Transcription:

Alyne Ellis (Host):  Have you had a mammogram lately? Welcome to our series, CGH About Your Health. I’m Alyne Ellis. I’m here today with Gina Grennan, the Director of Diagnostic Imaging at CGH Medical Center and Erika Adams, CGH’s Diagnostic Imaging Certified Breast Nurse Navigator. This podcast is called Basic Breast Care and How CGH Can Help. What do we mean by basic breast care?

Gina Grennan CNMT, BA, CRA (Guest):  One out of eight women are diagnosed with breast cancer annually. So, what we mean by early breast care is starting early detection for breast cancer is actually the best weapon against breast cancer is catching it early state which you can do that by having an annual mammogram starting at age 40. Also doing regular breast self-exams and being familiar with your breasts so you can notice any changes that may occur while you are doing the exam if you notice any changes, those would all be warranted on reasons to actually go see a physician and then have your physician also do a breast exam.

So, the key to breast cancer is early detection so it can be treatable and curable.

Host:  What about if you have a family history of breast issues? Does that mean that you step up exams more or anything else like that?

Gina:  Actually, it’s less than 10% of the population that develops breast cancer from genetic reasons. However, when you do come in for your mammogram, you do get asked a multiple series of questions in regarding your risk. We ask you questions to see again, if you have any family history, if you ever had a history of breast cancer in the past, also it depends on your age, if you are a smoker, any other types of cancer. Those are all risk factors that can contribute to breast cancer. So, every woman when they come in for a screening mammogram are asked specific questions in regards to their risk. And also, hopefully their primary physician is also aware of any family history that they may have which they can have these women come in at an earlier age to get their mammograms. So, typically if a patient has a mother, who has died of breast cancer or they have had breast cancer; the rule of thumb is they should start their screening ten years earlier than they were diagnosed. So, if I was 40 when I developed breast cancer, my daughter would start her screening process at age 30.

Host:  So, what is the difference between a screening mammogram and a diagnostic mammogram?

Gina:  Screening mammogram typically is just four images that a woman will have for their breasts. After they have that screening mammogram; the radiologist reads those images and if the radiologist sees anything unusual, new from prior exams such as density or calcifications, that would warrant a patient to come back for additional images which is considered a diagnostic image. Again, there’s two reasons why patients have a diagnostic image and again, that’s for density and calcifications. The other portion for density is sometimes besides the diagnostic mammogram a woman could also be asked to have recommended ultrasound for that same dense area. Because ultrasound of the breast and mammography of the breast show two different things. So, oftentimes if the patient is being called back for density, the radiologist will order a diagnostic mammogram and an ultrasound of the breast as well.

Host:  As a patient, when you are trying to keep up with all of these tests and appointments particularly when things ratchet up and you are finding something; it can really feel kind of complicated and Erika, I assume this is where you come in in your role as a breast nurse navigator. And if you can explain what is that? What do you do?

Erika Adams, RN, BSN, CN-BN (Guest):  So, a nurse navigator is really a nurse who helps patients move smoothly through the system as far as when they are first having their mammogram, when they are initially a call back, I’m the nurse who calls the patient and inform them of the findings of the mammogram and what additional imaging needs to be done. After I contact the patient, I get them scheduled with Central Scheduling and then after they have their second set of imaging, their diagnostic mammogram and ultrasound; the radiologist will read those images and at that time, they will indicate if the patient needs further workup or if they can return back to their annual screening.

If they need further workup, which would warrant a biopsy; then again, I am with the patient, with the radiologist talking about that process and giving the education for the preprocedure and answering any questions that I can and then getting them set up for their biopsy and we typically get them set up within three to five days of the findings. So, being the navigator we’ve actually expedited the process of getting the patient’s testing done and their biopsy so they can get the result sooner than later.

So, as a patient goes through their diagnostic testing and their biopsy, I’m with them through the entire process from start to finish. So, I’m also the nurse that are with them when they get the results positive or negative. And I follow them through their journey if they are diagnosed with breast cancer as they go through the different levels of care. So, I follow them through the entire process. And then I will do a hand off to our oncology navigator over in Dr. Alikhan’s office which her name is Sue Hagerman.

Host:  It sounds like it’s a very comforting thing for the patient as they go through this process. And you have other really comforting news too and that is that now these screenings are going to be free and I’m wondering if Gina you can delineate how that came about and what it means.

Gina:  Absolutely. We have found that there’s two barriers for reasons why women don’t get their imaging and one of them is scheduling and the other one is the financial impact of the out-of-pocket expense. What we now do is we offer same day screening every Wednesday. It’s beneficial for women with busy schedules and women who are oftentimes a callback as Erika referenced earlier. The mammo screening is done in the morning. The radiologist reads it the same day and if the patient has to be called back, then we are able to get them back in. We set time aside to where they can have their diagnostic screening done the same day or they can choose to come back another day. But we give them the opportunity to only have to take off one day from work or obligate one day to get that screening process done.

In addition, we are very fortunate to be able to team up with the CGH Health Foundation to offer year round screening mammograms, diagnostic mammograms and diagnostic ultrasounds. It’s all covered out-of-pocket, no out-of-pocket expense for the women regardless of their insurance coverage or their ability to pay. The CGH Health Foundation will make sure that there is no out-of-pocket expense to the women. If the woman would incur any additional testing; then the CGH Health Foundation will offer additional financial assistance as needed on a per need basis for the patients.

Host:  Thank you both very much. Gina Grennan is the Director of Diagnostic Imaging at CGH Medical Center and Erika Adams is CGH’s Diagnostic Imaging Certified Breast Nurse Navigator. I’m Alyne Ellis. Thanks for listening to this episode of CGH About Your Health. Head on over to our website at www.cghmc.com to get connected to one of your providers. And if you found this podcast helpful, please share it and be sure to check back soon for our next podcast. Thanks for listening.