Importance of Breast Cancer Screening

[one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

Early Detection Saves Lives!

[/fusion_text][/one_full][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]breast-cancer-self-examOctober is breast cancer awareness month and with this in mind the importance of screening for breast cancer is front and center for many women. Breast cancer is the second deadliest cancer in women with 1 in 8 women being diagnosed with breast cancer during their lifetime. Worldwide, in 2013, we saw over 464,000 breast cancer deaths. Undoubtedly, this is an important health topic for women and one that generates some degree of anxiety.

It’s important to note that the majority of breast cancers in the United States are diagnosed as a result of an abnormal mammogram study, although a significant number are also first brought to the attention of a physician by a patient being aware of anatomic changes of her breast.

Differences in opinion surround breast cancer screening, however. Specifically, opinions vary with regard to who should be screened, when to start screening, how to screen, how frequently to screen and when to stop screening.

The concern from specialist is that if we over screen we may over biopsy, over diagnose, and maybe even over treat. “Overdoing it” carries its own psychological and physiologic side effects. In some cases, we may be looking at a “False-Positive”, i.e. looks like cancer but not cancer.

When considering breast cancer screening we should always include in the equation an individual woman’s risks of breast cancer, her personal preferences, and the benefits and harms of screening. The most important point being that women should make an informed decision with their physician about breast cancer screening.

While recommendations vary from specialty to specialty, I’d like to throw my hat into the ring and give you recommendations from a primary care, internal medicine physician viewpoint. Generally speaking these are my recommendations for breast cancer screening in women and for the most part coincide with recommendations from the American College of Radiology, the American College of Obstetrics and Gynecologists and the American Cancer Society.[/fusion_text][/one_full][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

1. Begin at 40

[/fusion_text][fusion_text]In average risk women, breast cancer screening should begin at age 40. Screening before age 40 is reserved for women at higher risk of breast cancer. High risk includes a positive family history of breast cancer, personal or family history of positive BRCA1 or BRCA2 genetic mutation, or strong family history of ovarian, tubal or peritoneal cancer. Keep in mind that less than 1% of women in the general population are estimated to be at high risk for breast cancer.[/fusion_text][/one_full][two_third last=”no” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”solid” padding=”” margin_top=”” margin_bottom=”” animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

2. Mammography is the Standard

[/fusion_text][fusion_text]The tried and true method for breast cancer screening and the current standard of care is mammography. Other options, including MRI of the breast are reserved for high-risk individuals or women with a history of breast cancer.[/fusion_text][/two_third][one_third last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”https://intrepy7493.wpengine.com/wp-content/uploads/2016/10/Atlanta-mammogram.jpg” background_repeat=”no-repeat” background_position=”center center” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”solid” padding=”” margin_top=”” margin_bottom=”” animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ animation_offset=”” class=”” id=””][/one_third][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

3. How Often You Get Screened Depends on Age

[/fusion_text][fusion_text]Screening should occur annually for women age 40 to 54 and then every two years for women 55 years of age and older.[/fusion_text][/one_full][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

4. Screening Should Continue to 75-80

[/fusion_text][fusion_text]Screening should be continued as long as a woman has a life expectancy of at least 10 years. Most thought leaders recommend that screening for breast cancer should end around 75 to 80 years of age.[/fusion_text][/one_full][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

5. Physician Breast Exams Matter of Opinion

[/fusion_text][fusion_text]As far as clinical breast exams performed by your physician in the office, these have fallen out of favor as they have the potential of false positive findings and no scientific evidence that these exams result in better outcomes. As a general rule I don’t recommend these unless a patient has identified an area of concern and would like further evaluation. The American College of Obstetrics and Gynecologists does recommend clinical breast exams every one to three years for women ages 20 to 39, and annually thereafter.[/fusion_text][/one_full][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

6. Cannot Rely on Self-Exams

[/fusion_text][fusion_text]With regard to breast self-exams performed at home, these exams have also fallen out of favor and generally are not recommended except for patients who are high risk. It is my experience however that the yearly breast self-exam assist women in self-awareness of anatomy and in many cases may be beneficial in identifying abnormal anatomy of the breast. Examples of concerning anatomic changes of the breast include: lumps, bumps, dimpling, changes in the appearance of the nipple, fluid leakage from the nipple, or skin changes or redness that do not go away.[/fusion_text][/one_full][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]

7. Genetic Testing is Helping

[/fusion_text][fusion_text]Genetic testing for breast cancer is indicated in very few women. When considering genetic testing, patients should work directly with a breast care specialist and undergo genetic counseling in order to make an informed decision. Specifically, women should consider genetic testing if they are diagnosed with breast cancer early in life, have a strong family history of breast and/or ovarian cancer, are of Ashkenazi Jewish descent, or have a family history of male breast cancer.[/fusion_text][/one_full][one_full last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ animation_offset=”” class=”” id=””][fusion_text]Appropriate breast cancer screening is our best defense in early identification of breast cancer. As in most cases, knowledge is power. Take time to discuss screening options with your physician in order to have a clear strategy for early detection.

Dr. Edward Espinosa, DO, MPH. Buckhead Medicine. www.buckheadmedicine.com.  678-855-0817[/fusion_text][/one_full][button link=”#” color=”default” size=”” stretch=”” type=”” shape=”” target=”_self” title=”” gradient_colors=”|” gradient_hover_colors=”|” accent_color=”” accent_hover_color=”” bevel_color=”” border_width=”” icon=”” icon_position=”left” icon_divider=”no” modal=”” animation_type=”0″ animation_direction=”left” animation_speed=”1″ animation_offset=”” alignment=”center” class=”footer-button modal-trigger-one” id=””]Request Appointment[/button]

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FAQ

What services are provided as a part of my annual fee?
  • Same-day or next business day appointments
  • Direct access to Dr. Espinosa via his personal cell phone after hours, weekends, and holidays
  • Minimal office wait times
  • Longer, more comprehensive appointments
  • House Calls (requires additional trip fee)
  • A strong focus on preventive medicine, long-term health and wellness
  • A personal professional relationship with your physician
What is the mission of Buckhead Medicine?

We strive to provide the highest quality medical care, emphasizing a comprehensive approach to prevention and disease management. We want patients to be completely satisfied with every aspect of their care.

Where is your office and are you on the medical staff of a local hospital?

Yes, Dr. Espinosa’s office is in Buckhead, a suburb of Atlanta. He is on the medical staff of Piedmont Hospital in Atlanta, Georgia and Northside Hospital in Atlanta, Georgia. If you require hospitalization, Dr. Espinosa will coordinate your patient care by working with the hospital based physicians. He will also make periodic hospital visits during your hospitalization.

Who will cover for you when you are not available?

On infrequent occasions when Dr. Espinosa is out of town or otherwise unavailable, he will have another qualified physician cover for him. Even while out of town, Dr. Espinosa will generally be available by phone to his patients and to his covering physicians. For practical reasons, we reserve the right to designate another qualified physician to perform any and all services should the need arise.

Do you accept insurance?

Commercial Insurance and Medicare:
Buckhead Medicine is an In-Network provider for Blue Cross Blue Shield PPO, Aetna, Coventry, Humana, Cigna, Tricare and United Healthcare. Our practice fully participates in the Medicare program. Buckhead Medicine accepts all other insurance as an Out-of-Network provider. We, however, do not participate in the Medicaid program. Regardless of your plan, we will bill your insurance for all covered services. It is our intention that no insurance-covered medical services are included in your annual fee.

HMO and Medicare HMO:
We do not participate in HMO programs. As such, HMO patients will not be able to join the practice until they transition to either a PPO or traditional Medicare plan.

Do I still need insurance if I enroll with you?

Yes. Personalized medical practices do not take the place of general health insurance coverage. Buckhead Medicine is a primary care medical practice, not a health insurance program. You are advised to continue your PPO, Medicare or other insurance program. If you are an uninsured individual and desire to enroll in the practice, we will provide you with a discounted fee schedule for office visits, tests and procedures.

What if I don't have health insurance?

For uninsured patients, Buckhead Medicine offers an uninsured patient plan. Although this plan is not insurance, it does cover for all clinic visits and any labs or tests that are performed in our office. In many cases this plan provides for significant cost savings to uninsured individuals. Please contact our office for additional details on this plan.

Will my insurance still be billed for my office visits?

Yes, we will bill your insurance company directly. The annual fee does not cover costs for regular exams or testing conducted inside or outside of the clinic. These costs are billed to your insurance provider in the same manner that traditional practices bill insurers.

Is there a co-payment?

If you have commercial insurance, we will collect the co-payment at the time of service. Medicare patients usually do not require a co-payment.

Do you bill Medicare for the annual fee?

No. The annual fee is not covered by Medicare. The fee only includes services that are not covered by Medicare and, as such, cannot be paid for or reimbursed by Medicare. We will bill Medicare for your sick visits and for any additional services performed at this practice that are covered by Medicare.

Will my commercial insurance reimburse my annual fee?

No, commercial insurance does not typically reimburse for the annual fee. However, some Flexible Spending Account and Health Savings Account plans may pay for all or part of the annual fee. In addition, some insurance plans allow the concierge fee to apply towards the annual deductible. Members are advised to consult their human resources representative at their place of employment.

Is the annual fee tax deductible?

In many cases the annual fee is a tax deductible healthcare expense. Patients are advised to consult with their tax consultant to clarify qualification in their particular circumstance.

Does the annual fee cover lab, x-ray, specialist fees and hospitalization?

Services such as labs, x-ray, specialty visits or hospitalizations are covered based on coverage determined by your insurance plan.

Are there age limits?

Dr. Espinosa is an Internal Medicine physician. His specialty is Adult medicine. Dr. Espinosa is trained to manage acute and chronic medical illnesses among adults. As such, the practice is limited to patients 17 years of age and older.

What if I have an emergency?

If you have a life threatening emergency, call 911 immediately. After you call 911, please call Dr. Espinosa. He will contact the hospital and notify the emergency room of your tentative arrival. In addition, Dr. Espinosa will provide the emergency room with pertinent medical history information

How far in advance do I need to book an appointment?

Dr. Espinosa is committed to providing his patients with easy access to care. All urgent visits will be accommodated either same day or next day, placing the greatest priority on the sickest patients. Annual physical exams will be booked 1 to 2 weeks in advance.

What do I do if I become ill while traveling or away on an extended vacation?

Call 911 if you have a life threatening emergency. Then call Dr. Espinosa. Call Dr. Espinosa first if the problem is minor. With the exception of a few controlled substances, most prescriptions can be ordered anywhere in the country. If necessary, it may be possible for Dr. Espinosa to find you a resource in your area. If you seek care at an emergency room or urgent care center out of our area, we request that you have the doctor seeing you call Dr. Espinosa for coordination. Dr. Espinosa will be readily available by phone for consultation with you and/or other health care personnel. If you should require hospitalization while away, at your request, Dr. Espinosa will establish phone communication with you and your attending physician(s) to ensure continuity of care.

Do you make house calls?

House calls will be available to Buckhead Medicine members, within a limited radius from the clinic. These will be done as deemed appropriate by Dr. Espinosa on a case-by-case basis. Home visits will be billed to your insurance provider similar to an office visit. A separate trip fee is required for house calls.

What if I need to see a specialist or a surgeon?

Of course, Buckhead Medicine patients are free to see any specialist they wish. We are available to help you decide what specialists to see and to coordinate such consultations. Patients may frequently request for “doctors in my area”, and we can accommodate this. We will ensure that the most appropriate resources are used, the earliest arrangements are made, and your applicable medical information is sent in advance of your specialist visit.

What about the cost of prescription medications?

The cost of prescription medications are the patient’s responsibility and in most cases should be covered by their insurance plans. We have expertise in assisting patients in purchasing medications in the most cost effective manner.

Will I be required to pay my annual fee even if I do not use your services?

Yes. Paying your annual fee allows you to be a member of the practice whether you are sick or well. We encourage our patients to utilize the amenities offered such as wellness consultations and emails for appropriate non-urgent health related questions, regardless of your state of health.

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