HEALTH MATTERS: What doctors look for during breast exams and scans

LITTLE ROCK, Ark. – Breast exams and mammograms are the best way to detect cancer early, but many patients wonder what the doctors running the exams look for. Doctors at the Baptist Health Breast Center are giving an inside look into how they identify breast cancer.

Image after image and scan after scan, Baptist Health Breast Center Radiologist Dr. Rachel Pahls’ job is detecting breast cancer in women who come to this clinic.

“Breast imaging all day every,” Dr. Pahls said. “This was a screening mammogram where we actually saw a mass in the inner left breast here that ended up being a breast cancer.”

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A screening mammogram is done in women with no symptoms and starts at age 40.

“We do these four standard views of the breast so two different pictures of each breast,” Dr. Pahls said.

Then if they find a problem, a patient is having symptoms or has a history of breast cancer a diagnostic mammogram is done.

“They’re performed on the same machine,” Dr. Pahls said. “We use the same images. We may add additional images into the standard routine ones.”

There are some women who are more susceptible to breast cancer like those with a family history or women with dense breast tissue.

“Breast cancer likes to occur in that fibroglandular tissue so if you have a larger proportion of it the chances of having breast cancer are slightly higher,” Dr. Pahls said.

That tissue also makes it tougher to spot.

“Breast cancers kind of present as a white-ish dot or mass in the breast so you can see how much easier it would be to hide a breast cancer in this tissue,” Dr. Pahls said.

That’s when they use 3-d tomography to get an even closer look.

“These are multiple Xray beams taken at various angles to recreate this image,” Dr. Pahls said. “It is much easier to see small masses.”

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Now along with masses, Dr. Pahls is also looking for calcifications.

“We see this small area of calcifications in the breast,” Dr. Pahls said.

In that case, Pahls brought this patient back for some extra scans.

“These calcifications are definitely more suspicious because they are almost traveling in a line in the breast,” Dr. Pahls said.

After a biopsy, it ended up being breast cancer caught early with a good prognosis.

“If something is going to happen, we’ll catch it early, we’ll take great care of you and you won’t have to worry after that,” Dr. Pahls said.

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