Rachel Thelen (pictured) is an Advanced Oncology Certified Nurse Practitioner at Maui Memorial Medical Center Outpatient Clinic. Courtesy photo

Q: I have a family history of breast cancer. Do general mammogram recommendations apply to me?

Rachel Thelen, Advanced Oncology Certified Nurse Practitioner, Maui Memorial Medical Center Outpatient Clinic: Mammograms are an important screening tool for breast cancer because they are able to catch cancers when they are smaller and more treatable. Unfortunately, about 1 in every 8 women will develop breast cancer in their lifetime. With the help of early detection by mammogram, people are now living longer after breast cancer than ever before.

Having a strong family history of breast cancer, may mean that you have an increased risk of developing breast cancer yourself. Start by learning more about your family history. Ask your first degree relatives (parents, siblings, and children) as well as your extended family (grandparents, aunties and cousins). Don’t forget to include both your mother’s and father’s side of the family and be sure to ask about other cancers such as pancreas, uterine, ovarian and prostate cancer. It is important to find out what age your family member was diagnosed, if they had genetic testing and if they died of their cancer.

Family history is just one factor that can affect your cancer risk. Other factors include genetic mutations (like BRCA1 or 2), prior abnormal breast biopsies and chest radiation before you were 30. Regular alcohol use (more than 1 drink/day), some hormone therapies and being overweight also increases your risk of developing breast cancer.

Not everyone who has a family history is considered high risk, but it is important to see your health care provider for a risk assessment, ideally by age 25. Once your estimated risk is determined, your provider can recommend a screening plan that will be best for you.

For women at an average risk, The American Cancer Society recommends starting yearly mammograms at age 40-45 with an option to extend to every other year at age 55. The National Comprehensive Cancer Network, American College of Radiology and Society of Breast Imaging, recommend starting mammograms at age 40 and continuing every year for as long as you are healthy.

Women who are considered high risk for breast cancer need to start mammograms earlier, commonly around age 30. In some cases, an annual breast MRI in addition to the mammogram may be recommended for additional detailed views of the breast tissue.

Maui Health offers state-of-the-art mammogram technology, including the GE Selenia Dimensions 2D/3D Digital Mammography System which provides some of the highest quality images available in Hawai’i. Staying up to date with screening mammograms saves lives. Call 808-243-3012 to schedule your screening mammogram today!

Q: What should I do if someone tells me they are having suicidal thoughts?

Dr. Benjamin Thompson, Psychiatrist, Pacific Permanente Group: When someone you know talks about hurting themselves or taking their own life, it can feel overwhelming, but there are steps you can take to help. Start by gently asking direct questions to understand their situation and state of mind. Ask how they’re managing and if they’re thinking about hurting themselves. If they say yes, ask if they have a plan. Having a plan can indicate immediate danger, and it’s essential to act quickly.

Doctor Benjamin Thompson (pictured) is a Psychiatrist at Pacific Permanente Group. Courtesy photo

Key warning signs that someone may be considering suicide include talking about suicide or expressing a desire to die. They might make specific plans, such as gathering pills or a weapon. Behavioral changes, such as mood swings, withdrawal from loved ones, or saying goodbye to people, are also red flags. They may start giving away personal belongings, preparing a will, or taking other steps to settle their affairs.

If you believe someone is at risk, it’s crucial to take action. Encourage them to reach out for help by calling or texting 988, the suicide crisis helpline, or by using the lifeline chat at 988lifeline.org. If you think they’re in immediate danger, take them to an emergency department or call 911.

It’s important to understand that asking about suicide won’t give someone the idea or push them toward it. In fact, talking openly about it can help them feel supported and guide them to seek the help they need. Let the person know you care about their safety, and don’t hesitate to bring up your concerns. Your conversation could be the first step toward getting them the help they need.

We understand that dealing with a mental health crisis can be frightening. Our skilled behavioral health experts are here to support both you and your loved one during difficult times. For more information, visit our website at mauihealth.org/behavioralhealth.

n Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.