Keeping Abreast Of Your Health
Early detection and prompt treatment can turn a breast cancer sufferer into a breast cancer survivor. Various organizations, such as The American Cancer Society, The American College of Obstetricians and Gynecologists, and the US Preventative Task Force to name a few, have developed guidelines for how best to screen average-risk women for breast cancer based on age. The guidelines vary slightly but generally agree that breast cancer screening should begin at age 40 and occur every 1-2 years. Informed decision-making between patient and provider should guide the details of frequency and when to stop screening.
Mammography is the gold standard for most accurately detecting breast cancer over all other imaging modalities. For this reason, imaging centers do not offer ultrasound, also known as sonography, or magnetic resonance imaging (MRI) as a substitute for mammograms. Ultrasound, MRI, or thermography may be used as an adjunct to mammograms, however. Thermograms show heat patterns that may indicate cancerous changes, but the FDA does not endorse the use of thermography alone to detect early-stage breast cancer as according to the FDA acceptable scientific evidence is lacking for accuracy.
Still, a very large portion of breast cancers are initially detected by the person with cancer, so self-breast awareness is very important. Pay attention while bathing or dressing to changes in the contour or appearance of the breasts as well as to their texture. Report any bulges, dimpling, thickening, lumps, skin or nipple changes, nipple discharge, or new asymmetry to your care provider promptly. It is common for one breast to be larger than the other unless perhaps this is a change for you.
Once a breast change is noticed, you can expect your care provider to order a diagnostic rather than screening mammogram often along with an ultrasound. The mammogram detects densities and patterns of densities through x-ray while the ultrasound defines fluid vs. solid characteristics through sound waves. If the appearance of the abnormal area then warrants correlation with the microscopic characteristics of the cells at that location, a biopsy will be recommended.
A very large portion of breast cancers are initially detected by the person with the cancer, so self-breast awareness is very important. Pay attention while bathing or dressing to changes in the contour or appearance of the breasts as well as to their texture.
Kalispell OB/GyN
A diagnostic mammogram differs from a screening mammogram in that it is more targeted at the site of abnormality. Although the cost and insurance coverage of each is likely to be different, it is not appropriate to substitute a screening mammogram for a diagnostic mammogram when a breast change has been identified since the screening mammogram does not evaluate the abnormality to the extent that the diagnostic mammogram does.
Additionally, when a suspicious site is identified on a screening mammogram, diagnostic imaging is employed to gather more detailed information about the site in question. Most suspicious sites found on screening mammograms are determined to be benign upon diagnostic imaging. It is not uncommon to be called back for further imaging after a screening mammogram, particularly if it is your first mammogram. The first mammogram serves as a baseline to which subsequent mammograms are compared.
Do not be afraid to share breast concerns with your healthcare provider, who can address the safety of breast screening modalities or your preferences. A good time to discuss this is at an annual clinical exam. However, if you notice a breast change, do not wait for an evaluation. Schedule a breast exam even if you are not due for an annual exam. In the end, you are the best steward of your healthcare needs.
Financial programs such as Montana Cancer Screening Program and Save a Sister are available in Flathead County to assist with the cost of screening mammograms or additional studies. Your healthcare provider can refer you to either of these programs, or you can contact The Montana Cancer Screening Program at 406-751-8162 or enroll to see if you qualify for assistance through their Flathead County Website.
Other resources for information on breast cancer and breast cancer screening for the general public can be found through The North American Menopause Society, The American Cancer Society or The American College of Obstetricians and Gynecologists.
For more information Shawn Shanahan, APRN-WHNP has 35 years as a Women’s Health Nurse Practitioner and can be reached at Kalispell OB-GYN at the Falls at 406-752-5252.
This article appears in 406 Woman magazine.