Finding breast cancer: The mission of the Mammography Clinic Published March 21, 2018 By Tech. Sgt. James Hodgman 60th Air Mobility Wing Public Affairs TRAVIS AIR FORCE BASE, Calif. – A small clinic on the third floor of David Grant USAF Medical Center provides an important service to Tricare beneficiaries: Finding breast cancer. Breast cancer is the second leading cancer-associated death for women in the United States, according to the website, Breastcancer.org. About one in eight women will likely develop breast cancer in their lifetime. Because of this reality, it’s important for women ages 40 and up to have routine mammograms. A mammogram is a low-dose X-ray exam of the breasts to look for abnormalities. This exam allows doctors to analyze breast tissue and discover things that can’t be felt during a standard breast exam. The mission of the Mammography Clinic at Travis Air Force Base, California, is discovering breast cancer early. “The purpose of this clinic is to find breast cancer as soon as possible while providing the best care for our patients,” said Tech. Sgt. Shirley Velez-Nicholas, 60th Medical Diagnostics and Therapeutics Squadron Mammography Clinic noncommissioned officer in charge. “We want to catch cancer early so it can be treated and help our patients every step of the way.” The Mammography Clinic offers a variety of services including screening and diagnostic mammograms, breast ultrasounds, as well as ultrasound guided and mammographic guided biopsies. “We also assist doctors with wire localizations,” said Velez-Nicholas. “If cancer is diagnosed, we help doctors localize where the cancer is. We insert a wire into the breast exactly where the tumor is and then the surgeon goes in to that exact spot and cuts out the tumor. We then X-ray the tissue to ensure the doctor removed all of the cancer from the breast.” Of course, before breast cancer can be treated, it must be found, which is why routine mammograms are so critical, said Dr. (Maj.) Shannon Gaffney, 60th MDTS Mammography Clinic officer in charge. “We have to screen a significant portion of the population to find cancers and the point of screening is to find small cancers that can be treated much easier,” said Gaffney. “The alternative to screening is waiting until someone feels a lump in her breast and that could mean the cancer is at an advanced stage which could mean more extensive treatment. The focus of screening is to find early stage breast cancers that are less than a centimeter in total size.” Those cancers are sometimes so small, Gaffney stressed, they are only found by using sophisticated X-ray technology, such as 3-D mammography (tomosynthesis). “Every woman at DGMC has a mammogram with tomosynthesis (3-D imaging), which helps us detect small cancers and prevent false positives,” said Gaffney. “We will soon start 3-D-guided biopsies as well near the end of March.” Before 3D imaging was available, breast cancer screening was primarily performed using 2-D technology, said Velez-Nicholas. “The 3-D images allow us to scan the entire breast which provides a much better picture of the breast and where the cancer is located,” she said. The technology has enabled the Mammography Clinic to detect cancers at a rate that’s higher than the national benchmark. “In 2017, we did 2,357 screening mammograms and found a total of 24 cancers,” she said. “The national benchmark is about three to five cancers per 1,000 screening exams, so we are detecting cancers at a higher rate than what is generally expected.” Gaffney said those results show why it’s vital women 40 and above are routinely screened for breast cancer. Women who discover a lump on their breasts or are concerned about something they found during a self-exam, must first see their primary care manager before being referred to the Mammography Clinic. However, asymptomatic women 40 and above can self-refer and schedule a screening mammogram appointment by contacting the Mammography Clinic directly. Additionally, women who have a strong family history of breast or ovarian cancer, may need to begin screening exams earlier than age 40. These patients should contact their PCM to discuss their risk factors. Gaffney said her team has started a letter writing campaign to encourage women to obtain annual screenings. “Many women may forget to get a screening annually and could go several years without having a screening done,” she said. “To combat this we are starting to send out reminder letters to our patients. We mailed about 200 letters in February. Many women haven’t had a mammogram for up to five years and we want to encourage those women to come in and get their screening done.” Senior Airman Paige Ortberg, 60th MDTS mammography technologist, is one of the technicians who performs mammograms in the Mammography Clinic. She said she averages about 14 patients a day, one every 30 minutes. As a technician, she’s responsible for performing mammograms and assisting doctors with additional imaging if cancer is discovered. She said she enjoys her job. “The job is very rewarding,” she said. “Most people come in to figure out if they have cancer or not. It’s kind of a scary thing for someone to hear they have cancer. Being able to make them feel comfortable and want to come back again is something I take seriously. We are here for them throughout the entire process. To be able to help women through all of that is very rewarding.” Providing the best care to patients is the best part of the job, said Velez-Nicholas. “Our patients are so thankful when we find their cancer early and that we helped them,” she said. “We don’t simply screen them and send them away. We do everything. If a surgeon decides to operate, we assist them with that. We help our patients through the whole process and that experience is very rewarding.” To make an appointment with the Mammography Clinic, call 707-423-7275.