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Mobile unit brings digital mammography to rural areas

Farmers Independent of Bagley, Minnesota

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Since January of 2012 the pale pink Edith Sanford Breast Health mobile truck out of Fargo has been providing a mammography service to Clearwater Health Services two to three times a month. The truck is equipped with state of the art digital mammography technology that is used to capture information nstead of photographic screen G1m. The digital technology provides clearer images that can be enhanced, magnified, and easily transmitted from the mobile truck to Sanford Hospital Bemidji.

In 2009, South Dakota philanthropist T. Denny Sanford gave $100 million to create a breast cancer foundation in memory of his mother, Edith Sanford, who died of breast cancer when he was only four years old. The truck that bears her name is driven and staffed by female rnamriiographers much as Lina Eide and Jean Clemens, both of Fargo.

When a woman arrives for her appointment, Lina or Jean accompanies the patient to a coom inside the clinic to go over the patient's medical his-cory, ask if they have noticed any problems, and explain the procedure. While most women come in for routine screen-ings, in the rare case where an abnormality is suspected, Lina and Jean's knowledge-able experience and gentle manner greatly help to ease the situation. The patient s then taken for her digital mammogram by the same mammography technologist who interviewed her, ensur-ing continuity throughout the whole procedure.

The inside of the truck resembles a motor home with no windows. The first small room is a reception area. The catient is then shown to the change room just off a small hallway that connects the reception area with the larger maging room. After changing into a gown, it only takes a few minutes to get the im-ages. Screening mammograms usually involve two x-ray pictures, or images, of each breast. The mammographer views the images on the monitor, ensuring that the images are positioned accurately for the radiologist to read. The patient is not notified of the results until after the images have been read in Bemidji by a radiologist on nigher resolution monitors. A normal mammogram results in a letter being sent to the patient. If something suspicious s detected, the patient is notified via a phone call within a day or two, and the radiologist may order additional mam-mography images with posBible ultrasound at a facility where a radiologist is present to give results to the patient on site. Sanford Hospital in Bemidji has the identical digtal mammography imaging machine as the mobile truck, Sanford Bemidji has the ca-pability to perform additional maging of the breast, as well as ultrasound if needed when a problem area has been detected. From there, the doctor and patient will discuss treat-nent options.

Mammograms make it possible to detect many tumors that cannot be felt, and are also very good at detecting microcalcifications (tiny deposits of calcium) that sometimes indicate the presence of breast cancer. The National Cancer Institute recommends that women age 40 and older should have screening mammograms every year. They also provide the following information for consideration at False-negative results.

False-negative results occur when mammograms appear normal even though breast cancer is present. Overall, screening mammograms miss about 20 percent of breast cancers that are present at the time of screening. False-positive results.

False-positive results occur when radiologists decide mammograms are abnormal but no cancer is actually present. All abnormal mammograms should be followed up with additional testing (diagnostic mammograms, ultrasound, and/or biopsy) to determine whether cancer is present.

Overdiagnosis and over-treatment. Screening mammograms can find cancers and cases of ductal carcinoma in situ (DCIS, a noninvasive tumor in which abnormal cells that may become cancerous build up in the lining of breast ducts) that need to be treated. However, they can also find cancers and cases of DCIS that will never cause symptoms or threaten a woman's life, leading to "overdiagnosis" of breast cancer. Treatment of these latter cancers and cases of DCIS is not needed and leads to "over-treatment." Overtreatment exposes women unnecessarily to the adverse effects associated with cancer therapy.

Radiation exposure. Mammograms require very small doses of radiation. The risk of harm from this radiation exposure is extremely low, but repeated x-rays have the potential to cause cancer.

The benefits of mammography, however, nearly always outweigh the potential harm from the radiation exposure. Nevertheless, women should talk with their health care providers about the need for each x-ray. In addition, they should always let their health care provider and the x-ray technician know if there is any possibility that they are pregnant, because radiation can harm a growing fetus.

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Original Publication Date: November 7, 2012

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