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December 07th, 2021

swmc machineDiagnostic Imaging employees Delainy Holder, left, Director Kelly Denton and Guadalupe Arredondo have more than 40 years of combined experience working for the Southwest Medical Center department. L&T photo/Robert PierceROBERT PIERCE • Leader & Times


Southwest Medical Center’s Diagnostic Imaging (DI) department provides many services, including X-ray, CAT scan, ultrasound, MRI, nuclear medicine and mammography.

“We do all of the imaging needs of a patient, with the exception of cardiac ultrasound or echo cardiogram,” DI Director Kelly Denton said.  “We do all of it here to get the diagnosis for the doctors and the providers.”

Denton said cardiac ultrasound and echo cardiograms are specialized with a concentration on the heart and lungs and are done by SWMC’s respiratory therapy department.

Denton said DI’s services start with a patient’s primary health care provider ordering an X-ray or imaging study.

“If it’s just a plain X-ray, they can walk through the door Monday through Friday and check in and get it,” she said. “If they’re having a specialty X-ray that involves our doctor, that stuff has to be scheduled, and so does everything else – the CAT scans, the MRIs, ultrasound. Those all go through our outpatient scheduling department.”

Denton emphasized a patient has to have a provider’s order for most X-rays.

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“The only exception is a screening mammography exam,” she said. “With a screening mammogram, we are self-referral. A woman can call and request a screening mammogram as long as they’re not having any difficulties or any problems with the breasts. It’s a screening exam. The only thing we require is a provider for the report to go to. It doesn’t have to be a provider in Liberal, it can be a provider anywhere. They just need somebody who’s responsible to follow up on the report if there’s something there.”

October is Breast Cancer Awareness Month, and Denton said DI has a few things planned to observe the month.

“We had a breast care booth out at the health fair, where we had nurse practitioners doing clinical breast exams,” she said. “I am doing an education table and information out at National Beef. They’ve asked us  to come out and do some education for their employees.”

Denton said in recent years, the number of breast exams her department has done has remained steady between 1,000 and 2,000 a year.

“In 2019, we did 1,660 breast exams,” she said. “In 2020, we only did 1,463, and I think that’s directly related to COVID. I think women were nervous to come in for preventative care, and they were putting things off. So far this year, January to September, we’ve done 1,339.”

Denton said COVID-19 itself does not affect breast cancer, but the vaccine used to immunize against it does.

“The vaccine has an immune response,” she said. “All vaccines, not just COVID vaccines, have an immune response, and sometimes, people will get swollen lymph nodes  in the arms directly after a vaccine. For that reason, we asked women not have a mammogram directly after a vaccine and wait three to four weeks post-vaccine to allow those lymph nodes to go back to normal.”

Denton said it is the body’s response to the vaccine, mainly its foreign nature, that leaves the body trying to figure out what to do.

“That’s a very normal response,” she said. “If we see large lymph nodes on a mammogram, we think something could be very wrong, and if that has just happened because of the vaccine, it’s not normal. We don’t want to do further testing just because it’s from the vaccine.”

Denton said mammograms have to be scheduled, and they can only be done on an annual basis.

“Most insurance and Medicare is very strict about doing them once a year,” she said. “You’ve got to be careful you don’t do it too early because they might not pay for it.”

When patients get into the mammography room, Denton said a brief history is done, and that is renewed every year.

“We keep that information, and we take typically four pictures of the breasts,” she said. “You are done, and your physician provider gets a report in about a week. You get a letter from us with the results in about 10 to 20 days.”

Denton said breast cancer can occur between screenings, and if there are any changes at those times, patients need to call their providers.

“They would obviously do a check, and if they felt the need, they would send you in for a diagnostic mammogram,” she said. “If you’ve had a recent screening, we would just do the side that’s in question, and we typically do a diagnostic mammogram and an ultrasound so we can see it in two different ways.”

Denton emphasized the need for to get regular mammograms.

“Breast cancer’s one of the most preventable cancers, and when found in its earliest stages, it is completely curable,” she said. “When you wait and find it too late, that’s when it spreads, and you have long-term, and it can affect your life.”

Denton talked about several myths people have about breast cancer.

“People think if they don’t have a family history, they can’t get breast cancer,” she said. “That’s not true. Family history has to start with somebody. Some people think it’s only a female cancer. It’s not. Men can get breast cancer too. Some people think if they didn’t have anything on their first mammogram, they don’t need to have more. That’s not true. As you age, the likelihood to get breast cancer increases. When they say the statistic one in eight women get breast cancer, that’s averaged off of a woman who’s 80 years old. If you start looking at the younger, it’s less likely, but you never stop thinking about getting breast cancer. Any woman at any age can get it.”

Denton said a small amount of DI’s mammograms come about from screenings for something else.

“I would say about 15 to 20 percent of our screening mammograms,” she said. “I think the goal is to have 10 to 15 percent call back. Call back means I’m not quite sure, let’s get a better look. That’s when you end up with the diagnostic and the ultrasound. Of those 10 percent, only 10 to 20 percent end up being breast cancer.”

Of the total number of mammograms Denton’s department performs every year, a very small percentage turn out to be breast cancer.

“Last year, we found, I know of, 18 breast cancers,” she said. “That means we did the biopsy. We have a pathology report that says it was breast cancer. Some women choose to go somewhere else for their followup, and sometimes, we have difficulty getting those records. We try our best to get those records, but we don’t always get them. This year, in the first nine months, we’ve already found 14 breast cancers.”

Denton said Diagnostic Imaging now has a new provider to help with the process that takes place after a mammogram.

“Dr. Robert Williams is here as our radiologist now,” she said. “He is very conscious of a woman’s breast diagnosis and time. When we’re doing a diagnostic and we find something, he comes into the room. He visits with the woman. If the woman approves and she’s not taking any blood thinners, we will biopsy her that day. We will do everything we can, as long as the patient wants to and they’re not on blood thinners, to biopsy them that day, and they’ll find out those results of the biopsy in about five days.”

Denton has been working at SWMC for 25 years.

“I came in July 1996,” she said. “I came here as a brand new graduate from South Dakota, started in X-ray and trained in mammography right away.”

For Denton, what she does at DI is personal.

“I had a grandmother who passed away,” she said. “We found her breast cancer while I was in X-ray school when I was living here, and she was found at very late terms. I’m very passionate about women knowing about preventative care. Had my grandmother known about preventative care, she would’ve had a longer lifespan.”

Denton said she loves bonding with the patients she sees on a yearly basis.

“You get to know them,” she said. “You get to see them. As you’re doing the mammogram, we talk about how they’re doing. I just like the interaction we have with our patients.”

Denton said she has seen some of her patients for many years.

“I think I’ve seen some patients every year of my 25 years or at least every other year,” she said. 

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