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What our users have to say about MAMMOMAT Revelation

PH Inspiring Pink

The Philippines holds one of the highest incidence rates of breast cancer in Asia. According to the 2015 Philippine Cancer Facts & Estimates1, it is the most commonly known cancer found in women ranking first for both incidence and mortality. The report also suggests that occurrence start rising steeply at the age of 30 years. With early diagnosis and treatment, incidence can be reduced.

Siemens Healthineers has always been the pioneer for introducing innovative breast care imaging solutions and was also the first to introduce digital mammography system in the country. In 2018, another innovation was launched bringing the gold standard in mammography yet again with MAMMOMAT Revelation.

Siemens Healthineers interacted with two users of this system -- Dr. Angela U. Crisostomo, Senior Consultant, Breast Clinic, Makati Medical Center and Dr. Ma. Theresa S. Buenaflor, Consultant Radiologist – Women’s Center in Perpetual Help Medical Las Pinas. Please read about their experiences of using MAMMOMAT Revelation in their practice.
 

Experience from our users

Dr. Angela U. Crisostomo
Senior consultant, Breast Clinic at Makati Medical Center
Senior consultant, Breast Clinic at Makati Medical Center
Dr. Ma. Theresa S. Buenaflor
Consultant Radiologist at Breast Clinic, Centuria Medical Makati and Perpetual Help Medical Center - Las Pinas
Consultant Radiologist at Breast Clinic, Centuria Medical Makati and Perpetual Help Medical Center - Las Pinas

Case Studies*

Case 1

47-year-old female, asymptomatic with dense breasts and a screen-detected irregular mass in the right breast.

History: Patient showed no inclination of breast issues or palpable mass. Patient has no history of ovarian cancer but has family history of breast cancer through first cousins and paternal grand aunt.

Diagnostic Study: Digital Breast Tomosynthesis (DBT) showed an irregular equal density mass with microlobulations at the mid lower right breast. Titanium Contrast Enhanced Mammography (TiCEM) was performed, which subsequently enhanced.

Additional Procedure: Ultrasound-guided needle core Biopsy was performed on the same lesion with a benign histopathologic diagnosis of fibroadenoma with myxoid stroma in a background of fibrocystic change.

Impression: Patient subsequently was advised post-biopsy follow-up with attending physician after six months along with annual DBT and breast ultrasound.
 

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LOW ENERGY IMAGES
LOW ENERGY IMAGES - same as standard FFDM images and part of the Dual-energy image acquisition

A - D. Mediolateral oblique(A), cranio-caudal (B) views of the right breast and MLO (C) CC (D) views of the left breast
LOW ENERGY IMAGES
Insight CEM Contrast Enhanced Mammography
fibroglandular tissues
Insight CEM subtracted image
Correlate US image of the enhancing mass on TiCEM
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Case 2

48-year-old, asymptomatic female with dense breasts and screen-detected group of indeterminate microcalcifications at the left upper outer quadrant.

History: Patient showed no inclination of breast issues or palpable mass. Patient has (+) family history of breast cancer, maternal.

Diagnostic Study: Screening mammogram showed a group of microcalcifications in the left upper outer quadrant. As microcalcifications does not necessarily indicate malignancy, Titanium Contrast Enhanced Mammography (TiCEM) showed that the group of microcalcifications had no further enhancement.

Impression: This was a negative study and patient was subsequently advised regular screening digital mammogram or Digital Breast Tomosynthesis (DBT) rather than proceeding to a biopsy.
 

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LOW ENERGY IMAGES
LOW ENERGY IMAGES - same as standard FFDM images and part of the Dual-energy image acquisition

A, B. Mediolateral oblique projections of the right (A) and left (B) breasts
LOW ENERGY IMAGES
Mediolateral oblique
Recombined images in Mediolateral oblique
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On overcoming the pandemic challenge

MMC Breast Clinic

Dr. Angela U. Crisostomo
Senior consultant, Breast Clinic at Makati Medical Center

“As physicians we are bound by our duty to fulfil our oath of serving patients no matter the situation. Even if it means immersing ourselves in vulnerable setting with high potential exposure to the COVID-19 virus. This has posed a huge challenge for myself as well as fellow practitioners in the same age group as I am.

However, by observing and practicing prescribed protocols, we were able to work around the situation and have been continuously seeing patients regularly. When I perform breast ultrasound or mammography, I am donned in proper PPE. When I interact with patients, I ensure that there is enough physical distancing. When doing biopsies, patients are requested to wear masks and face shields. On the other hand, performing such screenings and procedures are best completed at the shortest time possible to limit possible exposure to the virus for both the patient and radiologist.

There are very stringent guidelines, which we had to integrate with our previous routine. Having these as part of our daily operations not only benefits the entire clinical team, but also protects our patients while fulfilling our responsibility to the society.”
 

Dr. Theresa

Dr. Ma. Theresa S. Buenaflor
Consultant Radilogist at Breast Clinic, Centuria Medical Makati and Perpetual Help Medical Center - Las Pinas

“A lot of researching and consulting for the protocols, processes and workflows was done to ensure safety for patients and as well as the staff to resume screening. This led to prioritizing which patients one can safely follow-up or delay monitoring, versus immediate diagnostic workup and biopsy if necessary. Some of the processes implemented were…

  • Over the phone consultation and discussions with clinicians regarding the patient’s case and requirements to be accomplished even before the patient goes in for their workup.
  • Implementing strict sanitation protocols – universal masking along with face shields for staff and patients and disinfection of equipment after use with each and every patient.

Amongst the patients, there was a fear of getting infected by coronavirus, which is quite understandable. However, we know more about the virus now and should be able to translate what we know into actionable processes and implementing safeguards, to ensure that the fear is allayed. Because the other side of the pandemic would be an upsurge of advanced cancers, which will further strain an already burdened healthcare system.”
 

1
http://www.philcancer.org.ph/vp-content/uploads/2017/07/2015-PCS-Ca-Facts-Estimates_CAN090516.pdf
* Cases courtesy of Ma. Theresa S. Buenaflor, MD, FPCR