1. What is a mammogram, and what are the different types of Mammograms?
A mammogram is an X-ray of the breasts using low energy x-rays to look for subtle differences in soft tissue (masses/tumors), and looking for certain types of calcifications in the breast which can be a sign of Breast Cancer. There are currently two types of mammograms done.
The different mammograms include digital Mammograms and Analog (or film) mammograms. Digital mammograms are the newer and the better technology. Digital mammography uses mechanical/digital image receptors rather than film to acquire an image. The digital images can be adjusted on a computer to better visualize abnormalities in the breast, much like you can manipulate and change pictures you take on your digital cameras using computer programs. Digital imaging of the breasts optimizes the visualization of abnormal findings in women with dense breasts, which more typically occur in younger women. Currently nearly 2/3’s of all mammography facilities use some form of digital mammography. Riverside has been using Digital Mammography throughout all Riverside Facilities since 2007.
2. What does a mammogram show?
A. Mammography allows the visualization of subtle differences in soft tissues (masses/tumors) in the breast as well as visualization of tiny calcifications, which can be associated with and found in breast cancers.
3 What is the biggest misconception about mammography that you would like to clarify?
Compression hurts. I know, I am a man and I just don’t understand since I have never had a mammogram. Actually, I have volunteered as a male model for a demonstration male mammogram when I was attending a Breast Imaging course at Harvard in Boston. I was in the army at the time and was wearing my uniform, which made me stand out. When the faculty technologist teaching the segment on male mammography asked for a volunteer, she was looking straight at me since I was the only male in that particular group of Radiologists and Technologists. I had no choice but to volunteer.(In basic training they said to NEVER VOLUNTEER) I actually went through the entire mammography procedure as a patient except they didn’t take the x-rays. I will definitely admit, compressing is uncomfortable and is probably painful for many women with very tender breasts. I would venture to say that the treatment for breast cancer particularly more advanced cancer in women whom have avoided mammography because of a painful mammographic experience is far greater. When a woman tells me that the mammogram she received previously did not hurt at all, my response is that,” I don’t think you had the best mammogram you could have had.” Breast Compression is the most important technical aspect of performing a mammogram, next is positioning. Both depend on cooperation of the patient and a well trained, experienced and competent technologist who can compassionately work with the patient to optimize the mammogram.
4. How did you get involved with the medical field?
My best friend’s dad was a family doctor in my hometown in Northern Ohio. I spent a lot of time with his family growing up and really respected Dr. Crosby. He taught me a lot as a young boy, and I wanted to be like him. As for becoming a Radiologist, I was always good in math and physics, which is important in radiology. When I worked as an ER doctor and Flight Surgeon at Fort Leonard Wood Missouri, I apparently caught the attention of one of the radiologists there. He came to me and said he thought I was pretty good at reading the ER x-rays when he reviewed the X-rays that I looked at and reported in the ER. He convinced me to apply for the Radiology Residency at Walter Reed Army Medical Center. As for my special interest and expertise in Breast Imaging. While a radiology resident at Walter Reed Army Medical Center, most of my fellow residents did not like interpreting the mammograms and I found it very interesting and challenging so I was asked frequently to read the mammograms. (Never Volunteer). I trained in Radiology before there were many fellowship training programs in Breast Imaging so I worked hard to learn Breast Imaging from mentors and faculty at Walter Reed who had the same interests as me. After completing my residency, I went to an Army Hospital in Northern Virginia, where my boss heard of my interest in Breast Imaging, and put me in charge of the breast imaging service. This was in the late 80’s and early 90’s when the Mammogram Quality Standards Act was being written and re-written by Senator Barbara Miculski and Congresswoman Patricia Schroder. I was fortunate to be asked by the Army Surgeon General and his Radiology Consultant to attend many of the extensive sessions on Capital Hill to make the changes needed to make the MQSA work. When I asked my boss to send me to a Breast Imagining Fellowship, he said that I have already been doing my fellowship on the job, and needed to come back to Walter Reed to teach the Radiology residents, Breast Imaging, I held that job for nearly 10 years teaching more than 100 residents, both Army and Navy as well as a few Air Force radiology residents.
5. What do you like best about your job?
Breast Imaging allows me to have a lot more contact with patients than most other areas of Radiology. I like the patient contact, and working closely with patients. I always try to find some common ground when I talk with patients particularly when doing biopsies. Conversations help calm the patients during a stressful time. I always try to learn something from my patients. I really want to help patients find cancers as early as possible. I feel like I am making a difference.
6. What are the biggest challenges that come with the job?
Technology is growing so rapidly, it requires a lot of time and effort and many continuing medical education courses to keep up with the technical growth, and it just keeps on growing.
7. What are your hobbies & interests?
I try to play as much golf as I can. My wife and I try to play at least one round a week. My wife and I also like to work in the yard keeping up with the landscaping. I am a bit of a camera geek and love to take pictures (too many according to my wife, but she never seems to mind looking at them) We have three adult children, two daughters and a son. Our daughters have two children each, one has a boy and a girl and the other has two boys. Grandkids are great and make great photo subjects. My little redheaded grand daughter has me wrapped around her finger. We try to spend time at our favorite beach and golf location in South Carolina.
8. If you could learn to do anything, what would it be?
Fly an airplane. I was fortunate enough to get some flight training as an Army Flight Surgeon which was all helicopter time, and a lot of fun. Flying a plane would be a lot of fun.
9. What is one of your favorite quotes, and why?
It is not a famous quote but has served me well since a young boy. My Dad always said to me, “If you don’t plan to do your best to do something right, then don’t do it at all. ”
There is also a corollary to the Golden Rule that I try to follow. Treat your patients in the same way you would your wife or children. Once when I said to a patient, “If you were my wife I would have advised you to get the treatment.” She immediately responded, “Are you still married to your wife?” I responded, “Yes, and for over 30 years!”