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Premenopausal women should not schedule their mammogram around the time of their menstrual period as the compression will be more painful and they will have lower quality films. Screening mammography is of greatest value for patients most likely to develop breast cancer and for whom early treatment is the most effective. The majority of women are of average risk (less than 15 percent life time risk) of developing breast cancer. In these women the most important decision is when to be screened. Breast cancer incidence rises with age. Breast cancer incidence is quite low under the age of 40, then begins to rise as women age. The sensitivity and specificity of mammography are also age dependent, being better in older women. When counselling women on screening we discuss potential benefits and harms – false positives and over treatments as a result of the test.
Under age 40: Suggest no
screening
Age 40-49: Encourage shared decision making with provider for average risk women. For women who decide to proceed, recommend screening every two years. Age 50-74: Suggest mammo-
Bryan Clendenen FIC, CLTC® Financial Associate 112 N Main St Bowman, ND 58623 701-523-3953
gram screening every two years unless previous screening identified finding that required shortterm follow up.
Age 75-older: offer screening only if life expectancy is at least 10 years. There is not a clear age limit and the incidence of cancer remains high into the 80s. They need to be allowed the option. Mammography is available in film and digital. Our facilities provide digital and offer 3-D as well. Digital mammography is preferred due to higher sensitivity especially for dense breast tissue. The cost of the exam can be prohibitive. Check with your insurance company to see what they cover. If you cannot afford to pay for a mammogram Women’s Way may provide a way to pay for your clinical breast exam and mammogram. Call 1-800-449-6636 or 701-328-2306 to see if you are eligible. This can be an option for women with high deductibles or no insurance.
Support
We no longer have a cancer center in Dickinson, but are fortunate to have a great facility in Bismarck, North Dakota. Once diagnosed, the patients are scheduled through the Cancer Center and are introduced to the team that will be with them through the journey. Programs include Breast Cancer
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Support for women of all ages. Face to Face for younger women. Counselling under the REACH program: Resources, Education, Advocacy, Caring and Hope. They provide these services even after discharge for both patient and family. There is a faith based cancer support group sponsored by Legacy United Methodist and Women of Strength Group at Sanford Oncology both in Bismarck. Multiple on line sites are available and some surrounding communities have groups of their own. Information is always available through the Cancer Center for location, dates and times. Pink It forward is a site that provides hope and empowerment by enriching the lives of those affected by breast cancer. All you have to do is enroll the person to receive information and items from that site. The Bismarck Cancer Care Foundation provides gas cards and lodging for those diagnosed.