October is National Breast Cancer Awareness Month, and two of the best tools for prevention are performing a monthly breast self-exam and getting a mammogram or breast ultrasound. Individual women are responsible for the former, and folks like breast care radiologist Amanda Demetri Lewis, D.O., are responsible for the latter. Demetri Lewis works in York Hospital’s breast care and diagnostics department.


Q: What types of procedures do you perform as part of your job?

A: Digital mammograms, breast ultrasound, stereotactic and ultrasound-guided breast biopsies and diagnostics.


Q: What kind of medical background do you bring to the position?

A: I went to medical school at the University of New England College of Osteopathic Medicine in Biddeford; did my internship at (University of Massachusetts Medical School) in Worcester, Mass.; and a four-year (diagnostic radiology) residency in Philadelphia, Pa., at Drexel Hahnemann University Hospital. I returned to Boston for a fellowship with Harvard and spent one year working at Beth Israel Deaconess Medical Center, where I became specialized in breast imagery.


Q: Can you tell me about the science involved with your job?

A: Yes. Breast imaging is reading screening mammograms. It is the primary screening tool to detect signs of cancer in the breast before a woman can actually feel it herself (by doing a monthly breast self exam). We can detect cancers that are on the level of millimeters in size. We also use ultrasound, which is more specific, if we find a suspicious mass. That technology can tell us if it’s a cyst or a solid mass.


Q: What is the difference between the two procedures?

A: A mammogram uses an extremely low dose of ionizing radiation, or an X-ray beam, to go through breast tissue (to take an image). An ultrasound uses sound waves. There is no radiation at all. And we are also very excited about an addition we are building right now to house an Aurora MRI unit we will be getting soon. It will be the only breast-specific MRI unit in the state. (Rather than standing and having their breasts compressed on the mammogram) patients will lie on their belly on a bed that looks like a masseuse table. The bed has holes in it that allow the breasts to hang down in a natural state of suspension for the procedure.


Q: What types of things do you look for on the X-rays?

A: Masses and strange looking calcifications or distortions.


Q: Do you then send those results to the ordering doctor for them to follow up with patients?

A: No. York Hospital has a slightly different working model than most hospitals. We look at the images and give patients the results right away, if we can. We really strive to provide same-day results.


Q: Why is that important?


A: It eliminates patients’ anxiety to have answers right away and a follow-up plan in place if it’s needed. If we see a mass, we work it up while the patient is still here. We call the ordering doctor if we find something suspicious to recommend doing a biopsy. And we have two nurse navigators here who help coordinate after-care, whether that is calling family members for additional emotional support if something is found, or to orchestrate a plan of follow-up care with the primary care doctors and surgeons.


Q: How often should women get a mammogram?

A: According the American Cancer Society guides, women should start being screened annually beginning at age 40 and around age 30 for those who have a family history of breast cancer.


Q: Can you take me through the mammogram process?

A: The procedure requires that we squash or compress the breasts (on a special X-ray machine) to get a total of two views on each breast — from top to bottom and obliquely (from the side) by the armpits, where the majority of breast cancers occur. We compress the breast to make them thinner as breast densities have a tendency to obscure a mass. The thinner we can get them, the more we can see.


Q: Is there any pain or discomfort?

A: There can be for some. Especially during a woman’s menstrual cycle, when the breast tissue is more tender. We recommend women make their appointments for their mammogram after their period. They can also to take a few Tylenol just before the appointment to help with any discomfort.


Q: What advise do you give women who are hesitant to have a mammogram?

A: Early detection saves lives. Statistics show that one in eight women will develop breast cancer in their lifetime. The earlier we find it, the better the chances for survival. For breast cancers detected at less than one centimeter, the 12-year survival rate is 95 percent.

Staff Writer Deborah Sayer can be contacted at 791-6308 or at: [email protected]


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