Reducing Risk Factors for Breast Cancer

Last week, we received an email from a reader asking if we could post some preventive measures against breast cancer. We appreciate your input and are happy to provide you with information. This week, we will be addressing this suggestion from our reader. If you'd like to suggest a topic or ask a question to be answered in an upcoming blog, please email us at ZwangerPesiri1@gmail.com or post a comment in the comments section of this blog.

While certain risk factors for breast cancer cannot be controlled, such as family history, there are some ways that you can lower your risks. Below are six risk factors that you can control:

1. Reduce your alcohol consumption. Higher alcohol consumption in women has been associated with an increased risk of breast cancer. If you must drink, have no more than one drink per day. (One drink equals a 12-oz bottle of beer, 5-oz glass of wine, or 1.5-oz (one shot) of hard liquor. If you have a typical mixed drink, such as a Cosmo, you are likely having at least 2 shots, or the equivalent of 2 drinks). Click here to listen to an audio tip from the U.S. Department of Health and Human Services.
2. Maintain a healthy weight. Being overweight or obese is associated with a higher risk of breast cancer, particularly after menopause. Being overweight can also increase the risk of recurrence in women who have already had breast cancer. Click here for information about obesity and triple-negative breast cancer.
3. Exercise. Exercising four or more hours per week may decrease hormone levels and help lower breast cancer risk. Sound like a lot of exercise? It's not.  Four hours a week works out to only a little over a half hour per day. If you've never exercised before, start slowly, and check with your physician first. Remember that things like gardening, dancing, walking and playing tennis are all forms of exercise.
4. Avoid hormone replacement therapy (HRT). Hormone replacement therapy, in the form of estrogen, progesterone, or both, is sometimes given to postmenopausal women or women who have had their ovaries removed in order to replace the estrogen no longer produced by the ovaries. Combination HRT (combined estrogen and progesterone) increases the risk of breast cancer, and the longer the HRT is continued, the greater the risk. It is still unclear whether estrogen alone increases risk; however, some scientists believe that long-term estrogen use (10 years or more) may also increase breast cancer risk.
5. Don't smoke.  Aside from raising the risk of lung, throat and mouth cancers, smoking has also been linked with a higher risk of breast cancer in younger, premenopausal women. In addition, smoking can increase complications from breast cancer treatments.
6. Make sure to go for your yearly digital mammogram or 3D mammogram. Early detection is key to improving your odds for defeating breast cancer. A breast sonogram may also be appropriate for women with dense breast tissue.

Other factors, including exposure to chemicals, certain plastics, low Vitamin D levels, and diet are suspected to be contributing factors to breast cancer; however, not enough studies have been done at this point to be conclusive.

Wondering what your risk is? The National Cancer Institute has an online Breast Cancer Risk Assessment Tool that can help you better understand your risk.

For more information on breast cancer risks and causes, visit:
Breast Cancer: Prevention, Genetics, Causes
Breastcancer.org

How much can a woman lower her breast cancer risk? Click here for an article on the topic.

10 Things You Should Know About Mammography

October is Breast Cancer Awareness Month -- a month when women typically think about mammograms. In recognition of this, we've decided to talk about mammography in this week's blog post. Specifically, there are ten things you should know about mammography:

1. A mammogram is essentially a low-dose X-ray of the breasts used to screen for breast problems such as lumps, and to distinguish between fluid-filled lumps (cysts) and solid masses.
   
2. Mammograms are able to detect cancer before you or a physician may notice anything wrong. Early detection is key in the treatment of breast cancer and significantly improves outcomes. Mammograms are currently the most effective screening method to detect early breast cancer.
   
3. The American Congress of Obstetricians and Gynecologists (ACOG) recommends that women 40 and over have yearly mammograms. Women with a family history of breast cancer or other risk factors may be advised to start having mammograms earlier.
   
4. Equipment matters! Digital mammography is slowly replacing traditional film-based mammography, which was limited in its ability to detect some cancers, especially those in women with dense breasts. Digital mammography has greatly improved the early detection of cancer. At Zwanger-Pesiri, we use only digital mammography, as well as Computer-Aided Detection (CAD) to help identify and locate masses. Why does this matter? According to the FDA, CAD could increase early breast cancer detection rates by as much as 23.4%.
   
5. 3D mammography (also known as 3D breast tomosynthesis) is the newest form of mammography and is offered at eight of our facilities. This groundbreaking technology creates 3D images which helps detect and diagnose small tumors that may be hidden on a regular 2D mammogram. Experts believe that 3D mammography will replace regular mammography as the standard of care. Newsday and CBS News recently covered this topic.
   
6. 3D mammography also reduces false findings (both positive and negative) because the 3D images are clearer and sharper than 2D images. This process creates millimeter-thin slices of the breast that allows the radiologist to see through the overlapping tissue. Because of this, fewer women are called back for additional imaging or biopsies.
   
7. Ever wonder why antiperspirants, deodorants and powders should not be used when having a mammogram? The reason is that these substances may make it more difficult to interpret results. Powders can sometimes look like microcalcifications, and antiperspirants can sometimes cause images to appear foggy.
   
8. Who performs the actual mammogram? At Zwanger-Pesiri, a specially trained radiologic technologist performs the mammogram, and then a radiologist, who has been subspecialty trained in women's imaging interprets the images.
   
9. What if a mammogram comes back abnormal? Don't panic. An abnormal mammogram does not mean that you have cancer. The majority of abnormalities are benign -- such as cysts, harmless lumps or areas of more dense breast tissue. However, in order to determine the cause of the abnormality, your physician may order additional tests such as an ultrasound, a breast MRI or a biopsy.
   
10. Why is compression necessary during a mammogram? Compression (or the squeezing of the breast between two plates) is the slightly uncomfortable part of the mammogram that many women dread. Compression, however, is necessary in order to obtain quality images. Compression spreads the breast tissue out more uniformly to help capture the clearest images. The good news is that the compression of the breast is very brief.

Now that you know more about mammograms, take this opportunity to schedule yours today.  If you have any questions about mammograms, feel free to email us. 

Resources for Women's Health

October is Breast Cancer Awareness Month, which is a reminder not just to take care of breast health, but to take care of health in general. Studies have shown that women are more proactive about their health than men. In fact, a recent study from the Centers of Disease Control and Prevention found that women were 100% more likely to seek preventive care (regular check-ups and health screenings) than men. Women are also far more likely to look for health information on the Internet.

The Internet is actually a wonderful resource for health information and guidelines, but sometimes it can be a little hard to know where to start. To help you, we've compiled a list of Women's Health resources on the Internet to use as your starting point. The more you know, the healthier you can be.

Women's Health Resources on the Internet

• The Office on Women's Health- http://www.womenshealth.gov/ - This government site, part of the U.S. Department of Health and Human Services, provides information on health topics involving women, news stories, reports, studies, and a monthly "Healthy Women Today" newsletter.
• The Women's Health Center of WebMD - http://www.women.webmd.com/ - provides health information in a variety of formats including videos, slideshows, articles, and interactive discussions.
• Healthy Women - http://www.healthywomen.org/ - is an independent, nonprofit, health information resource for women. This site includes news, an "ask the expert" section, recipes and healthy eating tips, as well as in-depth information on health conditions affecting women.
• Women's Health: MedlinePlus - http://www.nlm.nih.gov/medlineplus/womenshealth.html - is a government site providing very detailed information, including research, clinical trials, and journal articles.
• CDC Women's Health - http://www.cdc.gov/women/ - is a bit more scientific than some of the other sites, but provides healthy living tips, scientific research, and information on a variety of health topics affecting women.
• Women's Health, Mayo Clinic - http://www.mayoclinic.com/health/womens-health/ - This site allows users to look up diseases by name or search symptoms. It also provides information on medicines, diagnostic tests, and healthy living for women.

Zwanger-Pesiri Radiology is also a great source of health information for women. Through this blog, Facebook, Twitter, and our website, we provide information on women's health issues including: 3D Mammography, BRCA Genetic Testing, Breast Specific Gamma Imaging, Positron Emission Mammography, Breast MRI, Breast Biopsy and the know error system.

While the Internet is a great resource for information, nothing takes the place of a face-to-face discussion with your physician. Do the research and come prepared with questions to your next doctor's appointment. The old adage "knowledge is power" is especially true when it comes to health.

Liked this info? Our October email newsletter covers more women's health issues. If you'd like to sign up for our monthly email newsletter, please click here.

In the News - Sports Injuries

It's that time of the year again. Football has started up, baseball is winding down, and stories about professional sports injuries are appearing in the news.

Two recent sports injuries grabbed our attention because each called for the player to undergo a CT scan. The first involved Baltimore Orioles' second baseman, Robert Andino. During the ninth inning of a recent game, Andino was hit in the back of his helmet by a 94-MPH fastball. The player was rushed to a local hospital for a CT scan, which was negative. However, Andino had to have a concussion test before being cleared to play again.

The second injury involved Dallas Cowboys' player, Jason Witten, who was hit hard in the side during a preseason opener resulting in a lacerated spleen. Before Witten was allowed to play in another game, he was scheduled to have a CT scan.

We asked ZPR's Chief Medical Officer, Dr. Elizabeth Maltin, why the scans were ordered and what they were looking for.

Regarding the Orioles' Andino, "The CT scan of the head was ordered to see whether there was any bleeding around or within the brain," said Maltin. "Even though the results were negative, the player may still suffer a concussion, which is a clinical rather than an imaging diagnosis," she continued. "That's why he was scheduled for a 'concussion test,' which is a clinical neurologic and cognitive exam that is based on the patient's symptoms, the physician's observations and the mental functioning of the patient. There is a phenomenon known as 'second impact syndrome' which refers to increased risk of traumatic brain injury (TBI) after a concussion. Players sent back to play before fully recovering from the original injury are at a greatly increased risk of TBI if they sustain a second hit to the head. This can potentially be fatal."

Maltin pointed out that the American Academy of Neurology (AAN) has adopted recommendations for "The Management of Concussion in Sports" that are designed to prevent second impact syndrome and reduce the frequency of other cumulative brain injuries related to sports.

And what about Dallas Cowboys' tight end, Jason Witten, and his lacerated spleen? "Again, they are looking for bleeding," said Maltin. "The spleen is a highly vascular organ and lacerations can improve or get worse. Most isolated splenic injuries can be managed conservatively (non-surgically), which means watch and wait. The patient is observed for any sign of internal bleeding which would indicate a worsening of the splenic injury. Repeat CT scans are important in evaluating the athlete prior to returning to contact sports. An injured spleen requires five weeks of healing to be as strong as an uninjured spleen. The surgical literature supports repeat CT scanning at eight weeks post injury to ensure complete resolution of the injury."

ZPR is pleased to report that both players were cleared for play and are back in the game. In the future, we'll be looking at other sports injuries in the news and helping to explain them. If you have any questions, we'd be happy to answer them. Email us at zwangerpesiri1@gmail.com.