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This week the U.S. Preventive Services Task Force came out with a draft version of revised guidelines for mammography screening. The new recommendation endorses biennial screening mammography beginning at age 40 for all women. While this is an improvement over the prior recommendation to begin screening at age 50, it falls short of the current recommendation by the Society of Breast Imaging and the American College of Radiology to obtain annual mammograms beginning at age 40. Numerous studies have shown a significant increase in lives saved by early detection with annual screening mammography in women ages 40-74. Concern for radiation risk due to annual screening is really of no concern! The benefits of a mammogram each year far outweigh any risks from the minimal radiation dose. And concern for increased false positives and increased anxiety should also be reevaluated! Delaying a screening mammogram can delay detection of an early stage cancer, leaving a patient at risk of undergoing treatment for a larger, possibly more aggressive cancer. The small amount of anxiety associated with a mammogram should be compared with the larger amount of anxiety associated with a diagnosis of breast cancer. Lastly, the task force claims to need additional evidence to recommend additional screening in dense breast patients. The studies are out there… screening breast ultrasound has been shown to detect 4-6 additional cancers per 1000 women, and breast MRI detects up to 15 additional cancers per 1000 women. As we continue to make progress with the USPSTF, continued annual screening beginning at age 40 and advised supplemental screening in dense breast patients will remain the recommendation of both the SBI and ACR
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What has been a law in Connecticut since 2009, has now finally become federal legislation! Every woman in the United States who has a mammogram will be notified of her breast density, enabling her to be proactive in obtaining additional imaging to evaluate her breast tissue. Dr. Nancy Cappello spearheaded the breast density notification laws, beginning with her home state, Connecticut, after she was diagnosed with stage 3 breast cancer following a breast ultrasound. Nancy tirelessly worked with state legislatures, government officials, and patient advocates to pass dense breast notification laws in states across the U.S. Nancy passed away from complications of her breast cancer treatments in 2018. It was her dream that a federal bill be passed requiring notification of breast density for every woman in every state. It gives me great joy to see Nancy’s tireless efforts and perseverance, as well as those of many other breast cancer patients across the U.S., culminate in the new FDA reporting legislation. Notification is the start, but in the end, education will be needed to help women make appropriate decisions regarding additional imaging needed for the evaluation of breast density. In Connecticut we are familiar with the challenges which lay ahead, yet we have seen the benefits of increasing early detection in order to save lives. In the words of Leslie Yerger, CEO of My Density Matters, “I envision Nancy smiling down from heaven now after seeing what has come to pass.”  It is with great pleasure that I applaud my dear friend, Jan Kritzman, for her tireless efforts and dedication in obtaining insurance coverage in the state of Connecticut for women undergoing both breast and ovarian cancer screening and diagnosis. Jan was instrumental in the passage of a 2019 CT bill mandating insurance coverage for screening breast ultrasounds in women who have dense breast tissue. And once again, as a result of her persistence and commitment to save lives, she was able to get her proposed bill (SB358) passed in both the Senate and House this year. The new bill will extend insurance coverage to include diagnostic mammography, diagnostic breast ultrasound, breast MRI, breast biopsies, breast surgical procedures, and ovarian cancer screening exams. What an honor it is to have Jan as a great friend and an amazing advocate for breast and ovarian cancer awareness! Please take the time to read the article in today’s Hartford Courant…  This year, in honor of breast cancer awareness month, J Gershon Breast Imaging is teaming up with Breast Friends Fund. This amazing organization was started by Sandy Cassanelli, with an ultimate goal of finding a cure for breast cancer. Sandy was diagnosed with Stage 3 breast cancer in 2013, at age 37. After undergoing a bilateral mastectomy, 8 rounds of chemotherapy, and 28 rounds of radiation, she was declared cancer-free. Unfortunately, in 2015, Sandy was informed the cancer had spread to her liver and she was now Stage 4, with no cure. For the past 5 years Sandy has undergone numerous treatment therapies, none of which have been effective. With an incredible spirit and sense of optimism, Sandy views her disease as a means of helping others and understands the great importance of research needed in the area of metastatic breast cancer. Breast Friends Fund is voluntarily run and all operating costs are funded by Sandy and her husband Craig. 100% of all donations and event proceeds go directly to Metastatic Breast Cancer Research under the direction of Dr. Eric Winer, at the Dana-Farber Cancer Institute in Boston. Sandy lives in Glastonbury, CT with her husband and two beautiful daughters.  We know that breast cancer screening saves lives and continued research is needed to help those with advanced stages of the disease. During the month of October, we will be selling limited edition t-shirts with all proceeds going to Breast Friends Fund. T-shirts are on sale for $15. Get one before they are gone! Donations may also be made directly to Breast Friends Fund by going online to breastfriendsfund.org. Special shout outs to... Jake Gershon for our amazing t-shirt design! Aaron Schwanke @ Print Indie LLC for our awesome t-shirt printing! Many thanks for your time and generosity to make this project work!!  I am excited to help promote a new app specifically designed for breast cancer patients. Outcomes4me, recently launched, is the brainchild of a team of healthcare professionals, engineers, and patient advocates. The founders of the company focused on breast cancer, as this common diagnosis can often be overwhelming and difficult to come to terms with for many women, and men. Utilizing their expertise and clinical experience, the Outcomes4Me team assembled an easy to use app that allows patients to learn about treatment options, understand symptoms and explore clinical trials. Patients are able to ask questions and share their own journey. The app connects breast cancer patients across the United States and hopes each individual experience can lead to a deeper insight and improved outcome for those involved. Recently added to the app is a questionnaire regarding genetic testing. Outcomes4Me aims to empower the patient and lend a hand during a difficult time. I encourage you to check it out and pass along the information to friends and family. Click here for more information: Outcomes4Me  I am honored to be a part of an advocacy program for Breast Density Awareness in Ireland. Beingdense.com was started by Siobhan Freeney, a breast cancer survivor since 2015. She is following in the footsteps of Dr. Nancy Cappello in promoting awareness of breast density in Ireland. Have a look at her website and blog page.  "Being Dense is incredibly excited to introduce you to the newest member of our team, Radiology Expert, Dr Julie Gershon. Dr Julie worked with Nancy Cappello on the Areyoudense.org US advocacy and we are honored that she has agreed to support Beingdense.com by agreeing to be our Medical Advisor. Julie S. Gershon, M.D. is a board certified breast radiologist in Avon, Connecticut. She has been in private practice for 21 years and specializes in Women’s Imaging, specifically mammography and breast ultrasound. Dr. Gershon began her own private practice for women in November 2013, and offers specialized and personalized imaging to her patients. She is an active member of the American College of Radiology and the Society of Breast Imaging, and serves as a medical advisor for AreYouDense.org. Dr. Gershon is a strong advocate of screening breast ultrasound in dense breast patients and was presented with the “Champion” award from Are You Dense? in June 2016. Dr. Gershon resides in West Hartford, Connecticut with her husband and three children. We look forward to having Dr Julie on our team."
3D mammography (DBT-Digital Breast Tomosynthesis) has been promoted to the public as the “latest and greatest” form of mammographic imaging. Mammography centers have been slowly converting their systems to 3D units, as many feel pressure to keep up with their imaging competitors. Research has shown that 3D imaging significantly decreases call-back rates, however the cancer detection rate has only been shown to increase by 1-2 incidences/1000 patients. This month a study published in the American Journal of Roentgenology found no significant difference in the cancer detection rate of 2D full-field digital mammography vs. 3D mammography. Perhaps those who are being persuaded to have 3D mammography should look further into the necessity of such imaging. It is important to note that in most cases a 2D image is also acquired when a 3D image is obtained, thus doubling radiation dose. Additionally, many insurance carriers do not cover the cost of screening with 3D. Be aware of your care!
Yesterday I lost a good friend and comrade, Nancy Cappello. There are not enough words to describe such an amazing woman. Nancy’s loss to the breast imaging community, to every woman she saved from aggressive breast cancer, and to each heart she touched, is beyond imagination. Nancy was diagnosed this September with Myelodysplastic Syndrome, as a result of her chemotherapy treatments 14 years ago for her late stage breast cancer. Nancy’s accomplishments during those 14 years are more than most can hope to achieve in a lifetime. As a resident of Connecticut, Nancy championed the first ever dense breast notification law in our state. Currently there are 36 states that now have the notification law in place, thanks to the perseverance and tireless efforts of Nancy. The thousands of lives saved, due to early detection of breast cancer by means of breast ultrasound or MRI, in patients with dense breast tissue, can be attributed to Nancy’s never ending fight to let the patient be their own advocate. I am honored to have known Nancy, to have given lectures with her, to have attended many “Are You Dense?” events, and to have been named her breast “Champion” in 2016. While Nancy can never be replaced, all of us who loved and supported her will be here to continue her fight. One day, the entire United States will be “Pink” with notification laws. Nancy, you will be dearly missed, but your memory will live on in present and future generations.
  I recently returned home from Las Vegas where I attended the annual Society of Breast Imaging conference. While I always gain important knowledge about current technology, imaging methods and treatment advances, this year I was surprised to see a new topic discussed. Saturday morning was solely devoted to talks on patient experience and radiologist engagement. The importance of direct communication between the radiologist and the patient was stressed and it has been shown that 90% of patients prefer communication of breast imaging results directly from the radiologist. Surveyed patients have commented on their desire to establish a relationship with their doctor, such that their feelings are acknowledged, their questions are encouraged, and their results are explained. I am pleased to say that at J Gershon Breast Imaging, these wishes are granted! We take the time to meet with every individual, to answer all questions and to discuss imaging results. We aim to take the stress out of annual screening mammography and hope to create a comfortable, reassuring environment. Patients should feel free to call at any time, with any concern and with an understanding that their correspondence will be promptly acknowledged. Lastly, I leave you with a final take home message from the meeting, one that is of utmost importance...Annual screening mammography should begin at age 40, and continue every year thereafter! Give us a call, we look forward to seeing you soon! I recently wrote this article for Beekley Medical and it was published on their blog page. Enjoy! 
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AuthorJulie S. Gershon, M.D. Archives
May 2023
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J Gershon Breast Imaging
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21 Arch Rd., Avon, CT 06001
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P: 860-673-8379 F: 860-271-8025
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