and treatment options
at Moore Regional
Because one in every eight women develops breast
cancer and because early detection and appropriate
treatment greatly increase the chance of a cure,
FirstHealth Moore Regional Hospital offers digital screening
mammograms as well as advanced diagnostic procedures and
a complete arsenal of treatment options.
In addition to digital mammography, radiologists at Moore
Regional use computer-assisted detection (CAD) technology to
help them spot possible abnormalities in the breast. The CAD
system acts as another set of eyes and, in a major study, was
found to significantly increase the detection rate for early stage
If a mammogram shows a possible tumor, then a radiologist
usually orders specific diagnostic images that focus on that part
of the breast. The next step is typically an ultrasound exam to
provide the radiologist with more information about suspicious
area. These additional images determine if a biopsy is needed,
says radiologist Carolyn Maynor, M.D.
With a biopsy, the physician removes a small sample of tissue
for laboratory analysis. In addition to ultrasound-guided biopsy,
Moore Regional offers stereotactic biopsy, which provides a
three-dimensional image for even greater precision sampling.
In some cases, an MRI may be ordered to help with the final
diagnosis and a treatment plan.
Depending on the size, location and type of tumor, breast
cancer patients at Moore Regional have a number of treatment
“We may recommend radiation therapy, infusion
chemotherapy, oral chemotherapy, hormonal therapy, biologic
therapy or surgery,” says medical oncologist Ellen Willard, M.D.,
adding that a combination of therapies is often used.
Radiation oncologists at Moore Regional use CT scans for
treatment planning to help them precisely target beams of
radiation that kill cancer cells. “This allows us to focus the
radiation on the tumor and areas at risk while avoiding damage
to the surrounding tissue,” says Sushma Patel, M.D.
For some patients, physicians recommend a method of
delivering radiation called brachytherapy. With brachytherapy,
a balloon is placed inside a lumpectomy cavity to deliver high
doses of radiation. The balloon is temporarily implanted in the
breast and removed after the treatment is complete. Moore
Regional was one of the first hospitals in the state to offer
brachytherapy for breast cancer.
Some breast cancer patients require surgery, and some of
them have mastectomies (the removal of the entire breast). For
many patients, however, surgeons at Moore Regional are able
to perform a lumpectomy, meaning they remove the tumor
while leaving most of the breast intact.
at the RMH Women’s
Mention the Women’s Imaging Center at FirstHealth
Richmond Memorial Hospital to John Tucker, the
hospital’s director of Imaging, or to Radiology
Department Medical Director Scott Hees, D.O., and both will quickly
clarify one thing—comprehensive women’s imaging, not just breast
health, has been the center’s focus since its June 2004 opening.
“I am proud that we have focused on women’s imaging at
RMH,” says Dr. Hees, a staff physician since July 2002. “Essentially,
the center is a separate area of the Radiology Department that was
expanded and renovated to house mammography, ultrasound and
“Richmond Memorial relocated these units to the Imaging
Center to provide a more private setting for the imaging modalities
that are primarily used by women,” says Tucker. “Abnormal testing
results easily produce anxiety, and we try to make the overall
experience better for women.”
Indeed, maintaining privacy is critically important for any RMH
patient dressed out in a hospital gown and transitioning among
treatment areas. The center’s centralized screening and diagnostic
area was intentionally designed not to be associated with other
RMH imaging services, allowing gown-clad female patients to
discreetly cross the hall from mammography to ultrasound.
For the center’s four rotating radiologists, three mammographers
and a clinical supervisor, its adjacent location to the Radiology
Department also enables ease of transition between daily clinical
and administrative duties.
By way of the Women’s Imaging Center, Richmond Memorial’s
mammography unit became the first within the FirstHealth system
to boast both computer-aided detection (CAD) technology and
digital mammography. When it first opened, the center began
using CAD’s digital conversion to better detect abnormal findings,
although it remained a film-based mammography service. In May
2008, the center acquired digital equipment and became certified
to begin offering diagnostically superior digital mammography.
“Richmond Memorial was the first hospital in the region and
the first in FirstHealth to integrate CAD technology and digital
mammography,” says Dr. Hees. “Both have been shown to increase
the detection of breast cancer.”
Dr. Hees’ push for improved patient adherence to mammography
comes up throughout the discussion of his work. Both he and
Tucker especially value the center’s practice of having a hospital
radiologist speak directly with all mammography patients following
any diagnostic study—whether the findings call for a second round
of evaluation or not.
“An abnormal screening mammogram can really generate
anxiety, and I think it’s important for the patient to know the results
the day of the exam,” says Dr. Hees. “The anxiety is relieved if
the study is negative, and steps can be hastened to determine a
definitive diagnosis if it is positive. Whether at Richmond Memorial
or elsewhere, women need to start getting a yearly mammogram
after age 40.”