Health Beat - Fall 2019 - 8

When Should You Start


There's no one-size-fits-all answer, but your provider can help
you figure out what's best for you By James C. Falcon


When is a good
time to get your
first mammogram?
Is it when you are
40? Or 50? And what if you have a
family history of breast cancer? The
answer is, unfortunately, not simple.
The American College of Physicians
(ACP) recently issued new breast cancer
screening guidelines for average-risk
women under the age of 50 with no
symptoms of breast cancer.
The recommendations say that
starting at the age of 40, women should
speak with their primary care provider
about the benefits and harms of screenings and their personal preferences.
For most women, the recommendations
say, mammograms should begin at age
50 and be repeated every other year
until 74.
The ACP notes that women at a
higher risk of breast cancer or those
with prior abnormal screening results
should get screened before the age
of 50.
But these guidelines were met
with debate.
The American College of Radiology
(ACR) said in a statement that these
recommendations "may result in up
to 10,000 additional, and unnecessary,
breast cancer deaths in the United States
each year." Additionally, the recommendations could also likely result in
"thousands more women enduring extensive surgery, mastectomies and chemotherapy for advanced cancers." The ACR
and the Society of Breast Imaging, among
other groups, recommend annual screening starting at age 40.


"While we have
guidelines, there are
personal factors that
we have to consider as
well in deciding when
to start, when to finish,
and how often we
are screening."
Heidi Grondahl, WHNP

"It seems like when you just get
it figured out how often you need to
return for a mammogram or a Pap
smear, they go ahead and change the
rules," says Heidi Grondahl, a women's
health nurse practitioner and member
of the Family Medicine team at Trinity
Community Clinic - Western Dakota
in Williston. "Nowhere is this more
prevalent than in screening guidelines."
It's unquestionable that mammograms
save lives. Early detection of breast
cancer is extremely important; localized
breast cancer has a 99 percent five-year
survival rate, according to the American
Cancer Society. But screening does
come with risk; false positive results can

mean more time and money spent and
added anxiety.
The bottom line? The decision on
when to get a mammogram should be
made following a discussion between
the patient and her healthcare provider,
Grondahl says, because the need for a
mammogram is somewhat individualized.
"While we have guidelines, there are
personal factors that we have to consider
as well in deciding when to start, when to
finish, and how often we are screening."
For example, certain risk factors,
such as having a family history of breast
and ovarian cancers, would likely necessitate earlier screening.
Grondahl suggests seeing your
physician, physician assistant, or nurse
practitioner for a yearly health maintenance exam. "This is the best time to
talk about the screenings you are due
for, and it is one exam that most insurances pay in full for, without additional
cost to you." 1

Call 701-857-DR4U (3748).
The DR4U line is staffed
Monday to Friday from
8 a.m. to 4:30 p.m. It's
answered by a registered
nurse who can help select
the best healthcare provider
for you. Leave a message
after hours and your call
will be returned on the
next business day.

Health Beat - Fall 2019

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