Mammography exams aid in early detection of breast diseases
Mammographer Kim Fielder performs a mammogram on a patient at Cherokee Nation W.W. Hastings Hospital in Tahlequah, Oklahoma. Clinical trials and studies show that screening mammograms help reduce breast cancer deaths among women ages 40 to 74, especially for those over 50. ARCHIVE
TAHLEQUAH – A mammogram aids in the detection and diagnosis of breast diseases in women. A specialized imaging, it uses a low-dose X-ray system to see inside breasts. The X-rays make it possible to detect tumors that cannot be felt.
Screening mammograms can find micro-calcifications (calcium deposits) that can indicate breast cancer. Mammograms can also check for breast cancer after a lump or other sign is found. This mammogram is called a diagnostic mammogram.
Besides a lump, cancer signs can include breast pain, thickening of the breast’s skin, nipple discharge or change in breast size or shape. However, these signs may also be benign conditions.
A diagnostic mammogram can also be used to evaluate changes found in a screening mammogram or to view tissue when it is difficult to obtain a screening mammogram because of special circumstances such as the presence of breast implants.
Retired nurse practitioner Vickie Love said women’s health was “a priority” when she worked at the Wilma P. Mankiller Health Center in Stilwell.
“At the Mankiller clinic there where many people and departments committed to women’s health. The nurses, case managers and providers all reviewed charts to identify and remind patients if they where due for mammograms. The Cherokee Nation incorporated a system into our electronic health record that would flag a patient when they where due for cervical and breast exams,” Love, who retired in 2015 after 21 years, said.
She said a frequent concern about mammograms is pain. During a mammography, a radiologic technologist positions the woman’s breast in the mammography unit. The breast is placed on a special platform and compressed with a clear plastic paddle, and the technologist gradually compresses the breast.
“I was honest to tell them there was pressure involved that could be uncomfortable for just a few seconds and then released. Our mammogram technicians would ask if the women were OK or if they could withstand more compression. If not, the technician would not force more compression,” she said. “I did advise the more they could withstand for those few seconds would provide a better test for the radiologist to review.”
Another frequent concern, she said, is the fear of finding cancer.
“I advised the women that early detection was the key and treatment options where less radical if caught in the earlier stages. I discussed how important it was to have an initial mammogram and how the radiologist could compare future mammograms to this one and determine if there where new findings or if changes where being seen.”
Early cancer detection with screening mammography means treatment can be started earlier, possibly before it spreads. Clinical trials and studies show that screening mammograms help reduce breast cancer deaths among women ages 40 to 74, especially for those over 50. However, studies haven’t shown a benefit from regular screening mammography in women under 40.
To illustrate the importance of getting regular mammograms for women over 40, Love said she asked patients if they had a family member or friend who had breast cancer.
“Often this was affirmed, and I would listen to their recount. I would inquire how the cancer affected the person and/or the family. I would talk about how the family members could be at a higher risk for breast cancer, how each woman needed to follow up and encourage their mothers, grandmothers, daughters and sisters to be vigilant about breast exams and mammograms,” she said. “As women we couldn’t be complacent about our health because future generations depended on us. I also reminded them I had their address in their chart, and I would come looking for them. Caring about each of them and humor were always my allies.”
Love said she believes she was “successful” in getting women patients in for mammograms, but there was still a high overall “no-show rate.”
“I think dispelling rumors and fears are important, but it takes time and effort to find what these are. I believe being a Native provider has also helped me establish rapport and trust with my patients. And I always tell stories about my own experience that coincides with what is being asked of them. Just being real helps,” she said.