October 1, 2013 • Page 2 shop online at www.missourivalleyshopper.com Breast Cancer Screening: What’s a Woman to Do? cancers at a smaller, more favorable stage which decreases death from breast cancer and allows increased treatment choices. However, publication of the United States Preventive Health Services Task Force’s screening guidelines created a storm of controversy and left many women wondering what guidelines to follow Mary J. Milroy, MD, FACS, for optimal breast Board Certified Surgeon cancer screening. Specializing in Breast Surgery The American Yankton Medical Clinic, P.C. Cancer Society estimates that 232,340 Breast cancer contin- new cases of breast cancer ues to be the most common will be diagnosed in the cause of cancer in women United States and there will and second only to lung be 39,920 deaths from cancer as a cause of cancer breast cancer in 2013. death in women. Despite intensive research, Mammography detects the cause of breast cancer IMPROVE WORKING CONDITIONS FOR YOUR FEET. FREE SOCKS SALE! In stock. 6” & 8” styles. Up to 4E wide & size 15 in stock. Available in Safety & Non-Safety Toe. Boston 3rd • Yankton • to Boots Shoes 665-9092 312 W. remains elusive and prevention of breast cancer remains a dream and not yet a reality. Women often wonder who is at risk and who should be screened. A number of factors may place a woman at increased risk but the two greatest factors for developing breast cancer are being female and increasing age. The majority of women diagnosed with breast cancer have no other risk factors. Therefore, it is important for all women to be screened for breast cancer. Women do need to review their risk factors with their primary care provider to see if they are at increased risk and may benefit from genetic counseling and increased screening. Strong world-wide evidence supports screening mammography as the best method to detect early breast cancer. The current controversy revolves around the best age to begin screening, how often to perform screening and at what age to stop screening. When considering the options, the benefits versus the risks must be considered. The benefits of mammography are its ability to detect breast cancer at a smaller size where treatment options are greater, often less radical and death is decreased. There is no other test with stronger evidence behind it demonstrating its ability to save lives. The downsides are that mammography requires compression which can be uncomfortable, not all cancers can be seen by mammography which are called false negatives and some areas on a mammogram may appear suspicious but ultimately prove to be benign which are called false positives and which can create anxiety, require additional evaluation with diagnostic mammograms and ultrasounds or even at times require a biopsy. The US Preventive Services Task Force advised women to begin mammography at age 50, only every 2 years, and only until age 74. This was based on concerns about both the lower incidence of breast cancer in women in their 40s and concerns about increased false negative and false positive mammograms. However, in the May 2012 issue of Oncology, the American Cancer Society reviewed the evolving evidence in breast cancer screening and concluded by reaffirming its recommendations to begin screening mammography at 40 and then every year to an age where curative therapy would not be offered due to other medical conditions. While the evidence for mammography remains strong, some of the downsides are fortunately decreasing. Experienced, specially-trained mammography technologists can work with a woman to make mammography a very tolerable procedure. Modern digital mammography with the addition of computer aided detection (CAD) has been shown to greatly improve the accuracy of mammography especially in younger women and women with dense breasts. Experienced radiologists can decrease the frequency of breast biopsies. Also, the development of minimally invasive needle biopsy has turned breast biopsy into an outpatient procedure with local anesthesia and an incision so tiny that it usu- ally does not even require stitches. The American Cancer Society guidelines for breast cancer screening encourage a woman to be aware of her breasts and promptly report symptoms for evaluation. Clinical breast exam should begin at age 20 and continue every 3 years to age 40 and then become yearly. Mammography should begin at age 40 and continue yearly until an age when therapy for breast cancer would not be offered due to limiting medical conditions. The Yankton Medical Clinic Breast Cancer Screening Team stands firmly behind the American Cancer Society guidelines. Breast Cancer screening: What’s a woman to do? The answer is clear. Screening saves lives. Women should review their breast cancer risk factors with their primary care provider to determine their best screening guidelines, be aware of breast changes and promptly report symptoms, have clinical breast exams and be sure to have screening mammograms. Dave Says Lumping It To Pay Debt Looking for a self motivated person to perform booking and billing for agronomy services at the Vermillion/Meckling, SD location. Applicants must be proficient with computers, competitive wages, depending on experience. To apply contact Carl Hinz @ 605-670-2964. BY DAVE RAMSEY Dear Dave, I have $400 in debt on a credit card, and I haven’t made a payment on it in about two years. The debt has been sold several times, and now the amount they’re Sal Sal ale le 23rd Anniversary rd rs r rsary October 1-31, 2013 asking for is over $1,000. I’d like to work something out, but how do I know the collection company that is calling me now is legitimate? — Lorenzo Dear Lorenzo, It’s normal for a debt this old to have been sold a few times. My guess is the company that’s calling you is legit, and they probably bought the debt for pennies on the dollar. Whatever you do, don’t set up a payment arrangement. They’re asking for over $1,000 because they’ve added stuff like late charges and interest. Let’s go back to the original amount of $400 and see if they’ll accept a one-time, cash payment to settle things. Make sure you GUBBELS SALVAGE WANTED: • Old Cars • Farm Machinery • Any Type of Scrap Iron • Grain Bin We now offer a towing service Removal and skid loader work. Paying Top Dollar 1-402-640-6335 Will Pick Up Coleridge, NE There’s havesting........ and then there’s John Deere harvesting! 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Hwy 81 - Freeman, SD (605) 925-4241 39660 SD Hwy 46 - Wagner, SD (605) 384-4580 2200 E. Hwy 50 - Yankton, SD (605) 665-3762 Visit us on the Web!! deerequipment.com get it in writing if they accept and don’t give them a dime until after you get the written agreeDave ment. Then, once you RAMSEY have the agreement, send them $400. Do not, under any circumstances, give them electronic access to your checking account. You’ve waited a long time to take care of this, and in the process you’ve made things more difficult. I’m glad you’ve decided to clean up your mess, though. Late is better than never, Lorenzo. Just remember, you’re still responsible for debts you incur-even if the company you originally borrowed from has sold it to someone else! — Dave CUT THE HEALTH INSURANCE? Dear Dave, Is it ever okay to stop paying or drop health insurance altogether in order to pay off debt? — Shauna Dear Shauna, No! The No. 1 cause of bankruptcy in America today is medical bills, and credit card debt is a close second. That doesn’t mean medical bills only of the uninsured. It also includes money from co-payments, deductibles and the fact that people didn’t have any savings. One accident or unexpected event can leave you with thousands of dollars in medical bills, and that’s even with a good health insurance policy. I don’t want anyone walking around without health insurance. But I’m not talking about the Affordable Care Act and all the other mandated crap the government is trying to shove down our throats. I’m talking about a solid health insurance plan along with having some money saved. Do this first then you can have all the philosophical discussions you want about whether or not you’re supposed to pay for someone else’s healthcare and upkeep. At the end of the day, it’s absolutely vital that you have your own health insurance. I hope I haven’t been unclear on this topic! — Dave Read & Recycle!