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Originally published May 1, 2022
Last updated July 21, 2025
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As a kid, Christine Ysabal, JD, LLM, thought 鈥渄octors鈥 appointments were only for when you were ill,鈥 she says, not for preventing future health problems. She had routine vaccinations but never saw anyone in her family get an annual checkup or screening.
So, when she turned 40 and people told Christine she should start having a yearly mammogram, she put it off.
A busy mom and wife, she was studying for her master鈥檚 degree and working full-time as a contracts and compliance administrator in the Department of Radiology at 喵咪社区.
鈥淓verything got prioritized ahead of my own health,鈥 she says.
Christine finally made time for her first mammogram at age 46, and everything was fine. With that good report and no family history of breast cancer, Christine didn鈥檛 schedule another screening until four years later in October 2020.
At that time,聽聽diagnostic radiologist聽Mary Yamashita, MD, ordered a 3D mammogram for Christine due to her dense breast tissue. In any mammogram, dense breast tissue appears white on the image.
The problem? 鈥淏reast cancer also appears white, making it more difficult to find small cancer in women with dense breast tissue,鈥 Dr. Yamashita says.
The 3D mammogram technology produces multiple X-ray images from multiple angles, then reconstructs them into one-millimeter slices. Evaluating the breast 1 mm slice at a time can allow clinicians to detect cancers hidden by overlying dense breast tissue.
Keck Medicine has offered 3D mammograms 鈥 also known as digital breast tomosynthesis 鈥 since its approval by the U.S. Food and Drug Administration in 2011.
鈥淲e鈥檙e able to identify more cancer and smaller cancers as a result,鈥 says Dr. Yamashita, a clinical associate professor of radiology at the .
She recommends that every woman 鈥 whether at average risk or high risk for breast cancer, with dense breast tissue or fatty tissue 鈥 get a 3D mammogram.
For Christine, the technology was a lifesaver. In the detailed images, Dr. Yamashita saw something that concerned her: a suspicious-looking lesion.
鈥淚 don鈥檛 know how I missed the lump,鈥 Christine says.
A follow-up diagnostic ultrasound focused on the area of concern seen on the mammogram revealed an abnormal mass, as Dr. Yamashita suspected. A needle biopsy then confirmed that Christine had a 鈥減recancerous鈥 tumor that could develop into cancer.
鈥淏reast screening enables us to find cancers before you can feel it,鈥 Dr. Yamashita says.
Since 1989, when mammograms became widely available in the U.S., through 2015, the breast cancer death rate has dropped 43%.
鈥淲e want every woman to get screened because breast cancer when detected early is curable,鈥 she adds. 鈥淎nd you require less treatments, less surgery, and less toxic chemotherapy.鈥
In 2020 and early 2021, under the cloud of COVID-19, some women postponed their mammograms. 鈥淚n a few cases, we found cancer and wondered if we would have caught it smaller if the women had come in the year before,鈥 Dr. Yamashita says.
In November 2020, Christine had a lumpectomy, a surgical procedure to remove the lump from her breast. Because the lesion was not cancerous, Christine didn鈥檛 need additional treatment.
For the foreseeable future, she will have yearly checkups with a breast surgeon and two imaging studies annually 鈥 a mammogram and magnetic resonance imaging (MRI). These regular exams will ensure any future tumors will be caught early, such as the benign mass that was removed in April 2022.
Put yourself first. Get screened.鈥Christine Ysabal, patient, 喵咪社区 Norris Comprehensive Cancer Center
Put yourself first. Get screened.鈥
Which type of imaging is recommended 鈥 mammogram, ultrasound, and/or MRI 鈥 depends on the individual patient鈥檚 risk factors.
鈥淭his goes beyond personalized medicine,鈥 Dr. Yamashita says. 鈥淭his is precision medicine.鈥
Recently, Dr. Yamashita led Keck Medicine鈥檚 participation in a multi-center clinical trial studying fully automated breast ultrasound for women with dense breast tissue, which won FDA approval to broaden cancer surveillance options.
Christine advises others: 鈥淧ut yourself first. Get screened.鈥 She is determined to be a positive role model for her daughters: Isabella, 12, and Samantha, 32.
鈥淚 want to be around and healthy in their lives for a long time,鈥 Christine says.
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