Susan G Komen Race for the Cure Ozark

4 | Northwest Arkansas Democrat-Gazette | Susan G. Komen Race for the Cure | April 2018 Clinical Breast Exam A clinical breast exam (CBE) is a physical exam done by a health care provider. It's often done during your regular medical check-up. A CBE should be performed by a health care provider well trained in the technique (this may be a physician, nurse practitioner or other medical staff). Not all providers have this training. The National Comprehensive Cancer Network (NCCN) recommends a trained provider carefully feel your breasts, underarm and the area just below your clavicle (breast bone) for any changes or abnormalities (such as a lump). The provider will visually check your breasts while you are sitting up and physically examine your breasts while you are lying down. If a CBE is not offered at your check-up and you would like one, ask your provider if he or she can perform one (or refer you to someone who can). For most women, a clinical breast exam will find no signs of breast cancer. If your exam does find something abnormal, you'll need follow-up tests to check whether or not the finding is breast cancer. False positives occur when a CBE finds something that looks or feels like cancer, but turns out not to be cancer. Getting a false positive result not only leads to follow-up tests, but can also cause fear and worry. However, the goal of clinical breast exams is to find as many cancers as possible, not to avoid false positive results. Mammography Mammography uses X-rays to create images of the breast. These images are called mammograms. A radiologist trained to read mammograms studies the images for signs of breast cancer. In the past, mammogram images were stored on film (film mammography). Now, mammogram images are usually stored directly onto a computer (digital mammography). Digital mammography images can be lightened or darkened, and certain sections can be enlarged and looked at more closely. Because the images are stored on a computer, they can be shared easily with another radiologist for review. Breast cancer screening tools are used to find breast cancer in a person who doesn't have any warning signs or symptoms. Overall, mammography is the most effective screening tool used to find breast cancer in most women. It can find cancers at an early stage, when they are small and the chances of survival are highest. Mammography can also be used as a follow-up test when something abnormal is found on a screening mammogram or a clinical breast exam. When used as follow-up test (instead of screening), a mammogram may be called a "diagnostic mammogram." Although it's called a "diagnostic mammogram," it can't diagnose breast cancer. However, it can show whether the abnormal findings look like breast cancer. If the findings look like breast cancer, you will have a biopsy to diagnose (or rule out) breast cancer. Whether you are getting a screening mammogram or a diagnostic mammogram, the basic procedure is the same. However, you will likely have more views with a diagnostic mammogram. Like other X-ray images, mammograms appear in shades of black, gray and white, depending on the density of the tissue. Dense breast tissue and fatty breast tissue look different on a mammogram. The results of a mammogram may show a benign (not cancer) condition or an abnormal finding that needs follow-up tests to rule out cancer. For most women, a mammogram will show no signs of breast cancer. However, if your mammogram does show something abnormal, you will need follow-up tests to check whether or not the finding is breast cancer. Although mammography is the most effective screening tool used today to find breast cancer in most women, it's not perfect. Most major health organizations have concluded that mammography saves lives. However, there's ongoing debate about how much benefit there is from mammography (especially in younger women) and whether this benefit outweighs the risks. There's also debate about when to begin mammography and how often to get a mammogram. Three-dimensional (3D) mammography (breast tomosynthesis) Special imaging machines can take multiple two-dimensional (2D) digital images of the breast. Computer software combines the 2D X-ray images into a three-dimensional (3D) image (called breast tomosynthesis). Radiologists must have special training to read these 3D images. Getting a 3D mammogram is similar to getting a 2D mammogram. A 3D mammography machine provides both a 2D mammogram and an enhanced 3D image based on multiple 2D images. All the images are taken on the same machine, so you stay in one place while all of the images are taken. A 3D mammogram takes a few seconds longer than a 2D mammogram because more images are taken, but you won't likely notice a difference (if you've had a mammogram in the past). Depending on the method, 3D mammography gives the same or slightly higher radiation dose than standard 2D mammography. This higher dose is still within FDA guidelines. Some studies have shown 3D mammography may find a few more breast cancers than 2D mammography. Whether 3D mammography is better than standard 2D mammography for breast cancer screening is still under study. Currently, the American Cancer Society and the U.S. Preventive Services Task Force recommend standard 2D mammograms in their breast cancer screening guidelines. The National Comprehensive Cancer Network breast cancer screening guidelines, however, note that 3D mammography may be considered. Some centers in Northwest Arkansas offer 3D mammography. Although most insurance plans cover the cost, it's best to check with your insurance provider and the imaging center before getting a 3D mammogram. Low-cost or free mammograms Medicare, Medicaid and most insurance companies cover the cost of mammograms. Since September 2010, the Affordable Care Act has required all new health insurance plans to cover yearly mammograms with no out-of-pocket costs (co-payments or co- insurance) for women ages 40 and older. If you don't have insurance or your insurance doesn't cover mammograms, the Komen Ozark Affiliate can help you find a low-cost or free mammogram (or help with the cost). Komen Affiliates fund breast cancer education and screening projects in their communities for those who need it most. Call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) to find low-cost options in your area. Breast MRI Breast magnetic resonance imaging (MRI) uses magnetic fields to create an image of the breast. Breast MRI is more invasive than mammography because a contrast agent is given through an IV before the procedure. At this time, breast MRI is mostly used in breast cancer diagnosis and staging. It's also used in breast cancer screening for women at higher risk. Compared to mammography alone, mammography plus breast MRI can increase detection of breast cancer in: • Women with a BRCA1 or BRCA2 gene mutation • Women with a strong family history of breast cancer • For women at higher risk of breast cancer The National Comprehensive Cancer Network (NCCN) recommends yearly screening with mammography plus breast MRI for some women at By Sarah Haney NWA Democrat-Gazette

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