Month: October 2015

When it comes to breast cancer, ask the right questions

About 1 in 8 women will develop invasive breast cancer. This year alone, an estimated 231,840 new cases of invasive breast cancer will be diagnosed in the U.S. October is Breast Cancer Awareness Month, and it’s a great time to review your risks, ensure you’re up to date on your screenings and learn about treatment options available.

Before you speak with your doctor about breast-cancer screening, it’s important to know your risk. Being female and getting older are your biggest risk factors. You are at higher risk if there’s a history of breast cancer in your family or have a known BRCA1 or BRCA2 genetic mutation. But approximately 85 percent of breast cancers occur in women who have no family history of breast cancer.

Additional health risks that may contribute to breast cancer include: starting periods at a young age, having your first baby after the age of 30 or never having children, being obese, and having dense breasts. Knowing your risks can determine whether you should get screened for breast cancer sooner than is generally recommended.

In 2009, the U.S. Preventive Services Task Force recommended some big changes in its screening guidelines — most notably bumping the age from 40 to 50 for average-risk women to begin routine breast-cancer screening.

Routine screening includes mammograms every two years until age 74. The guidelines also stated that breast self-exams have little value, based on findings from a 2014 paper published in the journal of Obstetrics & Gynecology.

However, the American Cancer Society continues to recommend a mammogram every year for women age 40 and older, continuing for as long as they are in good health. The society’s guidelines also recommend clinical breast exams every three years for women ages 20-39, and list breast self-exams as an option.

To patients, we stress that early detection is key and recommend screenings based on their risk level. For average risk, we recommend starting routine screenings at age 40 and continuing every year as long as you are healthy. A routine screening involves a mammogram and a clinical breast exam, which is an examination of your breast by your doctor. For those at high risk, we recommend having a conversation with your physician earlier. Certain women should start screenings as early as 30, which may be with mammography and breast MRI. Additionally, we tell patients that if there is any cause for concern, such as pain, a lump or discharge, don’t ignore it and make an appointment with your doctor as soon as possible.

We also discuss how patients can make positive lifestyle changes that can help lower their risk: maintaining a healthy weight, eating fresh fruits and vegetables, getting regular exercise, cutting out smoking, limiting alcohol intake and minimizing hormone therapy.

If you’re unsure of where to start or what risk level you are, here are some questions to ask your primary care provider at your next visit:

  • What testing should I get at my age?
  • What do I need to know about my family history that could put me at higher risk for breast cancer?
  • What can I do to prevent breast cancer or decrease my risk?

When it comes to screenings, patients commonly ask about the BRCA1 and BRCA2 genetic mutation. People are not tested for it routinely unless there is a family history strongly indicating multiple members of your family carry the genetic mutation. People who have mutations in BRCA1 and BRCA2 genes are at a much higher risk of developing breast cancer. Some choose preventive surgery known as prophylactic mastectomy, the removal of both breasts to prevent breast cancer. For women at high risk, studies suggest this lowers the risk by 90 percent.

If you are diagnosed with breast cancer, the earlier it is identified the better. Treatment options include surgery with or without radiation. Chemotherapy, hormone therapy and targeted drug therapy may be used as additional treatments. Breast cancer can be a scary topic, but reliable information is your best defense. We recommend consulting with your primary care provider to address any concerns about breast health.

Take Advantage of Autumn to Get Healthy

Fall is a time of shorter days, crisp air and leaves bursting with color. It can be melancholic, with winter approaching and summer over. But it also can be seen as an exciting time: the start of a new school year, a new sports season, a new television season and a countdown to the holidays!

Autumn is also time to focus on your health and visit your health provider for an annual checkup. Together, you’ll discuss overall health and preventive care and review your current symptoms. Your provider will update your family history and check on your cancer screenings and vaccinations. You’ll review your blood pressure, weight and heart rate and examine all the major body systems.

I liken these annual preventive exams to oil changes for your car: with regular preventive maintenance, we can spot trouble early and optimize longevity and quality of life.

Preventing illness

Flu season typically begins in the fall. The flu vaccine is the best way to prevent influenza, that malady of achiness, fever and a sore throat. Influenza and pneumonia combined are the eighth leading cause of death.

Those at high risk for complications or death from influenza are individuals with chronic diseases, the elderly, children, pregnant women and anyone with a compromised immune system.

The Centers for Disease Control and Prevention (CDC) recommends everyone age 6 months and older be vaccinated for the flu, but despite that, the overall U.S. vaccination rate hovers at around 50 percent.

As the weather chills and we head indoors, illnesses such as common cold viruses spread more readily. Being in close quarters increases the transmission of infectious organisms from person to person.

Good hand-washing is the key to preventing viruses and bacteria from spreading. It’s important to use soap and water and to scrub for at least 20 seconds before rinsing and drying your hands. You know you have scrubbed long enough if you can hum “Happy Birthday” while you wash your hands!

If you are on the go, alcohol-based hand sanitizers with at least 60-percent alcohol content are very effective but may not eliminate as many germs as soap and water.

Healthful foods

One of the most exciting things about autumn is the plethora of healthful foods that are in season. You might think of blueberries as a summer food, but many varieties remain available through the fall. Blueberries are chock full of antibiotics and vitamin C.

Apples are probably the most recognizable autumn fruit. Head to a local orchard and pick them yourself for best freshness and family fun! You get 4 grams of fiber per apple and 14 percent of your daily vitamin C. Apples are 85-percent water, so you also are hydrating yourself at the same time. And all of this for only 95 calories!

Brussels sprouts are ubiquitous in the fall. Just one-half cup provides more than your daily recommended intake of vitamin K. They’re enormously good sources of iron and folate — important for healthy blood cells.

Roasting Brussels sprouts with some olive oil and salt until they’re crisp on the outside but tender on the inside brings out great flavor and texture. Your kids will say they taste like French fries!

And how about all those autumn root vegetables and squash varieties? From sweet potatoes to parsnips, and pumpkins to butternut, the choices are endless. All of these contain high levels of vitamins A and C; phytonutrients, which have anti-cancer properties; and omega-3 fatty acids, which are heart-healthy.


The long, hot days of summer that inspired your exercise routines might be gone, but don’t skimp on physical activity just because the days are cooler and shorter! Without the sweltering heat of summer, fall can actually be more conducive for outdoor exercise.

For most adults, the CDC recommends moderate intensity aerobic exercise for 30 minutes a day, five days a week. Intensity refers to the percentage of your maximum heart rate achieved. A good rule of thumb for moderate intensity is that you can carry on a light conversation while performing the exercise. Raking leaves, that common autumn chore, burns 315 calories per hour.

Finally, let’s not forget that National Family History Day is observed on Thanksgiving Day. It’s more than turkey and stuffing you’re sharing; it’s behaviors, lifestyles and genetics, too! Getting to know your family medical history and sharing it with your doctor is important to ensuring you are being screened appropriately for inherited conditions. French philosopher Albert Camus said, “Autumn is a second spring when every leaf is a flower.” Here’s to the fall season! Let’s enjoy this special time and take advantage of the opportunities autumn presents for optimizing our health.