Screening Saves Lives
The study from Massachusetts, as written in the article below, shows what women's imagers and radiologists have suspected all along. Screening mammography saves lives. Despite recent attempts by some to minimize the results of the progress that has been made in fighting this disease, it is apparent that screening mammography has a profound effect upon the lives of women in our community, as well as throughout the United States.
Amicha R. Khicha, MD
Cypress Women's Imaging and Wichita Radiological Group
October 28, 2009
Diagnostic Imaging
WOMEN WHO SKIP REGULAR MAMMOGRAMS RUN GREATER RISK OF DYING FROM BREAST CANCER
By Shalmali Pal
A long-term study of breast imaging in Massachusetts has confirmed what mammographers have argued for years: older adult women who do not receive regular screening mammography are far more likely to die of breast cancer than women who routinely undergo the procedure.
The findings were drawn from the experience of 6997 Massachusetts women who did, or did not, participate in regular screening and were diagnosed with invasive breast cancer between 1990 and 1999. The women also had to have follow-up data in their records through 2007 in order be included in the current study, according to lead author Dr. Blake Cady, professor of surgery emeritus at Harvard and Brown University in Providence, RI.
After a median of 12.5 years of follow-up, Cady and colleagues confirmed 461 deaths from breast cancer in the study population. Of those deaths, 15.6% resulted from nonpalpable, screen-detected cancers while 9.6% resulted from palpable, interval cancers. For regularly screened women, the total number of deaths was 116 or 25.2%.
The remaining 345 breast cancer deaths were among women who were not screened. Nearly two-thirds (60.9%) of the deaths occurred among women who had never undergone screening while 5% occurred in women who had at least one previous mammogram, but not within two years of diagnosis.
The researchers then extrapolated their data to more than 192,000 women in the U.S. who are estimated to be diagnosed with breast cancer in 2009. They determined that less than 5% of women who were regularly screened with mammography would be expected to die within 13 years compared with 56% of women who were not regularly screened. Cady pointed out that the 56% is similar to the rate of deaths from breast cancer in 1970, before the widespread use of mammographic screening.
“We know that the prospective randomized trials of mammography screening hypothesize that if women are offered screening, [screening will] reduce mortality. And indeed, that reduction in mortality ranges from 25% to 40%,” Cady said. “But in population-based studies, not everyone agrees to their assignment. In other words, women assigned to the experimental group may not get mammograms while women assigned to the control group may still get them. We wondered if the examination of women in this country who actually die of breast cancer might help illustrate the practical effect of mammography screening.”
The findings underscore the dangers of forgoing screening mammography for older adult women, noted Dr. Lori J. Pierce, a professor of radiation oncology at the University of Michigan in Ann Arbor.
“We have randomized trials that have shown us mammographic screening saves lives,” she said. “Dr. Cady’s study is extremely important because...the results clearly support the findings of the trials. We must encourage our patients to undergo routine screening mammography.”
The study was presented at the 2009 Breast Cancer Symposium in San Francisco Oct. 8-10. The event was jointly sponsored by the American Society for Clinical Oncology, the American Society of Breast Disease, the American Society of Breast Surgeons, the American Society for Radiation Oncology (ASTRO), the National Consortium of Breast Centers, and the Society of Surgical Oncology.
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August 2008
COLLEGE OF OB/GYN ENDORSES FIBROID EMBOLIZATION
In the August issue of Obstetrics & Gynecology (2008 112:387-400), the American College of Obstetrics and Gynecology (ACOG) came out in favor of the use of Uterine Artery Embolization as an alternative to hysterectomy for Fibroid Ablation. They noted that it has a high safety profile and an excellent track record of treating dysfunctional bleeding in women who do not want to undergo the time, expense, and risks of a hysterectomy.
"This is a significant advance in the discussion of treatment options for patients", states Tim Gronlie, MD an interventional radiologist for WRG. "There has been a tremendous amount of research work done in the US and other countries over the past decade that shows that this procedure is an important alternative for patients, particularly those who want to later have children."
Dr. John Kaufman, President of the Society for Interventional Radiology also noted that this announcement should make a full discussion of treatment alternatives by a woman and her physician easier and more complete. "This finding fully opens the door to women's choice," Kaufman said. "It will prompt gynecologists to discuss all treatment options for symptomatic uterine fibroids, including UFE, if they are not already doing so."
Fibroid embolization may not be appropriate for all individuals and it is important to have a discussion with an interventional radiologist prior to undergoing any such procedure. The interventional group in the Wichita Radiological Group has over a decade's experience in assessing patients, and when appropriate, performing this procedure. If you, a family member, or your physician have any questions about the procedure, please contact an interventional radiologist from the Wichita Radiological Group at 316-962-2900.
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JULY 2008
CYPRESS WOMEN'S IMAGING EAST EARNS AIUM ACCREDITATION
AIUM accreditation, a voluntary peer-review process, involves a stem-to-stern, top-to-bottom check-up on all aspects of an ultrasound practice. These aspects include doctor qualifications, physical facilities, the ultrasound machines, the detailed instructions (protocols) for performing each ultrasound test, and the policies in place for safeguarding the health and safety of every patient who has an ultrasound examination.
The AIUM’s Ultrasound Practice Accreditation Council is made up of professionals with an interest in quality ultrasound: obstetricians, gynecologists, radiologists, family practitioners, surgeons, and sonographers. Their goal is to provide health care facilities with the detailed specifications—based on nationally accepted standards—and the tools they need to perform ultrasound procedures accurately and consistently.
AIUM accreditation provides a good measure of reassurance for patients. This accreditation is the hallmark of an ultrasound practice that meets nationally accepted standards of patient care, demonstrates consistent excellence, and is current with the latest ultrasound technology.
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APRIL 2008
CYPRESS WOMEN'S IMAGING: BREAST IMAGING CENTER OF EXCELLENCE
Cypress Women’s Imaging has been notified that it has received the Breast Imaging Center of Excellence by the American College of Radiology. This requires certification in 5 separate areas, Mammography, Breast Ultrasound, Stereotactic Breast Biopsy, and Ultrasound Guided Breast Biopsy and an ongoing peer review process to meet the criteria for inclusion in this group.
“Over 3500 facilities in the United States offer mammography,” noted Rita Railing, manager of CWI, “ but only 242 facilities in the United States have achieved this level of accreditation. We are pleased to bring this to the women of Wichita.”
“This is a great testament to the commitment to quality of the technologists and physicians of Cypress Women’s Imaging”, stated John Knudtson, MD, medical director of CWI. “The combination of the Breast Imaging Center of Excellence and our prior certification for our MRI operations should lend confidence to the decision by women and their physicians to come to our offices.”
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APRIL 2008
CWI EARNS ACR ACCREDITATION IN BREAST ULTRASOUND
Cypress Women's Imaging has been awarded a three-year term of accreditation in Breast Ultrasound, including Ultrasound-Guided Breast Biopsy, as the result of a recent evaluation of image quality and breast dose data by the American College of Radiology (ACR).
The ACR, headquartered in Reston, VA., awards accreditation to facilities for the achievement of high practice standards after a peer-review evaluation of the practice. Evaluations are conducted by board-certified physicians and medical physicists who are experts in the field. They assess the qualifications of the personnel and the adequacy of facility equipment. The surveyors report their findings to the ACR’s Committee on Accreditation, which subsequently provides the practice with a comprehensive report.
The ACR is a national organization serving more than 32,000 diagnostic-interventional radiologists, radiation oncologists, and nuclear medicine and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services. For more information on the history of the ACR and the Ultrasound program, click here.
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MARCH 2008
CYPRESS WOMEN'S IMAGING HILLSIDE WILL MOVE TO A NEW LOCATION
In April 2008, Cypress Women's Imaging Hillside will move to a brand new facility located at 3232 E. Murdock, just one block away from our current location. The new center will feature larger more comfortable waiting areas and dressing rooms and will have easy access from the private parking lot including a covered portico for patient drop-off.
Please call us at 316-219-6700 for additional information about the move or to schedule appointments at our new facility.
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JULY 2007
ACR ACCREDITATION AWARDED TO CYPRESS WOMEN'S IMAGING IN STEREOTACTIC BREAST BIOPSY
Cypress Women's Imaging has been awarded a three-year term of accreditation in Stereotactic Breast Biopsy as the result of a recent evaluation of image quality and breast dose data by the American College of Radiology (ACR).
The ACR, headquartered in Reston, VA., awards accreditation to facilities for the achievement of high practice standards after a peer-review evaluation of the practice. Evaluations are conducted by board-certified physicians and medical physicists who are experts in the field. They assess the qualifications of the personnel and the adequacy of facility equipment. The surveyors report their findings to the ACR’s Committee on Accreditation, which subsequently provides the practice with a comprehensive report.
The ACR is a national organization serving more than 32,000 diagnostic-interventional radiologists, radiation oncologists, and nuclear medicine and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.
For more information on the history of the ACR and the Stereotactic Breast Biopsy program, click here.
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FOR IMMEDIATE RELEASE
JULY 2007
DR. AMISHA RAMJIANI KHICHA JOINS WRG, CYPRESS WOMEN'S IMAGING
The Wichita Radiological Group is pleased to announce the association of Amisha Ramjiani Khicha, MD as the newest physician in the Diagnostic Radiology Section. Dr. Khicha, a native of Colorado, attended Boston University for Medical School, completing her residency in Diagnostic Radiology at the Ochsner Medical Foundation in Louisiana. She then completed a Fellowship in Body Imaging with a concentration in Women's Imaging at the University of Pennsylvania.
"Dr. Khicha is a fine addition to the group. She has had great success at every level of her professional career. We look forward to having her work in both the general diagnostic group as well as at Cypress Women's Imaging. We believe that her caring, personal approach to her patients will be a great asset to the community," said Dr. John Lohnes, MD FACR, president of WRG.
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FOR IMMEDIATE RELEASE
June 2007
WRG HAS THREE DOCTORS CHOSEN AS BEST OF WICHITA
Drs. Charles McGuire, Dr. Daniel Housholder, and Dr. Grant Rine were named in a poll of Wichita area Physicians as the “BEST IN WICHITA” in their respective fields.
Dr. McGuire was the winner for General Radiology, Dr. Housholder was the leading vote getter for Nuclear Medicine and Dr. Rine was the winner for Best in Radiation Therapy. The poll was conducted by “Wichita Magazine”, during the 2nd quarter of 2007 and is published every other year.
“This is a great honor for these men, and one that is well deserved,” stated John Lohnes, MD president of the Wichita Radiological Group. Each of them has a great history of putting patients first and providing top notch service to our referring physicians. All are exceptional individuals as well as being great physicians.”
“It speaks well of WRG in that we had more physicians recognized for this award than any other single group of physicians. I believe that it is a direct reflection of our recruiting fellowship trained physicians and our continued involvement with the University of Kansas School of Medicine-Wichita and our residency program.”
The Wichita Radiological Group is a group of 21 radiation therapists and radiologists, which comprise the largest radiology group in South Central Kansas. WRG offers services through Wesley Medical Center and through their Cypress Women’s Imaging offices, as well as cooperative arrangements with individual physician’s offices and local imaging centers.
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FOR IMMEDIATE RELEASE
MAY 2007
LOHNES NAMED ACR FELLOW
Dr. John Lohnes was named a Fellow of the American College of Radiology at its national meeting this past May in Washington, DC. He was named for his work on behalf of organized radiology, having served as a board member and presidents of the South Central Kansas Radiological Society and the Kansas Radiological Society. He was also sited for his ongoing work with the Mid Kansas Affiliate of the Susan G. Komen Foundation.
Fewer than 10% of all radiologists achieve this rank, out of the over 40, 000 radiologists in current practice.
“It is most impressive that within our group of 21 radiologists and radiation oncologists that 5 are now Fellows,” noted Lohnes. It reflects our longstanding involvement in the community as a whole and the communities of radiology and organized medicine. Our group has the largest number of fellows within the state of Kansas. We remain committed to supporting these outside activities for our physicians, as we feel it makes us a more well rounded group, more broadly connected to the communities we serve.”
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FOR IMMEDIATE RELEASE
May 2007
DRS. DAVIS AND HOUSHOLDER NAMED AS EXAMINERS
Dan Davis, MD and Daniel Housholder, MD FACR of the Wichita Radiological Group were named as examiners for the upcoming oral examinations given as part of the certification process for the American Board of Radiology. Dr. Davis will be examining candidates in Musculoskeletal Radiology while Dr. Housholder will be administering the exam for the Nuclear Medicine section.
"This is a great opportunity for our residency program in that it will help our current and future residents to more fully understand the nature of the examinations and the types of areas in which they will be questioned. It is recognition that Drs. Housholder and Davis are among two of the best in the country in their areas of expertise," said Dr. Charles McGuire, Residency Director.
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Article date: March 28, 2007
Source: American Cancer Society
AMERICAN CANCER SOCIETY ADVISES MRI FOR SOME AT HIGH RISK OF BREAST CANCER
Get Scans Along With Mammograms, Not Instead of Them
Certain women with an especially high risk of developing breast cancer should get magnetic resonance imaging (MRI) scans along with their yearly mammogram, according to a new American Cancer Society guideline. The two tests together give doctors a better chance of finding breast cancer early in these women, when it is easier to treat and the chance of survival is greatest.MRI scans are more sensitive than mammograms, but they are also more likely to show spots in the breast that may or may not be cancer. Often there is no way of knowing whether or not these spots are cancerous short of a follow-up biopsy or some other invasive procedure. That is why the test is not recommended for women with an average risk of breast cancer, the guideline says.
"As with other cancer screening tests, MRI is not perfect and in fact leads to many more false-positive results than mammography," explains Christy Russell, MD, chair of the ACS Breast Cancer Advisory Group and co-author of the new guideline. "Those false-positives, which can lead to a high number of avoidable biopsies, can create fear, anxiety, and adverse health effects, making it imperative to carefully select those women who should be screened using this technology."For women at average risk, ACS recommends getting annual mammograms and breast exams by a physician, beginning at age 40. Most high-risk women should begin getting MRIs and mammograms at age 30, the new guideline says, unless they and their doctor think it's better to begin at a different age.
Better Evidence for Many Situations
The new guideline is published in the latest issue of the ACS journal CA: A Cancer Journal for Clinicians. It recommends MRI screening in addition to mammograms for women who meet at least one of the following conditions:
- they have a BRCA1 or BRCA2 mutation
- they have a first-degree relative (parent, sibling, child) with a BRCA1 or BRCA2 mutation, even if they have yet to be tested themselves
- their lifetime risk of breast cancer has been scored at 20%-25% or greater, based on one of several accepted risk assessment tools that look at family history and other factors
- they had radiation to the chest between the ages of 10 and 30
- they have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or may have one of these syndromes based on a history in a first-degree relative
The recommendations are based on studies that were published after the ACS last revised its breast cancer early detection guidelines in 2002-2003. At that time, the panel concluded there was not enough evidence to recommend for or against MRI in high-risk women, so the guideline advised these women to make the decision after talking with their doctor. Now there is more solid evidence that MRI is useful for certain women.
"These guidelines are a critical step to help define who should be screened using MRI in addition to mammography, a question of significant importance as we discover women at very high risk of breast cancer can be diagnosed much earlier when combining the two technologies rather than using mammography alone," says Russell, co-director of the University of Southern California/Norris Cancer Hospital Lee Breast Center.
More to Be Learned for Other High-Risk Situations
For some women, however, the jury is still out on whether MRI screening is beneficial, even though they have conditions that do give them a higher-than-average risk of breast cancer. The guideline says there still isn't enough evidence to recommend for or against MRI screening in women who:
- have a 15%-20% lifetime risk of breast cancer, based on one of several accepted risk assessment tools that look at family history and other factors
- have lobular carcinoma in situ (LCIS) or atypical lobular hyperplasia (ALH)
- have atypical ductal hyperplasia (ADH)
- have very dense breasts or unevenly dense breasts (when viewed on a mammogram)
- have already had breast cancer, including ductal carcinoma in situ (DCIS)
Screening MRIs are not recommended for women with a lifetime risk of breast cancer below 15%.
MRI Also Useful in Contralateral Diagnosis
Although the ACS guidelines find screening MRIs of uncertain value for breast cancer survivors, a newly published study shows the scans can be useful for finding tumors in the opposite (contralateral) breast of women newly diagnosed with the disease.
As many as 10% of women with breast cancer develop a new tumor in the opposite breast, even though nothing is found when they are checked with mammograms and physical exams at the time of their original diagnosis. Finding these cancers earlier could help women make treatment decisions (some women with cancer in just one breast opt to have both breasts removed as a precaution), and might spare them from extra rounds of surgery and chemotherapy later.
Researchers from the University of Washington Medical Center in Seattle studied 969 newly diagnosed breast cancer patients to see if MRIs could find contralateral cancers that mammograms and physical exams missed. The scans found 30 early-stage tumors the other tests could not detect, and missed only 3.
"This study gives us a clearer indication that if an MRI of the opposite breast is negative, women diagnosed with cancer in only one breast can more confidently opt against having a double (or bilateral) mastectomy," says John E. Niederhuber, MD, director of the National Cancer Institute, which sponsored the study.
The results appear in the New England Journal of Medicine. The study was released to coincide with the publication of the new ACS guidelines for MRI screening in high-risk women.
Citations: "American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography" Published in the March/April 2007 CA: A Cancer Journal for Clinicians (Vol. 57, No. 2: 75-89). First author: Debbie Saslow, PhD, American Cancer Society.
MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer Published in the March 29, 2007 New England Journal of Medicine (Vol. 356, No. 13: 1295-1303). First author: Constance D. Lehman, MD, PhD, University of Washington Medical Center, Seattle.
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FOR IMMEDIATE RELEASE
Feb 2007
DR. TIM GRONLIE JOINS WRG
The Wichita Radiological Group is pleased to announce the association of Tim Gronlie, MD as the newest physician in the Diagnostic Radiology section. Dr. Gronlie, a native of North Dakota and a graduate of the School of Medicine at the University of North Dakota is a 2005 graduate of the University of Kansas School of Medicine residency program in Diagnostic Radiology at Wesley Medical Center. He is board certified in Diagnostic Radiology by the American Board of Radiology.
"We are pleased to be able to add Dr. Gronlie to our group," said Dr. John Lohnes, President of WRG. "He already has a great reputation within the medical community because of the quality of his work and the 'can-do' attitude with which he approaches his work."
Dr. Gronlie will be working with the vascular-interventional section and in pain management as his main areas of interest.
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FOR IMMEDIATE RELEASE
May 2006
LOHNES NAMED LOCAL HERO BY LOCAL KOMEN GROUP
Dr. John Lohnes, president of the Wichita Radiological Group and Cypress Women’s Imaging was named the “Local Hero” for 2006 by the Mid Kansas Chapter of the Susan G. Komen Foundation.
“I am humbled by this recognition,” stated Lohnes. “It really belongs to my wife who serves as the registration chair for the local RACE FOR THE CURE and to my partners and our employees for understanding and buying into the Cypress Women’s Imaging concept of a comprehensive approach to breast imaging and health.”
“Each year over 5000 Kansas women get a diagnosis of breast cancer. If each has 4 family members and friends of at least 10 people that means that nearly 10% of the state is touched by this cancer each year. And of course, it isn’t just a single year proposition, so that in a very short time, nearly half the state knows someone affected by this disease.”
“Anything that we can do to make the diagnosis sooner, make the course of treatment quicker and more specific for that woman, we will do.”
Cypress Women’s Imaging is a specialized group of physicians and technologists that are focused upon the diagnosis of breast cancer. They currently operate two offices for mammographic and bone density studies in Wichita. All of the physicians hold joint appointments with the University of Kansas School of Medicine.
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FOR IMMEDIATE RELEASE
May 2006
DR. RICHARD BERGER NAMED AS EXAMINER
Dr. Richard Berger has been named as an examiner for the upcoming American Board of Radiology examinations. This is the second time he has been nominated and accepted. He has also previously served as an examiner for the Certification of Added Qualification in Neuroradiology examination.
"This is a fine honor for Dr. Berger and speaks well of our residency program and the quality of individuals that serve as the teachers for this program. It is unusual for a program such as ours, that is based in private practice, to be acknowledged in such a manner," said David Brake, MD FACR and Chairman of the Dept of Radiology for the University of Kansas School of Medicine Wichita. The program is administered by the Wichita Radiological Group and is one of only two radiology residency programs in the state.
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