Rapid Breast Cancer Diagnostics
with Alex Munitz, MD
What is the radiologist’s role?
When a woman has a mammogram and finds out she needs further testing, she may go through sleepless nights, wondering if she will be diagnosed with breast cancer.
With Alex Munitz, MD, Director of Imaging, Sandra and Malcolm Berman Comprehensive Breast Care Center at GBMC, says he wants patients to spend less time waiting and worrying by getting a quicker diagnosis. “We have a very dedicated staff that is willing to go the extra mile to help our patient get the results as soon as possible,” he says.
As part of the Rapid Diagnosis Program at GBMC’s Comprehensive Breast Care Center, the staff makes every effort to shorten the process of diagnosing or excluding breast cancer. “In the past it has taken up to three months to get from the original mammogram, where the abnormality is suspected, to the point where a diagnosis is actually made,” says Dr. Munitz. “Three months is an agonizingly long time for a woman to have to go through this process.”
Women who come to the Center for mammograms will be contacted within three or four days if an abnormality is detected. Additional tests, such as a diagnostic mammogram and an ultrasound, are then performed to focus on the abnormality that was detected in the initial mammogram. “If it remains an abnormality at that point, we try to do a biopsy on the same day,” says Dr. Munitz. If insurance permits, doctors may even be able to call the patient within 24 hours and give her a diagnosis.
“So you shorten the waiting to a few days, rather than a few months,” says Dr. Munitz. “If it is benign, the patient is given the reassurance quickly, instead of having to worry unnecessarily.”
Patients who are diagnosed with breast cancer will also be able to receive a referral for treatment right away. “If a patient needs a breast surgeon, we can frequently facilitate an appointment within a few days and she can get on with the process,” says Dr. Munitz.
Radiologists at the Center serve as caregivers throughout the entire process, from recommending further testing to performing the patient’s biopsy. “We have a relationship with the patient where we are recommending the biopsy, doing the biopsy, giving them the results and recommending therapy,” says Dr. Munitz. “Frequently the patient will call back three or four times for support during the process of transferring their care to the breast surgeon.”
Nationwide, more diagnostic biopsies are being performed by radiologists, with GBMC at the forefront. “We do more biopsies than anywhere in the state of Maryland. The Center is staffed by breast imaging specialists and technologists who are focused completely on breast imaging,” says Dr. Munitz. “We have a combination of a great staff and superb technology.”
Currently, about 40 to 50 percent of the patients treated through the Rapid Diagnosis Program have a biopsy performed by their radiologist on the day of their diagnostic mammogram. Dr. Munitz says as the program moves forward, that number could reach 100 percent.
“We can do 20 of these procedures in one day,” says Dr. Munitz. “It makes tremendous sense to do this through a three- to four-millimeter incision under local anesthesia and save the patient a trip to the operating room.”
Often, the procedure itself is also much less traumatic for patients. “More than 50 percent of the biopsies we do are going to be benign, so what we have done is saved these women the disfigurement of having a three-inch scar and a dent in the breast. We can give her the same information through a three-millimeter incision.”
The goal of the Rapid Diagnosis Program is to shorten the amount of time a woman has to wait for a definitive diagnosis. “We have a very tightly controlled Center and there is a dedication to a cause,” says Dr. Munitz. “We all realize the emotional toll of the diagnosis or exclusion of breast cancer.”
