Updates on Women's Health
Posts for: February, 2016
Evidence Based Care…
‘EARLY DETECTION IS OUR BEST PROTECTION’
We advocate for and utilize common sense, evidence-based guidelines seasoned with clinical judgment and individualized care. Nothing is cookbook or cast in stone.
The landmark work of Johns Hopkins University, the endorsement of the American College of Radiology and the Society for Breast Imaging attest to the proper use of ultrasound for breast screening in appropriate candidates according to risk status.
Breast Density Law…
California law SB 1538 as of April 2013 and many other states now require women who have heterogeneously dense and/or extremely dense breasts (the majority of the population) to be informed of this condition and in turn be offered additional screening tests if desired. The additional most practical test is bilateral (both breast) ultrasound due to its safety, effectiveness and low cost.
Schools of Thought…
To screen or not to screen? There really is no true debate on this issue. Of course screening saves lives when done properly. Just as prenatal care, dental care, adult check ups, blood pressure, diabetes and cholesterol screening save lives and improve our quality of life when performed appropriately. The screening simply must be evidence-based, of high quality, accessible and affordable.
How and When to Screen:
Regarding age and the decades of life we advocate for the following: Teens: SBE
- 20-30 years: SBE
- 30-40 years: SBE, Breast Ultrasound
- 40-80 years: SBE, Breast Ultrasound, Mammography
- 80 years plus: same as 40-80 if one has 5 or more years of life expectancy
The time interval (frequency) is generally once per year unless high risk…then consider every 6 months for Ultrasound.
Accuracy of Screening…
When SBE, PBE, Mammogram and Bilateral Ultrasound are combined in the proper interval, most (90%) of breast cancers are found in stage 0, I or II and are lymph node negative (excellent prognosis).
What about false positives and so-called ‘unnecessary biopsies’?
This is not an issue when careful risk assessment, appropriate high-quality screening and follow-up are conducted in an evidence based, individualized manner.
Who Conducts the Clinical Testing?
Full time gynecologist and women’s health specialist, John Armstrong MD MS Inc. personally conducts the PBE, the ultrasound examination and interprets the study for you in real time at the visit. There is no waiting for your result or interpretation. He has extensive training and experience in the examination and clinical correlation of the findings (what to do with the results and how to use the information). Dr. Armstrong has 34 years of post-training experience in breast health having conducted approximately 8000 ultrasound examinations with accurate interpretations to date. We have state of the art, high-definition Toshiba Ultrasound equipment and each study is hand-held rather than automated by a robot or obtained by a technician. This technique of real-time image acquisition, interpretation and clinical correlation all in one is far more accurate and efficient and leaves no room for fragmentation of care or ‘separation’ errors in the conclusions and recommendations. And, there is no waiting!
To provide Comprehensive Women’s Healthcare that is evidence-based, simple, safe, comfortable, accurate, accessible, useful and affordable.
To reduce the mortality and morbidity of women’s cancers through education, prevention and early detection.
Candidates for Evaluation
Any woman 25 to 90 years of age with a life expectancy of 5 or more years. Prior mammograms, mammogram issues or abnormalities are NOT required for evaluation or screening.