Dr. Priya Krishnarao explains the importance of mammograms, Automated Breast Ultrasound technology, why monthly self-exams are no longer recommended and other important breast health facts.
El Camino Health is pleased to announce radiologist Priya Krishnarao, MD, as the new director of the El Camino Health Women's Imaging Center. The El Camino Health Women's Imaging Center has been accredited as a Breast Imaging Center of Excellence by the American College of Radiology.
Below, Dr. Krishnarao discusses some of the most common questions she gets asked about breast health and breast cancer.
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Q: My last mammogram was clear; do I really need to be rescanned every year?
Dr. Krishnarao: Different organizations have different recommendations. I encourage my patients to follow the American College of Radiology recommendations, which is yearly mammograms for women starting at age 40.
Q: I don’t have a family history, what is my risk of developing breast cancer?
Dr. Krishnarao: Here are some statistics: One in eight women will get breast cancer, and 85% of women diagnosed with breast cancer have no family history. This is why annual screening is so important.
Q: What should I do if I find something during my monthly breast self-exam?
Dr. Krishnarao: Monthly self-exams are no longer recommended. The research did not show that it made a difference in survival from breast cancer. Women should know what their breasts look like and feel like so that any changes in the way the breast looks or feels can be recognized right away. Any noticeable change should be followed by a visit to the doctor. The doctor can then order a mammogram to examine the change in the breast.
Men also can get breast cancer, but it is quite rare. Knowing how the chest looks and feels is important for men, too. If a change is noticed, a visit with the doctor is necessary and a mammogram may be required.
Q: What happens if I get called back after my mammogram?
Dr. Krishnarao: Patients often become concerned when they are called to come back for more images after a mammogram. Most often when the patient is called to come back it is because more images are needed for an accurate reading. Additional imaging may include a diagnostic mammogram and ultrasound.
Q: I've been told I have dense breasts. Why is that important?
Dr. Krishnarao: Breast screening by mammogram is very effective for women without dense breast tissue. But if a woman has dense breasts, it is difficult for the radiologist to see any areas that might be cancer. Additional imaging may be needed. Fifty percent of women have dense breasts, and breast density is only discovered when the mammogram images are viewed.
In California, the patient must be informed that they have dense breasts, and then they can decide with their doctor if additional exams are needed.
At El Camino Health Women's Imaging Center, a technology called automated breast ultrasound (ABUS) is available for women with dense breast tissue. This technology is available at only a few hospitals in Northern California. ABUS is known to be a supplemental screening modality and does not use radiation or contrast.
For this exam, the patient will lie down on an exam table and the scanner obtains 3,000 to 5,000 images of the breast from three to five different angles. The images are recorded as a movie. The radiologist can then control the speed of the movie and go forward or backward to see any areas of concern.
Some insurance companies don't cover ABUS exams. There is currently some legislation being considered to improve access to supplemental screening like ABUS. El Camino Health offers a 75% discount for patients wishing to pay for their services rather than use insurance.
Q: What is my risk for breast cancer? How can someone reduce their risk?
Dr. Krishnarao: There are several known risk factors. Family history and genetic risk factors are risk factors that cannot be changed or reduced. But this is important information in determining the risk of getting breast cancer. There are also several risk factors that women have some control over. By maintaining a healthy lifestyle, a woman can reduce her risk. It is important to get regular exercise, maintain a healthy weight and make healthy food choices to keep from increasing the risk of getting breast cancer. Breastfeeding is also known to reduce the risk.
Q: As an expert, have you noticed any trends in breast health stemming from the COVID-19 pandemic?
Dr. Krishnarao: Some research presented at the 2020 San Antonio Breast Cancer Symposium showed that women who missed their annual mammogram due to the pandemic were found to have advanced breast cancer on their next mammogram. This resulted in a larger number of women needing neoadjuvant therapy prior to surgery for breast cancer. Neoadjuvant therapy is given to reduce the size of the tumor prior to the surgery to remove the tumor.
Similarly, the Centers for Disease Control (CDC) reported that the number of screening tests for breast cancer decreased by 87% during April 2020. After missing the mammogram last year, more advanced tumors were found on the following breast screening exam.
The takeaway is that the importance and value of yearly mammograms is clear.
Take steps to reduce your risk for breast cancer
Dr. Krishnarao emphasizes the importance of knowing your risk for breast cancer and taking steps to reduce your risk by:
- Knowing your family history and genetic risk factors
- Maintaining a healthy lifestyle
- Following the screening recommendations
Dr. Krishnarao is proud of the robust breast screening program at El Camino Health Women's Imaging Center.
It is important to know how your breasts look and feel so that you can recognize a change immediately. Make an appointment with your doctor for any changes in your breasts and ask if a mammogram is right for you.
Go to El Camino Health Breast Screening and Diagnostics to learn more.
This article first appeared in the October 2021 edition of the HealthPerks newsletter.
