Dr. Mason Hicks and radiology technologist Ashely Morquecho are always busy, but during Breast Cancer Awareness Month in October things ramp up even more.
Hicks, a radiologist and fellowship-trained breast imager, and Morquecho are at Medical Center Hospital’s Women’s Imaging Center.
After putting off mammograms the past couple of years, Morquecho said she feels like people are finally coming around.
Hicks said the majority of women are of average risk and should start having yearly mammograms at age 40.
“… The importance of that is we want to detect breast cancer early when it’s small, because in those cases, it’s most of the time treatable and [we can) save more lives, than waiting until a lump is felt, or a problem has presented itself to the patient …,” Hicks said.
For those who wait, he said, treatment is usually more extensive and there’s less chance for a cure.
Morquecho said a lot of women think that if they don’t feel anything or there’s no family history, then they probably don’t have breast cancer.
“But I would suggest getting it every year because some cancers, you’re not able to feel; you’re not able to have any symptoms. So like Dr. Hicks was saying, you might as well just do your yearly and make sure you’re good instead of waiting until you have problems, and it might be far along,” Morquecho said.
Hicks said about 75 percent of the breast cancer they see are in women that don’t have any known risk factors or family history.
“So if we were only concerned about screening, the patients that are known to be high risk, we’d be missing the majority of the breast cancers,” Hicks added.
Even if women have implants, Morquecho said they should still get a mammogram.
“We’re checking the implant and the breast tissue,” she added.
Some women should start having mammograms earlier than 40 if they have a significant family history of breast cancer, or a known genetic disposition.
“There are a few other situations where ladies would need to start earlier. If they’re unsure about that, that’s something to talk to their doctor about to see if they meet any of those criteria that would necessitate them starting at a younger age,” Hicks said.
Hicks said a comfortable pace for reading screening mammograms for him is 15 to 20 per hour.
“… But it’s rare for that to happen just because we’ve got other things going on and phones ringing and questions and all of that stuff,” he said.
Morquecho said some women have misconceptions about mammograms and get very anxious about the short procedure and think it’s going to hurt.
“… It does get tight. It is compression, but we’re not trying to make every woman just fall down with tears. … Most of the time after the exams done, they say … it wasn’t as bad as I expected. So I feel like the stories and all of the negative stuff about mammograms hurting really bad, I would just say come check out for themselves. It’s not as bad as they play it out to be. It does get tight, but it’s nothing like labor pains. I feel like as women we go through a lot worse than a mammogram. And if it is severely hurting them during the exam, just tell the tech, we will stop. It’s not like, sorry, gotta keep going,” Morquecho said.
Hicks said the exam is tailored for each patient.
“It’s not a set amount of compression on every patient. It just depends on the anatomy and the patient’s comfort. I would say also in pre-menopausal ladies that are still having menstrual cycles, strategic scheduling of the screening … around the time when the breasts tend to be less tender can also be helpful,” he added.
The techs also walk you through the process and explain what they’re doing.
It is cold in the exam rooms. The temperature can’t reach over 70 for the machines.
“If they start to overheat, then they’re not going to turn on. So our exam rooms are pretty chilly …,” Morquecho said.
Virtually 100 percent of the screenings are 3D, Hicks said.
“I can think of maybe one or two exams over the last year that I can remember a screening that wasn’t 3D. But for all intents and purposes, every screening we do down here now is 3D,” he said.
3D Screenings help doctors see a lot more.
“Not only does it help us to detect potential abnormalities, when they’re smaller, or could be potentially obscured by dense tissue. Also on the flip side, it also decreases the likelihood of you being recalled for additional imaging that doesn’t pan out to be anything, so it’s beneficial in multiple ways,” Hicks said.
Usually, for the screening mammograms the exam itself takes five or six minutes, Morquecho said.
“It’s pretty quick. You probably wait longer to get checked in, fill out your papers, all that stuff up front before coming back. …,” she said.
Hicks said for a breast without any kind of abnormality it can take a minute or two to read the image.
“3D does take a little bit longer to read than the traditional 2D mammograms, but … a lot of it Just depends on the patient anatomy and how complicated it is. But generally speaking me three, four minutes, most of the time to read a screening mammogram. We really, really try to read those exams within a day or two. We have to read all screening mammograms within 30 days, that’s a requirement under the MQSA. The exam has to be reported within 30 days,” Hicks said.
Generally, the patient would get their results within a week from the exam.
It can take longer if a patient has moved here from another state or town, or had their mammogram at another facility. Hicks said it’s always good to have their current images to compare with previous ones.
If something is found, Hicks said the patient would receive a letter saying their mammogram showed something that needs to be looked into further.
“The report would go into the medical record and to their doctor. We have a process in our department where we get those patients over to the schedulers so the doctor’s office can be contacted and the patient can be contacted to get the patient back in for the additional imaging that’s needed,” Hicks said.
Morquecho said when the patient returns for a diagnostic exam and the extra images and possibly an ultrasound taken, Hicks will give them the results the same day.
The patient will also get the results in the mail and they will be faxed to the patient’s doctor.
Hicks performs breast biopsies and localization procedures, but not actual surgery.
“Sometimes, if they do come in for a diagnostic workup, and we do need to do a biopsy, sometimes we are able to do it that same day, depending on insurance, orders and medications, and the schedule …,” Morquecho said.
Hicks said if it’s not the same day, it’s definitely within two or three days.
“It would be rare for somebody to have to wait longer than that,” he said.
Hicks stressed again the importance of making sure to get a yearly mammogram “because it’s a very simple and relatively inexpensive test that could potentially save your life.”
Morquecho added that breasts change over time, so it’s good to have a trail of images to compare.
“… I would just come every year. I always hate the ones that wait 5, 10 years and it’s like oh, this doesn’t look good. I wish they would have come every year. We would have caught it a lot earlier than what it is now. It’s just a process, so I agree; just come every year to try to eliminate the chaos,” she said.
According to the American Cancer Society, overall, the average risk of a woman in the United States developing breast cancer sometime in her life is about 13%. This means there is a 1 in 8 chance she will develop breast cancer. This also means there is a 7 in 8 chance she will never have the disease.
According to the Brevard Health Alliance website, “Breast Cancer Awareness Month began in 1985 as a partnership between the American Cancer Society and the pharmaceutical division of Imperial Chemical Industries. Betty Ford helped kick off the week-long event, as she was herself a survivor of breast cancer. She was diagnosed when her husband, Gerald Ford, was president of the United States and brought even more attention to breast cancer.”
