Celebrated Physician: Brooke M. Wolvin, MD

Brooke Wolvin, MD, an attending physician for MedStar Medical Group Radiology, also serves as assistant director of MedStar Washington Hospital Center’s Breast Imaging Center, and director of Breast MRI.

That may seem like a long title, but it’s illustrative of imaging technology’s critical role in breast health. And it’s a field well-suited to Dr. Wolvin’s personal and professional interests. The Potomac, Md., native earned her medical degree at New York Medical College, followed by a radiology residency at New York Presbyterian Hospital-Weil Cornell campus. She then completed a breast imaging fellowship at Memorial Sloan Kettering Cancer Center before returning “home” to the Hospital Center in 2008.

Why Radiology?

“I chose radiology because you get to deal with a wide variety of patients,” Dr. Wolvin says. “Breast imaging is a particularly interesting niche, as it also involves a lot of patient interaction. It starts with the mammogram—still the best way to initially detect a potential breast health issue—and continues across a variety of tools to treat patients who need extra care.”

Among those valuable technologies is 3D imaging, also called tomography, which Dr. Wolvin calls “the greatest innovation in past 20 years.” She likens tomography to a CAT scan of the breast, allowing physicians to scroll through each layer of a scan to spot even the tiniest hint of a tumor or other condition.

“Along with increasing the cancer detection rate, tomography also lowers the number of patients who need to be called back for additional tests,” adds Dr. Wolvin, who has been instrumental in implementing tomography across MedStar. “It’s wonderful that we’ve been able to bring this capability to so many of our breast imaging centers.

Yet another of Dr. Wolvin’s responsibilities is serving as assistant medical director of Radiology at the new MedStar Health at Lafayette Centre in downtown Washington, D.C. There, she says, “we work with a different set of patients and issues, which enhances both our experience and the quality of our services.”

Outside the Hospital

What gives Dr. Wolvin the greatest sense of pride is setting a positive example for her two children, ages 4 and 18 months.

“My mother was a full-time professor, and proved to me that a working Mom can successfully balance work and family,” she explains. “I want my kids to have the same sense of possibility I did.”

Improving Breast Health: One Ward at a Time

Screening tests are a powerful weapon in the fight against breast cancer. Mammography is a breast cancer screening tool used to help doctors pinpoint when a change has occurred in a woman’s breast. In spite of these benefits, and in spite of having health insurance, too many women in Washington, D.C. are forgoing their annual mammograms out of fear. For the last two years, breast health navigators at MedStar Washington Hospital Center have been working passionately to reverse the trend. After first focusing on women in the District’s Ward 5 neighborhood, the hospital’s Get2Breast CARE program is expanding across the city into Wards 7 and 8, thanks to a generous $100,000 grant from the AVON Breast Cancer Crusade.

“Early detection and early treatment of breast cancer increases the chance of survival,” said Elmer Huerta, MD, MPH, director of the Cancer Preventorium at the Washington Cancer Institute at MedStar Washington Hospital Center. “It is shocking to see that 97 percent of women with advanced breast cancer treated at the Hospital Center have health insurance. This validates the need to offer breast health education in the community.”

Research led to a Successful Partnership

During Phase I of the program, as part of the Get2Breast CARE (Cancer Awareness & Resource Education in Ward 5) program, which was funded by the Avon Foundation for Women, breast health navigators surveyed 1,091 women over the course of a year, to find out what they know about breast cancer and breast cancer services and to know why they were postponing their mammograms in spite of having health insurance. Of the 1,336 personal opinions that were analyzed from the 31-question survey, 22.7 percent noted fear and 23.5 percent noted personal factors as reasons for delaying or skipping routine mammograms, the first line of defense to look for early signs of breast cancer. In their opinions, many respondents indicated fear of cancer, treatment, receiving bad news and abandonment, as well as personal reasons such as a busy lifestyle, no time to see a doctor, laziness and lack of preventative health education in their answers.

During Phase II of the study, also funded by the Avon Foundation, women told us that having more access to mammography facilities and more educational programs were important factors to increase the number of women getting checked.

Those successful outreach efforts have led the Avon Breast Cancer Crusade to award the Washington Cancer Institute another grant for the third year in a row, to provide more education, screening and patient navigation services to women not only in Ward 5, but also in Wards 7 and 8. The team will host educational events, mammography services and follow up care, if needed.

“Empowering women with life-changing knowledge about prevention, and teaching them how to use their health insurance coverage will make a difference,” added Dr. Huerta.

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Medical Advice: Mammogram and Pap Screening Recommendations

Mammogram and Pap Screening Recommendations

The federally sanctioned U.S. Preventive Services Task Force recently issued new findings about women’s health. The panel of experts recommended that women begin routine screening mammograms at age 50. This differs from long-established guidelines advising women at low risk for breast cancer to begin screening at 40, and continue them annually. That’s still the recommendation of the American Congress of Obstetricians and Gynecologists. And, more recently, the American Cancer Society changed its recommendation to age 45. With these differences, it is challenging to determine which mammogram and Pap screening recommendation to follow.

Mary Melancon, MD, an obstetrician/gynecologist, says patients often ask what they should do. “We are happy they are reaching out,” Dr. Melancon said. “Every woman’s situation is different, and your health provider is your best resource.” Dr. Melancon notes that the major advisory groups, including the American Cancer Society, agree that women with low risk factors for cervical cancer need a Pap screening every three years from ages 21-29, and every five years for ages 30-65, including a screening for human papillomavirus, or HPV. Women are at high risk for cervical cancer if they have a weakened immune system, are HIV positive, or have a previous history of cervical cancer or pre-cancer. These are a few conditions that can influence the frequency of mammograms and Pap screenings. Women should discuss their specific situations with their physicians to determine the plan that is best for them.

Dr. Melancon emphasizes, even if testing isn’t recommended yearly, it’s still important for women to receive regular gynecological checkups. “We urge women to maintain a relationship with their providers, even after menopause,” she says. “It’s vital to check in, remain current with health screenings and discuss any changes or concerns.” 

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