INTERVIEW TRANSCRIPT from Podcast (AIUM Speaker Series)- 5/2024
I became a Gynecologic Sonologist because two of the other physicians in my group were maternal fetal medicine doctors who also did gynecologic ultrasound, but they were more interested in the fetuses. I frankly, was more interested in the pelvis. I transitioned over the years and I became a specialist in GYN ultrasound. I co-wrote a textbook on this topic. Maybe half of our practice is second opinions, especially in GYN ultrasound. Ultrasound is not typically performed by the physician. It's performed by sonographers (ultrasound technicians). They're taught very well but there is an added layer of validity when you, the physician is the one taking the images, when you understand the physiology and what you're looking at-- it affects interpretation. Our sonographers are excellent- there's so much more control in scanning the patient if YOU the physician are the one navigating the probe firsthand.
I became a Gynecologic Sonologist because two of the other physicians in my group were maternal fetal medicine doctors who also did gynecologic ultrasound, but they were more interested in the fetuses. I frankly, was more interested in the pelvis. I transitioned over the years and I became a specialist in GYN ultrasound. I co-wrote a textbook on this topic. Maybe half of our practice is second opinions, especially in GYN ultrasound. Ultrasound is not typically performed by the physician. It's performed by sonographers (ultrasound technicians). They're taught very well but there is an added layer of validity when you, the physician is the one taking the images, when you understand the physiology and what you're looking at-- it affects interpretation. Our sonographers are excellent- there's so much more control in scanning the patient if YOU the physician are the one navigating the probe firsthand.
Cohort Study (Part 1)- Dense Breast Scanning Survey / Molloy University:
ACADEMIC PREFLIGHT STUDY OF ULTRASOUND SCREENING APPLICATIONS FOR DENSE BREAST CASES
Transcript by: Noelle Cutter, Ph.D.
Edited by: Roberta Kline, MD and Lennard M. Goetze, Ed.D
The Dense Breast paradigm continues to plague our population of the underdiagnosed and underserved women. uniting with public advocates and legislative change makers like the ARE YOU DENSE? FOUNDATION raises significant public awareness in both the clinical and patient communities (see news feature). Meanwhile, this cohort study received great support from the medical research and diagnostic society whereby scientific leaders like Dr. Robert L. Bard (diagnostic imaging specialist) and Dr. Roberta Kline (epigenetics expert in women's health) helped to spearhead their own respective areas of study to help offer new insight and data in support of the launch of this field research program.
My technicians and I found the Terason to be "super portable" and upon scanning our first few subjects, we immediately understood why Dr. Bard suggested this brand and model. The picture quality and imaging system is very clear and the user interface is very easy to read. For someone who is not experienced or well trained in using an ultrasound, with one or two training sessions I was able to easily use the machine to work with our volunteer subjects.
An underlying test is the feasibility of using the Terason itself in actual field work. The portability is astounding (to me). This means we can pack it up. I don't even need any sort of a car. I could throw it on my back and get on a bicycle and bring it to a, uh, a destination.
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| Click image to see full scan report |
FINAL STATEMENT
Breast density is a key factor in early detection because mammograms routinely miss breast cancer in dense breasts, especially in younger and more athletic women. Ultrasound offers a supplemental scan and peace of mind because it finds the pathology and almost instantaneously distinguishes from a benign cyst from a possible cancer - or a definite cancer. Ultrasound even goes further because if there is a definite cancer or something highly suspicious of a cancer, you can look at the other organs such as the glands under the arm to see if it's spread into the lining of the lungs to see if it's invading the pleura or the lymph nodes in the abdomen or the brain. Since we are now armed with expert diagnostic over-readers and remote collaborative imaging options, I urge our gynecologic and obstetric community to take advantage of this affordable non-invasive screening solution.
Epigenetic Research Notes: Profiling the Dense Breast Paradigm
A Clinical Report by: Dr. Roberta Kline
LINKING DENSE BREAST WITH BREAST CANCER
We have known for a very long time that there is an increased risk of breast cancer for women who have dense breasts. Until recently, the research has been lagging in terms of what's the molecular mechanism, why do dense breasts present an increased risk of breast cancer? Without this knowledge, we can’t address the root causes, and are left with a lot of trial and error based on incomplete understanding.
It's very encouraging to know that currently there are 124 clinical trials ongoing looking at dense breasts and the relationship with breast cancer, anywhere from improved diagnostics, to treatment, to prevention, and, what’s close to my heart, to understanding the molecular mechanisms - what's happening at the cell level, at the genetic level that is causing different women to have an elevated risk of breast cancer. One of the striking features that we're learning about dense breasts and what is creating that density is the microenvironment, which means the environment in the supporting tissue surrounding the glands. This includes fibroblasts and collagen. It seems that rather than estrogen being the dominant factor, it is inflammation that is creating the increased density of breast tissue.
WHAT'S NEXT AFTER CANCER?
The Importance of Maintaining a Healthy Lifestyle and Monitoring
Written by: Dr. Leslie Valle-Montoya
Staying vigilant with regular check-ups, lifestyle adjustments, and continued screenings is essential. Early detection of any signs of recurrence greatly increases the chances of successful treatment. Maintaining a healthy lifestyle after being declared “cancer-free” is not always easy, but it’s vital. We are constantly exposed to environmental toxins in our food, water, and surroundings, so addressing the root causes of disease and making healthier choices is crucial. A nutritious diet, physical activity, and stress management all support overall wellness and strengthen the immune system. I often guide patients in addressing lingering dental infections and maintaining a healthy internal environment, whether by enhancing the microbiome or reducing bodily acidity, which cancer thrives on.
Avoiding smoking, limiting alcohol, and maintaining a healthy weight are also key to lowering the risk of recurrence. By focusing on what you can control—your health and regular monitoring—you empower yourself to stay well and ensure long-term health.
May 21, 2024, leading members of the NY Cancer Resource Alliance (NYCRA) held a special meeting with State Senator Patricia Canzoneri‐Fitzpa...
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