Significant Advances in Treating Breast Cancer
3D mammography, expanded care resources and more
“Big changes have come about in the detection, diagnosis and treatment of breast cancer in the past decade,” says Paul Sylvan, MD, Medical Director of Eisenhower Lucy Curci Cancer Center’s three Breast Center locations. Board Certified in Internal Medicine and Radiology, Dr. Sylvan specializes in breast imaging.
Importantly, the Breast Center is on the leading edge of these changes, giving desert patients convenient, close-to-home access to an ever-expanding array of care resources. Dr. Sylvan outlines what’s new and significant:
“One of the most significant technological advances in breast cancer detection has been 3D mammography,” he says. Also referred to as tomosynthesis, 3D mammography uses multiple low-dose X-ray images from different angles to create a three-dimensional picture of the breast, enabling the radiologist to view the tissue in thin “slices,” which provides greater visual clarity, leading to increased cancer detection and reducing the number of stressful recalls for additional views.
“It was a big step forward and continues to be, particularly for women with dense breast tissue,” Dr. Sylvan says. He also notes that the Breast Center has opened a facility in Palm Springs, the Anne and Kirk Douglas Breast Center, making screening mammography and DEXA scans (bone density tests) more accessible to patients in the west valley. Starting in the summer of 2024, diagnostic breast imaging and ultrasound will also be available in Palm Springs. And there are now four dedicated breast imagers — including himself — to ensure high-quality interpretation.
The quality of breast MRI has also “improved tremendously,” he points out, reducing false-positive results and the anxiety-provoking additional testing this often triggers.
“In addition, we’re the only place in the Coachella Valley — and one of just a handful in all of Southern California — to offer contrast-enhanced mammography,” Dr. Sylvan continues. This modality uses intravenous iodinated contrast dye to help find breast cancers that can’t be seen on regular mammograms.
When it comes to diagnosing breast cancer, ultrasound continues to play a vital role, both in diagnosis and in performing biopsies. “Performing a biopsy under ultrasound guidance is a much easier procedure for the patient — it’s better tolerated, faster and more comfortable than biopsies done under stereotactic or MRI guidance. Any biopsy that can be done under ultrasound guidance is done that way,” he notes.
There also have been significant advances in treating breast cancer.
“Medical oncologists have much more in the way of targeted therapies now, in addition to the cytotoxic agents used in chemotherapy,” Dr. Sylvan says. “These agents have greatly improved the treatment of breast cancer.”
In fact, Eisenhower Lucy Curci Cancer Center recently added Manasa Vulchi, MD, a Board Certified Medical Oncologist who works exclusively with breast cancer patients.
Plus, the Cancer Center has also recently added a renowned breast surgeon to its team. Nationally recognized, Edgar Staren, MD, PhD, MBA, is the former president of the American Society of Breast Surgeons.
“These additions to our staff are important because we’re developing a comprehensive multidisciplinary breast clinic here at the Center,” Dr. Sylvan says. “When a patient is diagnosed with breast cancer, she will be able to come in and see all the specialists who will be involved in her care in one visit, all in one place. Through our affiliation with the UC San Diego Health Cancer Network, we also can offer access to genetic testing and counseling,” he adds. “This multidisciplinary clinic will be a huge step forward.”
Dr. Sylvan also notes that the Cancer Center will be establishing a high-risk breast clinic. Designed for women who have a greater than 20 percent lifetime risk of developing breast cancer — they may have a strong family history of breast cancer or may carry the BRCA gene mutation, for example — they will be screened and followed more closely than the average woman.
While having access to today’s most advanced diagnostic and treatment resources and top-notch providers is crucial to ensure optimal patient outcomes, Dr. Sylvan and the Breast Center team never lose sight of the human side of delivering care.
“It’s not just a matter of performing procedures and giving patients results,” he says. “It’s about communicating with them and establishing a good rapport. We understand how concerned and stressed they are, and we try very hard to make their experience here as good as it can be under the circumstances.
“Patients who come in for a diagnostic mammogram and/or ultrasound — they may have been called back from a screening mammogram and may have a palpable lump — receive their test results while they are here and are spoken with by the radiologist so they don’t have to wait for their results and worry,” he continues.
And each newly diagnosed patient is connected to the Center’s oncology nurse navigator whose job it is to facilitate the entire treatment process by helping to make appointments and connecting patients to breast cancer specialists and resources they need.
“This process can be overwhelming and we want to help make it less so,” Dr. Sylvan says. “Our most important job is to be empathetic to the situation they’re in.”
For more information about Eisenhower Lucy Curci Cancer Center breast health services, call 760.674.3602, or visit EisenhowerHealth.org/Breast.
