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Healthy Women Project: Frequently Asked Questions

Breast Cancer Screening Questions

1. What is breast cancer?
2. Who is at risk for breast cancer?
3. What can I do to prevent breast cancer?
4. How often do I need to be screened for breast cancer?
5. Why should I make time for a test that probably won’t show anything anyway?
6. Where can I get a Mammogram if I have a disability?
7. What if my doctor hasn’t offered to screen me?
8. What if I can’t afford the screening tests?
9. What if I am on Medicare or MediCal?
10. How can I get to a screening appointment?
11. Is the test itself scary or painful?
12. Will mobility issues interfere with me getting a screening test?
13. Will chronic pain interfere with me getting a screening test?
14. What if screening is in conflict with my cultural or religious beliefs?
15. What if I have been abused?
16. What if the test comes back positive?
17. What should I do after a test?

1. What is breast cancer?

Breast cancer occurs when cells in the breast change and grow out of control, forming a lump. These cells, when allowed to grow unchecked, can spread to other parts of the body. Not all lumps are cancerous. Some lumps are so small that only a mammogram can detect them. Once found by a mammogram, many small cancerous lumps are easily treatable and easily removed.

2. Who is at risk for breast cancer?

All women are at risk for breast cancer. Breast cancer is THE MOST common kind of cancer among women, and one of the most deadly. Women in the US have a 1 in 8 chance of developing breast cancer. Factors that elevate your risk of developing breast cancer include heredity, age (women over 40 are most likely to develop this disease), early menstruation, late childbearing, being greatly overweight, smoking, a high fat diet, and high doses of chest radiation. Late detection of breast cancer reduces your ability to treat it successfully. That’s why having regular mammograms is so important.

3. What can I do to prevent breast cancer?

Get a mammogram every year. While knowing and addressing the behaviors that may put you at risk is important, this doesn’t guarantee you will not develop the disease. Regular mammograms are your best defense against breast cancer. A mammogram is a low dose x-ray that detects microscopic lumps and can catch the disease in its early and most treatable stages. By having regular mammograms, you will be able to catch the cancer long before it affects your health.

4. How often do I need to be screened for breast cancer?

At 40, a woman should have a baseline mammogram. Women 40-50 should have at least one mammogram AT LEAST every two years, and women 50 and older should get one annually. If breast cancer runs in your family, it is a good idea to start your exams before age 40 and have them more frequently.

5. Why should I make time for a test that probably won’t show anything anyway?

Breast cancer does not discriminate, and usually produces no symptoms until it’s too late. Even regular breast self-exams are not as effective as mammograms. Every woman is at risk for this disease. You may feel overwhelmed by other health issues. However, keeping up with cancer screening is an important part of taking care of yourself. Early detection can save your life!

6. Where can I get a Mammogram if I have a disability?

Many disabilities may affect your mammography experience. If you live in Alameda County, click here for a directory of clinics and doctors that have experience and equipment that better accommodates women with disabilities.

7. What if my doctor hasn’t offered to screen me?

Just because your doctor has not specifically discussed mammograms doesn’t mean it’s not a good idea. If you are a woman with a disability, your providers may be so focused on other ongoing health or disability-related needs that they overlook screening issues. Don’t be afraid to ask your provider about regular mammograms. It’s important to be proactive in your own health care. Most insurance companies do not require a referral for a mammogram, so set your own appointment if your doctor does not suggest it.

8. What if I can’t afford the screening tests?

Many states have free screening programs. In California, a state program called Every Woman Counts assures access to mammograms for women with low incomes. Call (800) 511-2300 to see if you qualify. If you have no insurance and no regular doctor, the California Department of Health Services Breast Cancer Early Detection Program may be able to help.

9. What if I am on Medicare or MediCal?

Medicare Part B will pay for most of an annual screening, or you will be charged the usual 20 percent deductible if you have not met your annual Part B deductible. Call Medicare at (800) MEDICARE or visit them online www.medicare.gov for more information. If you live in Alameda County, please check the provider directory for facilities that will accept MediCal and Medicare. In the unlikely circumstance that you are diagnosed with breast cancer, free treatment is available to Californians who qualify at the Breast and Cervical Treatment Program. Call (800) 824-0088 to see if you are eligible or to get more information.

10. How can I get to a screening appointment?

If you live in Alameda County, you can click on these links to learn more about accessible transportation options, including Paratransit, a door-to-door service for people unable to use public buses or BART.

Paratransit links:

http://www.actransit.org/riderinfo/paratransit.wu
http://www.sfparatransit.com

Public buses and BART

http://www.actransit.org
http://www.bart.org

11. Is the test itself scary or painful?

The test is an x-ray. Your breasts will be pressed between two plates so that the image includes as much of your breast as possible while exposing you to as little radiation as possible. The resulting compression may be a little uncomfortable or painful depending on your disability, but will only last for about 30 seconds. While you may not enjoy the procedure, it sure beats getting cancer!

12. Will mobility issues interfere with me getting a screening test?

Depending on your disability, you may need to plan ahead and allow yourself some extra time for your mammogram. If you live in Alameda County, you can click here for a list of providers and facilities that can accommodate women with disabilities. When you make your appointment, tell the staff about your concerns and any extra time or assistance you might need.

Here are some specific ideas about what you can do: If you use a wheelchair with removable arms and you go to a place that has an adjustable mammography machine, you may not even need to get out of your chair. If you are concerned about positioning, you may want to bring a friend or attendant who can hold up your arms or assist positioning you (this person would be protected from the radiation).

Feel free to bring any equipment you feel may assist you to the exam, such as foam supports, crutches, etc. If you have spasticity, tell the technicians about this issue and remind them of your need for extra time. You can pre-medicate yourself with anti-spasm drugs, stretch, or explore alternative positions with the technician.

13. Will chronic pain interfere with me getting a screening test?

Though some women may experience additional discomfort or pain during the mammogram, the test is still important to do. Be sure to communicate with your provider, who may have some additional tips on making the procedure more comfortable. With chronic pain, you may never be completely pain free, but you can try to manage the experience to maximize your comfort. Some strategies include: pre-medicating yourself, avoiding mammograms the week before your period begins when your breasts are tender, using relaxation techniques, bringing supports such as blankets, pillows, or crutches, and taking a friend or relative along for moral support.

14. What if screening is in conflict with my cultural or religious beliefs?

First and foremost, keep in mind this is a medical procedure that may save your life. You may choose to see a female provider if this makes your more comfortable. Mammogram technicians are almost exclusively female; you may call ahead to inquire if this is a source of anxiety. Providers and technicians should be able to explain every step of the process to you as it is being done. You will not be completely disrobed during a mammogram, only partly so. You may wish to have an older woman or relative with you to oversee the entire experience and put you at ease.

15. What if I have been abused?

Taking care of yourself is a great way to take control of your body and life. Being physically or sexually abused is devastating, but don’t let it keep you from moving forward. You may want to talk to someone or attend a support group if this is an ongoing issue. These organizations may be able to support you:

Domestic violence:
www.fvlc.org
www.co.alameda.ca.us/health/index.htm
www.bfwc.org
www.save-dv.org

Sexual assault:

16. What if the test comes back positive?

You have a 99.9 % chance of having a clean mammogram. Only 1 in 1,000 women who have mammograms finds cancer on her mammogram. In the unlikely case that a mammogram does find cancer, it is likely that it will be caught at an early state, when it has an excellent chance of being cured and more treatment options are possible. More than 96% of women whose breast cancer is discovered early survive.

17. What should I do after a test?

It’s important to get the results of the test; provider silence does not always mean negative results. And celebrate! Do something nice for yourself after the test. You’re doing a great job taking care of yourself!