Transcription:

Prakash Chandran:  About one in eight women in the United States will develop breast cancer in her lifetime. So it is really important to have regular screenings because early detection can help save lives. But what exactly do you need to know about these screenings and what should you do to stay healthy? We're going to talk about it today with Samantha Schneller, a lead mammographer at Aspirus Health.

This is Aspirus Health Talk, the podcast from Aspirus Health. I'm Prakash Chandran. So first of all, Samantha, it's great to have you here today. This may seem obvious, but let's start with it anyways. Why exactly is it so important for women to have breast screenings?

Samantha Schneller:   It's very important because a lot of breast cancers aren't detected by feeling a lump or pain. So with the mammogram and sometimes we use ultrasound to look at the size and different shapes of how the breast tissue is lain in the breast. And sometimes there's calcifications in the breasts and we have to take closer looks at those to see if   it needs to be worked up, possibly have a biopsy, or if it's nothing to be concerned about.

Prakash Chandran: Okay. That makes a lot of sense. And when we're talking about breast screenings, we're talking specifically about those mammograms, right?

Samantha Schneller: Correct.

Prakash Chandran: Okay. So I had a question around how often women should get their mammogram and when they should start?

Samantha Schneller: Women should start at age 40 and we recommend them every year here at Aspirus Ironwood. I know there are some facilities that recommend every two years.

Prakash Chandran: So every year to two years. Is there ever a case where a woman might want to start sooner?

Samantha Schneller: Possibly with their family history.

Prakash Chandran: So my mother-in-law got diagnosed with breast cancer at 42 years old. And I've heard that the daughter should come in 10 years before the diagnosis. So is that timeframe generally correct? Like my wife should be coming in at 32?

Samantha Schneller: Generally. Yes, it would be up to   that patient's physician and the patient ultimately. And then when someone that young comes in, we would go over that with the radiologist, just to make sure that we don't   overexpose them with radiation, if it's really necessary to do it that young depending on what type of breast cancer the mother had.

Prakash Chandran: So let's talk about some of the latest technology in breast screening. I've heard that we now have 3D mammography and there's a lot of advancements and benefits that come along with that. So can you speak to that a little bit?

Samantha Schneller: So 2D mammogram,   you take two pictures usually, one up and down and one side to side and the machine just stands still while taking those pictures. With the 3D mammogram, the top part of my machine makes a sweep above the patient from left to right and it takes multiple images of the breast and then the computer stacks those images up.

So the radiologist can somewhat scroll through the breast tissue. So if there's an area that looks   kind of suspicious.    They can see if it's a mole by if it's on the first couple of slices of those pictures or the last couple of slices. And then,   sometimes the vessels, they lay on top of each other. So scrolling through, they can kind of follow the vessel and see if that's   like a loop of a vessel or if   it's something that they need to take a closer look at.

Prakash Chandran: I'd like to talk a little bit about the procedure itself. You know, we talked about some of the advancements and all of the benefits that they offer, but what can women expect when they come in to get their mammogram?

Samantha Schneller: So,   we will lift your breasts up onto our imaging plate and slowly pull your breast tissue out. While we do that, we   compress your breast and our hand kind of slides out underneath. And then my paddle, which is what holds your breasts tight comes a little bit down until you tell me when to stop. And, like I said, the more compression, the better, but it's not the end of the world if you can't take that much. It's still going to give us a good picture.

And then from all those pictures, the radiologist will look at those films to see if they have any concerns about areas. And then this would be after you leave. And then if there is something to be concerned about,   your provider would give you a call and say, "We would like you to come back for some additional imaging with the 3D mammogram." Most of the time patients go right to ultrasound. Before, they used to have to come back when we had a 2D mammogram and use a little bit smaller of a compression pedal to focus in on a certain area. But with the 3D, that has eliminated the majority of that, and patients go right to ultrasound, which I know is,   I feel like a lot of patients come back because of that, because then they don't want to do another mammogram if they don't have to. Although, if there is calcifications in the breast, we do have to do that with the mammography machine because   they are very hard to see under ultrasound.

Prakash Chandran: And what can women do to better prepare for their screening appointment? For example, are there questions that they need to answer or certain things that they need to do beforehand?

Samantha Schneller:   For their first time, we do go over a bunch of history. We ask how many   pregnancies they've had, if any; how old they were when they got their first menstrual cycle,   if they went through menopause or not yet, family history   for breast cancer or if they themselves have had any type of cancer or previous radiation or chemo treatments.

And then we always ask patients if they are wearing deodorants or powder, because some of them contain aluminum. And that actually shows up on our   mammogram image. And it's very hard to tell   if those little white specks are from your deodorant or powder, or if it is calcifications in your breasts, because calcifications can sometimes   mean that there is breast cancer. It just depends on what they look like and what the grouping is like and how many calcifications there are if it's something to be concerned about or if they don't have to worry about it at all.

Prakash Chandran: And, you know, just in terms of after women get the mammogram, you said that if there is a need that they will get a call back,   you know, just to put some minds at ease, can you talk a little bit about if that is the majority of people or the minority. I imagine that, you know, screening is something that is more of a proactive measure, but they shouldn't worry about always getting a call back. Is that correct?

Samantha Schneller: Correct. You should not worry. There are some people that just have denser breast tissue than others. And unfortunately, they get called back like every year, every other year. But with the 3D mammograms, that has definitely went down in numbers, but for the most part, the majority of patients that get called back, it's nothing to be concerned about. It's just that the breast tissue looks different than   usually in previous years. And we want to make sure that it's nothing to be concerned about   so then you can wait a full year for your next screening mammogram.

Prakash Chandran: Let's talk a little bit about self-examination.   I imagine that this is something that should be done in conjunction with the annual mammogram, but probably more frequently, right?

Samantha Schneller: Yes.   We do have little not a pamphlet, but, I don't know   Something that you hang in your shower or on your door and it actually gives multiple ways on how to check your breast exams and it tells you exactly what to do. And then at the bottom of it, it has little punch out January through December, so that once you do your breast exam that month, you can take that out and know that you already did it that month. Because when some patients   went through menopause and don't have their periods, they don't always do it on a regular basis. And then,   their healthcare provider should be doing a breast exam on the patient, because some patients don't want to do breast exams on themselves.

Prakash Chandran: So just as we close here, if there is one piece of advice that you could leave our audience with around prepping for their mammogram, what would it be?

 Samantha Schneller: Don't be scared to come in because of compression. I have done a ton of patient's first mammograms and they have all left saying it is not nearly as bad as what everyone made it out to be. A lot of my patients have been saying the 3D mammogram seems to be faster and less uncomfortable. And honestly, it is the exact same positioning that we do if we were to do a 2D mammogram, say a couple of years ago.

So please don't be fearful of the mammogram.   Some other tech will definitely work with you when we will try to make it as comfortable as possible to get good images and take care of you to make sure there's nothing going on in your breast tissue.

Prakash Chandran: All right, Samantha. Well, I truly appreciate your time and your insight today. It was very informative.

 That's Amantha Schneller a lead mammographer at aspire as health for more information, head to aspire us.org. And as a friendly reminder, patients should check with their insurance companies to see if they cover a 3d mammogram. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.

 This is the Aspirus Health Talk, the podcast from Aspirus Health. Thanks. And we'll talk next time.