When NBC News correspondent Kristen Dahlgren came to Mayo Clinic to report on a new study, she thought it was just another routine assignment. Three years later, she credits it with saving her life.

When NBC News correspondent Kristen Dahlgren came to Mayo Clinic to report on a new study on unusual breast cancer symptoms, she thought it was just another "routine assignment," she writes on Today.com. Three years later, Kristen calls it "a story I credit with saving my life."

Back in 2016, Kristen reported that researchers in England found that 1 in 6 breast cancer patients had symptoms other than breast lumps. "What this new study tells us is it's profoundly important to be aware of your breasts, to be familiar with your breasts, even outside of a ritual monthly self-breast exam," Deborah Rhodes, M.D., from Mayo's Breast Diagnostic Clinic told Kristen at the time.

Those words came back to her last year on her 47th birthday. "I was getting ready to meet friends when I caught a glimpse of a slight dent in my right breast. I had never noticed it before," Kristen writes in a December 2019 piece on Today.com. "Beneath the dent, I didn't feel a lump, but something I might describe as a 'thickening.' It just felt different than everywhere else."

Read the rest of Kristen's story.
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This story originally appeared on the In the Loop blog.

The post In the Loop: Kristen Dahlgren reported on rare cancer symptoms — then discovered her own appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (0:59) is in the downloads at the end of this post. Please "Courtesy: Mayo Clinic News Network." Read the script.

"MBI is a relatively new tool for imaging the breast that was designed to overcome the limitations of mammography for imaging the dense breast," says Dr. Rhodes.

You see, dense breast tissue and cancer both appear white on a mammogram.

"So this tool images the breast in such a way that the tumors stand out from the background tissue and are not obscured by overlying breast density," says Dr. Rhodes.

Two large studies showed that MBI detected three to four times more cancers than mammography in women with dense tissue.

How do you know if you have dense breasts?

"Lots of women will say to me: 'Oh, I have dense breasts. I can tell by the way they feel because they're lumpy.' But that actually does not correlate with the density of the tissue. Dense tissue is defined solely by the mammographic appearance of the breast. The more white tissue on the mammogram, the denser the breast," says Dr. Rhodes.

The post Mayo Clinic Minute: What is molecular breast imaging and who needs it? appeared first on Mayo Clinic News Network.

October is Breast Cancer Awareness Month, a time to reflect on new, individualized approaches to detecting and treating a cancer that affects 1 in 8 American women. Deborah Rhodes, M.D. and her Mayo Clinic colleagues are working to identify the best targeted screening tools and guidelines for women with a higher risk of developing breast cancer – those with dense breast tissue and those with an inherited genetic variation linked to the disease.

With support from the Center for Individualized Medicine, Dr. Rhodes and her colleagues have developed research to find the best way to screen for breast cancer in these populations, with the goal of detecting and treating the disease sooner.

“It’s critical to detect breast cancer early because survival is linked to tumor size at the time a patient is diagnosed. If we discover a tumor when it is less than one centimeter, that patient has over a 90 percent chance of surviving. That’s why we are evaluating how to use new imaging techniques and genetic tests to provide the best care for patients who are at higher risk of developing breast cancer.” – Deborah Rhodes, M.D.

“It’s critical to detect breast cancer early because survival is linked to tumor size at the time a patient is diagnosed. If we discover a tumor when it is less than one centimeter, that patient has over a 90 percent chance of surviving,” says Dr. Rhodes, a Mayo Clinic Breast Clinic physician. "That’s why we are evaluating how to use new imaging techniques and genetic tests to provide the best care for patients who are at higher risk of developing breast cancer.”

Evaluating screening tools for women with dense breast tissue

According to Dr. Rhodes, the 27.6 million women in the U.S. who have dense breast tissue may not be effectively screened with mammography alone. Many states have laws that require physicians to notify women if they have high breast density and how this affects breast cancer detection and risk.

As Dr. Rhodes explains, “We want to build awareness so that women understand that high breast density is the primary reason for missed or delayed breast cancer detection. Dense breast tissue can mask cancer tumors on mammography. Since high breast density increases a woman’s risk of developing breast cancer, it’s important that we find effective screening methods to identify the cancer early, when it is most treatable,” says Dr. Rhodes.

Since there are no consensus guidelines on how best to screen these patients, Dr. Rhodes and her colleagues are conducting a comprehensive evaluation of two screening approaches – 3-D mammograms and molecular breast imaging (MBI).

3-D mammograms have replaced 2-D mammograms as the standard screening tool in many centers. Research has shown that the main benefit of a 3-D mammogram is that it reduces the chance that a patient will be recalled for additional testing because of findings that are false positives and not due to cancer.

“MBI has been shown to more clearly distinguish between dense breast tissue and tumors. In a Mayo Clinic study, MBI detected more than three times the number of cancers compared to 2-D mammograms. We’re exploring whether MBI provides this same advantage over 3-D mammograms,” says Dr. Rhodes.

In addition to comparing cancer detection rates, the Mayo MBI research team is also analyzing the costs associated with each screening method.

“One of the advantages of MBI is that it can be performed at a relatively low cost, comparable to the cost of a mammogram, and many insurance carriers are starting to cover MBI for screening, "says Carrie Hruska, Ph.D., a Mayo Clinic physicist. "In current trials, researchers are tracking the costs of MBI screening as well as costs of downstream testing generated by findings on MBI and 3-D mammograms in order to compare their cost-effectiveness.”

The team is also addressing a common concern about the higher radiation dose used in MBI, compared to 3-D mammograms. Dr. Hruska and physicist Michael O’Connor, Ph.D. have made several modifications to the MBI system to permit the exam to be performed at a low radiation dose that is safe for routine screening.

The researchers are aiming to lower the radiation dose even further to the same level as a mammogram by applying an image processing algorithm to reduce “noise” in the MBI images. In preliminary studies, using this mathematical model allowed radiation dose to be cut in half, yet the ability to detect breast cancers was preserved.

“We’re carefully evaluating both screening tests and hope to have substantial data to support cancer screening recommendations for patients with dense breast tissue – recommendations that are needed to save lives through earlier detection and treatment,” says Dr. Rhodes.

Hereditary breast cancer – guidelines for a lifetime of care

Mayo researchers and physicians are also collaborating to streamline care for patients whose breast cancer is linked to inherited genetic mutations. A finding of hereditary cancer could lead to changes in treatment, and it could alert other family members that they may also be at a higher risk of developing breast cancer.

Along with Myra Wick, M.D., Ph.D., Dr. Rhodes is co-chair of the Mayo Clinic Familial Cancer Cross Disciplinary Disease Group. The group brings together experts from many specialties –radiology, genetics, surgery, gynecology, oncology, endocrinology, laboratory medicine, pathology and primary care. Their goal is to identify the best care guidelines for patients who either have or are suspected to have a genetic variant linked to hereditary cancer.

“Whether these patients have already been diagnosed with hereditary breast cancer or have a family history suggesting they may have a hereditary breast and ovarian cancer syndrome, we want to identify the best care pathway for them. We’re mapping each patient scenario to determine how to guide their medical care over a lifetime,” says Dr. Rhodes.

Learn more about individualized medicine

For more information on the Mayo Clinic Center for Individualized Medicine, visit our blog, Facebook, LinkedIn or Twitter at @MayoClinicCIM.

See highlights from Individualizing Medicine: Advancing Care Through Genomics, which was held Sept. 12-13 in Rochester, Minnesota:

• CIM CON day 1 – Precision cancer care: ‘So much power’
• CIM Con day two: Unlocking the mystery of rare diseases
• CIMCON18 — how genomics discovery is transforming individualized care and the path forward

The post Science Saturday: Finding and treating breast cancer sooner appeared first on Mayo Clinic News Network.

Mayo Clinic researchers hope to decrease the number of cancer deaths by developing new ways to detect and treat cancer. For example, they developed molecular breast imaging, a new screening tool for breast cancer, which is the most common cancer among American women.

The technology may benefit women with dense breasts. Research shows molecular breast imaging detects more breast cancers in this group of women than mammography. Up to half of all women have dense breast tissue.

In this Mayo Clinic Minute, reporter Vivien Williams talks to Dr. Deborah Rhodes about molecular breast imaging.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:59) is in the downloads. Read the script.

The post Mayo Clinic Minute: Looking at molecular breast imaging on World Cancer Day appeared first on Mayo Clinic News Network.

MBI is a test that uses a radioactive tracer and special camera to find breast cancer. Rather than simply taking a picture of a breast, molecular breast imaging is a type of functional imaging. This means the pictures it creates show differences in the activity of the tissue. Tissue that contains cells that are rapidly growing and dividing, such as cancer cells, appears brighter than less active tissue.

During MBI, a small amount of radioactive tracer is injected into a vein in your arm. The tracer attaches to breast cancer cells that can then be detected using a camera that detects the gamma radiation released by the tracer (gamma camera).In this Mayo Clinic Minute, reporter Vivien Williams talks to Dr. Deborah Rhodes, a lead researcher in pioneering this tool for tumor detection.

Watch: The Mayo Clinic Minute

Molecular breast imaging may be used to:

• Screen for breast cancer in women with dense breast tissue. Molecular breast imaging, when combined with a breast X-ray (mammogram), detects more breast cancers in women with dense breast tissue than a mammogram alone.Typically, if you and your doctor decide you will have molecular breast imaging, it is done every other year along with an annual mammogram.Breast tissue is composed of milk glands, milk ducts and supportive tissue (dense breast tissue), and fatty tissue. Women with dense breasts have more dense breast tissue than fatty tissue. Both dense breast tissue and cancers appear white on a mammogram, which may make breast cancer more difficult to detect in a woman with dense breasts. Studies show combining molecular breast imaging and a mammogram results in finding 3 times more breast cancers than a mammogram alone. Molecular breast imaging has U.S. Food and Drug Administration clearance, which is an acceptance for lower-risk medical devices, and there is evidence of its benefits in detecting cancers in women with dense breasts.
• Investigate breast abnormalities. Molecular breast imaging may help doctors evaluate a breast lump or an unusual area detected on a mammogram. Your doctor may recommend molecular breast imaging if other imaging tests have been inconclusive. Molecular breast imaging may be used in women for whom an MRI is recommended, but can't be performed, such as those with allergies to the contrast material.

Related Mayo Clinic News Network posts:

Cost-effective addition to mammography in detecting cancer in dense breast tissue

Mayo Clinic Q & A: In addition to mammogram, MBI useful for women with dense breasts

Breast Exam Nearly Quadruples Detection of Invasive Breast Cancers in Women with Dense Breast Tissue

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Here's the Mayo Clinic Radio podcast.

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Myth or Matter-of-Fact: You can tell whether or not you have sinusitis by the color of your mucus discharge.

Listen to the program on Saturday, March 26, at 9:05 a.m. CDT, and follow #MayoClinicRadio.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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Myth or Matter-of-Fact: You can tell whether or not you have sinusitis by the color of your mucus discharge.

Listen to the program on Saturday, March 26, at 9:05 a.m. CDT.

Miss the show?  Here's the Mayo Clinic Radio podcast.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

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high heels, can create postural stressors that often cause muscle imbalances and injury. Having good posture is essential for good health; however, understanding what good posture is and maintaining it are

hard.

“When some people try to work on their posture, they tend to overdo it,” says Alynn Kakuk, physical

therapist at the Mayo Clinic Healthy Living Program. “They get into a super-extended position with their shoulders way back — enough that it creates too much of an arch on their back. So, they just start shifting their weight too far back.”

Bad posture habits can cause imbalanced body alignment, strain on ligaments and muscles, chronic pain, injuries, impingement, low back pain, neck pain, hip pain, joint stiffness and muscle tightness, according to Kakuk.

Simple exercises, stretches and being conscious of your posture can eliminate these ramifications.

Journalists: Sound bites with Alynn Kakuk and b-roll of a posture analysis are available in the downloads.

MEDIA CONTACT:
Kelley Luckstein and Naomi Ogaldez, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

Practice a healthy posture

Stand up against a wall, and make sure your upper back, shoulders and bottom touch the wall. Your feet don’t have to be against the wall — just a couple of inches away from it. You should have a slight space in your lower back and be able to fit your hands in that space. But, make sure it’s not a big gap. Then, step away from the wall, and try to see if you can maintain that position. Keep in mind, strengthening your muscles will make it easier for you to maintain that posture overtime. Be careful of overdoing it or hyper-extending your back.

Using technology with a healthy posture

In a world filled with modern technology, reaching for your cellphone and keyboard are common movements. These movements can place stress on your upper back and neck, resulting in rounded shoulders and forward head. This can cause chronic upper back, shoulder, neck pain and headaches. Also, people can text so much that they develop pain and injury in their thumbs from that overuse. Here are some tips on how to maintain the correct posture while using technology.

• Try to have your cellphone at eye level, so you’re not bending forward.
• Do exercises that strengthen your upper back and shoulder, along with core strengthening exercises.
• Stay aware of your posture throughout the day.

Ergonomics at the office

Those who sit at a desk all day should be conscious of posture and the importance of getting up at least once an hour to move. “Standing up and focusing on good posture for a few minutes can relieve muscle strain and improve breathing and circulation, which also helps improve attention and engagement,” says Deborah J. Rhodes, M.D., physician and cancer researcher at Mayo Clinic. Nonetheless, having good office ergonomic habits can keep your muscles and ligaments healthy. Here are some tips on ergonomics at the office.

• Ensure your keyboard is at elbow height, so your hands can rest on the desk.
• Place your computer at eye level. Place laptops on platforms for them to be at eye level.
• Set your chair at a height that your feet touch the ground.
• Take a walk or stretch break every hour.

Walking in high heels with the correct posture

Walking in heels is essentially walking on your toes, which results in a chain reaction on the rest of your body. It causes the knees to hyperextend, the pelvis to tip forward, the lower back to tighten, and the abdominals to become weak. Here are some tips on how to maintain the correct posture while using high heels.

• When wearing heels, ensure you draw in your abdominal muscles to prevent that extra curve in your low back.
• Try to limit the use of your heels.
• Pick a heel that is smaller with a wider surface area that will help distribute your foot and weight better.

Maintaining good posture can help you walk, sit, stand and lie in positions that cause the least pressure on your muscles and ligaments during movement and weight-bearing actions.

It also gives confidence.

“People who have better posture tend to appear more confident and knowledgeable to others. It makes them feel confident internally as well,” says Kakuk.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

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Researchers at the Mayo Clinic Center for Individualized Medicine found that adding MBI to mammography of women with dense breast tissue increased the costs of diagnosis 3.2 times, compared to costs of mammography alone, and nearly quadrupled the rate of cancer detection. Because the supplemental test found more cancer, screening with a combination of mammography and MBI saved $8,254 per cancer detected.

While mammography is still the standard tool for widespread breast cancer screening, it is now known to perform less effectively in women with dense breast tissue. Both tumors and normal dense breast tissue can appear white on a mammogram, making tumors hard to detect. Nearly half of all women over age 40 have mammograms classified as “dense,” according to Carrie Hruska, Ph.D., a medical physicist in the Mayo Clinic Department of Radiology and the study’s lead author. Supplemental screening techniques like MBI address a significant need for better cancer detection methods for this patient population.

Journalists: Sound bites with Dr. Hruska are in the downloads.

MEDIA CONTACT: Bob Nellis and Shea Jennings, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

In an MBI examination, a radioactive tracer readily absorbed by cancerous breast cells is injected into the body. A small, semiconductor-based gamma camera then scans the breast, lighting up any areas where the tracer is concentrated. “It works really well in our practice at Mayo Clinic,” Dr. Hruska says. “Patients generally like it, and radiologists think it’s relatively easy to read.”

The screening combination of MBI and mammography can detect more cancers than mammography alone at acceptable radiation doses for screening, as the research group reported in a study published in AJR in February. But, concerns persist about the cost-effectiveness of MBI. Though the test finds more cancer in dense breast tissue, additional screening could also generate more false-positive results and lead to biopsies that do not result in a cancer diagnosis, ultimately increasing costs unnecessarily.

Dr. Hruska and her colleagues used the same data from the February study to compare the cost-effectiveness of screening 1,585 women with dense breast tissue with mammography alone and the combination of mammography and MBI. The comparison resulted in these findings:

• Cost per patient screened increased from $176 to $571 for the combination of tests. Mammography alone detected cancer in five of these patients. With the combination, physicians detected cancer in the first five women and an additional 14 patients — nearly a fourfold improvement.
• The cost per cancer detected was $55,851 for mammography alone and $47,597 for the combination of mammography and MBI — a savings of $8,254 per cancer detected.
• The risk of receiving an unnecessary biopsy because of a false-positive result increased from 0.9 percent with mammography alone to 3 percent with the addition of the MBI examination. However, this 2.1 percentage point increase in the benign biopsy rate is lower than the 6-point increase observed in outside studies using screening ultrasound or screening MRI, two alternative supplemental techniques.
• The positive predictive value (PPV) of MBI, or the likelihood that a biopsy generated by MBI would result in a cancer diagnosis, was 30 percent. In contrast, biopsies generated by screening ultrasound and MRI have PPVs of 6 percent and 20 percent, respectively.

“Cost saving per cancer detected with supplemental screening MBI is compelling evidence for future coverage of screening MBI of women with dense breasts,” the authors write. The study did not consider any costs beyond the point of cancer detection; however, the authors speculate that earlier detection with MBI may reduce the costs of treatment of advanced cancer further. When dense breast tissue is the only criterion for supplemental imaging like MBI, insurance coverage varies from state to state and among insurance providers.

Dr. Hruska calls the latest study a critical step in developing MBI as an individualized screening approach for patients with needs unmet by current options.

“The question is: What’s the right screening regimen for you?” says Dr. Hruska. “For about half of women of screening age, mammography works well. The other half – those with dense breasts – may want to consider adding another test. If you have additional risk factors, like family history or a genetic mutation that predisposes you to breast cancer, then you should have a supplemental MRI. But, there’s this huge group of women in-between who don’t qualify for a supplemental MRI and need something more than a mammogram. That’s who we’re trying to reach.”

Study co-authors are Amy Conners, M.D., Katie Jones, M.D., Michael O’Connor, Ph.D., James Moriarty, M.Sc., Judy Boughey, M.D., and Deborah Rhodes, M.D.

The study was supported by grants from Komen for the Cure, the Mayo Clinic Center for Individualized Medicine, and the National Center for Advancing Translational Sciences, which is a component of the National Institutes of Health, as well as philanthropic gifts from James L. and Donna K. Barksdale, Mabel W. Brown, Thomas C. and Michelle A. Tiller and other generous benefactors of Mayo Clinic.

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About the Mayo Clinic Center for Individualized Medicine
The Mayo Clinic Center for Individualized Medicine is home to the Individualized Medicine Clinic, the world’s first integrated, multidisciplinary genomics clinic, serving patients with advanced cancer and diagnostic dilemmas. The center discovers and integrates the latest in genomic, molecular and clinical sciences into personalized care for each Mayo Clinic patient. Visit http://mayoresearch.mayo.edu/center-for-individualized-medicine/ for more information.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit mayoclinic.com or newsnetwork.mayoclinic.org.

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