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Published on March 04, 2019

Jan Perrion and Dr Josie Alpers

More Tools for Early Detection

Diagnostic imaging tools are valuable in the fight against cancer because they help physicians find potential cancers earlier.

Contrast-enhanced spectral mammography (CESM) has been is offered at Avera Cancer Institute in Sioux Falls, which has the highest volumes among sites that offer this test in the United States.

CESM was recently added in Pierre and Aberdeen, S.D. and Marshall, Minn.

“It’s a great additional tool and it’s used in many cases where mammography or ultrasound show questionable findings,” said Josie Alpers, MD, Avera Medical Group diagnostic radiologist in Sioux Falls.

Patients have an injection of contrast immediately prior to a mammogram. Through a combination of low- and high-energy X-rays, an image is produced that removes all the dense tissue; only areas of concern are enhanced. It can show where there is increased blood flow – a sign that may be associated with cancer.

Cysts, breast density or other benign conditions can lead to inconclusive results from mammography or ultrasound. Yet CESM can deliver more definitive information that physicians can use.

“This tool helps to decrease the number of unnecessary biopsies. It can also make a clinic visit more convenient for patients, because with CESM, we know we have the best possible imaging, all in one day,” she said.

James Simon, MD, Avera Medical Group radiation oncologist in Marshall, says CESM is also a great tool for evaluating how treatment is affecting a tumor. “It can provide us with a much clearer determination, and it’s allowing us to see things that may have been missed a few years ago.”

For Jan Perrion of rural Ipswich, S.D., CESM made a tremendous difference. Her physician had determined she carried a genetic trait that could make her susceptible to breast cancer, which she faced 11 years ago. She was on a routine of mammograms every six months, and a breast MRI each year.

In January 2018, she and her doctor, general surgeon Roger Werth, MD, Avera Medical Group Aberdeen Surgical Associates, agreed she should substitute her MRI appointment with one for CESM.

“I’m glad they had this new approach because six months before, they found nothing. This time, they found a tumor,” she said. After a double mastectomy, Perrion is doing well.

“I was happy they found it and got rid of it. If we had waited another six months, it could have spread … thankfully we got it out soon enough.”

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