Doctor Radio

serious xm, dr radio, welcome back to dro reports. i'm dr mark seigel, medical director of dr radio, clinical professor, medicine, nyu health. a lot of changes in the world of breast cancer imaging treatment, prognosis, surgery all of its changing. who better to talk about with it than dr mark robson and who is the chief of the breast medicine service at memorial sloan kettering medical center. he's a professor of medicine at wild cornell medicine. he specialises in breast medical oncology. he's an oncologist and clinical genetics. prior to joining memorial sloan kettering, he was a staff hematologist oncologist at walter reed army medical center. welcome mark, great to have you on. lovely, thank you for having me. so how has the improvement in imaging, which is incredible, change the perception of both doctors and patients who are in this field? in other words, you know the use of the use of m. i better defined mammograms when knowledge of when to use ultrasounds went to biopsy. how has that changed the world of intervention and treatment n. i mean i think it's over the years changed things tremendously. when i was young and just getting started, we were still only have a graph for screening, and even that was considerably less sensitive and less accurate than what we have now with tomography. and the whole field of much more limited interventions to make diagnoses was formed. so back in the day, if you actually had a finding on your mammogram, you had to have a wire placed there and then the surgeon would have to take you to the r and essentially cut out the end of the wire to find out what was going on. and now, of course, we have a lot of other techniques stereotactic by you have ultrasound guided by eps, and you have i guided biopsy if you need to do that for things that you can't see on mammogram, so we have a much more comprehensive ability to define how much disease is present in the breast for the women who are diagnosed with breast cancer, and to do so in a much less in base. those same techniques are being turned to war words improving early detection of cancer. i mean i mentioned that there are improvements even in play film mammography, with the addition of, with the addition of tomography and also, with contrast, enhanced mammography, which is a relatively new technique. ultrasound has been around for a while and has been kind of more and more used to help overcome the limitations of homography, and women who have dense breasts and m. i, of course, is being used in women who are at increased risk, with an even further increase in sensitivity, albeit with some increase in the rate of false positives as well. and now we're entering kind of the next phase, which is bringing things like ai. and these do. techniques to bear first of all in diagnostic to assist radiologists with computer assisted detection modalities, but more and more now, i think we're looking towards using ai to help define risk, looking at the characteristics of mammograms or the characteristics of mrs, and using them to essentially help us identify people who are at higher degrees of risk. so the whole area of imaging, which is not again my primary areas, has really been moving along