THIS PROGRAM IS MADE BY MPT TO ENRICH ALL OF OUR DIVERSE COMMUNITIES AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

CLOSED CAPTIONING HAS BEEN MADE POSSIBLE IN PART BY MARYLAND RELAY, EMPOWERING THOSE WHO ARE DEAF, HARD OF HEARING OR SPEECH DISABLED TO STAY CONNECTED BY PHONE.

LIVE FROM MARYLAND PUBLIC TELEVISION, THIS IS "DIRECT CONNECTION" WITH JEFF SALKIN.

♪♪] >> JEFF: GOOD EVENING AND WELCOME TO YOUR "DIRECT CONNECTION."

COMING UP TONIGHT BREAST CANCER AWARENESS MONTH WE'LL HAVE IMPORTANT REMINDSERS FROM A BROWNS SPECIALIST.

FIRST TONIGHTED OPEN EN ROMMENT PERIOD FOR MEDICARE IS HERE.

JOINING US TO ANSWER YOUR QUESTIONS IS AYSE TOKBAY OF THE STATE HEALTH INSURANCE ASSISTANCE PROGRAM.

THANK YOU FOR JOINING US AGAIN.

>> THANK YOU FOR HAVING ME AGAIN, JEFF.

>> Jeff: TELL US ABOUT THE SHIP PROGRAM.

PEOPLE ALL OVER THE STATE?

>> SHIP IS A NATIONWIDE PROGRAM.

THERE IS A SHIP WHICH IS WHAT WE CALL OUR PROGRAM FOR SHORT IN EVERY STATE.

IT MIGHT GO BY DIFFERENT NAMES IN OTHER STATES.

IN MARYLAND WE ARE SHIP IN FLORIDA THEY CALL IT SHINE.

HERE IT'S SHIP BUT THERE IS ONE IN EVERY COUNTY.

>> Jeff: IF WE SUCCEED IN CONFUSING ANYONE OR FAIL TO REMEDY ANYBODY'S CONFUSION ABOUT MEDICARE OPEN ENROLLMENT FIND YOUR LOCAL SHIP OFFICE EVERY COUNTY GOVERNMENT WILL KNOW WHERE YOU SHOULD TURN.

ENROLLMENT GOES THROUGH 7TH OF DECEMBER THAT NEVER CHANGES.

>> THIS YEAR EVERY YEAR.

>> Jeff: FOR MOST PEOPLE IT SOUNDS LIKE YOU HAVE TO DO SOMETHING BUT MOST PEOPLE DON'T HAVE TO DO ANYTHING IF YOU ARE HAPPY WITH YOUR ORIGINAL MEDICARE OR MEDICARE ADVANTAGE PLAN YOU'RE COOL.

>> I ALWAYS SAY AT MINIMUM MAKE SURE WHAT YOU ARE CURRENTLY IN WORKS FOR YOU NEXT YEAR.

THE LAST THING YOU WANTED IS FOR JANUARY TO ROLL AROUND, YOU GO TO A PHARMACY OR PROVIDER AND YOU ARE SURPRISED.

>> Jeff: HOW OFTEN DOES THAT HAPPEN?

>> IT HAPPENS QUIETED A BIT.

PEOPLE LOSE TRACK OF IT AND I GET IT I JOKE I DO IT FOR A LIVING AND I FORGET TO LOOK AT MY OWN.

IT IS DIFFERENT MEDICARE THAN EMPLOYER INSURANCE WHY IT'S IMPORTANT TO CHECK.

>> Jeff: MEDICARE IS KNOWN FOR BEING A BIT OVERCOMPLICATED.

WHERE DO PEOPLE TRIP UP HERE?

>> ONE OF THE THINGS PEOPLE ARE OVERWHELMED THEY LISTEN TO I COMBAT A LOT OF MY FRIEND TOLD ME, MY NEIGHBOR TOLD ME, MY FAMILY MEMBER TOLD ME.

WHAT PEOPLE DON'T UNDERSTAND IS THEIR SITUATION IS UNIQUE TO THEM AND THERE IS A LOT OF DIFFERENT MOVING PIECES TO MEDICARE.

A LOT OF DIFFERENT RULES AND EVERYBODY'S CIRCUMSTANCE IS DIFFERENT.

YOU COULD BE A FEDERAL RETIREE AND IT MEANS YOU DON'T NEED TO WORRY ABOUT A SUPPLEMENTAL POLICY OR GAP.

OR YOU COULD HAVE A RETIREE SPONSORED PLAN THROUGH OUR EMPLOYEE.

PEOPLE DO NOT UNDERSTAND THERE IS NUANCE THAT WE GET THAT THE LAY PERSON DOESN'T UNDERSTAND.

>> Jeff: DIFFERENCE BETWEEN A METHODDY GAP AND A MEDICARE ADVANTAGE.

>> A MEDI CAP, EASY QUESTION.

I'LL ANSWER THAT IN TWO SECONDS AND EVERYBODY WILL GET IT.

WE CALL IT ORIGINAL MEDICARE OR SUPPLEMENTAL POLICY.

THAT IS ANOTHER THING ABOUT THE MEDICARE WORLD THEY GIVE MULTIPLE NAMES TO THE SAME THING.

>> Jeff: A SUPPLEMENTAL POLICY IS A GAP.

>> YES.

AND PEOPLE GET CONFUSED AND THEY THINK THAT OPEN ENROLLMENT IS FOR SUPPLEMENTAL POLICIES BUT IT IS NOT.

THERE IS A SEPARATE WINDOW A LAW THAT PASSED A FEW YEARS AGO, THE MARYLAND BIRTHDAY RULE EVERY YEAR ON YOUR BIRTHDAY YOU GET A 30-DAY WINDOW TO SHOP WITHOUT MEDICAL UNDERWRITING THEY CANNOT ASK QUESTIONS ABOUT YOUR HEALTH THEY HAVE TO SELL YOU A POLICY THERE'S NUANCE TO IT.

BUT THAT IS THE WINDOW FOR THAT.

>> >> Jeff: FOR WHAT?

>> TO SHOP FOR A MEDI GAP TO GET THE BEST RATE.

YOU WILL BE SUBJECT TO UNDERWRITING.

THIS OPEN ENROLLMENT PERIOD IF YOU HAVE A MEDI GAP IS YOUR DRUG PLAN YOUR STAND ALONE DRUG PLAN.

YOU ARE SHOPPING FOR THAT.

IF YOU HAVE A MEDICARE ADVANTAGE PLAN THAT IS A DIFFERENT PATH IT IS A MANAGED PLAN.

SO FOR EXAMPLE, DIFFERENT CARRIERS WILL COME AND THEY WILL STAB ANY THUMB OF PLANS AND YOU WILL JOIN THEM AND PUT YOUR MEDICARE CARD AWAY.

YOU MAY HAVE TO WORRY OR CONSIDER A NETWORK, THEY HAVE BUILT IN DRUG PLANS YOU HAVE TO LOOK AT THAT.

THERE ARE MOVING PIECES BUT IT'S MANAGED BY THEM.

>> Jeff: IF YOU HAVE A QUESTION ABOUT THE MOVING PIECES OF MEDICARE, SEND US AN E-MAIL RIGHT NOW TO THE ADDRESS ON THE SCREEN.

SO MEDICARE PART A, PART B. MOST PEOPLE ARE FAMILIAR WITH THAT THEY ADDED A DRUG PLAN PART D. IF YOU SIGN UP FOR A MEDICARE ADVANTAGE THING, IT SORT OF IT'S LIKE AN OVERLAY FOR ALL OF THAT.

>> THEY ARE MANAGING IT, SO, YES.

IT IS A DIFFERENT PAYMENT STRUCTURE.

YOU ARE USUALLY LOOKING AT COPAYS AND COINSURANCE.

LIKE MAYBE YOU GO TO A PRIMARY CARE DOCTOR AND IT IS A $50 CO-APAY MAYBE AN OUTPATIENT PROCEDURE IT'S 450.

IT'S A FLAT COPAY VERSUS IN THE ORIGINAL MEDICARE WORLD ONCE YOU PAY YOUR PART B DEDUCTIBLE YOU ARE PAYING FROM 20-35% OF THE COST WITH NO OUT OF POCKET MAXIMUM WHICH IS WHY YOU NEED A SUPPLEMENTED.

>> Jeff: DID YOU TELL ME BEFORE THAT MARYLAND RESIDENTS SUBSCRIBE AT HIGHER RATES TO MEDICARE ADVANTAGE OR LOWER?

>> IT'S LOWER.

BECAUSE WE DO LIVE IN A DENSE FEDERAL EMPLOYEE AREA, FEDERAL RETIREES DON'T HAVE TO IT WOULD BE EXCESSIVE A THIRD INSURANCE THAT THEY DON'T NEED TO SIGN UP FOR AN ADVANTAGE PLAN OR IF THEY DO IT'S NICHE CIRCUMSTANCE WHERE YOU HAVE MOVING PIECES.

FOR THAT REASON, NATIONALLY WHEN YOU LOOK AT IT, ABOUT OVER 50% OF THE COUNTRY IS IN AADVANTAGE PLANS WHILE IT'S GROWN IN POPULARITY IN OUR AREA, TOO THE LAST TIME I CHECKED WHICH I HAVE NOT SEEN THE NUMBERS FOR THIS YEAR BUT IT WAS 19%.

WELL BELOW THE NATIONAL AVERAGE NOT AS COMPETITIVE AS OTHER MARKETS.

>> Jeff: AND IT'S POPULAR BECAUSE?

YOU GET SOME PERKS, YOU GET BENEFITS AND MAYBE A DIFFERENT DRUG FORMULARY BUT PART OF THE TRADE OFF I DON'T KNOW IF YOU ARE PAYING OUT OF POCKET FOR THIS BUT YOU WILL HAVE A LIMITED POOL OF PROVIDERS YOU ARE IN SOMEBODY'S NETWORK.

>> DEPENDS ON THE PLAN.

SOME WILL LET YOU GO OUT-OF-NETWORK AND PAY MORE BECAUSE THEY WANT TO ENCOURAGE YOU TO STAY IN THE NETWORK.

BUT FOR THE MOST PART I THINK A LOT OF TIMES IT'S THE SUPPLEMENTAL BENEFITS YOU CAN HEARING, VISION AND DENTAL AS WE AGE MY EYESIGHT HAS NOT IMPROVED.

SO IT'S KIND OF A THING THAT PEOPLE LOOK FOR A LOT.

>> Jeff: AND TRADITIONAL MEDICARE DOES NOT HAVE THAT?

>> NO, IT DOES NOT.

IF YOU HAVE AN EYE INJURY OR A SURGERY BUT STRAIGHT VISION CARE THAT IS NOT SOMETHING COVERED BY MEDICARE.

>> Jeff: VIEWER QUESTIONS.

NICK, I SWITCHED TO A ADVANTAGE PLAN FOR ONE YEAR CAN I SWITCHBACK TO TRADITIONAL MEDICARE?

>> WITHOUT HAVING THE BOOKLET BECAUSE THERE'S LANGUAGE ABOUT THIS, BUT WHEN YOU FIRST STARTED MEDICARE, THERE IS A RULE CALLED A TRIAL RIGHT.

WHERE IF YOU ALWAYS HAD ORIGINAL MEDICARE YOU GET A 12-MONTH WINDOW TO TRY THAT.

DO NOT QUOTE ME JUST RUNNING OFF MY HEAD BUT THERE IS SOMETHING CALLED A TRIAL RIDE IF YOU CALL YOUR LOCAL SHIP WE WILL PINPOINT THE RULE AND DOUBLE-CHECK WHAT YOU HAVE TO HEADACHE SURE IT APPLIES TO YOU AS WELL.

>> Jeff: THERE'S SO MUCH FEDERAL MONEY FLYING AROUND, VERY EXPENSIVE PROGRAM ALL THE INSURANCE ACCIDENTS COMPETING FOR IT ARE THERE SCAMMERS OUT THERE?

IT FEELS LIKE ESPECIALLY IN THE A.I.

WORLD WHERE YOU CAN IMPERSONATE ANYBODY, WHAT DO PEOPLE WATCH OUT FOR?

>> THERE'S LOTS OF RED FLAGS TO LOOK OUT FOR.

CMS OR MEDICARE IS NEVER GOING TO CALL YOU OR SHOW UP AT YOUR DOOR.

WE GOT A CALL JUST FROM OVER THE WEEKEND WHERE SOMEBODY CALLED FOR THEIR MOTHER SAYING SOMEONE SHOWED UP AT THEIR DOOR SAYING THEY WERE FROM CMS THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.

>> Jeff: WHICH IS HERE.

>> IN OUR BACKYARD THAT WOULD NEVER HAPPEN.

THE ONLY TIME THAT MY EXPERIENCE AND I'M NOT SAYING ANYTHING COULD NOT HAPPEN OUTSIDE OF THIS AND THEN YOU WILL KNOW MEDICARE NUMBERS GOT COMPROMISED AND THEY SEND OUT NEW HEAD CARE CARDS.

ANYBODY SAYING THEY ARE FROM MEDICARE AND ASKING YOU FOR THE MEDICARE NUMBER THAT IS A RED FLAG.

AS YOU SAID AT A.I.

WORLD I WOULD BE SUSPICIOUS OF ANYTHING THAT I DID NOT INITIATE MYSELF.

>> Jeff: QUESTION FROM DEWHO WANTS TO KNOW DON'T MEDICARE ADVANTAGE PLANS MAKE MONEY BY DENYING CARE IN CONTRAST MEDICARE IS A NONPROFIT WITH NO EXECUTIVE PAY.

TAKE A CRACK AT THAT.

>> GOOD QUESTION.

>> MEDICARE ADVANTAGE IS IN THE COMMERCIAL INSURANCE WORLD.

RIGHT?

SO THERE IS A PROFIT INCENTIVE TO NOT SPEND MONEY ON EXPENSE SICH PROCEDURES AND DRUGS.

IF YOU ARE NOT IN ONE OF THOSE THE FEDS ARE PAYING DIRECTLY?

>> ADVANTAGE PLANS ARE PAID A FLAT-RATE AMOUNT PER BENEFICIARY WHO JOINS.

I WILL MAKEUP A NUMBER IN THE BALL PARK OF LIKE $3,000.

THAT IS THE BUDGET WITH WHICH THEY HAVE TO MANAGE THE CARE.

NOW, THERE ARE SOME SITUATIONS WHERE THEY CAN REPORT UP THIS PERSON HAS A CHRONIC CONDITION AND GET MORE MONEY THROWN IN THEIR DIRECTION.

BUT THAT IS THE BUDGET.

WHICH IS WHY SOME YOU WILL SEE HMO'S RESTRICTIVE IN BUDGET ARE CHEAPER BECAUSE YOU ARE HELPING THEM MANAGE COSTS.

AND BIGGER PPO'S LET YOU GO OUT-OF-NETWORK AND THEY ARE HIGHER BECAUSE YOU CAN GO OUT-OF-NETWORK.

BUT THERE WAS A REPORT PUT OUT SOME YEARS AGO FROM THE OFFICE OF THE INSPECTOR GENERAL THAT LOOKED AT DENIALS.

BUT THERE IS A PROCESS FOR ALL OF THIS.

BUT IT'S NOT JUST ADVANTAGE PLANS.

I WAS JUST READING THE OTHER DAY THERE IS A TERM FOR IT IF YOU TRY BIG CORPORATIONS TRY TO OVERWHELM PEOPLE WITH THE PROCESSES TO GET THROUGH.

I THINK IT'S JUST PART OF BIG BUSINESS IN OUR WORLD.

IT'S HARD DEALING WITH PEOPLE AND YOU TRYING TO GET YOUR NEEDS MET.

>> Jeff: WHEN YOU ARE HANGING AROUND THE NICE DLUM YEAH SENIOR CENTER, COLUMBIA SENIOR CENTER AND TALKING TO PEOPLE IS THERE ANY DECISION PEOPLE MAKE IN THIS FIELD THAT THEY LOVE?

IS THERE ANYBODY IN LOVE WITH EITHER REGULAR MEDICARE OR PARTICULAR MEDICARE ADVANTAGE?

YOU CAN'T ENDORSE IT I KNOW.

ARE THERE HAPPY PEOPLE OUT THERE ON MEDICARE?

>> IT'S ONE OF MY GO TO LINES I FEEL LIKE I'M THE BEARER OF BAD NEWS BUT WHAT I'M DOING IS THIS IS IT JEFF, NOBODY CALLS ME TO SAY I LOVE MEDICARE.

I'M THE COMPLAINT DEPARTMENT.

>> Jeff: ONE MORE QUESTION I'M NOT SURE.

A VIEWER WHY NOT USE AN UNDERWRITER?

DOES THE COST TO THE SUBSCRIBER CHANGE?

A BROKER, MAYBE?

>> MEANS A BROKER.

I DON'T DISCOURAGE OR ENCOURAGE THERE ARE CERTAIN SITUATIONS WHERE A BROKER IS TOTALLY APPROPRIATE.

LIKE IF I'M SHOPPING FOR A MEDI GAP AND I DON'T HAVE PROTECTION FOR IT.

HONESTLY, MY PHILOSOPHY I'M NOT HERE TO JUDGE YOU.

WHATEVER WORKS FOR YOU IT'S NONE OF MY BUSINESS.

SO IF YOU FIND A BROKER THAT YOU TRUST AND GIVES YOU PEACE OF MINDS AND MAKES IT EASIER FOR YOU, BY ALL MEANS.

JUST KNOW THEY ARE WORKING FOR A PROFIT THEY MAY NOT SHARE ALL THE OPTIONS BUT IT'S YOUR MONEY.

>> Jeff: AYSE TOKBAY WITH THE HOWARD COUNTY STATE HEALTH INSURANCE ASSISTANCE PROGRAM CALL ANY COUNTY OFFICE BUILDING AND ASK FOR THE SHIP PROGRAM AND YOU CAN GET HELP.

WE APPRECIATE YOUR TIME.

>> THANK YOU.

>> THANK YOU SO MUCH.

WE WILL BE RIGHT BACK.

>> Jeff: JOINING US TO TALK ABOUT YOUR HEALTH IS KAI ANDREWS A BOARD CERTIFIED BREAST CARE NURSE AT THE BREAST CENTER AT THE UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER.

THANK YOU FOR JOINING US.

>> THANKS FOR HAVING ME.

>> Jeff: BREAST CANCER AWARENESS MONTH, FAMILY AND FRIENDS THIS IS ONE OF THE MOST COMMON CANCERS.

>> YES, IT IS.

ONE IN EIGHT WOMEN WILL DEVELOP BREAST CANCER CHANCES ARE EVERYONE KNOWS SOMEONE WHO HAS BEEN IMPACTED BY IT.

>> Jeff: WE'RE READING A LOT AND WE HAVE BULLET POINTS THAT YOU THINK OF IT AS A CANCER THAT OCCURS LARGELITH OLDER PEOPLE, BUT INCREASINGLY WE'RE HEARING ABOUT IT IN YOUNGER PEOPLE.

DO YOU SEE THAT IN YOUR PRACTICE?

>> UNFORTUNATELY THIS MONTH WE HAVE HAD A LARGE NUMBER OF PEOPLE UNDER THE AGE OF 40 BEING DIAGNOSED.

I WOULD SAY IN THE PAST TWO WEEKS WE'VE HAD ABOUT FIVE PLUS PATIENTS UNDER THE AGE OF 40.

INCLUDING ONE DIAGNOSED WHO JUST HAD A BABY.

DEFINITELY BECOMING WAY MORE COMMON IN PATIENTS WHO ARE YOUNGER.

>> Jeff: AND THE NUMBER OF BREAST CANCER SURVIVORS ESTIMATED 18 MILLION.

AND THOSE ARE THE PEOPLE YOU REALLY CARE FOR AS A SURVIVORSHIP NURSE PRACTITIONER.

TELL BUS THAT ROLE?

>> I AM FORTUNATE TO BE THE SURVIVORSHIP NURSE PRACTITIONER AT THE UNIVERSITY MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER AND MY JOB IS TO DEDICATE MY TIME TO WORKING WITH PATIENTS WHO HAVE HAD A DIAGNOSIS OF BREAST CANCER.

I SEE PATIENTS AFTER THEY'VE HAD TREATMENT WHETHER THAT IS RADIATION THERAPY, CHEMOTHERAPY OR SURGERY, AND MY GOAL IS TO DO ROUTINE BREAST EXAMS AND MAKE SURE THERE IS NO SIGN THAT THE CANCER IS COMING BACK.

I ORDER ROUTINE IMAGING AND MAKE PATIENTS KNOW WHAT THEIR FOLLOW-UP PLANS AND WAYS THEY CAN KEEP THEMSELVES HEALTHY.

>> Jeff: WHAT ARE THE BIG MILESTONES OR EVENTS IN THAT SURVIVORSHIP JOURNEY?

SO MUCH IS GIVEN IN THE FIVE-YEAR INCREMENT.

BUT A LOT HAPPENS BEFORE YOU GET TO FIVE YEARS.

>> YES, IT'S INTERESTING.

THE TERM SURVIVOR IS SHIFTED.

WE CONSIDER SOMEONE A SURVIVOR FROM DAY ONE OF DIAGNOSIS.

EVERYONE HAS DIFFERENT MARKERS FOR WHAT THEY CONSIDER THEY ARE REALLY A SURVIVOR BUT IT'S FROM DAY ONE.

A LOT OF PATIENTS LOOK AT IT WHEN THEY FINISH THEIR CHEMOTHERAPY TO RADIATION THERAPY WE LIKE THE FIVE YEAR MARK IT MEANS AFTER FIVE YEARS THE CHANCE OF THE CANCER COMING BACK IS LOWER.

AT THE BREAST CENTER WE HAVE A CEREMONY WHERE PATIENTS SIGN OUR CANVAS AND RING THE BELL AND IT IS A NICE WAY TO MEMORIALIZE THEIR NAME AND WRITE A MESSAGE.

>> Jeff: AND INTERESTINGLY, PEOPLE WHO ARE NOT YET IN THAT WORLD, DO NOT WANT TO BE IN THAT WORLD, RIGHT?

NOBODY WANTS TO MAYBE THERE'S A HESITATION TO GET A MAMMOGRAM OR DO OTHER TESTING BECAUSE I'VE SEEN SO MANY PEOPLE HAVE SUCH A TOUGH TIME ON THE FAR SIDE OF THE JOURNEY BUT THAT MAYBE CHANGING?

>> ABSOLUTELY.

WE DO HAVE PATIENTS WHO ARE IN THEIR 60s AND THEY HAD THEIR FIRST MAMMOGRAM.

A LOT OF PEOPLE ARE AFRAID POSSIBLY OF FINDING OUT SOMETHING BAD.

I WILL SAY THE EARLIER WE DO FIND OUT THERE IS A PROBLEM THE MORE LIKELY WE ARE TO TREAT IT.

BUT I FEEL LIKE WITH TECHNOLOGY AND SOCIAL MEDIA A LOT MORE PEOPLE ARE TALKING ABOUT GETTING SCREENED SO WE HAVE A LOT OF PATIENTS ASKING WHEN THEY CAN GET SCREENING HOW THEY CAN GO ABOUT IT.

>> Jeff: WE FOUND AN UPSIDE TO SOCIAL MEDIA FINALLY.

>> YES,.

>> Jeff: AND THAT TRUE OF PEOPLE PASSING ALONG STORIES OF SOMEBODY WHO CAUGHT IT EARLY.

AND THAT SEEMS TO BE THE MAIN THING.

>> ABSOLUTELY.

THEY ALWAYS SAY EARLY DETECTION IS THE BEST DETECTION.

I WOULD RATHER SOMEONE COME TO ME AND ARE CONCERNED AND IT IS BENIGN AS OPPOSED TO THEY IGNORED IT AND WE ARE LOOKING AT A SEVERE CANCER DIAGNOSIS DOWN THE ROAD.

>> Jeff: DO YOU NOT IGNORE SOMETHING.

>> YOU CAN START WITH YOUR PRIMARY CARE.

YOU CAN START WITH YOUR OBGYN.

OBVIOUSLY SOME PATIENTS MAY NOT BE GOING ROUTINELY BUT WE AT THE BREAST CENTER IN ADDITION TO SEEING PATIENTS WHO HAVE A CANCER DIAGNOSIS WE ALSO HAVE A HIGH-RISK AND BENIGN BREAST DISEASE PROGRAM.

WE ALSO TAKE CARE OF PATIENTS WHO DO NOT HAVE A CANCER DIAGNOSIS.

IF YOU HAVE BREAST CHANGES, EVER UNSURE WHAT IS GOING ON YOU CAN COME TO US AND WE WILL BE HAPPY TO EVALUATE YOU AND SEE IF ANYTHING REQUIRES MORE WORK.

>> Jeff: YOU HEAR THE TERM DENSE BREAST TISSUE AND THAT IS A PROGRAM WITH MAMMOGRAMS?

>> BREAST DENSITY WHEN YOU GET A MAMMOGRAM YOU WILL GET A REPORT THAT WILL TELL YOU WHAT YOUR BREASTS ARE LIKE.

YOU HAVE FATTY BREASTS AND IT MAKES IT EASY TO SEE IF THERE IS A MASS OR ANYTHING CONCERNING.

THE DENSER YOUR BREASTS GET IT MAKES IT CLOUDY AND HARD TO TELL WHAT IS GOING ON.

HAVING DENSE BREAST TISSUE CAN MAKE IT TRICKIER TO DETECT A BREAST CANCER.

>> Jeff: THE OTHER FEAR OF ANYONE GETTING A MAMMOGRAM IS FALSE POSITIVES.

>> ABSOLUTELY.

I UNDERSTAND THAT UNFORTUNATELY HAVING A FALSE POSITIVE IS SCARY AND IT WILL REQUIRE YOU TO HAVE A BIOPSY.

IT IS A FEAR THAT I UNDERSTAND BUT WE PREFER PEOPLE TO GET THEIR ROUTINE SCREENINGS AS OPPOSED TO IGNORING IT.

>> Jeff: AT AN AGE WHERE WE'RE SEEING YOUNGER WOMEN IN YOUR PRACTICE HAVE THE SCREENING RECOMMENDATIONS CHANGED?

>> WE DO RECOMMEND THAT PATIENTS START AT AGE 40.

HOWEVER, THERE IS A CAVEAT THERE ARE PATIENTS WHO ARE AT AN INCREASED RISK FOR DEVELOPING BRAUNSZ THAT MIGHT BE IF YOU HAVE A FAMILY HISTORY MAYBE A GENETIC MUTATION, OR MAYBE YOU'VE HAD BENIGN PATHOLOGY LIKE THAT PUTS YOU AT HIGH-RISK THESE ARE THINGS THAT MIGHT INCREASE YOUR CHANCE OF DEVELOPING CANCER.

YOU MIGHT BE ELIGIBLE TO START MAMMOGRAMS SOONER OR ELIGIBLE TO DO AN MRI ANOTHER TEST THAT CAN BE USED IN ADDITION TO THE MAMMOGRAM TO DETECT CHANGES SOONER.

>> Jeff: AS PART OF THEIR SURVIVORSHIP CARE THAT YOU PROVIDE, DO MOST PEOPLE REQUEST THE GENETIC TESTING, ESPECIALLY IF YOU HAVE FEMALE RELATIVES, I GUESS?

>> WHEN PATIENTS MEET WITH OUR BREAST SURGEONS WE DO SCREEN THEM IF THEY MEET ELIGIBILITY FOR GENETIC TESTING WE REFER THEM OUT.

A LOT OF PATIENTS ASK WHAT THEIR FAMILY MEMBERS CAN DO.

WE'LL SAY IF YOU HAVE A SISTER WE CAN BRING YOU TO THE HIGH-RISK PROGRAM AND DO A CANCER RISK ASSESSMENT TO SEE IF YOU ARE ELIGIBLE FOR THE EARLIER SCREENING.

>> Jeff: YOU ARE A YOUNG PROVIDER.

I'MET GUESSING YOU HAVE SEEN A LOT OF CHANGE ALREADY IN YOUR TIME IN THIS FIELD.

>> I HAVE.

THE BIG THING IS A.I.

THE QUESTION I GET ASKED THE MOST.

A LOT OF TIMES WITH MAMMOGRAMS THERE IS AN OPTION TO PAY 30-40 TO HAVE A.I.

TAKE A SECOND LOOK A LOT OF PATIENTS ARE ASKING IS A.I.

HELPFUL?

AT OUR BREAST CENTER WE ARE IMPRESSED HOW GOOD THE A.I.

HAS GOTTEN IT IS NOT GOING TO REPLACE YOUR RADIOLOGISTS BUT IT IS A SECOND CHECK TO MAKE SURE THERE'S NOTHING WRONG.

>> Jeff: SHOULDN'T BELONG UNTIL THAT IS COVERED AND DOESN'T COST THE EXTRA 30 OR $40 AND FOR THE RADIOLOGIST IT IS A BACKSTOP.

>> YEAH.

I TELL PATIENTS LIKE OBVIOUSLY IF YOU ARE HAVING FINANCIAL STRUGGLES I DON'T WANT YOU BREAKING THE BANK BUT I THINK IN FIVE TO 10 YEARS IT WILL BE ROUTINE THEY WANT MORE DATA ON THAT.

>> Jeff: PREVENTION A LITTLE BIT.

I'VE SEEN ARTICLES INDICATING THAT PHYSICAL MOVEMENT BEING PHYSICALLY ACTIVE CAN MAKE A DIFFERENCE.

DO YOU BELIEVE THAT?

>> I DEFINITELY DO.

I KNOW A LOT OF PEOPLE DON'T WANT TO HEAR THAT.

BUT IT'S EASIER SAID THAN DONE AND I UNDERSTAND.

THE AMERICAN CANCER SOCIETY, THEY RECOMMEND THAT CANCER PATIENTS TRY TO DO AT LEAST 150 MINUTES OF MODERATE ACTIVITY PER WEEK.

AND MODERATE ACTIVITY CAN BE THINGS LIKE SWIMMING, CYCLING, DOING A BRISK WALK BUT DOING THOSE THINGS CAN HELP TO DECREASE THE CHANCE OF THE CANCER COMING BACK AND IF YOU DON'T HAVE CANCER KEEP YOU AT A HEALTHY WEIGHT TO PREVENTS YOU FROM DEVELOPING CANCER.

>> Jeff: OTHER LIFESTYLE CHANGES?

>> SMOKING COMES TO MIND IF YOU ARE A SMOKER, DEFINITELY CONSIDER QUITTING.

THEY DO RECOMMEND LIMITING ALCOHOL OR ABSTAINING FROM ALCOHOL IF YOU CAN.

AND ALSO TRYING TO EAT A HEALTHY DIET LIMITING THE FUN STUFF MCDONALD'S AND THE CHICK-FIL-A AND EAT MORE FRESH FRUITS AND VEGETABLES AND INCORPORATE MORE WHOLE GRAINS LESS RED MEAT.

>> Jeff: ARE ALL CONTRACEPTIVES STILL THOUGHT TO BE A FACTOR?

>> IT CAN PLAY A ROLE IN YOUR RISK FOR DEVELOPING BREAST CANCER.

YOU KNOW A LOT OF THINGS HAVING CHILDREN AT A LATER AGE THERE ARE OTHER FACTORS THAT CAN PLAY A ROLE WHY WE DO RECOMMEND ONCE YOU ARE AT THE AGE OF 40, TO MAKE SURE THAT YOU'RE ESTABLISHED WITH OBGYN, PRIMARY CARE SOMEONE WHO CAN MAKE SURE YOU ARE GETTING THE RIGHT SCREENING.

>> Jeff: FOR ANYBODY WATCHING WHO MIGHT BENEFIT FROM YOUR SERVICES, WHAT IS THE BEST WAY TO REACH OUT TO THE CENTER?

>> THEY CAN GOOGLE US AT THE UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER AND WE ARE OF THE BREAST CENTER AND HAPPY TO HELP WHETHER YOU HAVE CANCER OR AT HIGH-RISK WE ARE ABLE TO DO IT ALL.

>> Jeff: VERY GOOD.

KAI ANDREWS IS A BOARD CERTIFIED BREAST CARE NURSE AT THE BREAST CENTER AT THE UNIVERSITY OF MARYLAND BALTIMORE WASHINGTON MEDICAL CENTER.

THANK YOU FOR JOINING US.

I APPRECIATE YOUR TIME.

>> THANK YOU.

>> THAT IS SCHOOL DISTRICT DIRECT WE'RE BACK FRIDAY WITH "STATE CIRCLE" THE LATEST ON MARYLAND POLITICS.

WHICH INCLUDES AN ELECTION JOIN US FRIDAY EVENING AT 7:00 P.M.

FOR ALL OF US AT MPT THANK YOU FOR WATCHING "DIRECT CONNECTION".

AND HAVE A GOOD NIGHT.

CLOSED CAPTIONING HAS BEEN MADE POSSIBLE IN PART BY MARYLAND RELAY, EMPOWERING THOSE WHO ARE DEAF, HARD OF HEARING OR SPEECH DISABLED TO STAY CONNECTED BY PHONE.

[♪♪]