BREAST CANCER

EARLY DETECTION

GUIDEINSIDE:• Warning Signs & Risk Factors

• Self-Exam Guide

• Local Mammogram Resources

• Four Ways To Reduce Breast Cancer Risk

• Would You Want To Know?

• If You’re Called Back After A Mammogram

This special section generously provided by

2 October 22, 2014

Source: Centers for Disease Control and Prevention

Tell your doctor if you experience any of these warning signs of breast cancer.

New lump in the breast or underarm (armpit).

Thickening or swelling of part of the breast.

Irritation or dimpling of breast skin.

Redness or flaky skin in the nipple area or the breast.

Pulling in of the nipple or pain in the nipple area.

Nipple discharge other than breast milk, including blood.

Any change in the size or the shape of the breast.

Pain in any area of the breast.

Keep in mind that some of these warning signs can happen with other conditions that are not cancer, but it’s important to report them to your doctor so he or she can determine the cause.

WARNING SIGNSFour Ways to Reduce Your Breast Cancer RiskOctober is National Breast Cancer Awareness Month, a perfect time to take steps to help lower your risk of developing breast cancer. About 1 in 8 women will develop breast cancer at some point during her life. While you can’t change some risk factors — genetics and aging, for example — there are things you can do that may lower your breast cancer risk. Here are 4 ways to help protect your breast health.

1. Watch your weight. Being overweight or obese increases breast cancer risk. This is especially true after menopause and for women who gain weight as adults. The major source of estrogen for postmenopausal women is not the ovaries, but fat tissue. The increased risk may be due in part to more estrogen being made in fatty tissue. If you’re already at a healthy weight, stay there. If you’re carrying extra pounds, try to shed some. There’s evidence that losing weight may lower breast cancer risk. One easy goal to get started is to try losing 5% to 10% of your current weight over 6 months. For most women, that means dropping just half a pound per week.

2. Exercise regularly. Many studies have found that exercise is a breast-healthy habit. As little as 75 to 150 minutes of brisk walking each week has been shown to lower risk. Ramping up your exercise routine even more may lower your breast cancer risk even further. The American Cancer Society recommends getting at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity each week. (Or a combination of both.) And don’t cram it all into a single workout — spread it out over the week.

3. Limit alcohol. Women who have 2 or more alcoholic drinks a day have about 1½ times the risk of breast cancer compared to women who don’t drink at all. Follow the American Cancer Society’s recommendation of no more than 1 drink per day for women and 2 drinks per day for men. A single drink amounts to 12 ounces of beer, 5 ounces of wine or 1½ ounces of 80-proof distilled spirits (hard liquor).

4. Avoid or limit menopausal hormone therapy. Taking hormones such as estrogen and progesterone had long been used for night sweats, hot flashes, and other troublesome symptoms of menopause. But in 2002, researchers found that postmenopausal women who took a combination of estrogen and progestin were more likely to develop breast cancer. Breast cancer risk appears to return to normal within 5 years after stopping the combination of hormones. Talk with your doctor about all the options to control your menopause symp-toms, and the risks and benefits of each. If you do decide to try HRT, it is best to use it at the lowest dose that works for you and for as short a time as possible.

3October 22, 2014

MAMMOGRAMIf You’re Called Back After a Mammogram

Stacy SimonACS.org

Most women who get their routine mammogram will receive a letter within 30 days saying the results were normal.

But if doctors find something suspicious, they’ll call you back — usually within just 5 days — to take new pictures or get other tests.

Getting that call can be scary, but a suspicious finding does not mean you have cancer. In fact, less than 10% of women called back for more tests are found to have breast cancer.

What else could it be?A suspicious finding may be just dense

breast tissue, a cyst, or even a tumor that isn’t cancer. Other times, the image just isn’t clear and needs to be retaken. Or, if this is your first mammogram, your doctor may want to look at an area more closely simply because there is no previous mammogram for comparison.

What will happen at the follow-up appointment?

You are likely to have another mammogram called a diagnostic mam-mogram. (Your previous mammogram was called a screening mammogram.) A diagnostic mammogram is still an x-ray of your breasts, but it’s done for a different reason. Often, more pictures are taken during a diagnostic mam-mogram so that any areas of concern can be carefully studied. A radiologist is on hand to advise the technician (the person who operates the mammogram machine) to be sure they have all the images that are needed.

You may also have an ultrasound test that uses sound waves to create a com-puter image of the tissues inside your breasts. For this test, you will lie on a table while a technician applies some gel and places a transducer – a small instru-ment that looks like a microphone – on your skin. The test is painless and does not expose you to radiation. This test is often used to look more closely at areas

of concern found on a mammogram.In addition, some women will have an

MRI. For a breast MRI, you will lie face down inside a narrow tube for up to an hour while sensors capture information used to create a more detailed image of the tissues inside your breasts. The test is painless, but can be uncomfortable for people who don’t like small, enclosed spaces.

You can expect to learn the results of your tests during the visit. You are likely to be told 1 of 3 things:

The suspicious area turned out to be nothing to worry about and you can return to having yearly mammograms.The area is probably nothing to worry about, but you should have your next mammogram sooner than 1 year — usually in 4 to 6 months — to make sure it doesn’t change over time.Cancer was not ruled out and a biopsy is needed to tell for sure.

You will also get a letter with a sum-mary of the findings that will tell you if you need follow-up tests or when you should schedule your next mammogram.

What if I need a biopsy?Even if you need a breast biopsy, it still

doesn’t mean you have cancer. Most biopsy results are not cancer, but a biopsy is the only way to find out. During the procedure, a small amount of tissue is removed and looked at under a microscope.

There are several different types of biopsies — some use a needle and some use an incision. The type you have depends on things like how suspicious the tumor looks, how big it is, where it is in the breast, how many tumors there are, other medical problems you might have, and your personal preferences.

The tissue sample will be sent to a lab where a specialist, called a pathologist, will look at it. It will take a few days, maybe even more than a week, for you to find out the results. Once you get

them, it’s important to learn whether the results are final, or whether you need another biopsy. You may also decide that you want to get a second opinion.

If the results are negative or benign, that means no cancer was found. Be sure to ask the doctor whether you need any additional follow-up, and when you should have your next screening mammogram. If the biopsy shows that you do have cancer, your doctor may refer you to a breast surgeon or other breast specialist.

What if it’s cancer?If you do have cancer and you are

referred to a breast specialist, use these tips to make your appointment as useful as possible:

Make a list of questions to ask at the appointment. Download a list from the American Cancer Society or call us at 1-800-227-2345.Bring a family member or friend with you. They can serve as an extra pair of ears, help you remember things later, and give you support.

Ask if you can record important conversations.Take notes. If someone uses a word you don’t know, ask them to spell it and explain it.Ask the doctors or nurses to ex-plain anything you don’t understand.

How can I stay calm while waiting?

Waiting for appointments and the results of tests can be frightening. Many women experience strong emotions including disbelief, anxiety, fear, anger, and sadness during this time. Some things to remember:

It’s normal to have these feelings.Most breast changes are not cancer and are not life-threatening.Talking with a loved one or a counselor about your feelings may help.Talking with other women who have been through a breast biopsy may help.The American Cancer Society is available at 1-800-227-2345 around the clock to answer your questions and provide support.

4 October 22, 2014

The BSE can help you become familiar with what’s normal for you and alert you to changes. There are different ways of doing a breast self-exam. Your nurse or doctor may teach you a different method from what is shown here, and that is OK.

BREAST SELF-EXAM

With arms by your sideWith arms over your head With hands on hips,

chest muscles tightened

Use light, medium and firm pressure to feel all the breast tissue.

Use an up-and-down pattern to check all of your breast.

With your arm only slightly

raised, feel the area under

each arm.

See your doctor or nurse if you notice any of the following:• Lump, hard knot or thickening• Change in size or shape of the breast• Dimpling or puckering of the skin• Rash, redness or scaliness of the nipple or breast skin• Nipple discharge that starts suddenly• New pain that does not go away

Light

Medium

Firm

1.

3.

Use the pads of your middle fingers to feel for lumps in the right breast, using overlapping dime-sized circular motions.

Use a mirror to look for changes in:

Sit or stand, and feel each underarm area.

Size, shape, contour, dimpling, rash, redness, scaliness of nipple or breast skin

Repeat the exam on your left breast.

2. Lie down and feel for changes in each breast with the opposite hand. Start by placing a pillow under your right shoulder, and your right arm behind your head.

Examine your breasts at the same time every month,

usually about a week after the start of your period.

Source: American Cancer Society; Graphics: American Cancer Society, Andy Marlette

5October 22, 2014

For women who carry gene for breast cancer, knowledge is powerWould YOU want to know?

“I’m a BC survivor — my mother and cousin are both deceased — and I participated in a genetic testing study not for knowledge

but because information and research in the African-American community is often limited. Little did I know. My results

were positive for a mutated gene, so I have a 48 percent probability of developing ovarian and uterine cancer. I will continue with the study as long as possible.’’

— Erica Mack, 39, Academic Advisor, University of West Florida

By Beth Rodgers

“My sister is fighting breast cancer and she has been tested … but if I don’t think about it,

it will go away, right?” — Pamela Meadows****

“I am BRCA-2 positive. My sister was frantic to know the results of my test but then

decided against being tested for fear of what her insurance company would do to her.”

— Lynda Jewett****

“I had a lumpectomy, and I am fine. But I’m adopted. Without family history, yes, I would

like to be tested.” — Julie Davis****

“My friend has the gene and fought breast cancer … her mother died of it, and her niece

also has the gene.’’ — Addie Logan Taylor****

“BRCA saved my life.” — Frances Yeo****

These heartfelt responses and more flooded my inbox in reply to a simple inquiry: “Would you want to know?”

Ignorance may be bliss, but if you could have a better picture of your risk for breast cancer, wouldn’t you want to know?

Knowledge is power, but is uncovering your own genetic profile knowledge you desire?

Diet and exercise can be controlled; your genetic makeup cannot. If you carry a genetic risk for breast cancer, do you want to know?

In 1990, researchers uncovered a gene that produces tumor suppressor proteins and named it BRCA. The proteins pro-duced by BRCA repair damaged DNA to keep our cell’s genetic material stable.

According to the National Cancer Insti-tute at the National Institutes of Health, if the BRCA gene mutates, important repair-proteins are not produced, render-ing cells more likely to develop “genetic alterations” leading to cancers of the breast and ovaries.

Only 12 percent of women will develop breast cancer in their lifetimes, and not everyone who has breast cancer has the BRCA gene.

But NIH statistics predict that 55 per-cent of those who do carry the BRCA1

gene or 45 percent of those who carry the BRCA2 gene (discovered in 1994) will develop breast cancer by the age of 70.

Although BRCA1 and BRCA2 gene mu-tations are rare — somewhere between one in 400 and one in 800, according to the Susan G. Komen Foundation — the mutation can be inherited from your mother or your father, meaning every child of a parent with the gene has a 50 percent chance of inheriting that particu-lar mutation. What complicates matters is not everyone with the mutated gene will develop cancer, so a parent can be a car-rier with no outward evidence of cancer in his or her lifetime.

While the presence or absence of the BRCA1 or BRCA2 gene gives physicians a clearer picture of a patient’s profile, it is only once piece of the puzzle.

WEIGHING YOUR OPTIONSPensacola surgeon Dr. M. Jane Benson

recommends patients for testing and ge-netic counseling who have an early cancer (younger than the average breast cancer patient, who is 55 years old) as well as multiple close family members within two generations with a history of ovarian or breast cancer.

The BRCA test, a simple blood test that requires a doctor’s order, costs about $3,000 and may not be covered by a patient’s insurance, according to Breast-cancer.org.

Pensacola surgeon Dr. Nicholas Sholty reminds his patients that, “BRCA is not a simple test with simple results. If you take a pregnancy test and the results are positive, you are pregnant. If you take an HIV test and the test is negative, you are negative. But if you have a BRCA test with a positive result, you are positive for the gene, and that is all. You are not guaran-teed to get cancer, and if your BRCA is negative, you still may get cancer. It’s not black and white.”

In fact, in a recent study at the National Human Genome Research Institute (NIH) half of the women with a positive BRCA never developed cancer. When research-ers mapped the isolated gene, they identified over 100 different “alterations” scattered over the gene, each creat-

ing variables in the mutations and possible cancers.

As important as a patient’s decision to pursue genetic screening, says Dr. Sholty, is an-other matter: “Who is reading the test results, and how do the results impact the physician who is crafting a treatment plan?”

Some BRCA positive patients, according to the National Cancer Institute, choose to begin clinical breast exams, mammograms, or ultra-sounds as early as age 25. A patient’s choice of contraception or the timing of child-bearing may also be impacted.

‘WOULD YOU WANT TO KNOW?’ Most women answering this inquiry cited

the changes they would make in diet and exer-cise if they knew they were positive.

The Mayo Clinic recognizes the positive and negative aspects of testing this way: A positive test can bring a sense of relief and empower a patient once a battle plan is formulated in consultation with a physician.

In some patients, though, a positive test brings anxiety, sadness, or a feeling of inevi-tability. Some patients are concerned with insurance or employment discrimination. Some experience strife with family over the inheritance of this genetic mutation.

Conversely, a negative test can bring a sense of relief followed by “survivor guilt,” especially when other family members test positive or are diagnosed with cancer. A negative test can provide a false sense of comfort, leading individuals to ignore other healthy changes that may be advisable. Ultimately, there are social and psychological consequences to knowing the results of a BRCA test that must be considered.

The biggest decision to be made by a BRCA positive woman is whether or not to pursue prophylactic surgery, the pre-emptive removal of the breasts and ovaries.

While the removal of breasts seems like

a radical step to take — one Angelina Jolie wrote about in her New York Times article “My Medical Choice” (May 14, 2013) — pa-tients who underwent this elective surgery experienced a 50 percent to 80 percent reduction in their risk for dying from breast cancer.

Reconstructive surgery following the re-moval of breast tissue can produce results that are “quite remarkable,” according to forces.org (“Facing Our Risk of Cancer Empow-ered”), whose website boasts a gallery of post-reconstruction images.

The truth is only 5 percent of breast cancers and 10 percent to 15 percent of ovarian cancers are linked to a BRCA gene mutation, according to the Mayo Clinic, but knowing you carry the gene assists you and your doctors in creating a strategy for treatment.

‘BRCA SAVED MY LIFE’Frances Yeo, Coordinator of Recreation and

Leisure at Pensacola State College, shared her story.

In 2004, she was diagnosed with cancer in her left breast, then three years later, her right. Since her family had a history of cancer, her surgeon suggested the BRCA test. When the test came back positive, doctors recommend-ed a double mastectomy as well as removal of the ovaries.

One ovary had “a quarter inch tumor, which was malignant. I had no symptoms,” says Yeo, who reminds us that with ovarian cancer, “There are no warning signs ... until it is too late to do much.”

Without her doctors acting on the BRCA test results, that ovary would have remained undiscovered.

BRCA gave her choices for treatment, a treatment she credits with saving her life.

“Sticking your head in the sand with the idea, ‘If I ignore it, it will go away,’ is NOT the best option,’’ Yeo says.

With hands on hips, chest muscles tightened

6 October 22, 2014

By Sloane Stephens Cox One in eight American women

will develop breast cancer some-time in her lifetime, and the most important thing women can do is be vigilant by performing regular self-exams and undergoing regular clinical exams and mammograms, doctors say.

Finding cancer early does not always reduce a woman’s chance of dying from breast cancer. But early detection and early treatment leads to the greatest possibility of success.

A key component in early detec-tion is having an annual mam-mograms beginning at age 40. A mammogram is a low-dose X-ray of the breast that’s used to detect and evaluate breast changes. It can detect breast masses years before they can be felt, and it may reveal other critical changes in the breast tissue.

Women with certain breast can-cer risk factors should begin clini-cal screenings and mammograms earlier. For example, women who have received thoracic radiation between ages 10 and 30 have a significantly increased risk of breast cancer.

But getting a mammogram isn’t always easy. Many women have to overcome obstacles that can in-clude cost, accessibility, finding the time, getting a doctor’s referral and the fear of the exam itself.

Here, we provide information on some of the local breast services that are offered, from free to reduced-price exams to mobile units that come to your area.

BAPTIST HEALTH CAREFREE SCREENINGS: Baptist

Hospital provides “Free Screening Mammos” for uninsured women within the community during October, which is Breast Cancer Awareness Month. This program is funded by community donations and fundraisers. To qualify for a free mammogram, patients must:

• Have a primary care physician.

• Be over age 35.• Not have had a mammogram

within the past 12 months.• Have had at least five years

of cancer-free screenings. (No diagnostic screening will be done in this program.)

• Not currently be experiencing any breast problems.

• Be uninsured — self-pay.• Meet or be at least 200 percent

above Federal Poverty Guidelines. (Patients must have completed Fi-nancial Assistance Application, along with providing proof of income, proof of Food Stamps eligibility, prior year tax returns and two most recent bank statements, plus any other required documentation to prove financial hardship.)

Upon meeting this criteria and as long as Baptist has spaces avail-able (due to available funding), patient would qualify for a Free Screening Mammo. For infor-mation, 850-434-4080.

REFERRALS: The hos-pital requires patients to have seen their physician within the last two years. For a screening mammo-gram, patients don’t need a referral. But patients

having any kind of breast problem need an order from their physician.

DIGITAL MAMMOGRAPHY – 3D BREAST IMAGING: In 2011, Baptist was the first hospital in Florida to gain FDA approval to perform digital breast tomosyn-thesis, or 3D digital mammography, which is available at these Baptist Health Care locations:

• Baptist Hospital• Gulf Breeze Hospital• Baptist Medical Park - Nine MileDIGITAL MAMMOGRAPHY:

Baptist offers the most advanced equipment available for digital mammography, Hologic Selenia Dimensions, at these locations:

• Baptist Hospital• Gulf Breeze Hospital• Baptist Medical Park - Nine Mile• Baptist Medical Park - Navarre• Atmore Community HospitalDIGITAL MAMMOGRAPHY

E-REMINDERS: For women over age 40, Baptist Health Care offers Mammography e-Reminders to help them remember their appoint-ments.

To schedule a mammogram, 850-469-7500.

Details: www.ebaptisthealthcare.org.

MAMMOGRAM RESOURCES

Options abound in local mammographyExtended hours, assistance programs help meet patient needs

Q: What is a mobile mammography unit?

A: It’s is a customized vehicle that goes to various locations

to offer mammograms. The purpose is to make

screenings convenient and to increase community access to

mammograms.

FREE MAMMOGRAMS:Mammograms are usually covered at 100 percent by most insurance carriers. If a patient does not have insur-ance, there are several programs, such as those through the Escambia County Health Department to help with free or reduced-fee services to qualifying patients. Uninsured patients ages 50 to 64 are eligible.Details: 850-490-5910 or 850-595-6650. OTHER MAMMOGRAM RESOURCES:American Breast Cancer Foundation’s Key to Life Breast Cancer Assistance ProgramEligibility: Need doctor’s referral and will be mailed an application. No age limit. Need proof of residency and must not make more than 300 percent above the poverty level.Details: 877-539-2543.

Santa Rosa County Health Department’s Breast and Cervical Cancer Program Eligibility: Ages 50 to 63, must make no more than $20,800 in a one-person family, $28,000 in a two-person family or $35,000 in a three-person family. Must make an appointment, have a Pap test and exam completed and then will be referred for a mammogram. Patient must bring a driver’s license.Details: 983-5200, ext. 139.

Mobile Mammography Van, West Florida Hospital affiliateEligibility: 35 and up. Travels through Pensacola.Details: 494-3462.

Angel Williamson Imaging CenterOffers 30 percent discounts on all medical services to the uninsured.Details: 476-1161 or www.awimaging.com.

Baptist Hospital’s HealthSourceEligibility: Call for an appointment. Must be 35 and complete a short phone interview.Details: 434-4080.

7October 22, 2014

MAMMOGRAM RESOURCESSACRED HEART HEALTH SYSTEM

FREE AND REDUCED-PRICE MAM-MOGRAMS: Routine screening mammo-grams are covered by most major insurance plans. The Ann L. Baroco Center for Breast Health also provides a limited number of free and reduced-price mammograms to the uninsured throughout the year through the Ann Baroco Cares program.

LOCATIONS: Sacred Heart Health Sys-tem has two locations: Sacred Heart Hospital in Pensacola and Sacred Heart Medical Park in Pace.

REFERRAL: No referral is needed for a routine annual screening mammogram. However, you do need to have a primary care physician for the hospital to send your results to.

To schedule a mammogram, 850-416-8078. Details: www.sacred-heart.org.

WEST FLORIDA HOSPITALBREAST HEALTH SERVICES OF-

FERED: West Florida Hospital was the area’s first hospital to be designated as a Breast Imaging Center of Excellence and is fully accredited by the American College of Radiology. It offers a full range of breast health services. West Florida has an all-female staff of registered and certified mammog-raphy technologists. In addition, two board-certified radiologists read all mammograms.

West Florida is certified as a Medicare Mammography screening facility. Breast health services include digital mammography, computer-aided detection (CAD), mobile mammography, breast ultrasound, breast MRIs, bone densitometry, stereotactic guided biopsy, ultrasound guided biopsy and MRI-guided biopsy.

MOBILE MAMMOGRAMS: West Florida Hospital provides mobile mammogra-phy services. The mobile unit is a customized 37-foot coach containing dedicated digital mammography equipment that is FDA-certi-fied and accredited by the American College of Radiology. The unit travels throughout Northwest Florida and Southwest Alabama.

REFERRALS: Patients do not need an order from their physician to have a screen-ing mammogram, but they must designate a physician to receive the mammogram results.

West Florida Hospital offers a discounted rate for mammograms for self-pay patients (uninsured).

To schedule a mammogram, call West Florida Mammography Services at 494-3497 or toll-free 888-894-2113.

Details: http://westfloridahospital.com.

WOODLANDS MEDICAL SPECIALISTS

FACILITY: Woodlands Medical Special-ists’ breast health facilities were designed to provide an alternative to the standard experience for breast care. Mammograms and breast biopsies can be stressful, and this facility was designed to create a warm and inviting atmosphere. Its breast health team focuses exclusively on the detection and diag-nosis of breast cancer.

BREAST-IMAGING SERVICES: Woodlands Breast Health’s GE Digital Mam-mography system provides physicians with a clear and precise all-digital image rather than just X-ray films. This equipment allows for a large field of view to accommodate the breast size of most women. Woodlands’ im-aging services for breast health include digital mammography, breast ultrasound, breast MRI, MRI-guided breast biopsy, ultrasound guided biopsy and stereotactic breast biopsy.

REDUCED-PRICE MAMMOGRAMS: Insurance will cover a screening mammo-gram for women 40 and older. But if insur-ance does not, Woodlands provides screening mammograms for $99.

REFERRALS: Referrals are not needed for a mammogram at Woodlands. However, any physician in the area can refer a patient to Woodlands. Woodlands handles all of the necessary referral paperwork and can transfer records upon the patient’s request. It can accept walk-in appointments and is now open on until 7 p.m. on Tuesdays to accommodate women who cannot schedule daytime appointments.

DIAGNOSIS: If a mammogram patient is diagnosed with breast cancer, the Woodlands oncology team is located on-site and can

While mammograms can miss some cancers,

they are still a very good way to find breast cancer. Eighty percent of the women treated

in Woodlands’ oncology division do not have a

family history of breast cancer.

be scheduled to see the patient during the follow-up visit. Its team of board-certified oncologists will help patients understand their diagnosis, develop an individualized treatment plan and coordinate all aspects of treatment and surveillance. The oncology team works collaboratively with other spe-cialists to help expedite the healing process.

To schedule a mammogram, 850-696-4000.Details: www.woodlandsmed.com.

NAVAL HOSPITAL PENSACOLABREAST HEALTH SERVICES: For

the past 15 years, the Naval Hospital has had a breast cancer coordinator available to its patients. The Naval Hospital was the first hospital in the Pensacola area to provide this service and the first to have a breast patient navigator certified by the National Consor-tium of Breast Centers on staff. The breast cancer coordinator guides patients through the diagnosis and treatment of breast cancer or symptoms associated with breast cancer. The coordinator also works with the patient and family to deal with emotional stress as-

sociated with breast cancer. PATIENT QUALIFICA-

TIONS: All TRICARE Prime beneficiaries

enrolled at Pensacola Naval Hospital are eligible to receive a mammogram there.

If you are enrolled, you can call your

Medical Home Port Team or Central Appointments at 505-6719 to schedule a mammogram. Mammograms can be scheduled to coincide with other appoint-ments in order to eliminate additional visits.

SANTA ROSA MEDICAL CENTERBREAST HEALTH SERVICES: The

Women’s Place at Santa Rosa Medical Center offers all-digital mammography, ultra-sound, stereotactic breast biopsy and bone densitometry in a spa-like environment. It is the only center in Santa Rosa County with a certified breast health navigator who can pro-vide education and guidance to women facing tough medical care decisions. Hours are 8 a.m. to 4:30 p.m. Monday through Friday.

QUALIFIED PATIENTS: The medi-cal center does see uninsured patients, and some of those are self-pay.

REDUCED-PRICE CARE: For those who cannot afford mammograms, the medi-cal center works to see if they are eligible for the Florida Breast Cancer Program. If the patients are self-pay, the cost for a screening mammogram is $20 (a 65 percent discount from the insurance-billed rate). The payment is typically due at the time of care, but if someone is unable to pay the full amount, the clinic is able to work with the patient to establish a payment plan. This applies not only to self-pay patients, but also to those who have not met deductibles or have high co-pays.

To schedule a mammogram, 850-626-5130.

8 October 22, 2014

SUPPORT THE AMERICAN CANCER SOCIETYWhen you support the American Cancer Society, you join millions of others who are committed to the fight to end cancer.You help save lives in the community and around the world. Thank you for supporting these lifesaving efforts that get us closer to a world with less cancer and more birthdays.

Sign Up for Reminders:cancer.org/remindme

Get Information:cancer.org/ breastcancer

Donate:cancer.org/donate

Volunteer:cancer.org/volunteer