Reprinted from the Health District's quarterly publication mailed to district residents (Fall 2002)
TOPIC: What's a woman to do when it comes to mammograms?
 
by chryss cada

Dr. Christina Kuroiwa has a simple answer for women 40 to 50 years old wondering if they should get a mammogram: “Just do it.”

A recent study casting doubt on the effectiveness of mammograms coupled with conflicting age guidelines for getting the cancer-screening procedure has women wondering what to do.

Late last year, a respected British medical journal printed the findings of a study which contends that there is no solid evidence that women who have mammograms have a higher survival rate. A recent study by American researchers drew the opposite conclusion, finding that there were up to 45 percent fewer breast-cancer deaths among those who had annual mammograms.
“Nobody is saying mammograms are perfect, but right now it’s the best screening tool we have,” says Melanie Marin, medical services coordinator for the Health District. “We know that, and we know that it saves lives.”

Barbara Brommers, 62, believes a mammogram saved her life. The test detected a malignant cancer growth the size of her fingernail in her breast. After The National Cancer Institute recommends women in their 40s with risk factors have screenings every year or two and begin annual screenings at 50.

Some might think that to be on the safe side, all women older than 40 should have annual mammograms. But because mammograms are more difficult to read in younger women, they have a higher incidence of false positives and undergo more unnecessary biopsies.
The best bet, say experts, is to discuss your risk factors with your doctor and make a decision on mammography together, and do a breast exam monthly.

Screening options
If you are uninsured or your health insurance doesn’t cover mammography, here are a few options:

• The Colorado Women’s Cancer Control Initiative provides free cervical and breast exams to women whose income meets their guidelines. For example, a single woman who makes $22,100 a year or less would qualify. Also, women who are “underinsured” (defined as having a deductible of $200 or higher) qualify. Because the program has limited funds, it is only women 50 and older who automatically qualify for free mammograms. Younger women may qualify. To qualify for the program, women older than 65 cannot receive Medicare Part B. Call 498-6751 for details.

• Well Women Clinics at the Health District arrange for free mammograms to women meeting Colorado Women’s Cancer Control Initiative income requirements of all ages. Through a grant from the Denver affiliate of the Susan G. Komen Foundation, the Health District also has funds for initial treatment of breast cancer. Call 416-7447 for details.

If you have private insurance, here are facilities in Fort Collins that offer mammography:

• The Breast Diagnostic Center, on Poudre Valley Health System’s Harmony Campus, 2127 E. Harmony Road, Suite 130. For an appointment, call 207-4700. Also accepts Medicaid and Colorado Indigent Care Program (CICP).
• Front Range Radiology Consultants, 1101 E. Elizabeth St. For an appointment, call 482-9414. Also accepts Medicaid.
• Women’s Clinic of Fort Collins, 1106 E. Prospect, 493-7442.

Risk factors for breast cancer include age, a family history of breast cancer, early age onset of menstrual period, late age onset of meno-pause, breast abnormalities (such as atypical hyperplasia), breast density of 75 percent or more (for those older than 45) and having a first child after 30. Though not proven to prevent cancer, reducing the amount of dietary fat and increasing physical activity may have preventive potential.

Experts agree that any woman, regardless of age or risk factors, should get immediate medical care if she finds a lump during her monthly self exam.

“A woman’s best defense at home is to monitor what’s going on with her own body by doing breast self exam,” says Dr. Kuroiwa, who runs the Health District’s Well Women Clinics. “Making it (BSE) a habit early and sticking with it is crucial for a woman’s health.”

did you know?
According to the Health District’s 2001 community health survey, 52 percent of women age 40-49 had a mammogram within the past year. That compares to 71 percent of women age 50 and older.