Understanding Ultrasound : life-saving technology
As a breast cancer survivor and proud Community Ambassador for the MDC, Lee-Anne Murdoch hopes and prays a cure will be found before too long. The Mother’s Day Classic is close to her heart and she hopes her efforts fundraising every year will make a difference especially for her 13 year-old daughter Catherine and the younger generation to come.
Lee-Anne feels extremely lucky. Diagnosed in 2011 when she was fifty and with her daughter starting kindergarten. She found a lump in her breast and booked in for a mammogram but one of best friends is a medical specialist and strongly suggested she go for an ultrasound as well as a mammogram. The mammogram didn’t reveal anything abnormal but the ultrasound did. Lee-Anne believes this literally saved her life. This can be a common narrative for many women these days as we see an increase in detection of aggressive forms of breast cancer affecting many younger women with higher density breast types.
Ultrasound is the term used for high frequency soundwaves. An ultrasound examination uses these sound waves to produce an image onto a screen that shows the inside of your body. Ultrasound is a vital part of women’s imaging and provides excellent imaging of the soft tissue of the body and is often the best and most appropriate diagnostic test.
Sonographers are the professionals who use ultrasound to perform specialised diagnostic examinations – they work with breast cancer patients, and in fact they are usually the first point of call in a woman’s breast cancer journey.
Louise Worley is a highly skilled and accredited sonographer with over thirty years experience in the field who works and teaches at I-MED in Melbourne and has been a member of the Australasian Sonographer Association (ASA) for twenty-six years. The association has 6000 members across the country.
She also travels regularly conducting sonography masterclasses and lectures with skilled sonographers. Louise holds a particular interest in breast and obstetric diagnostics.
She is also a survivor of breast cancer.
Diagnosed in 2007 with a stage one breast cancer, she underwent chemotherapy treatment for nearly four months. During her treatment she took the decision to continue an exercise regimen to maintain her health and well-being. She strongly believes this routine assisted in her successful recovery and return to a healthy life.
At this point, she is feeling extremely lucky to have achieved 100% recovery, as Louise found that her family history showed up seven people in her family tree affected by the disease. Her mother was one of them. She was tested for the BRCA 1 and 2 gene mutations but was relieved to have received a negative test.
Louise says that the sonographer plays a significant role in the journey of a breast cancer patient as it includes dealing with the patient throughout their journey, at the initial diagnosis and then continuing pre and post treatment.
With ultrasound, the sonographer is right next to the patient for about twenty to thirty minutes, looking in “real time” and diagnosing off the images seen. They take hard copy images to represent what they have seen. If they don’t see the pathology, it is missed. The sonographer has to involve with touching and imaging the patient for this lengthy period of time, and they deal intimately with the patient often asking questions whilst the diagnostic process is proceeding. It isn’t always simple either, as pathology can “camouflage”, so it needs a very trained eye and a lot of skill.
Patient check-ups can also continue for a period of time post-surgery. There are certain types of breast cancer, particularly aggressive forms like triple negative type in younger women that can lead to neoadjuvant chemotherapy, treatment that is designed to shrink tumours and performed before surgery and involves much diagnostic ultrasound. Sonographers are a very much a vital part of the whole medical care team working alongside surgeons, oncologists, radiologists, radiographers and pathologists.
The ultrasound process is about scanning of the whole breast and with the personal contact required and time shared with the patient, a role that requires highly developed professional and emotional skills. The scanning equipment is continuously evolving and the ability to read these machines and determine the outcomes has improved greatly over time due to academic study and specialist training. The manufacturing companies who produce the machines invest in cutting edge technologies.
Louise is responsible for the training of many post-graduate students, who often are skilled in medical imaging before proceeding into these specialist diagnostics. In Victoria her students are from the post-graduate program from Monash University and across Australia, there are a number of universities that offer post graduate studies in this modality.
Something that is not as easy to teach is the emotional quotient required for this particular profession which needs the sonographer to understand and effectively facilitate a level of patient collaboration to produce effective diagnostic quality. Louise invests much of her time now in passing on her specialist knowledge through running seminars and conferences all over Australia.
There is a shortage of highly skilled, well trained sonographers in Australia.
In Lee-Anne Murdoch’s case, she did not have any family genetic history at all and appreciates first hand specialist skills in the diagnostic technology like Louise’s. She is passionate about always telling people to book in for an ultrasound if you have found something abnormal and the initial test results may seem clear. Lee-Anne now has tests every year and always requests an ultrasound even when the doctor may not think it necessary. It is peace of mind for her.
Lee-Anne is fundraising with her daughter’s school Kimbala College in Sydney’s eastern suburbs. They are currently the leading school fundraiser for 2019.
Louise will be running with her husband in the 4km around the Tan in Melbourne this Sunday on Mother’s Day.
Note: This October is Breast Cancer Awareness month and the 27th October will be Australasian Sonographers Day