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BREAST CANCER

EARLY DETECTION GUIDE INSIDE:

• 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

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October 22, 2014

WARNING SIGNS Four Ways to Reduce Your Breast Cancer Risk October 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 symptoms, 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.

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

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.

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.

Source: Centers for Disease Control and Prevention

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October 22, 2014

MAMMOGRAM

If You’re Called Back After a Mammogram Stacy Simon ACS.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 mammogram. (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 mammogram 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 computer 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 instrument 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 summary 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 explain 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.

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October 22, 2014

BREAST SELF-EXAM 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.

1.

Use a mirror to look for changes in: Size, shape, contour, dimpling, rash, redness, scaliness of nipple or breast skin With arms by your side

2.

With hands on hips, chest muscles tightened

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.

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

Light

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

3.

With arms over your head

Firm

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

Repeat the exam on your left breast.

Sit or stand, and feel each underarm area.

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

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

October 22, 2014

Would YOU want to know?

For women who carry gene for breast cancer, knowledge is power

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 produced by BRCA repair damaged DNA to keep our cell’s genetic material stable.

According to the National Cancer Institute at the National Institutes of Health, if the BRCA gene mutates, important repair-proteins are not produced, rendering 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 percent 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 mutations 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 particular mutation.What complicates matters is not everyone with the mutated gene will develop cancer, so a parent can be a carrier 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 OPTIONS Pensacola surgeon Dr. M. Jane Benson recommends patients for testing and genetic 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 Breastcancer.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 guaranteed 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 researchers mapped the isolated gene, they identified over 100 different “alterations” scattered over the gene, each creat-

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“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

ing variables in the mutations and possible cancers.

As important as a patient’s decision to pursue genetic screening, says Dr. Sholty, is another 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 ultrasounds 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 exercise 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 inevitability. 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) — patients 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 removal of breast tissue can produce results that are “quite remarkable,” according to forces. org (“Facing Our Risk of Cancer Empowered”), 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 recommended 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.

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October 22, 2014

MAMMOGRAM RESOURCES

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

By Sloane Stephens Cox One in eight American women will develop breast cancer sometime 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 detection is having an annual mammograms 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 cancer risk factors should begin clinical 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 include 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 CARE having any kind of breast problem FREE SCREENINGS: Baptist need an order from their physician.

Hospital provides “Free Screening DIGITAL MAMMOGRAPHY Mammos” for uninsured women – 3D BREAST IMAGING: In within the community during 2011, Baptist was the first hospital October, which is Breast Cancer in Florida to gain FDA approval to Awareness Month. This program perform digital breast tomosynis funded by community donations thesis, or 3D digital mammography, and fundraisers. To qualify for a free which is available at these Baptist mammogram, patients must: Health Care locations: • Have a primary care • Baptist Hospital physician.

• Gulf Breeze Hospital • Be over age 35.

• Baptist Medical Park - Nine Mile • Not have had a mammogram DIGITAL MAMMOGRAPHY: within the past 12 months.

Baptist offers the most advanced • Have had at least five years equipment available for digital of cancer-free screenings. (No mammography, Hologic Selenia diagnostic screening will be done in Dimensions, at these locations: this program.)

• Baptist Hospital • Not currently be experiencing • Gulf Breeze Hospital any breast problems.

• Baptist Medical Park - Nine Mile • Be uninsured — self-pay.

• Baptist Medical Park - Navarre • Meet or be at least 200 percent • Atmore Community Hospital above Federal Poverty Guidelines.

DIGITAL MAMMOGRAPHY (Patients must have completed FiE-REMINDERS: For women over nancial Assistance Application, along age 40, Baptist Health Care offers with providing proof of income, Mammography e-Reminders to proof of Food Stamps eligibility, help them remember their appointprior year tax returns and two ments. most recent bank statements, plus To schedule a mammogram, any other required documentation 850-469-7500. to prove financial hardship.)

Details: www.ebaptisthealthcare.

Upon meeting this criteria and as org. long as Baptist has spaces available (due to available funding), patient would qualify for a Free What is a mobile Screening Mammo. For informammography unit? mation, 850-434-4080.

REFERRALS: The hosIt’s is a customized vehicle pital requires patients to that goes to various locations have seen their physician to offer mammograms. within the last two years.

The purpose is to make For a screening mammoscreenings convenient and to gram, patients don’t need increase community access to a referral. But patients

Q:

A:

mammograms.

FREE MAMMOGRAMS: Mammograms are usually covered at 100 percent by most insurance carriers. If a patient does not have insurance, 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 Program Eligibility: 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 affiliate Eligibility: 35 and up.Travels through Pensacola.

Details: 494-3462.

Angel Williamson Imaging Center Offers 30 percent discounts on all medical services to the uninsured.

Details: 476-1161 or www.awimaging.com.

Baptist Hospital’s HealthSource Eligibility: Call for an appointment. Must be 35 and complete a short phone interview.

Details: 434-4080.

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October 22, 2014

MAMMOGRAM RESOURCES SACRED HEART HEALTH SYSTEM FREE AND REDUCED-PRICE MAMMOGRAMS: Routine screening mammograms 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 System 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 HOSPITAL BREAST HEALTH SERVICES OFFERED: 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 mammography technologists. In addition, two boardcertified 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 MRIguided biopsy.

MOBILE MAMMOGRAMS: West Florida Hospital provides mobile mammography services.The mobile unit is a customized 37-foot coach containing dedicated digital mammography equipment that is FDA-certified 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 screening 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 Specialists’ 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- be scheduled to see the patient during the nosis of breast cancer. follow-up visit. Its team of board-certified BREAST-IMAGING SERVICES: oncologists will help patients understand Woodlands Breast Health’s GE Digital Mam- their diagnosis, develop an individualized mography system provides physicians with treatment plan and coordinate all aspects a clear and precise all-digital image rather of treatment and surveillance.The oncology than just X-ray films.This equipment allows team works collaboratively with other spefor a large field of view to accommodate the cialists to help expedite the healing process. breast size of most women.Woodlands’ imTo schedule a mammogram, 850-696-4000. aging services for breast health include digital Details: www.woodlandsmed.com. mammography, breast ultrasound, breast MRI, NAVAL HOSPITAL PENSACOLA MRI-guided breast biopsy, ultrasound guided BREAST HEALTH SERVICES: For biopsy and stereotactic breast biopsy. the past 15 years, the Naval Hospital has REDUCED-PRICE MAMMOGRAMS: had a breast cancer coordinator available to Insurance will cover a screening mammoits patients.The Naval Hospital was the first gram for women 40 and older. But if insurhospital in the Pensacola area to provide this ance does not,Woodlands provides screening service and the first to have a breast patient mammograms for $99. navigator certified by the National ConsorREFERRALS: Referrals are not needed tium of Breast Centers on staff.The breast for a mammogram at Woodlands. However, cancer coordinator guides patients through any physician in the area can refer a patient the diagnosis and treatment of breast cancer to Woodlands.Woodlands handles all of or symptoms associated with breast cancer. the necessary referral paperwork and can The coordinator also works with the patient transfer records upon the patient’s request. It and family to deal with emotional stress ascan accept walk-in appointments and is now sociated with breast cancer. open on until 7 p.m. on Tuesdays PATIENT QUALIFICAto accommodate women who TIONS: All TRICARE cannot schedule daytime While mammograms Prime beneficiaries appointments. can miss some cancers, enrolled at Pensacola DIAGNOSIS: If a they are still a very Naval Hospital are mammogram patient is good way to find breast eligible to receive a diagnosed with breast cancer. Eighty percent mammogram there. cancer, the Woodlands of the women treated If you are enrolled, oncology team is in Woodlands’ oncology you can call your located on-site and can division do not have a

family history of breast cancer.

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

SANTA ROSA MEDICAL CENTER BREAST HEALTH SERVICES: The Women’s Place at Santa Rosa Medical Center offers all-digital mammography, ultrasound, 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 provide 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 medical center does see uninsured patients, and some of those are self-pay.

REDUCED-PRICE CARE: For those who cannot afford mammograms, the medical 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.

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October 22, 2014

SUPPORT THE AMERICAN CANCER SOCIETY When 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