Breast exams and mammograms: 
Lifesaving strategies get more important as you get older.

Zera-Richard
Richard Zera, MD   

Breast cancer often makes itself known in its early stages, when there’s a good chance for a cure. But here’s the catch: You must be doing the right screenings to detect breast cancer. That includes monthly breast self-exams, regular clinical breast exams and regular mammograms.

Yet many women still put off these exams for any number of reasons. If you have an excuse for not being tested, read on. The following reasons to get screened should help convince you that now is the time to take action:

Your risk increases as you age — breast cancer undertreated in older patients
According to the American Cancer Society, roughly half of patients diagnosed with breast cancer are age 61 or older. Richard Zera, MD, Oncologist and Director of Hennepin’s Comprehensive Cancer Center says, “Women over 70 have the highest incidence of breast cancer. Early detection through screening mammography offers patients the most treatment options.”

But a recent study published in the American Medical Association’s Archives of Surgery suggests that breast cancer diagnosis is sometimes delayed in older patients because of the underuse of mammograms. In addition, aggressive therapy (such as chemotherapy, radiation and hormonal therapy) is not used as often as for younger patients. The researchers suggest that screenings and treatments should be based on each individual’s health conditions, rather than age.

Why don’t older women get screening mammograms?
Jane Van Deusen-Morrison, the Breast Cancer Navigator at the Comprehensive Cancer Center says. “As to why women over age 60 do not get mammograms as often—it is the same for most screenings—fear, cost, time, transportation, denial: ‘I am having no problems,’ ‘never had a lump,’ ‘no one in my family has ever had cancer/breast cancer.'”

Discomfort:
The little inconvenience and discomfort of getting a mammogram is far outweighed by its big benefits. Regular breast screening exams are the number-one way to reduce your risk of dying from breast cancer. A mammogram takes about 20 minutes (the actual breast compression lasts for only a few seconds) and can bring great peace of mind. Only one or two mammograms in 1,000 lead to a diagnosis of cancer, according to the ACS. And even if a malignant lump is detected, if it’s caught early and confined to the breast, the survival rate is more than 95 percent. The whole point of getting regular screening tests is to find the disease at its earliest, most treatable stage.

Convenience:
photo4c
Kari Saloka, RT (M) (R), in the new HCMC Mammography Van

Screening mammography is available at most of the clinics throughout the Hennepin Health System. Check HCMC.org for a full schedule. First, contact your doctor for a referral and then schedule by calling HCMC Patient Access Center at 612-873-6963.

Cost:
Screening mammograms are usually covered by your insurance provider.

There are also programs in Minnesota, such as the Sage program at the Minnesota Department of Health that will cover mammograms and other preventive services.

Women can enroll in the Sage program at the following Hennepin Clinics:
HCMC Medicine, HCMC Ob-Gyn, HCMC Cancer Center
Whittier
Brooklyn Center
East Lake
Richfield

Women can call 612-873-2576 (English) or 612-873-3814 (Spanish) to schedule an appointment at the downtown clinics with a Nurse Practitioner whose time is solely dedicated to Sage CBE, Pap/Pelvics and mammograms.

Mammography screening:
Leah Olstad, RT, (M) (R) and Kari Saloka, RT, (M) (R) do it all. They drive the mammography van and do the screening mammography for the patients. Leah says discomfort is probably the main concern for women. “The pressure is uncomfortable but if we don’t spread out the breast tissue enough, the doctors who read the scan cannot see the cancer. It’s like imagining a bag of white marbles,” she explained, “if there is a blue marble hiding within the white marbles, you couldn’t see it unless you spread the white marbles apart.”

Kari said that certain cancers cause calcification in the breast in their early stages. These changes cannot be felt, like a lump. It’s worth it to find breast cancer as early as possible.”

She also said that providers sometimes don’t order regular screening mammograms for older women. “Media reports about national recommendations caused some confusion about how often you need them for your age group. But … we ask older women, if you found out you had breast cancer, would you have it treated? If they say yes, then they should be tested. We have women in their 90s come in for screenings.”

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