3-D Mammography at MVH: A Positive Advancement for Dense Breast Tissue

(April 2, 2019 - Carroll Township, Pa.)

Natalie Furgiuele, M.D., FACS photo
Natalie Furgiuele, M.D., FACS

Radiologic technologist Jessica Meier poses with the 3-D mammography unit at Monongahela Valley Hospital photo
Radiologic technologist Jessica Meier poses with the 3-D mammography unit at Monongahela Valley Hospital.
The Food and Drug Administration (FDA) is proposing new mammography regulations that would standardize information given to women related to the density of their breast tissue. In 2013, the Pennsylvania General Assembly enacted the Breast Density Notification Act requiring the notification of breast density to patients who receive a mammogram.

According to Natalie Furgiuele, M.D. FACS, breast surgeon at Monongahela Valley Hospital (MVH), while having knowledge of breast density is important, one of the best ways to detect breast cancer at its earliest stage is through 3-D mammography.

"For women with dense breast tissue, 3-D mammography is a very positive advancement because we can find cancer earlier and more accurately," said Dr. Furgiuele. "At Monongahela Valley Hospital, if the 3-D mammogram indicates something suspicious, we make every effort to offer radiologic interventions simultaneously — often the same day"

Also known as digital breast tomosynthesis, 3-D mammograms capture a series of consecutive images from different angles across the arc of the breast to produce three-dimensional slice images. The slices enable radiologists to examine breast tissue one layer at a time instead of viewing all of the layers together as a flat image. An abnormality that is hidden behind dense tissue in one image may be visible in another image at a slightly different angle.

"Not all abnormalities are cancerous. A breast biopsy is the only way to obtain an accurate diagnosis," explained Dr. Furgiuele. "Consultation with a breast surgeon is advised anytime an abnormality is detected whether radiographicaly or on physical exam."

At MVH's Breast Care Center, located in the Hospital, radiologists perform breast biopsies to remove cells - either surgically or less invasively with a hollow needle - to determine if an abnormality is benign or cancerous. The Breast Care Center offers different types of breast biopsy procedures to obtain tissue samples. The type of biopsy a physician prescribes largely depends on the size, location and other characteristics of the breast abnormality. The types include:

  • Stereotactic, which uses X-ray equipment and a special computer to analyze pictures of the breast, precisely identifies the abnormal area in which to insert the needle for the removal of a tissue specimen
  • Ultrasound-Guided, which uses high-frequency sound waves to produce precise images of the abnormality on a computer screen, enabling radiologists to insert a needle that removes several core samples of tissue to be sent to the on-site lab for analysis
  • MRI-Guided, which is minimally invasive, involves computer technology that guides a needle to the mass which is then removed and sent to the onsite lab to undergo the testing process and review
  • Surgical (Open) Biopsy, which is used less frequently, involves cutting the breast to remove the lump to review it under a microscope.

MVH is one of only a few hospitals that offers routine breast cancer risk assessments. During a woman's first visit to the Breast Care Center, a member of the health care team performs a breast cancer risk assessment to calculate her risk of developing breast cancer. Based on the risk assessment, genetic testing may be suggested.

"I constantly remind women that the best way to detect breast cancer early, when the outcomes can be most positive, is through annual mammograms. If you haven't had a mammogram in over a year, plan to get one tomorrow," said Dr. Furgiuele.

Monongahela Valley Hospital offers 3-D mammograms at both the Hospital and at HealthPlex Imaging located at the Monongahela Valley Hospital HealthPlex. Walk-in mammograms without a prescription are available at the Hospital Monday through Friday from 8 a.m. to 4 p.m. and at the HealthPlex Monday through Friday from 8 a.m. to 4 p.m.; Tuesday until 8 p.m.; and Saturday 7 a.m. to Noon.

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