Geisinger: Screening Versus Diagnostic Mammogram

Early detection remains the most effective defense against breast cancer. Regular mammograms save thousands of lives each year — and have the potential to save even more.

A mammogram is a low-dose X-ray examination that can identify abnormal changes in breast tissue that are not detectable through a physical breast exam. These screenings play a vital role in detecting and diagnosing both breast cancer and benign (non-cancerous) conditions that may cause lumps, skin changes, or other abnormalities. When breast cancer is detected in its earliest, localized stages, the five-year survival rate reaches 99%.

Women are advised to begin annual mammograms at age 40, or earlier if risk factors are present. There are two primary types of mammograms — screening and diagnostic. Although both use the same specialized X-ray equipment, they serve distinct purposes. Understanding the difference between them empowers individuals to take proactive steps toward maintaining optimal breast health.

What Is a Screening Mammogram?

A screening mammogram is an annual X-ray examination performed to check for early signs of breast cancer in women who have no symptoms, such as lumps, skin dimpling, nipple discharge, or noticeable changes in breast size or shape since their last exam.

The primary goal of a screening mammogram is early detection — identifying potential signs of breast cancer before any visible or physical symptoms appear. Because some types of breast cancer can grow and spread rapidly, finding cancer at an early stage, when it is small, significantly increases the likelihood of successful treatment.

During a screening mammogram, a certified technologist positions the breast between two plates that gently compress the tissue to capture clear and detailed images. Typically, two images of each breast are taken from different angles, though additional images may be needed depending on breast size to ensure all tissue is included. The exam generally takes between 15 and 20 minutes.

After the images are taken, a diagnostic radiologist reviews them for any signs of abnormality and sends a report to the patient’s physician. Within about a week, the patient receives a letter indicating one of two outcomes: either the mammogram results were normal, or something was detected that requires further evaluation.

What Is a Diagnostic Mammogram?

A diagnostic mammogram is a specialized imaging test used to investigate the cause of breast symptoms or to further examine an abnormality found during a screening mammogram. It is also performed for women who have previously been treated for breast cancer, particularly within the first five years following treatment, to monitor for any signs of recurrence or new concerns.

During a diagnostic mammogram, the technologist captures images as directed by the radiologist to closely evaluate the area of concern or the specific symptoms being experienced. This examination is more detailed than a screening mammogram and typically includes additional views of a particular region of the breast. In some cases, advanced imaging techniques or a breast ultrasound may also be performed to provide a clearer, more precise look at the tissue.

Because diagnostic mammograms are more comprehensive, they generally take longer to complete. However, results are typically available during the same visit. After reviewing the images, the radiologist may share one of several possible outcomes:

  • There is no cause for concern, and the patient can resume regular annual screening mammograms.
  • The findings are likely benign, but a follow-up mammogram in about six months is recommended to ensure no changes occur.
  • The results suggest the possibility of breast cancer, and a biopsy is needed for a definitive diagnosis.

Being called back for a diagnostic mammogram does not necessarily indicate the presence of cancer. It simply means that the healthcare team wants to take a closer look at a specific area. In most cases, the findings turn out to be non-cancerous.

The Importance of Breast Cancer Screening and Early Detection

The recommended age to begin annual mammogram screenings is 40. However, individuals with a family history of breast cancer or other risk factors should consult their physician to determine whether earlier screening is appropriate.

In addition to routine clinical breast exams, yearly mammograms remain the most effective way to take proactive control of breast health. Regular screenings can identify potential issues before symptoms appear, significantly improving the chances of early detection and successful treatment.

Anyone who notices changes in their breasts—such as lumps, skin dimpling, nipple discharge, or alterations in size or shape—should contact their doctor promptly, even if a recent screening mammogram showed normal results. Detecting breast cancer at an early stage allows for more effective treatment and, in many cases, less invasive options.

For ongoing health and wellness guidance, visit geisinger.org/balance.

Dr. Anne Dunne is a board-certified and fellowship-trained radiologist.

Geisinger: What Are the Stages of Breast Cancer?

When a person is diagnosed with breast cancer, they may wonder whether the cancer has spread and, if so, how far. A doctor can answer these questions after determining the stage of the disease.

Rebecca Jordan, DO

Staging refers to the process of describing how extensive the cancer is, including the size of the tumor and whether it has spread to surrounding tissues or other parts of the body.

Generally, a lower stage number indicates that the cancer has spread less. Stage 0 breast cancer is the earliest, non-invasive form of the disease, while stage 4 is the most advanced and means the cancer has spread beyond the breast to other areas of the body.

Staging also helps doctors determine the most effective treatment approach and predict how successful that treatment may be. It allows them to create a more personalized treatment plan, as each stage presents different therapy options. A lower stage typically indicates a more localized cancer, which can often be treated less aggressively and may have a more favorable outcome. In contrast, higher stages of breast cancer often involve more extensive disease that requires more intensive treatment strategies.

How Stages of Breast Cancer Are Determined

Based on the results of a physical examination, biopsy, and/or imaging tests, a doctor assigns a stage to the breast cancer diagnosis. The clinical staging system is guided by the TNM classification, which evaluates three key factors:

  • (T): The size of the tumor
  • (N): The presence of cancer in the lymph nodes
  • (M): Whether the cancer has metastasized, or spread, to distant parts of the body

In addition to the TNM classification, doctors may also consider other biological markers, such as the presence of estrogen, progesterone, or HER2 receptors, and how rapidly the tumor cells are likely to grow and spread.

Together, these factors help define the cancer’s stage, providing a more detailed diagnosis and enabling a more targeted and personalized treatment plan.

Stages of Breast Cancer Explained

Breast cancer is classified into five main stages — from stage 0 to stage 4 — each with distinct characteristics and corresponding treatment options.

Stage 0 Breast Cancer

Stage 0 breast cancer, also known as ductal carcinoma in situ (DCIS), represents the earliest and non-invasive form of the disease. In this stage, abnormal cells are present within the lining of the breast milk ducts but have not spread into surrounding tissues.
Typically, there are no noticeable symptoms, and the prognosis is excellent. Treatment often includes surgical removal of the affected tissue, commonly followed by radiation therapy to prevent recurrence.

Stage 1 Breast Cancer

Stage 1 breast cancer indicates early invasive disease, in which the tumor measures up to 2 centimeters (cm) and has not spread beyond the breast. In some cases, cancer cells may be found in a very small number of nearby lymph nodes.
Possible symptoms include a breast lump, nipple discharge, or changes in breast shape. The prognosis is highly favorable, and treatment generally involves a combination of surgery, radiation therapy, and, depending on the tumor’s biological characteristics, hormone therapy or chemotherapy.

Stage 2 Breast Cancer

Stage 2 breast cancer is defined by a larger tumor (between 2 and 5 cm) and/or cancer that has spread to nearby lymph nodes but remains confined to the breast region.
Common symptoms may include a noticeable lump, swelling, or discomfort in the breast. The prognosis remains very positive, with treatment typically consisting of surgery, radiation therapy, and systemic treatments such as chemotherapy and hormone therapy, depending on the cancer subtype.

Stage 3 Breast Cancer

Stage 3 breast cancer is considered locally advanced. The tumor is often larger than 5 cm and/or has spread to multiple nearby lymph nodes and possibly surrounding tissues, such as the breastbone or chest wall.
Symptoms may become more pronounced and include lumps in the armpit, skin or nipple changes, and breast pain. While the prognosis is still favorable with appropriate care, treatment is usually more aggressive, often combining surgery, radiation therapy, chemotherapy, and targeted therapies.

Stage 4 Breast Cancer

Stage 4 breast cancer is the most advanced stage, indicating that the disease has metastasized beyond the breast to distant organs such as the bones, liver, lungs, or brain.
Symptoms can vary depending on where the cancer has spread and may include chest pain, persistent cough, bone pain, or fatigue. At this stage, the focus shifts toward controlling the disease and improving quality of life through palliative care and systemic treatments, including chemotherapy, targeted therapy, and hormonal therapy.

Importance of Breast Screenings and Early Detection

Early detection remains the most effective defense against breast cancer. Along with routine clinical breast examinations, annual mammograms are the most reliable method for monitoring breast health and identifying cancer in its earliest stages.

The recommended age to begin yearly mammograms is 40. However, individuals with a family history of breast cancer or other risk factors should consult their doctor to determine whether earlier screening is appropriate.

In addition to screenings, reducing controllable risk factors can help lower the likelihood of developing breast cancer. These lifestyle choices include:

  • Eating a healthy, balanced diet
  • Exercising regularly
  • Limiting alcohol consumption
  • Avoiding smoking
  • Maintaining a healthy weight

Anyone who notices changes in their breasts or develops new symptoms should contact their doctor immediately — even if a recent mammogram showed no abnormalities. Detecting breast cancer early allows for more effective treatment and may enable the use of less invasive therapies.

For the latest health and wellness tips and advice, visit geisinger.org/balance.

Rebecca Jordan, DO, is a general surgeon specializing in breast surgery.

Geisinger: What Does It Mean to Have Dense Breast Tissue?

Regular mammograms can detect breast cancer when it is too small to be felt as a lump. Detecting cancer at this early stage — before it has the opportunity to spread — allows for simpler, more effective treatment with a higher likelihood of success.

Kayleigh Taylor, MD

In addition to identifying cancer, mammograms can also determine whether a person has dense breast tissue, which may indicate the need for additional screening.

In simple terms, breast density refers to how breast tissue appears on a mammogram. Having dense breasts is common and entirely normal — nearly half of women aged 40 and older have dense breast tissue.

However, knowing one’s breast density is important because it can influence both screening recommendations and overall breast health. In some cases, mammograms alone may not be sufficient to detect breast cancer, making awareness and supplemental screening critical for early detection.

What Is Dense Breast Tissue?

Breasts are composed of two main types of tissue:

  • Fibroglandular tissue, which includes:
    • Glandular tissue (milk glands and ducts)
    • Fibrous tissue that supports and holds the breast structure in place
  • Fatty tissue, which surrounds and cushions the fibroglandular tissue

Each individual’s breasts contain different proportions of fatty and fibroglandular tissue. Based on these proportions, breast density is classified into four categories:

  1. Mostly fatty tissue – the least dense type
  2. Scattered fibroglandular density – primarily fatty with some dense areas
  3. Heterogeneously dense – mostly dense tissue with some fatty areas
  4. Extremely dense – predominantly dense tissue throughout the breast

Individuals with heterogeneously dense or extremely dense breasts are considered to have dense breast tissue, meaning that more than half of the breast consists of glandular and fibrous tissue rather than fat.

Breast density cannot be determined by appearance or feel; it can only be identified through imaging tests, such as a mammogram.

What Causes Dense Breast Tissue?

Several factors can increase the likelihood of having dense breast tissue, including:

  • A genetic predisposition
  • Being younger than age 50
  • Having a lower body weight or body mass index (BMI)
  • Taking hormone replacement therapy
  • Being pregnant or breastfeeding

Breast density can change over time, meaning that a person who currently has dense breast tissue may not have it later in life.

Hormonal fluctuations also play a significant role in breast density. Changes that occur during the menstrual cycle, pregnancy, and menopause can all affect the composition of breast tissue. Pregnancy often results in increased breast density, while postmenopausal women generally experience a decrease in density due to hormonal changes.

What Does Having Dense Breast Tissue Mean?

Having dense breast tissue is associated with a higher risk of developing breast cancer. For this reason, regular mammograms are especially important. In some cases, healthcare providers may also recommend supplemental screening methods to ensure a more comprehensive evaluation.

Because both dense breast tissue and tumors appear white on 2D mammograms, cancers can sometimes go undetected, as the dense tissue may obscure abnormalities. In contrast, fatty breast tissue appears darker on a mammogram, making it easier to identify potential issues.

To improve detection, doctors may order additional imaging tests that provide a more detailed view of the breast tissue, including:

  • 3D Mammogram (Tomosynthesis): An advanced imaging technique that uses X-rays from multiple angles to create a detailed, three-dimensional image of the breast.
  • Breast Ultrasound: A noninvasive test that uses sound waves to produce 3D images of the breast, helping distinguish between solid masses and fluid-filled cysts.
  • Breast MRI: A test that uses magnetic fields to generate detailed 3D images of the breast and can identify smaller cancers that might not be visible on a mammogram. Breast MRIs are typically recommended for individuals with dense breast tissue and a higher risk of breast cancer.

In most cases, follow-up imaging after a standard screening mammogram reveals no abnormalities. However, undergoing these additional tests is important, as early detection of breast cancer leads to simpler, more effective treatment and better overall outcomes.

Dense Breast Tissue: Knowledge Is Power

Because breast cancer often develops in fibroglandular tissue, individuals with a higher proportion of this tissue face an increased risk of the disease. Unfortunately, dense breast tissue can also mask tumors on mammograms, potentially delaying diagnosis and treatment.

However, dense breast tissue is only one of several risk factors for breast cancer. Other contributing factors may include:

  • Lifestyle choices, such as alcohol consumption, being overweight, or a lack of regular physical activity
  • Not having children or not breastfeeding
  • Use of hormone replacement therapy to manage menopausal symptoms
  • Inherited gene mutations, such as BRCA1 or BRCA2
  • A family history of breast cancer

If mammogram results indicate dense breast tissue, it is important to consult a healthcare provider to discuss next steps. Working collaboratively, individuals and their providers can take proactive measures to monitor breast health, manage risk factors, and promote early detection for the best possible outcomes.

For the latest health and wellness tips and advice, visit geisinger.org/balance.

Kayleigh Taylor, MD, diagnostic radiology

Wright Center Employees Earn Statewide Recognition

Three standout employees from The Wright Center for Community Health received statewide recognition from the Pennsylvania Association of Community Health Centers (PACHC) during its Annual Conference and Clinical Summit in Lancaster.

Each year, PACHC recognizes the outstanding efforts of dedicated individuals and teams who work in and volunteer for community health centers throughout the state with their Awards for Primary Care Excellence, commonly referred to as the APEX awards.

Dr. William Dempsey

This year, PACHC recognized Dr. William Dempsey, a longtime family physician at The Wright Center for Community Health Clarks Summit, with the Outstanding Primary Care Clinician Award. In addition to his clinical role, Dr. Dempsey serves as The Wright Center’s chief population health value-based care officer. He was selected for his unwavering dedication to expanding access to affordable, high-quality, whole-person primary health services, particularly for vulnerable populations. The award also highlights his collaborative approach to patient care, which has improved screenings, follow-ups, and outcomes, especially for patients managing mental health challenges, substance use disorders, and chronic conditions.

Catherine Nealon

PACHC presented Catherine “Catie” Nealon, associate vice president of clinical program development, population health, and the 340B Program at The Wright Center, with its Innovation Award. The award honors initiatives that lead to improved patient outcomes, reduced health disparities, increased patient satisfaction, or greater efficiency and effectiveness in delivering primary care. Nealon was recognized for spearheading several projects that have strengthened The Wright Center’s ability to set and achieve measurable improvement goals. Her leadership has advanced the integration of innovative software that tracks clinical quality measures – ensuring patients receive appropriate and timely screenings, follow-up care, referrals, and other essential services that enhance overall health outcomes.

Nicole Sekelsky

Nicole Sekelsky, the director of needs-responsive outreach engagement and enrollment at The Wright Center, was recognized by PACHC with the Coverage Champion Award. She was selected for her tireless efforts to help individuals and families across Northeast Pennsylvania gain access to health insurance. Through Sekelsky’s leadership, The Wright Center expanded its presence at community outreach events and developed new opportunities to connect with those in need of coverage. As a result, The Wright Center assisted more than 1,000 people with health insurance inquiries in fiscal year 2025 – a 200% increase over the previous year.

For more information about The Wright Center, visit TheWrightCenter.org or call 570-230-0019.

Wright Center for Community Health’s CEO Elected to State Health Board

Dr. Linda Thomas-Hemak, president and CEO of The Wright Centers for Community Health and Graduate Medical Education, has been appointed to serve on the Pennsylvania Association of Community Health Centers’ (PACHC’s) Board of Directors.

PACHC represents the commonwealth’s largest network of primary health care providers that serve nearly 1 million patients annually at more than 475 sites in underserved rural and urban areas in 55 counties. Its 15-member Board of Directors is made up of community health center CEOs from across Pennsylvania, representing a broad spectrum of expertise that spans finance, clinical care, workforce development, advocacy, policy and regulation, nonprofit health care administration, and human resources.

“I am deeply honored and profoundly grateful to join the reputable Board of Directors of the Pennsylvania Association of Community Health Centers. I am excited for the opportunity to collaborate with dedicated and talented colleagues from across our state as we work together to advance access, affordability, and excellence in community-based primary and preventive health services for all Pennsylvanians,” said Dr. Thomas-Hemak. “Together, we will continue to strengthen the mission-driven voice of community health centers to ensure that the patients, families, and communities we are privileged to serve remain at the forefront of health care conversations and strategies.”

Dr. Thomas-Hemak is a quintuple board-certified primary care physician in internal medicine, pediatrics, addiction medicine, obesity medicine, and nutrition. Alongside her executive leadership, she continues to care for multigenerational families at The Wright Center for Community Health Mid Valley in Jermyn, her hometown. She has earned national recognition for advancing innovative community-based primary care delivery models, expanding access to essential health services, and cultivating the current and future interprofessional health care workforce.

A proud graduate of Scranton Preparatory School and the University of Scranton, Dr. Thomas-Hemak went on to earn her medical degree as a Michael DeBakey Scholar at Baylor College of Medicine in Houston, followed by completing Harvard’s Combined Internal Medicine/Pediatrics Residency Program in Boston. Guided by a profound sense of service to her community roots, she returned to Northeast Pennsylvania to practice primary care. She joined The Wright Center in 2001, became its president in 2007, and assumed the role of CEO in 2012.

She and her husband, Mark, have three children, Mason, Maya, and Antoinette. Dr. Thomas-Hemak is the daughter of Johanna Cavalieri Thomas, who lives in Archbald, and the late William Thomas.

For more information about The Wright Centers for Community Health and Graduate Medical Education, visit TheWrightCenter.org or call 570-230-0019.

Greater Scranton YMCA Awarded BK5K Youth Grant

On October 9, 2025, the Greater Scranton YMCA received a grant award of $2,000 from the BK5K Youth Fund of the Winona Community Foundation. Funds will support the continued development of youth programs at the Y.

From left: Marcelo DeSousa, Regional Operations Manager, Fastenal; Rich Surridge, President & CEO, Greater Scranton YMCA; Meghan Carnevale, Mission Advancement & Marketing Director, Greater Scranton YMCA; Whitney McDonald, SHUB Help Desk Manager, Fastenal

UNC Receives Generous Donation Presented by Fastenal Company

United Neighborhood Centers of Northeastern Pennsylvania (UNC) is one of the recipients of the annual BK5K 5-kilometer road race and walk presented by Fastenal Company. A check for $3,000 was recently presented to UNC and will directly support renovations at our Progressive Child Care Center to purchase new classroom equipment. The 2024 BK5K was held on July 19, 2025, at Nay Aug Park in Scranton.

The BK5K was created to honor Bob Kierlin, founder of Fastenal Company and lifelong supporter of youth initiatives. The event, which includes multiple races around the world, raises hundreds of thousands of dollars annually to benefit local youth programs.

UNC operates three licensed child care centers in Lackawanna County, offering affordable, high-quality early education and after-school programs that foster growth, learning, and social development.

Chrissy Manuel, UNC Director of Development and Communications; Kelly Langan, UNC Director of Children & Teens; Donna Veater, UNC Progressive Child Care Center Director; Lisa Durkin, UNC President and Chief Operating Officer;
Whitney McDonald, Fastenal SHUB Help Desk Manager; Marcelo Desousa, Fastenal Regional Operations Manager; and Geyshelle Brown, UNC Progressive Child Care Center Assistant Group Supervisor.

My Benefit Advisor: Technological Integration and Data Security in Employee Benefits

Technological integration in employee benefits management is crucial for enhancing efficiency, accessibility, and user experience. By leveraging digital platforms, employers can streamline the administration of benefits, allowing employees to easily access and manage their benefits information, such as health insurance, retirement plans, and wellness programs. This integration supports real-time updates, reduces administrative errors, and provides a seamless experience for both HR departments and employees.

However, with the increased reliance on digital systems comes a heightened need for robust data security measures. Employee benefits platforms often handle sensitive personal and financial information, making them prime targets for cyberattacks. A breach can lead to significant consequences, including identity theft, financial loss, and a loss of trust among employees. For employers, a data breach can result in legal liabilities, regulatory penalties, and damage to the company’s reputation.

As a result, investing in advanced cybersecurity measures, such as encryption, secure authentication, and regular security audits, is essential. Ensuring data privacy and protection not only complies with legal requirements but also fosters a secure environment that reassures employees their personal information is safe. In this way, technological integration and data security are intertwined in maintaining an efficient, effective and trustworthy benefits system.

Click here for more information.

SWB RailRiders Announce Banana Ball Games in 2026

Banana Ball is coming to PNC Field in 2026!

The global phenomenon, made famous by the Savannah Bananas, will stop in Scranton/Wilkes-Barre for two games on May 22 and 23.

As revealed Thursday night during the 2026 Banana Ball City Selection Show, which aired on ESPN2, Scranton/Wilkes-Barre has been selected as a tour stop for the brand-new Banana Ball Championship League (BBCL). PNC Field will host official league games featuring the Loco Beach Coconuts against the Firefighters.

Fans must enter the ticket lottery at bananaball.com/tickets by October 31, 2025, for a chance to purchase tickets. Tickets will go on sale approximately two months prior to the scheduled event dates for those selected in the ticket lottery. Individual ticket sales for the games are being handled exclusively by Fans First Entertainment, the company that manages the Savannah Bananas and BBCL member teams. Standard tickets start at $35.

Banana Ball has taken the sports world by storm, drawing millions of fans with its non-stop action, viral moments and unique rules – including a two-hour time limit, no bunting and fans catching foul balls for outs. The 2026 BBCL season will feature six teams playing 60 games across the country, all leading to a can’t- miss championship series in October. With dancing players, surprise guests and one-of-a-kind in-game antics, Banana Ball delivers an entertainment experience unlike anything else in sports.