Doctor Q&A: Breast Health for Women 65+

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As a woman, you know how important it is to be proactive with your health, including getting your breasts checked regularly. A mammogram can catch breast cancer at early stages, which can make it easier to treat. We sat down with Joanne Armstrong, MD, Aetna's senior medical director, to discuss breast health for women age 65 and older.


Q. What's a mammogram?

A. A mammogram is an X-ray image of your breasts used to screen for breast cancer. During a mammogram, your breasts are compressed between two firm surfaces to spread out the breast tissue. Then an X-ray captures black-and-white images of your breasts that are displayed on a computer screen and examined by a doctor who looks for signs of cancer. Mammograms don't prevent cancer. Mammography is an important tool to detect cancer and help decrease breast cancer deaths.

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Q. What should women age 65 and older ask their doctors about mammograms?

A. It's very important to openly communicate with your doctor about your health. Ask questions and don't be shy. Your doctor is there to help you. Here are some questions to ask about getting a mammogram:

  • How do I prepare for a mammogram?
  • When do test results come back?
  • What are the guidelines for how often I should have one?
  • When do I stop getting mammograms?

Q. How should I prepare for a mammogram?

A. Make sure you choose a certified mammogram facility. Ask whether the facility is certified by the FDA. This will ensure that the facility meets certain standards. When you schedule your mammogram, you may be asked if it's a screening or a diagnostic mammogram. Your doctor should tell you which one you're having.

Don't use deodorant under your arms before your mammogram. Deodorant or antiperspirants may have tiny metallic particles that can confuse the reading of your mammogram. Many centers will give you a wipe to remove any deodorant that may be present. You may also want to consider taking Tylenol about an hour before your mammogram to reduce discomfort.

Q. How often should women over 65 get a mammogram?

A. You should always check with your doctor. They can best advise you on how often you should get a mammogram. The U.S. Preventive Services Task Force recommends women start screening every two years starting at age 50 until age 74.

The age to stop mammograms is less clear. Older women with other serious medical issues should discuss the benefits of mammography with their physician, as it may make sense to stop mammography at some point and monitor risk through physical exams. Patients should develop a personalized plan for screening and surveillance with their doctors based on their current health and medical history.

Q. Does Medicare cover mammograms?

A. Medicare Part B covers one baseline mammogram for women ages 35 to 39. Part B also covers screening mammograms once every 12 months to check for breast cancer if you're age 40 or older. Medicare covers both digital and 3D mammography for screening. Part B covers diagnostic mammograms more frequently than once a year if medically necessary.

Q. Why is it important for women to be proactive with their breast health as they age?

A. As you age, the tissue and structure of your breasts begin to change. This is due to differences in your reproductive hormone levels caused by the natural process of aging. There's also an increased risk of developing growths in the breast such as fibroids, cysts, and cancer. Keep in mind that women of any age can develop these conditions.

Q. What's your breast health advice for women over 65?

A. It's important to eat healthy, exercise, and get routine preventive care. Here are some quick tips to maintain a healthy lifestyle:

  • Maintain a healthy body weight: Maintain a BMI less than 23 throughout your life. Weight gain and obesity may increase your risk of breast cancer.
  • Make time for regular exercise: Adopt an active lifestyle. Aim for 30 minutes or more of moderate aerobic activity at least five days per week.
  • Minimize or avoid alcohol: Alcohol is one of the most well-established dietary risk factors for breast cancer. Women who consume more than two glasses of alcohol a day are at higher risk.
  • Quit smoking: The risk of many cancers, including breast cancer, and other health problems increases if you smoke.
  • Eat more veggies: Consume more cruciferous vegetables (broccoli, cabbage, cauliflower), dark leafy greens, carrots, tomatoes, citrus fruits, berries, and cherries.

Remember, it's always best to talk with your doctor about your breast health. They can make recommendations based on your current health and family history.

Speak to a licensed Aetna representative about Medicare
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