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During the COVID-19 pandemic, routine doctor’s visits and preventative care often had to take the back burner, so over the next few months, the Health & Wealth will be speaking with experts about how you can get back on track with your preventative health care.Have a pressing question? Reach out and let us know at smithbecky@missouri.edu or aspidel@missouri.edu.

Checking Up on Mammograms: 'About age 40 is the right place to start.'

This past summer, the U.S. Preventive Services Task Force, or USPSTF, came out with new recommendations, which proposed that women at average risk of breast cancer should begin getting mammograms at age 40 and have a mammogram every other year.

KBIA’s Rebecca Smith sat down with Dr. Logan Frank, the director of breast imaging for Ellis Fischel Cancer Center, to discuss how mammogram recommendations have changed and why this preventative health measure still matters.

During the COVID-19 pandemic, routine doctor’s visits and preventative care often had to take the back burner, so over the next few months, the Health & Wealth Desk will be speaking with experts about how you can get back on track with your preventative health care.

Rebecca Smith: We're gonna talk about how some of our recommendations have, but I kind of was hoping you could set the scene for us and for our listeners: How much of an issue is breast cancer? Have things increased? Have they stayed the same? Have we seen any reductions? And why is it something that people should be, you know, aware of and concerned about,

Dr. Logan Frank: Breast cancer is still very relevant, it is the second leading cancer cause of death among women – around one in eight women will get breast cancer in their lifetime, on average.

And the reason screening is important is because if you have a very early breast cancer that we find, before it spread to or past the lymph node, the survival rate is almost 100%. It is fantastic. Once you get distant spread beyond the lymph node, it gets a lot harder to treat.

So, breast cancer gets more and more likely, as we get older, it's very rare for extremely young people to get breast cancer. So screening at, you know, middle and older age is a good thing to do.

The question is – when do we start screening? And that's what has changed recently. Most physician groups and research groups that have looked at this problem, have decided that well, about age 40 is the right place to start.

Rebecca Smith: I've, you know, kind of grown up with the horror stories of mammograms from my mother and my aunts, and so, what should women or people with breast tissue expect when they're walking into a mammogram? What does that screening process look like? And what would you say to someone who's maybe very cautious or even scared of the procedure?

Dr. Logan Frank: So what we expect for a screening mammogram when you come in, as we want two different X ray views of each breast… That gives us two views from different angles of all the breast tissue to see what's going on.

You know, you hear a lot about the compression, and, you know, how uncomfortable that can be, but I say go in with an open mind. Most people say it maybe wasn't as bad as maybe they've heard.

And if you can only tolerate a little bit, that's better than nothing, you know, a soft compression mammogram is much better than no mammogram.

If you get that letter or that phone call that says there was something on your mammogram that we want to look more at, don't be worried – that's kind of not the stage to worry, we there's a lot of things we have to look closer at, look at different views or do an ultrasound to see better. Most of those things don't end up being cancer.

So the biggest things we'd be looking for early signs would be a lump, like, typically harder or feels different than the rest of the breast tissue, or a bloody or water, clear nipple discharge.
Dr. Logan Frank

And if you have cancer, if you do if we do find cancer, you know, again, remember that we're finding very early very small cancers and usually very treatable cancer, so even that, you know, typically has a good outcome.

Rebecca Smith: What should people be looking out for, you know, with themselves before they go into mammograms, that could be early signs.

Dr. Logan Frank: So, the biggest things we'd be looking for early signs would be a lump, like, typically harder or feels different than the rest of the breast tissue, or a bloody or water, clear nipple discharge. Those are the things that would be could be signs of early breast cancer.

Breast tissue pain, or any color of nipple discharge or any other color such as milky, green, brown, anything like that. Usually, that's just old debris and not worrisome. So, bloody or clear nipple discharge, or, or a painless lump.

Rebecca Smith: Well, so then this is the last thing that I have for you is again, kind of, you know, not necessarily that scared or cautious. But for women who maybe have gotten out of the habit or people with breast tissue that have gotten out of the habit of preventative health care, why would you say it's important to get back in that habit of preventative screening when it comes to mammograms when it comes to breast tissue screenings?

Dr. Logan Frank: Great question. Because if you do the screening, as the guidelines are written, you are around 40% less likely to die of breast cancer, and breast cancer being the second leading cause of death, cancer death among women, that that is a significant lifesaver there.

To schedule a mammogram, reach our to your primary care physician or find a provider via the Show Me Healthy Womenprogram.

Rebecca Smith is an award-winning reporter and producer for the KBIA Health & Wealth Desk. Born and raised outside of Rolla, Missouri, she has a passion for diving into often overlooked issues that affect the rural populations of her state – especially stories that broaden people’s perception of “rural” life.
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