ROME — Rome Memorial Hospital is using new computer software to help doctors detect breast cancer in its earliest stages when it is easiest to treat.
The software, called Volpara, assists radiologists in accurately determining the density of a woman’s breast tissue during a routine mammogram. Studies have identified breast density as a factor in assessing a woman’s risk for breast cancer and detecting it early, the hospital says.
Designed to help overcome the limitations of mammography in detecting cancer in women with dense breasts, the Volpara software generates objective, automatic measurement of volumetric breast-density values along with a breast-density classification for mammograms acquired from commercially available digital- mammography system.
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Rome Memorial had already been planning to pursue the software, but new legislation in Albany provided it further impetus to purchase the technology.
The New York State Legislature in January approved the Breast Density Inform law that requires all imaging centers to notify patients who have higher breast density that additional tests may be recommended, says Dr. John Restivo, radiologist and chairman of the hospital’s medical-imaging department.
Radiologists have used a standard numbering system for breast-density measurement, and in the past, measurements have been subjective, such as dense or not dense, based upon a visual review of the mammography image, he says.
“If this is going to be utilized by our providers, we certainly want to provide a very consistent breast-density measurement so that the referring physicians have a very consistent baseline in terms of talking with their patients and being able to help them,” Restivo says.
The Volpara software uses algorithms for a “very objective” breast-density measurement from information contained in the mammogram, Restivo says.
“It looks volumetrically at the breast tissue, and it tells you what category of breast density the breast falls into,” he says.
Breast density is measured on a scale of one to four, with one being the least dense. Changes in a woman’s breast density are normal and can be attributed to a number of physical and environmental factors including age, diet, caffeine consumption, changes in hormones, and significant changes in weight, he adds.
Calculating density with the Volpara software ensures that any measured change isn’t a function of a different radiologist reading the mammogram or using a different piece of equipment. It’s a true change in the density of the breast tissue, Restivo explains.
If measurement falls into category three or four, or a very dense tissue, then what radiologists try to tell the patient is to contact their doctor and talk to their clinician about other options for imaging and screening for breast cancer.
The options include screening breast ultrasound and a breast magnetic-resonance imaging (MRI). Radiologists like to have the patient and the doctor have that conversation to determine if they want to look further, or screen for the cancer in another way.
Restivo calls it a “very personal decision” that needs to be made with the clinician.
“So what our goal is to help the clinician have a reliable and reproducible measurement of density, so they can have a much more beneficial discussion with the patient,” Restivo says.
Dense breasts have a lot more breast tissue compared to fat, Restivo says. When reviewing a mammogram, a radiologist is trying to find changes in the mammogram, such as small masses, and a lot of breast tissue can make much more difficult to find smaller abnormalities or delineate subtle changes, he adds.
“In theory, if you have a denser breast, it is harder to find breast cancer,” Restivo says, noting at that point, it’s recommended the patient look at other options for screening for breast cancer, especially if there’s a strong family history or another higher risk.
The use of the Volpara software helps Rome Memorial meet the state-law requirement, make a reliable scientific measure of density, and help the clinician, Restivo says.
“That was our commitment,” he says.
Rome Memorial Hospital declined to disclose the exact cost of the Volpara software, but indicated the purchase did not require outside financing because it was less than $75,000.
Wellington, New Zealand–based Matakina Technology produces the Volpara software. The world’s top imaging scientists designed Volpara and has been validated by comparison to expert radiologists over thousands of images, according to its website volparadensity.com
Rome Memorial Hospital has nearly 1,000 full and part-time employees, 181 physicians, 130 acute-care beds, 80 long-term care beds, and 6,000 yearly patient visits, according to its website. The hospital’s total operating budget in 2012 was $93 million.
Contact Reinhardt at ereinhardt@cnybj.com
