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FAQ About Breast Cancer Care in Mankato
At the Hoffman Paschke Breast Clinic in Mankato, Minnesota, we're with you every step of the way — from education and support to diagnosis review and treatment. There's no shame in asking questions and speaking your mind. In fact, we encourage it. Here are a few of our most frequently asked questions.
When should I schedule my screening mammogram?
Screening mammograms are recommended yearly for women starting at the age of 40. Schedule the test for a time when your breasts are least likely to be tender. If you haven't gone through menopause, that's usually during the week after your menstrual period. Your breasts are most likely to be tender the week before and the week during your period.
How do I prepare for my mammogram appointment?
Avoid using deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on your breasts the day of your appointment. Metallic particles in powders and deodorants can interfere with the imaging.
Wear a two-piece outfit to easily change for the procedure. You will be asked to remove any necklaces and clothing from the waist up.
What should I expect during my mammogram?
You will be given a gown and asked to remove any necklaces and clothing from the waist up. To make this easier, wear a two-piece outfit that day.
For the procedure itself, you stand in front of an X-ray machine equipped to perform 3D mammograms. The technician places one of your breasts on a platform and raises or lowers the platform to match your height. The technician helps you position your head, arms and torso to allow an unobstructed view of your breast.
Your breast is gradually pressed against the platform by a clear plastic plate. Pressure is applied for a few seconds to spread out the breast tissue. The pressure isn't harmful, but you may find it uncomfortable. If you have too much discomfort, tell the technician.
The machine will move above you from one side to the other as it collects images. You may be asked to stand sill and hold your breast for a few seconds to minimize movement.
The pressure on your breast is released, and the machine is repositioned to take an image of your breast from the side. Your breast is positioned against the platform again, and the clear plastic plate is used to apply pressure. The camera takes images again. The process is then repeated on the other breast.
What should I expect during molecular breast imaging (MBI)?
This technology is available at Mayo Clinic in Rochester or Mayo Clinic Health System in La Crosse.
You will be given a gown and asked to remove any necklaces and clothing from the waist up. To make this easier, wear a two-piece outfit that day. You may also receive a blanket to keep your chest warm, as being warm and relaxed can improve the uptake of the tracer to your breast tissue.
To begin your MBI test, you'll receive an injection of the radioactive tracer into a vein in your arm. The tracer contains a substance that is quickly absorbed by fast growing cells, such as cancer cells. The tracer emits gamma rays that are detected by two small gamma cameras that are part of the molecular breast imaging system.
You will be seated in a chair facing the molecular breast imaging system, which looks similar to a mammogram machine. You'll be asked to open or remove your gown and place one breast on the flat surface of a gamma camera in front of you. You may need to lean forward a little and pillows may be placed behind your back to make this more comfortable.
The flat surface of a second gamma camera will be lowered on top of your breast. The compression is light — just enough to hold your breast in place during the test — and shouldn't be painful or uncomfortable. You will sit still for 10 minutes as the gamma camera records the activity of the tracer. Your breast will be repositioned for a second image, and you'll be asked to sit still again for 10 minutes as the image is created.
If you're having both breasts imaged, your other breast will be positioned in the imaging machine and the process will be repeated. Two images are created of each breast, and each image takes about 10 minutes. In total, you will be asked to sit still for 40 minutes, though you can get up and stretch between images. A television is available to watch during your test. Women with larger breasts may need additional images.
The machine will move above you from one side to the other as it collects images. You may be asked to stand sill and hold your breast for a few seconds to minimize movement.
The pressure on your breast is released, and the machine is repositioned to take an image of your breast from the side. Your breast is positioned against the platform again, and the clear plastic plate is used to apply pressure. The camera takes images again. The process is then repeated on the other breast.
How do I know if I have dense breast tissue?
Dense breast tissue refers to the appearance of the breast tissue on a mammogram. It's a normal and common finding. The radiologist who analyzes your mammogram determines the ratio of nondense tissue to dense tissue and assigns a level of breast density.
You will receive a letter with the results of your mammogram which will include your breast density. Levels of density are described using a results reporting system called Breast Imaging Reporting and Data System, as provided by the American College of Radiology:
- A — This level indicates that the breasts are almost entirely composed of fat. About 1 in 10 women has this result.
- B — Scattered areas of fibroglandular density indicates there are some scattered areas of density, but most breast tissue is nondense. About 4 in 10 women have this result.
- C — Heterogeneously dense indicates there are some areas of nondense tissue, but most breast tissue is dense. About 4 in 10 women have this result.
- D — Extremely dense indicates that nearly all of the breast tissue is dense. About 1 in 10 women has this result.
In general, women with breasts that are classified as heterogeneously dense or extremely dense ― levels C and D ― are considered to have dense breasts. About half of women undergoing mammograms have dense breasts.
Why does dense breast tissue matter?
Having dense breast tissue will not affect your daily life. However, it increases the chance that breast cancer may go undetected by a mammogram, since dense breast tissue and breast cancer both appear white in a mammogram. It also increases your risk of breast cancer, though we aren't certain why yet.
Women with dense breasts, but no other risk factors for breast cancer, are considered to have a higher risk of breast cancer than average. Despite concerns about detecting cancer in dense breasts, 3D mammography is more effective in finding cancer in dense breast tissue than older film mammogram technology.
You and your doctor may consider additional or supplemental testing such as MRI or molecular breast imaging, or MBI, based on your other risk factors and personal preferences.
What is the risk of developing lymphedema?
Lymphedema is a chronic condition, and it's important to catch it early. About 40% of people with breast cancer will develop lymphedema within the first five years of diagnosis, usually in the arm or chest wall. It occurs when tissues swell due to the buildup of lymph fluid that usually drains through the body's lymphatic system.
Signs of lymphedema or chronic swelling include:
- Skin feeling tight or full
- Limb(s) feeling full or heavy
- Difficulty fitting into garments without an overall weight gain
- Decreased sensations in the area
- Jewelry may start to feel tight
Causes of lymphedema or chronic swelling include:
- Surgical removal of lymph nodes (most common)
- Radiation therapy to lymph nodes
- Congenital, or born with, defect of having too few or damaged lymph nodes
- Injury to the lymph system
How is lymphedema treated?
At the Breast Clinic, patients diagnosed with breast cancer complete a baseline assessment of the amount of fluid in and out of the cells in their bodies. This is done before cancer surgery and treatment using bioimpedance technology.
The bioimpedance device looks like a standard scale. Patients step onto the machine with two electrodes on their feed and two electrodes on their hands. This painless scan takes about 30 seconds to complete.
The first scan provides a baseline measurement and scans are repeated every three months for two years and then every six months. Bioimpedance technology can identify tiny changes in baseline measurements, often before symptoms or tape measurements can detect changes.
Using scan measurements as a guide, our certified lymphedema therapists develop preventive treatment plans to lower the risk of lymphedema, which may include:
- Compression bandages and/or garments
- Gentle massage to reroute and remove the fluid
- Exercise programs
- Scar management
- Stretching
- Wound and skin care routines
- Adaptations to improve limitations with independence
- Education sessions in precautions and self-management techniques
How can I save my hair during chemotherapy treatment?
Patients have the option to use a scalp cooling cap, an effective and FDA-approved for use during chemotherapy for breast cancer and many other cancers. 50-60% of people retained half or more of their hair with scalp cooling therapy.
Keeping hair is not about vanity – it's about the preservation of self and identity and reducing the psychological toll of chemotherapy.
For many, hair loss is tied to:
- Loss of privacy — hair loss emphasizes illness
- Social isolation — uncomfortable in social settings
- Loss of self-esteem — individuals feel they don't look like themselves
How does scalp cooling cap work?
- During chemotherapy, patients wear a special cap connected to a machine that circulates coolant.
- The cap chills the scalp to 63–67 degrees Fahrenheit.
- The cap is worn for at least 30 minutes before chemotherapy, during treatment, and for 60–90 minutes after.
- Blood vessels in scalp constrict from cold, keeping chemo drugs from reaching hair follicles.
What should I expect during my first appointment, and what should I bring?
Your appointment will take place at the Hoffman Paschke Breast Clinic, located in the Madison East Health Center in Mankato. Bring any medical records from non-Mayo Clinic Health System facilities. If needed, complete a medical records release form to authorize the transfer of health records from another health care facility to us. A member of our team will meet with you to obtain your medical history and assess your breast cancer risk and whether additional testing is recommended.
If you are coming for a second opinion, or your initial mammogram detected an abnormal finding you will meet with a member of our care team to discuss next steps. If additional imaging, and/or a biopsy is recommended, we strive to complete your work up in a timely manner. Please note, diagnostic imaging may require two to three hours or longer if a biopsy is performed. Results of additional testing can be expected within one to two business days.
Do I need a referral to be seen in the Breast Clinic?
You can make an appointment without a referral from your provider – simply call 507-495-4700. If you're a provider, you can refer patients to the Breast Clinic online, by phone or fax. We value the opportunity to collaborate with you on a breast care plan.
What are my payment options, and do you offer financial assistance?
Screening mammograms are typically covered by commercial insurance; however, we recommend that you check with your insurance provider to confirm coverage and co-pay prior to your appointment.
For women without insurance or insurance that does not cover breast cancer screening, you may be eligible for free breast cancer screening through the Minnesota's Sage Breast and Cervical Cancer Screening Program. Call 888-643-2584 or review eligibility requirements.
We serve patients in difficult financial circumstances and offer financial assistance to those who have established need to receive medically necessary services. Learn more about financial assistance options.
Can I be in a clinical trial or research study if I'm not currently being treated for cancer?
Yes. Part of our commitment to patient care involves conducting medical research with the goal of helping people live longer, healthier lives. We discuss clinical trials and research studies with current patients, but also extend the opportunity to others who may benefit from participating. Explore more than 2,800 cancer clinical trials to help prevent, detect, treat or manage cancer.