrinking effect on tumor cells.

Unfortunately, Apigenin is not a wonder drug or a substitute for treatment. Currently, more research is underway to determine the way Apigenin works, its effectiveness and future uses.

This is good food for thought for the seasonal party attendee or planner!

So remember, if you find yourself surveying the buffet, pondering an appetizer tray, or planning your own holiday get-together, consider celery, and the little war it may be waging on breast cancer one stick at a time.

Holiday recipe – Stuffed Celery

Apigenin is also found in other foods (source):

  • Apples
  • Chamomile
  • Basil
  • Oregano
  • Tarragon
  • Cilantro
  • Endive
  • Broccoli
  • Cherries
  • Leeks
  • Onions
  • Tomatoes
  • Grapes
  • Tea
  • Beans and barley

Happy Holidays,


8 Steps to Manage Breast Pain

  1. Wear a properly fitted supportive bra, even while sleeping. Be sure to wear a sports bra during exercise.

    via flickr

  2. Limit your salt intake to reduce fluid retention and swelling.
  3. Eliminate, or at least limit, caffeine. Remember that caffeine can also be found in chocolate and some over-the-counter medications.
  4. Use an over-the-counter pain reliever, such as Tylenol, Advil or Motrin and follow dosage instructions and labels.
  5. Get enough key nutrients through your diet, especially calcium, magnesium and vitamins A, B, C and E.
  6. Drink water to help flush excess fluid from your body.
  7. Experiment with relaxation therapy, which can control anxiety associated with more severe breast pain.
  8. Consider evening primrose oil, a supplement that appears to alter fatty acid balance.

Most breast discomfort is not cancer, but please report unrelieved and/or focal pain to your physician. Pain confined to one very specific area is considered focal pain.

- Brenda

8 Breast Changes That Should Not Be Ignored: What is Your Normal?

via Flickr

You should always be aware of any changes in your breasts or underarm areas. If you notice any of the following changes, see your health care provider.

  1. Lumps, hard knot or thickening inside the breast or underarm area
  2. Swelling, warmth, redness or darkening of the breast
  3. Change in the size or shape of the breast
  4. Dimpling or puckering of the skin
  5. Itchy, scaly sore or rash on the nipple
  6. Pulling in of your nipple or other parts of the breast
  7. Nipple discharge that starts suddenly
  8. New pain in one spot that does not go away

For more information about breast cancer, visit or call the breast care helpline at 1-877 GO KOMEN (1-877-465-6636).

- Brenda 

Susan G. Komen for the Cure®
1-877 GO KOMEN (1-877-465-6636)

Genetic Testing for Breast Cancer Prevention

During the month of October it’s hard to watch a television show or go shopping around town without seeing the pink ribbon that is the International symbol of Breast Cancer Awareness. Texas Oncology’s Dr. Beth Hellerstedt spoke at the Breast Cancer Awareness Seminar on Oct. 16th and spoke to the importance of genetic testing in breast cancer prevention. Mutations in genes associated with hereditary cancer dramatically increase the risk for cancer development and there are specific medical management options to test for these mutations. Most insurers provide coverage for genetic testing as well. Along with regular exams and self-examination, this is another option to consider to combat breast cancer.

On Thursday, Oct. 25th Tarie Beldin will host a cooking class regarding the the myths of cooking and cancer. It’s often so hard to know what to believe when it comes to nutrition and preventing cancer. Tarie will try and dissect some of those myths. You can still register by calling 512-478-3627. We hope to see you there!

Holly Krivokapich
Health and Wellness Coordinator
St. David’s Round Rock Medical Center

Breast Cancer Awareness Month – St. David’s Round Rock Medical Center

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