Lying face down on a raised biopsy table, 70-year-old Sally Ann Kortge twisted her body so the MCMC diagnostic imaging team could get a better look at her right breast.
Kortge cuddled her old friend Anonymous, a teddy bear that has kept her company during multiple surgeries at MCMC.
During the procedure, known as a stereotactic breast biopsy, the medical specialists worked beneath her to remove potentially cancerous tissue that had been identified during a routine mammogram.
A stereotactic breast biopsy uses a vacuum-like device to remove samples of breast tissue so a pathologist can examine them. It is one of the many biopsies performed at MCMC, and while every woman dreads one day being in the same position as Kortge, being examined for the presence of breast cancer, this procedure typically does not end in a grim result.
In fact, if a woman requires a stereotactic biopsy, it is more than likely she does not have cancer, says Dr. Kerry Proctor, medical director of MCMC’s unique Center for Breast Care.
“Most breast biopsies that women receive are benign, but gettinga breast biopsy is incredibly stressful,” she says.
“Of course the waiting is always difficult,” says Kortge of her biopsy which was performed last summer. “You just do what you have to do, soldier through, and the answer comes.”
A Florida native, Kortge has lived in The Dalles since 1997. She and her husband, Walter Kortge, grow cherries and wine grapes on an 80-acre farm just outside town.
Still spry, and a little bit fiesty, when Kortge is not in her garden, you can find her in her art studio creating custom jewelry or redesigning used clothing to fit her petite frame.
Breast cancer does not run in Kortge’s family, but when she found out about the biopsy, she told no one about it except her husband. Walter remained optimistic from the beginning until Sally Ann got the results everyone wants to hear — it wasn’t cancer.
MCMC performs 3,500 to 4,000 mammograms each year, says Donna Culp, lead mammography technologist. A stereotactic biopsy is usually performed when microcalcifications show up on a mammogram.
Micro calcifications are small calcium deposits a woman will not feel in a breast self-exam. Though calcifications are quite common, they can indicate early stage breast cancer.
Before a biopsy is performed, women are frequently called back so medical staff can get a better look at calcifications and other changes in the breast. For example, cysts and benign tumors may appear on a mammogram but can be difficult to identify without more information.
To get more information about what was seen on the mammogram, medical staff may order additional views of the breast using ultrasound or magnification views, says Joe Abbas, director of diagnostic imaging for MCMC.
Ultrasound uses high-frequency sound waves to produce a picture of the internal structures of the breast. It provides a better view of soft tissue than a mammogram, which uses X-ray technology to take a picture of the entire breast.
Magnification views also use X-rays from a mammography machine. Instead of taking pictures of the whole breast, medical staff home in on a small portion of the breast to get a better view of whatever was seen on the original mammogram.
Most people who get called back will receive both an ultrasound and magnification views, Abbas says.
Kortge gets her mammograms on a regular basis and had been called back once or twice, but never for a biopsy.
A stereotactic biopsy usually takes 30 to 45 minutes. After a local anesthetic is applied, the medical team, normally two X-ray technologists and a radiologist, take additional images to locate the tissue that will be removed.
A needle is inserted through a small incision in the breast. Attached to the needle is the vacuum device, which sucks the tissue into a collecting tube.
Once the tissue is removed, a small titanium clip, smaller than a staple, is inserted into the breast.
If the tissue is non-cancerous, the clip is left inside the breast and will show up on future mammograms. If the tissue is cancerous, it is usually surgically removed by performing a lumpectomy using the clip for guidance, Culp says.
Kortge’s biopsy led to good news beyond just a cancer-free diagnosis. It also resulted in her booking a 36-day cruise, fulfilling her lifelong wish to see Antarctica. Her brush with cancer put things in perspective, made her ask herself, “What have I always wanted to do that I can accomplish now?”
“I didn’t actually contact the travel agent until after I got the results,” she says. “I just thought, You need to do this because you never know how much longer you’re going to be around.”
Thanks to a national accreditation program, Kortge, and women like her, can feel confident that at MCMC they will receive breast care that meets or exceeds the industry’s highest standards.
The Center for Breast Care is one of only six facilities in the state to earn accreditation from the National Accreditation Program for Breast Centers. That means the hospital meets a comprehensive series of standards.
“I think by being an accredited breast care center, patients are absolutely assured, even in this small town in Oregon, you will receive the best care,” Dr. Proctor says. “You don’t have to go to Portland. Everything you need related to breast care is here.”
The Center for Breast Care is an institution without walls, Abbas adds. It includes components spread throughout the hospital, such as mammography, medical oncology, surgery and radiation oncology.
MCMC also is accredited as a Breast Imaging Center of Excellence, one of less than 20 facilities in Oregon that has achieved the honor. To be accredited as a Breast Imaging Center of Excellence, a facility must be fully accredited for mammography, stereotactic breast biopsy and breast ultrasound.
Although a private person, Kortge says she was happy to share her story with Gorge-area families because MCMC has done so much for her.
“I just love the hospital in our community,” Kortge says. “I just want to do something positive for them because they’ve done so much for me.”