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Our Cigna insured patients may have received a letter stating that MAWC will be out of network. This is NOT true. Negotiations with Cigna are complete and MAWC remains in network with Cigna.


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Healthy Tips

Breast cancer awareness is saving lives and families

October 2014

Breast cancer is the second-most cancer (behind skin cancer) among women in the United States. And due to a growing awareness of this disease, millions of women are surviving it.

We encourage you to read the following information and share it with other women. Early detection and proper treatment are simple to achieve and can have a long-lasting, positive impact on you and your family.

What is a screening test?
A screening test is used to find diseases, such as cancer, in people who do not have signs or symptoms. This allows early treatment. The earlier cancer is treated, the greater the chance of survival.

What screening tests are used to screen for breast problems?
Screening for breast problems includes mammography, clinical breast exams, and breast self-awareness.

What is mammography?
Mammography is an X-ray technique used to study the breasts. No dyes have to be injected or swallowed, and no instruments will be put in your body.

Why is mammography done?
Mammography is done for two reasons: 1) as a screening test to regularly check for breast cancer in women who do not have signs or symptoms of the disease, and 2) as a diagnostic test to check lumps or other symptoms that you have found yourself or that have been found by your GYN doctor.

When should I start having annual mammograms?
Age 40 years is recommended as the starting point in order to find cancer at an early and more treatable stage.

What if the result of my mammography reveals a lump?
Mammography by itself cannot tell whether a lump or other finding is benign (not cancer) or malignant (cancer). If a mammography finding is suspicious for cancer, a biopsy is needed to confirm that cancer is present. In a biopsy, the lump or a small sample of cells from the lump is removed and looked at under a microscope.

How do I prepare for a mammogram?
The day you have a mammogram, do not wear powders, lotions, or deodorants. Most of these products have substances that can be seen on the X-ray and make it hard to read.

What happens during mammography?
To get ready for the test at our GYN clinic which serves women in Virginia Beach, Chesapeake, Norfolk, Portsmouth, Eastern Shore, Peninsula, Hampton Roads and North Carolina, you will need to completely undress from the waist up and put on a gown. You will be asked to stand or sit in front of the X-ray machine. One of your breasts will be placed between two smooth, flat plastic or glass plates. You will briefly feel firm pressure on your breast. The plates will flatten your breast as much as possible so that the most tissue can be viewed with the least amount of radiation. After the first X-ray, the plates may be removed so that another X-ray can be obtained from one or more other positions. The test then is done on the other breast.

What are the risks of mammography?
The risk of harm from the level of radiation used in mammography is low. Having a yearly screening mammogram does not increase cancer risk.

What is a clinical breast exam?
Your GYN doctor will examine your breasts during routine checkups. This is called a clinical breast exam. Women aged 29–39 years should have a clinical breast exam every 1–3 years. Women aged 40 years and older should have one every year.

How is a clinical breast exam done?
The exam may be done while you are lying down, sitting up, or both. You may be asked to raise your arms over your head. The breasts are first checked for any changes in size or shape. Your GYN doctor also looks for puckers, dimples, or redness of the skin. She then feels for changes in each breast and under each arm. The nipple may be gently squeezed to check for discharge.

What is breast self-awareness?
Breast self-awareness is an understanding of how your breasts normally look and feel.

How is breast self-awareness different from the traditional breast self-exam?
In the traditional breast self-exam, you use a precise method to examine your breasts on a regular basis, such as once a month. Breast self-awareness does not require you to examine your breasts once a month or with a precise method. Instead, it focuses on having a sense of what is normal for your breasts so that you can tell if there are changes—even small changes—and report them to your GYN doctor.

What is digital mammography?
Digital mammography is a type of mammography technique. It differs from standard mammography only in the way the image is stored. Instead of using film, the image in digital mammography is stored as a digital file on a computer. A computer program allows the image to be enlarged or enhanced or specific areas to be magnified. Digital mammography may be better at detecting cancer in some groups of women, such as those with dense breast tissue, women younger than 50 years, and women who have not gone through menopause.

What is dense breast tissue?
Breasts are made up of a mixture of lobules, ducts, and fatty and fibrous connective tissue. Lobules produce milk, and the ducts are the tiny tubes that carry milk from the lobules to the nipple. The breast lobules are sometimes called glandular tissue because they produce milk. The fibrous connective tissue and the fatty tissue give breasts their size and shape and hold the glandular tissue in place.

Your breasts are considered dense if you have a lot of fibrous or glandular tissue but not much fatty tissue. Some women have more dense breast tissue than others for reasons we do not clearly understand. For most women, breast density decreases with age. But in some women, there is little change. Breast density is very common in many women, and it is not abnormal.

How do I know if I have dense breasts?
Breast density can be determined only by mammograms. It is not related to breast size or firmness. You may think that because your breasts are firm, they are dense; but breast density is not determined by how your breasts feel.

When the radiologist looks at your mammogram, they determine your breast density. There are four categories of breast density. They go from almost all fatty tissue to extremely dense and very little fatty tissue. The radiologist decides which of the four categories best describes your level of breast density.

Some mammogram reports sent to women contain information about breast density. This information may be worded in a language that is easier to understand instead of using the numbers 1 to 4. Women whose mammograms show 3 or 4 breast density may be told that they have “dense breasts.”

Why is breast density important?
Having dense breast tissue may increase your risk of getting breast cancer. Women who have dense breast tissue have a higher risk of breast cancer compared to women with less dense breast tissue.

We are not certain at this time what it is about dense breast tissue that increases a woman’s risk of breast cancer. We know there are many risk factors for breast cancer – starting menstrual periods early and having a late menopause, first pregnancy after age 30, personal history of breast cancer, family history of breast cancer – just to name a few. The two most important risk factors though are being a female and getting older.

Some risk factors put women at higher risk for breast cancer. For example, women who have a breast cancer gene are at high risk for the disease. Women at high risk could consider having magnetic resonance imaging (MRI) in addition to their yearly mammograms.

Women with dense breast tissue are at moderate risk for breast cancer. MRIs are not recommend for women at moderate risk based on what is known today.

Dense breast tissue also makes it harder for GYN doctors to see cancer on mammograms. On mammograms, dense breast tissue looks white, and breast masses or tumors also look white. So, the dense tissue can hide tumors. Fatty tissue looks almost black, therefore, something white, such as a tumor, can be easily seen. So, mammograms can be less accurate in women with dense breasts.

If I have dense breasts, do I still need a mammogram?
Yes. Most breast cancers can be seen on a mammogram even in women who have dense breast tissue. So, it is still important for you to get regular mammograms. And we know that mammograms save women’s lives.

Even with a normal mammogram report, women should be familiar with their breasts and know how they normally look and feel. At any time, if a woman feels or see something that isn’t normal, she should report this breast change to her doctor without delay.

Are there any other tests that I should have if I have dense breast tissue?
In breasts that are dense, cancer can be hard to see on a mammogram. Studies have shown that ultrasound and MRIs can help find breast cancers that can’t be seen on a mammogram. However, both MRI and ultrasound show more findings that are not cancer. These can result in more tests and unnecessary biopsies. And the cost of ultrasound and MRI may not be covered by insurance.

Two additional tests available to women are the 3D mammogram or the 3D breast ultrasound. The 3D breast ultrasound has the advantage of no additional radiation, and is available at our MidAtlantic Imaging Centers which serves women in Virginia Beach, Chesapeake, Norfolk, Portsmouth, Eastern Shore, Peninsula, Hampton Roads and North Carolina.

What should I do if I have dense breast tissue?
If your mammogram report says that you have dense breast tissue, talk with your GYN doctor about what this means for you. Be sure that your doctor or nurse knows your medical history and whether there is anything in your history that increases your risk for getting breast cancer.

This is not something that needs to be done immediately, unless, of course, you will feel better having talked with your doctor or nurse.

At this time, experts do not agree what other tests, if any, should be done in addition to mammograms in women with dense breasts. After talking with your doctor, you may choose to have other tests.

Women who are already in a high-risk group (based on gene mutations, a strong family history of breast cancer, or other factors) could consider having an MRI along with their yearly mammogram.

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If you have questions about breast exams, breast cancer, mammograms, digital mammography, dense breast tissue, or menopause, and live in Virginia Beach, Chesapeake, Norfolk, Portsmouth, Eastern Shore, Peninsula, Hampton Roads or North Carolina, please contact our GYN Clinic at (757) 312-8221 or by clicking here. Our GYN doctors can help you.

About our GYN Clinic

Our all-female practice of GYN doctors covers a wide spectrum of health issues, including, breast exams, breast cancer, mammograms, digital mammography, dense breast tissue, and menopause.
  Our GYN clinic cares for women of all ages in Virginia Beach, Chesapeake, Norfolk, Portsmouth, Peninsula, Eastern Shore, Hampton Roads and North Carolina.

Gynecology Specialists  |  516 Innovation Drive, Suite 305, Chesapeake, VA 23320  |  Ph: (757) 312-8221 Fax:(757) 312-8382  |  Medical Disclaimer
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