- Women’s Imaging National Subspecialty Lead, Radiology Partners
- Lead Breast Imager, Advanced Diagnostic Imaging
- Director of Breast Imaging, Ascension Saint Thomas Midtown Center for Breast Health
According to the National Breast Cancer Foundation, “1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime. In 2023, an estimated 297,790 women and 2,800 men will be diagnosed with invasive breast cancer. Chances are, you know at least one person who has been personally affected by breast cancer.”
In recognition of Breast Cancer Awareness Month, ImagineSoftware is incredibly honored to be joined by women’s imaging expert, Dr. Dana Bonaminio – Shedding light on the daunting statistics, revolutionary treatments, and innovations in finding a breast cancer cure.
"Taking an active role in your own breast health is empowering!” - Dana N. Bonaminio, MD
1. Tell us a little about yourself and your career journey – what led you to being Lead Breast Imager and Director or Breast Imaging?
Being an active part of patient care and having the opportunity to impact women’s health in the early detection of breast cancer and other breast related issues is a great honor! I love my patients - and thoroughly enjoy working as a team with breast surgeons, pathologists and oncologists to ensure the overall success of each patient. Learn More About Dr. Bonaminio Here
2. Can you provide guidance on breast cancer screening – when to start, how often to screen, and important risk factors?
Yearly screening mammography saves lives. One in eight women will be diagnosed with breast cancer in her lifetime, making the early detection of the disease even more important. Routine exams can reduce the mortality rate of breast cancer by 40% and can detect the disease before it is large enough to feel or cause symptoms. Early detection not only improves survival rates, but it can also make treatment easier and less expensive for patients. Missing your annual mammogram may allow tumors to go undetected and to advance into later stages, making treatment more invasive.
All patients should discuss breast cancer screening with a health care professional by age 25 to determine when they need to begin scheduling their mammogram. Women at average risk of the disease can begin receiving annual mammograms at age 40. Some patients may be considered high-risk due to a family history of breast cancer, dense breast tissue, or other factors and can begin screening before age 40. Talk to your doctor to determine what personalized screening plan is right for you.
3. What additional factors/abnormalities are you looking for during breast cancer screenings?
Your radiologist is reviewing your screening mammogram assessing for subtle changes in your tissue that may indicate the need for additional imaging, including microcalcifications or masses, especially if they are new or changing. Your radiologist will also comment on your breast density, as new FDA regulations will require all breast centers to notify patients of their breast density as of September 10, 2024. Having dense breast tissue is an independent risk factor for breast cancer. Masking can occur on a mammogram when surrounding breast tissues obscures a cancer – which is more likely if you have dense breast tissue. If you discover that you have dense breasts, be sure to ask for a 3D mammogram or tomosynthesis which allows for better cancer detection in dense tissue than a 2D mammogram.
4. How can imaging centers and screening facilities make it easier for patients to schedule appointments, understand their bill, and get the follow-up treatments they may need after an initial mammogram?
Helpful strategies include offering multiple channels for patients to schedule appointments and pay their bill, including offering online options, plus phone and walk-ins. Reminder systems to assist in reduction of missed appointments are key. Streamline the check-in and check-out processes to minimize wait times which demonstrate respect for patient’s time. Developing a secure online patient portal where patients can access their test results, view appointment history, and communicate with their breast care team for follow-up is essential.
5. What are some ways you think imaging centers/diagnostic departments can better engage with their patients?
Engaging with patients effectively is crucial for breast imaging centers to provide a positive healthcare experience. This starts with the involvement of the breast radiologist while encouraging patients to be active participants in their healthcare decisions and treatment plans. Working in a breast imaging center is a calling – we see our patients year after year – they become our extended family. Nearly every woman that is called back for additional imaging is worried she has breast cancer. Staff must be compassionate, empathetic, and responsive to our patients' needs and concerns.
6. Are there ways to prevent breast cancer?
Taking an active role in your own breast health is empowering! Consider a few basics for preventative care regarding your breasts.
First, get your annual mammogram for those over 40 as recommended by major health institutions such as the USPSTF and American College of Radiology. Additionally, scheduling regular clinical exams may assist with early detection and identification of breast problems.
Second, know your risk factors for developing breast cancer - such as family history and breast density - which help your health providers facilitate more rigorous screening techniques if necessary, including genetic testing, 3D imaging, and possibly, breast MRI. Maintaining a healthy active lifestyle is also critical to reducing risk of many medical diseases, including breast cancer.
Lastly, being your own advocate and knowing your own body is essential to maintaining breast health. Pay attention to changes in your breasts with self-examinations and be familiar with monthly changes in your breasts that might coincide with your menstrual cycle.
7. What are some of the common misconceptions or myths about breast cancer?
Often, women without a family history of breast cancer feel that they are low risk of being diagnosed with breast cancer. In reality, most breast cancers are diagnosed in women without a family history - up to 80%, in fact! Additionally, the use of deodorants or antiperspirants, shaving or wearing an underwire bra have not been shown to increase your risk of breast cancer. Another myth I hear regularly is that women with small breasts don't have as much risk of breast cancer as women with larger breasts. However, the size of a woman's breast bears no relation to her risk of developing breast cancer.
8. Can men develop breast cancer?
Breast cancer is much less common in men than in women. On average, about 1 in 833 men will be diagnosed with breast cancer in their lifetime. Only 1% of all breast cancers diagnosed occur in men. The risk of breast cancer increases with age and a family history of breast cancer, especially in a first degree female relative, can increase the risk for men. Mutations in certain genes, such as BRCA1 and BRCA2, which are associated with breast cancer in women, can also increase the risk in men. Breast cancer in males is often diagnosed at a later stage because men may not be as vigilant about breast health or may not realize they can develop the disease.
9. Is there a role for genetic testing in the early detection of breast cancer? Are there ways to test for breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) genes, and what to do next?
Genetic testing has become more widely available but it’s important to note that genetic testing should be conducted under the guidance of a healthcare provider or genetic counselor who can assess an individual's personal and family history, provide counseling about the implications of genetic testing, and help interpret the results. The decision to pursue testing should be made based on individual circumstances and risk factors. Genetic testing for mutations in the BRCA1 and BRCA2 genes is one of the most well-known applications of genetic testing for breast cancer. Mutations in these genes significantly increase the risk of both breast and ovarian cancers. Individuals with certain BRCA mutations have a much higher lifetime risk of developing breast cancer compared to the general population.
In addition to BRCA1 and BRCA2, there are several other genes associated with an increased risk of breast cancer, such as TP53, PTEN, PALB2, CHEK2, and ATM, among others.
Genetic testing can identify mutations in these genes that may contribute to an individual's risk. Genetic testing is often recommended for individuals with a family history of breast cancer, especially if multiple close relatives have been diagnosed with the disease at an early age or if there is a history of ovarian cancer. Identifying specific genetic mutations can help assess the risk for the individual and their family members.
10. What do you consider to be the most exciting new developments in breast cancer research, or innovations in treatments?
To me, the most exciting advances in genomics and molecular profiling have enabled oncologists to better understand the specific genetic mutations driving a patient's cancer. This information allows for more targeted and personalized treatment approaches. Advancements in early detection and treatment options, along with a multidisciplinary approach to breast cancer care, have significantly improved survivor rates for breast cancer patients. Regular screening, early diagnosis, and ongoing research will continue to play critical roles in further improving breast cancer survivorship.
11. How has the adoption of artificial intelligence changed the landscape of breast cancer research and treatment?
While AI has shown great promise in breast cancer research and treatment, it is essential to ensure the quality and reliability of AI algorithms, protect patient privacy, and integrate these technologies into the healthcare system effectively. Collaboration between radiologists, researchers, and AI developers is crucial to harness the full potential of AI in combating breast cancer. Recently, I’ve been focused on AI solutions to assist in early detection and diagnosis, which can analyze mammograms to assist radiologists in detecting breast cancer at an earlier stage. Additionally, AI can help assess a patient's risk of developing breast cancer based on imaging textures and numerous factors, such as family history, lifestyle, and genetic predisposition. This information can drive supplemental screening protocols and expose the need for additional preventative measures.
12. What is your advice for spouses, partners, or caregivers of those battling with breast cancer?
I always recommend that my newly diagnosed patients bring along a family member or trusted friend to each appointment, particularly at initial visits with the patient’s care team - including breast surgeons, medical and radiation oncologist - as the information can be overwhelming. It is helpful to have another set of ears, as well as another mind, to ask questions and remind the patient of what was actually discussed at the appointment. I encourage patients to write down their questions and concerns between appointments so each can be adequately addressed - as it’s typical to forget or ‘freeze’ when asked if there are any questions toward the end of an office visit.
Utilize your Breast Nurse Navigator! Nurse Navigators are patient advocates that meet with patients during the initial phases of diagnosis, providing information and education, hopefully reducing a portion of the stress involved. Navigators will be your liaison throughout the entire cancer journey, learning the physical and social needs of the patients and their families, often offering referrals and coordinating the patient’s multidisciplinary care.
Dr. Dana Bonaminio is a board-certified and fellowship-trained radiologist, specializing in breast imaging and image-guided procedures. Dr. Bonaminio graduated from Miami University in Oxford, Ohio, and received her medical degree from University of Cincinnati College of Medicine. She completed her residency and fellowship training in breast imaging at the Medical University of South Carolina and Indiana University. As the Director of Breast Imaging for Premier Radiology and Ascension Saint Thomas Midtown Center for Breast Health, she is deeply motivated to empower women to take an active role in their breast health and advocates for annual screening mammography. Dr. Bonaminio serves in a national leadership role for Radiology Partners. In addition, she serves on the executive board for Tennessee Women in Medicine and is an active member of the Society for Breast Imaging and American Medical Women’s Association.
Dr. Bonaminio maintains an active, healthy lifestyle – enjoying all that Nashville has to offer with her husband and two small children. As an avid supporter of breast health, she regularly participates in the Susan G. Komen Race for the Cure events.