Case Study | February 01, 2012 | Case Study Supplied by Hologic Inc.

How a Small Clinic Led the West Coast in Adopting Breast Tomosynthesis

InHealth Imaging, Poulsbo, Washington

How a Small Clinic Led the West Coast in Adopting Breast Tomosynthesis

You can drive the 90 minutes to the small town of Poulsbo on the Kitsap Peninsula in Washington State. Or better yet, just jump on a ferry from Seattle and head directly across Puget Sound. Poulsbo is home to InHealth Imaging. In July 2011, InHealth was featured on television and in local newspapers for being the first imaging clinic on the West Coast to purchase a Selenia Dimensions breast tomosynthesis system, which also doubles as a stereotactic system for performing breast biopsies. Women from all over Washington State have been making appointments to have their mammograms at InHealth.

One of those patients – Carrie Goller – had been diagnosed with an aggressive form of breast cancer 10 years ago after having a mammogram at InHealth. “It was hard to detect on a standard mammogram. The calcifications were extremely small, and you had to use your magnifying glass and even then, they were difficult to see,” explains InHealth founder Manfred Henne, M.D., Ph.D., M.S. So when InHealth purchased the Selenia Dimensions, Goller wanted to be among the first patients to get a scan with the new technology.

New breast tomosynthesis technology, Henne explains, takes multiple low-dose images of the breast, acquired at different angles. These images are then processed using a computer to produce a series of 1mm-thick slices that can be viewed as a “3D” reconstruction of the breast, giving radiologists the ability to identify and characterize individual breast structures without the confusion of overlapping tissue.

“We had four cancers within just over a week of installing our new 3D breast tomosynthesis system. Two were really hard to see or possibly could have been missed with regular mammography,” says Henne.

“Cancers are not always obvious, especially early cancers. We want the best tools to diagnose cancer early on because that saves patients lives,” he adds, noting that one patient even came all the way from the Philippines to have her mammogram at the clinic.

In addition to tomosynthesis, InHealth takes full advantage of Hologic’s biopsy solutions, including the Affirm breast biopsy guidance system, ATEC and Eviva breast biopsy devices, and SecurMark and TriMark biopsy site markers.

Just as tomosynthesis provides a new dimension in mammography, the Hologic Affirm system represents the next generation in upright breast biopsy guidance. It was specifically designed to attach to the Selenia Dimensions system and to provide optimal use with the Eviva and ATEC breast biopsy devices, allowing radiologists to quickly and easily transition from 2D mammography to upright biopsy.

“The Hologic biopsy solution is the most sophisticated on the market. The device utilizes a rotary-type technique to flush and retrieve tissue with no reinsertion of the needle,” explains Henne. “We step on a pedal and the needle begins to take biopsy samples, with the cycle repeating itself until we are satisfied with the number of samples taken. Its strong vacuum ensures that enough tissue is pulled into the notch. I never have to reset anything.”

And as Henne says, “Women who have had biopsies at other facilities, then come here, tell me — with a few exceptions — that the procedure is basically painless. This is due in large part to the ability to continually lavage the cavity with saline and pain medication, which also reduces bleeding.”

Henne also notes how much he appreciates that the Selenia Dimensions system offers direct capture technology — a real benefit when it comes to biopsy procedures. “Images are taken quickly and with greater detail. This is particularly important for small lesions because they can be difficult to localize. Being able to do the procedure quickly makes it easier on my patients, because they don’t have to hold still for as long.”

He also says the Affirm system’s 70 cm source-to-image distance — the longest of any breast biopsy guidance system on the market — creates greater distance between the tube and the patient. “It’s awkward. You have to get in there and insert a syringe to numb the tissue,” he says. “The Affirm system gives me more room to work. And it offers an angled approach, making it easier to access the lesion through the chest wall.”

Just as Henne prides himself on providing outstanding service to his patients, Hologic offers radiologists the same level of one-on-one support. “I’m very pleased with Hologic’s service,” says Henne. “Just the other day, for example, I knew a specific procedure was going to be difficult. The lesion was very close to the skin, which I knew from experience would mean the loss of the vacuum sucking action as I pulled the tissue into the notch. Hologic sent one of its clinical education specialists here to help. She shared best-practice approaches for this type of case. We were able to get good samples which, when it comes to breast biopsies, is the name of the game.”

Views and opinions expressed herein by third parties are theirs alone and do not necessarily reflect those of Hologic. This information is intended for medical professionals in the U.S. and other markets and is not intended as a product solicitation or promotion where such activities are prohibited. Because Hologic materials are distributed through websites, eBroadcasts and tradeshows, it is not always possible to control where such materials appear. For specific information on what products are available for sale in a particular country, please contact your local Hologic representative or write to [email protected].
    Hologic, Affirm, ATEC, Dimensions, Eviva and SecurMark, Selenia and TriMark are trademarks and/or registered trademarks of Hologic and/or its subsidiaries in the U.S. and/or other countries.

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