October 2014

How 3D Mammography Saved My Wife's Life

Author: Drew Wade

As the one and only doctor in my extended family, I field the family’s questions about all sorts of problems large and small. I can usually provide some help, but as a radiologist, many times those questions fall well outside the scope of what I do day-to-day. A year ago, however, one of those issues hit home fully and completely when my wife went for her first regular screening mammogram.

Julie had a normal baseline mammogram at 37. Her physician, an Ob/Gyn in my group at SouthCoast, followed the recommendations for women with no strong family history and sent her for a routine annual mammogram when she turned 40. Conveniently, we have 3D mammography on site. Minutes later, my heart dropped when I reviewed the images, seeing tiny calcifications branching across the inside of Julie’s left breast, new from her baseline mammogram.

I suspected that these new calcifications represented early breast cancer, ductal carcinoma in situ (DCIS), the early stage where the cancer is most easily treated. Hoping I was overreacting, I confirmed my suspicion with a second opinion from one of my partners. Still hoping for the best, I called Julie and told her about the workup we would need to do next. A needle biopsy shortly after proved that the calcifications were DCIS. Though the news was bad, it could have been worse. An avid runner and deep into training, Julie still ran a marathon prior to her mastectomy and her time qualified her for the first time for the Boston Marathon.
However, the day of her surgery, news went from bad to worse as her expected stage 0 cancer (DCIS) was discovered at mastectomy to be stage II, not only invading the surrounding breast tissue, but also a nearby lymph node. Had it been only DCIS, her mastectomy and reconstruction would be the extent of treatment. Because of the distressing information, Julie’s surgeons helped Julie, me and our three young children understand what was ahead for the coming year—chemotherapy and radiation.

The bad news is that breast cancer, even at age 40, is an all-too-common problem. The silver lining of the high incidence of breast cancer, however, is that it is probably the most studied and best understood of all cancers. For example, Julie’s medical and radiation oncologists were able to determine genetic information specific to her tumor in order to tailor her treatment. With this treatment, her risk of recurrence drops from 50 percent in 10 years to probably less than 5 percent—from a coin flip to a near certainty of cure.

Dr. Drew Wade and his wife Julie, with their three children Margaret, Henry and Etta

The treatment, while sometimes exhausting for Julie to endure, and difficult for me and the kids to witness, was something she bore with a remarkably positive outlook. Julie took charge and decided she would continue her running, not just as a routine, but also to and from her chemotherapy appointments. This caused a bit of happy confusion at her doctors’ offices, and also great cheers from family and friends. She tracked those times publicly with a Facebook page, “Running thru chemo,” that kept her positive and close to her cheering section.

I have always taken mammograms seriously, and now I also have a better understanding from the other side of the curtain. Mammography is the best tool we have to detect cancers in asymptomatic women, though there are still tumors that are undetectable by imaging. In the course of the last few years, new technologies, especially 3D mammography, have improved detection of early cancers sometimes hidden by dense tissue. In our practice at SouthCoast, I am proud to say that we have three sites with 3D mammography—on Hilton Head Island, in Savannah on the main SouthCoast campus, and at SouthCoast Ob/Gyn. In our first year using 3D mammography, we diagnosed 40 percent more cancers than we did using only standard digital mammography the prior year. This is similar to national studies showing a 50 percent increase in detection of invasive cancers and a 30 percent increase in overall cancer detection (including DCIS).

Mammography enables early detection, thus shortening the time from development of the tumor to treatment, critically important to halting the cancer’s spread. I would not wish this experience on any family, but after personally enduring the anxiety of diagnosis and treatment with my wife, I now have a new perspective when I see patients. I can provide reassurance, not only when everything looks fine, but also, God forbid, when the news does not initially seem reassuring.

Which is to say that there is a happy ending. For us, Julie completed her treatments in August, and we just returned from a beautiful and fun celebration bicycling vacation. She is still as feisty and determined as ever, now having registered for that Boston Marathon for which she qualified. Not only that, but we—Julie, our kids Henry, Margaret, and Etta, and I—are reassured that we’ve done everything we could do to catch it early enough to cure it. Every day at work, I hope I can give that same chance to everyone who comes through our door.

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