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Breast Cancer Reminder: Get Your Annual Screening

Image of Military personnel in mammogram screening. U.S. Navy Capt. Kelly Elmore, Walter Reed National Military Medical Center's chief of staff, documented her recent mammogram appointment with hopes of encouraging other women to get their mammograms. Annual mammograms are highly effective at detecting cancerous cells in breasts. (DOD photo: Vernishia R. Vaughn-Lucas)

Breast health and annual mammogram screenings should be your top priorities to protect against cancers and are easier than ever to schedule wherever you are.

TRICARE covers breast health services and has guidelines for those at risk of developing breast cancers.

The guidelines lay out which patients need early screening, versus patients who can start breast cancer screening between the ages of 40 and 50.

"The most important thing is starting a conversation with your primary physician or your primary provider to learn when you should start annual screenings," said U.S. Navy Lt. Cmdr. (Dr.) Matthew Nealeigh, director of the Breast Care and Research Center at Walter Reed National Military Medical Center, and an assistant professor of surgery at the Uniformed Services University of the Health Sciences, both in Bethesda, Maryland.

No Need for Doctor Referral

TRICARE covers mammograms during a health promotion and disease prevention exam without a referral for women over 40 or younger if they have an increased risk for breast cancer, according to their health care provider, said Tonya Utterback, referral manager of the clinical oversight and integration section of the TRICARE health plan.

Naval Hospital Bremerton in Washington makes the annual mammography screening exam easy to schedule.

"When a patient comes in for an annual mammogram, the technologist lets them know they do not need a doctor's order for their next annual screening mammogram visit," said Marde Buchart, lead mammography technologist for the hospital's radiology department.

"As a mammogram technologist, under the American College of Radiology's rules and regulations, we can create an order under "self-referral." As long as the patient has their provider established, we can do it for them, "Buchart explained.

"We also encourage patients to be aware of any changes they may see or feel in their breasts."

Bremerton also offers walk-in mammograms on a space-available basis so patients can get their exams when they are at the hospital.

The hospital is responsible for serving the third largest fleet concentration in the U.S. Navy and is one of the most active medical facilities across the Military Health System.

Mammography Gold Standard and Early Detection

Digital mammography using digital breast tomosynthesis, also known as DBT, is the current gold standard for mammography, said U.S. Navy Cmdr. (Dr.) Matthew Bauer, the radiology department head at Bremerton.

"This technique obtains multiple images of the breast in different planes and creates a 3D image series similar to a computerized tomography scan."

"All screening mammograms performed at Bremerton use DBT, and all breast densities can benefit from the use of the technology," Buchart explained.

"DBT is able to see sub-centimeter masses that can then be further assessed by ultrasound," Bauer said.

"Both DBT and conventional 2D mammography can identify suspicious micro-calcifications that can be the first indication of cancer, which is the classic benefit of screening mammography," he explained.

"The 3D nature of DBT allows the radiologist to define small masses within the denser breast tissue," Buchart said.

"Women with denser breasts may have greater benefit from DBT, as increased breast density does limit the sensitivity of mammograms."

"DBT has also been shown to both decrease recall rates for negative or benign diagnostic mammograms, as well as increasing sensitivity for detecting small cancers," Buchart added.

That can be a comfort to patients.

Digital imaging and advances in equipment have lowered the radiation dose associated with mammography, "which is reassuring for patients having these screening exams performed annually," she said.

Your Records Go with You

Current digital mammographic technology has advanced annual screenings in several ways, making your breast health records portable.

"With digital images, the exams can be transferred easily between facilities, whether via computer connections or CDs, which is especially important in the military community as service members change duty stations," Buchart said.

The MHS GENESIS patient electronic health record portals, which are customized to patients' wellness needs, include a specific reminder for annual mammograms and breast exams.

What's Coming Next?

The newest innovation in breast screening involves the use of a contrast agent administered via IV so radiologists can see more small tumors or suspicious breast tissue.

"Contrast-enhanced mammography is an evolving technique, where an iodinated contrast dye is administered intravenously prior to performing the mammogram," Bauer said. "Much like the use of iodinated contrast with CT scans, this technique may allow radiologists to more easily identify masses in the breast."

What if You are Diagnosed with Breast Cancer?

Madigan Army Medical Center at Joint Base Lewis-McChord in Washington offers top-notch treatment and care for patients diagnosed with breast cancers.

While other military medical hospitals and clinics offer similar programs, Madigan's Breast Cancer Diagnosis and Treatment Pathway is one of the first programs of its kind in the U.S. military and civilian medical systems and is more than 25 years old.

The goals of the program are prevention of fragmented care after a diagnosis, a coordinated multidisciplinary approach, reduction of risk-management problems, seamless personalized patient care and increased efficiency.

Cancer survivorship is also included in the program to give the patient a plan of continued care related to breast cancer once treatment is complete.

In addition, Walter Reed's Breast Care and Research Center is certified by the National Accreditation Program for Breast Centers under the American College of Surgeons.

"It certifies that a given center has a world-class level of medical care for all breast diseases," Nealeigh said. "It emphasizes our partnership with the breast imaging center. It emphasizes our multidisciplinary care between the surgical oncology service, the medical oncology service, the radiation oncology service, the pathology team, and different support services, including physical therapy and an oncology-certified social worker who are embedded to help patients and the families with the anxiety and mental health component that comes with these diseases."

The final word from Buchart is "get your annual screening mammogram! There's really no excuse because the system has been made so simple."

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Pelvic Health Rehabilitation: A Mission Critical Resource that Enables Military Readiness

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6/7/2023
U.S. Army Lt Col. (Dr.) Leigh Anne Lechanski, department chief of rehabilitation at Eisenhower Army Medical Center, guides a patient through a pelvic floor muscle exercise training session using a surface electromyography biofeedback system. This intervention gives patients a visual aid and objective information about muscle activation in the pelvic floor structures. (Courtesy Photo)

Pelvic floor muscle dysfunction can present with symptoms such as pelvic pain, incontinence, constipation, abdominal weakness, and pelvic organ prolapse. These conditions can significantly impact female service members' physical and emotional health.

TRICARE Preventive Health Benefits Women Should Know

Article
5/25/2023
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Eating well, exercising often, and getting enough sleep are habits that can help you live your healthiest life. And when it comes to feeling and staying well, getting preventive health care is also a must.

Walk-in Contraception Services at Military Medical Treatment Facilities

DHA Publication
2/8/2023

Policy Number: 6025.09

Establishes DHA's procedures for implementation of walk-in contraception services at all Military Medical Treatment Facilities, for Active Duty members of the Armed Forces and for eligible beneficiaries of the Military Health System on a space available basis.

Working Together to Improve Black Maternal Health

Article Around MHS
4/28/2023
The Mother Infant Care Center team at Walter Reed National Military Medical Center ensures patients receive safe, high-quality care, equitable, culturally diverse and inclusive care as a leader in advanced childbirth health care, according to WRNMMC Chief of Staff Navy Capt. (Dr.) Kelly Elmore, an OB/GYN. WRNMMC celebrated Black Maternal Health Week during April 11-17. (Photo by Aisha Lomax, Walter Reed National Military Medical Center)

“Black Maternal Health Week is a reminder that so many families experience pain, neglect, and loss during what should be one of the most joyous times of their lives. It is an urgent call for action,” states a proclamation signed by President Joe Biden in observance of Black Maternal Health Week 2023, observed April 11-17.

MHS Video On Sexual Assault in the Military

Video
4/25/2023
MHS Video On Sexual Assault in the Military

Ms. Seileen Mullen, Principal Deputy Assistant Secretary of Defense for Health Affairs, stopped by DHA headquarters to discuss everyone's role in preventing sexual harassment and assault and DHA's unique role in treating patients after sexual trauma. Sexual assault is a real problem within our military. Everyone in the military community can play a role in preventing this crime and creating a zero-tolerance atmosphere that supports survivors. Visiting the Safe Helpline website for more information or to talk to a counselor. https://safehelpline.org/

U.S. Army Colonel Says it’s OK to Take a Knee with Breast Cancer

Article Around MHS
4/17/2023
In 2020 , U.S. Army Col Theresa Lewis, was diagnosed with breast cancer. She went through treatment, but keeping a leadership role working long hours like she was used to became increasingly difficult. (Courtesy photo)

U.S. Army Col. Theresa Lewis, a registered nurse, spent the last 29 years taking care of soldiers. “I was a private at Fort Stewart and my dream was to return to Fort Stewart to retire there.” She did come back to Fort Stewart as the deputy commander of nursing of Winn Army Community Hospital.

Blanchfield Army Community Hospital Mom & Me Program Provides Specialized Support to Military Families

Article Around MHS
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Audrey Sundbye, a certified lactation consultant at Blanchfield Army Community Hospital,  checks the weight of U.S. Army Spc. Jaqueline Kerchner’s baby following his feeding at a Mom & Me meeting in the hospital on March 20. Mom & Me provides breastfeeding mothers of infants age newborn to 12 months, walk-in access to the hospital’s lactation consultants. (Photo: Maria Christina Yager, Blanchfield Army Medical Hospital)

There was a party recently during Blanchfield Army Community Hospital’s breastfeeding support group, Mom & Me. Group moms and babies gathered round in support and a dinosaur birthday cake was nearby. The Mom & Me program connects and provides breastfeeding mothers with lactation consultants.

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Frequently Asked Questions on Reproductive Health Care

Publication
2/16/2023

On Oct. 20, 2022, the Secretary of Defense released a memorandum, “Ensuring Access to Reproductive Health Care,” directing the Department take a series of actions to ensure Service members and their families can access non-covered reproductive health care. On Feb. 16, 2023, the Department of Defense released those directed policies, which will be effective no later than 30 days from Feb. 16, 2023.

DOD Releases Policies to Ensure Access to Non-Covered Reproductive Health Care

Article Around MHS
2/16/2023
A captain deploys, while pregnant wife stays home

The Department of Defense has released the directed policies on command notification of pregnancy, administrative absence for non-covered reproductive health care, and travel allowances for non-covered reproductive health care.

Command Notification of Pregnancy

Fact Sheet
2/15/2023

This policy clarifies when a Service member’s pregnancy status is shared with commanders, standardizes and extends the timeframe for Service members to inform their commanders about a pregnancy, and reinforces that commanders must always exercise objectivity and discretion when handling reproductive health care issues.

Travel for Non-Covered Reproductive Health Care Services

Fact Sheet
2/15/2023

This regulation ensures Service members and eligible dependents are eligible for travel and transportation allowances to access non-covered reproductive health care services when timely access to non-covered reproductive health care services is not available within the local area of the member’s permanent duty station, temporary duty location, or the last location the dependent was transported on authorized government orders.

Overview: Ensuring Access to Non-Covered Reproductive Health Care

Fact Sheet
2/15/2023

These policies reflect our commitment to taking care of our people and ensuring that the entire Force remains ready and resilient. These policies ensure Service members are able to access non-covered reproductive health care regardless of where they are stationed.

Administrative Absence for Non-Covered Reproductive Health Care

Fact Sheet
2/15/2023

This policy provides Service members the ability to request an administrative absence from their normal duty stations in order to access, or accompany a dual-military spouse or dependent to access, non-covered reproductive health care without being charged leave.

USU, Canadian Armed Forces Host Military Women’s Health Workshop

Article Around MHS
2/15/2023
Panelists at the Armed Forces Health Services and Uniformed Services University's International Military Women's Health Workshop

Women make up nearly 20% of the the United States Armed Forces, so having more females in healthcare professions creates a much more effective force. That's why the Uniformed Services University and Canadian Armed Forces Health Services collaborated recently to advance research on women’s health issues and to optimize care for women in uniform.

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Last Updated: December 15, 2022
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