Facing Your Risks - and Your Future
OCTOBER 1, 2010
Assessing our risks can be a daunting task. If you've followed any of my
personal story, you may know that my mother died of ovarian cancer and her
mother died of breast cancer. My own hysterectomy included an oophorectomy for
prophylactic reasons. Tracing out my family tree further finds even more
red flags to the genetic cancer risks. And more importantly, do my children have those risks?
Recently, after a consultation with a genetics specialist, I was advised to
begin with the BrCa1 and BrCa2 genetics tests. It was an easy "test," with
mouthwash and spitting and a quick trip to the Fed Ex Office nearby. Now as I
await the results, I am confident that with the help of a genetics specialist,
my family history, and my personal medical files, I will be able to make more
decisions for my future. My daughter will be better armed to make medical decisions for herself.
Of course, assessing my personal risks comes at a cost. Instead of denying the
potential for cancer, I am choosing to meet it head-on. Instead of waiting for
time to lapse, I am choosing proactive facts along with my yearly mammogram and
It's time to make a plan of action. Call and make an appointment today for your
mammogram. If you have family members who have been diagnosed with breast or
ovarian cancer (or both!) consider meeting with a genetics specialist to
determine your personal risk. Grab your future!
Lower Your Breast Cancer Risk
OCTOBER 1, 2010
The most effective way to fight breast cancer is to detect it early.
Self-exams? Good! But the most effective detection is a mammogram. Have you
scheduled yours this year? We like to encourage our members to have their
well-women checkup and mammogram during their birthday month as an easy way to
While our genes can work against us, there are ways to lower our risk. Here
are 7 ways to lower your breast cancer risk.
Scheduled exercise more than three times a week can reduce your risk of
breast cancer by 30%-50%.
2. Control your weight and maintain a healthy body weight (BMI).
Women who are 25 pounds or more overweight seem to get breast cancer more
than twice as often as those who are not overweight.
3. Stop smoking.
There is no need to explain this one. Smoking adds many risks to our
4. Minimize or avoid alcohol.
The Harvard Nurses' Health study, along with several other studies, has
shown that consuming more than one alcoholic beverage a day can increase
breast cancer risk by as much as 20-25 percent.
5. Consume as many raw fruits and vegetables as possible.
Eating seven or more servings per day is ideal.
6. Minimize the wrong fats.
The type of fat you eat can affect your risk. Avoid Omega-6 fats and
maximize Omega-3 fats. This can include taking Omega-3 supplements.
7. Maintain a healthy lifestyle. Make arrangements to sleep 7-8
hours each night.
And be sure and check out the
Breast Health forum at HysterSisters.com to find woman-to-woman support
for your breast health questions.
The first step in your self-examination is to be familiar with your own
breasts. That will help you recognize when any changes occur. Ask your
doctor to show you how to do a breast self-exam. The American Cancer Society
recommends that doctors inform women about the benefits and limitations of
breast exams when they reach the age of 20.
Tips for your breast self-exam:
Be thoughtful with the timing: Choose the time during the month when your
breasts are less tender. If you have ovaries, your hormone levels fluctuate
each month, causing changes in your breast tissue. If you do not have
ovaries or do not menstruate because of a hysterectomy, pick a certain day
of the month.
Make notes: Keep a notebook handy to record anything you may notice with
your breasts. Draw a map of the breast to note any thick tissue areas.
Generally, the breast can be divided by quadrants or like a clock, which may
help you when mapping changes in your notebook. Be sure and write the date
with your map of changes.
Contact your doctor if you notice:
- A hard lump or knot near your underarm.
- Changes in the way your breasts look or feel, including thickening
from surrounding tissue.
- Changes in color, size, texture or shape.
- Dimples, puckers, or bulges on the skin of your breast.
- A nipple that is pushed in (inverted) instead of sticking out.
- Redness, warmth, swelling, or pain.
- Itching, scales, sores, or rashes.
- Bloody nipple discharge.
Your doctor may follow up with a breast exam, mammogram and ultrasound.
Menopause: A Time for Choices
OCTOBER 1, 2010
Because each woman is different, there's no one-size-fits-all estrogen therapy. From creams to gels to pills to patches, there are several types of estrogen therapy. Choosing the type of treatment that's right for you starts with knowing your options, understanding your unique set of needs and personal preferences, and discussing these questions with your doctor: How severe are your symptoms? Is there a convenient option that will work best with your active lifestyle? Do you prefer an estrogen therapy derived from a plant or an animal source? What exactly is bioidentical hormone therapy?
The most commonly used forms of estrogen therapy are daily pills and transdermal patches you change once or twice a week. One of the major differences is how they deliver estrogen to your body. In order for your body to receive enough estrogen, the dose in an oral pill has to be higher than the dose used in a transdermal patch. That's because when taken orally, estrogen has to pass through the stomach and then be metabolized by the liver before reaching estrogen-receptive tissue. During this process, a lot of estrogen is broken down and destroyed.
Another major difference between pills and a transdermal patch is dosing schedule. Pills have to be taken on a daily schedule. The patch only needs to be applied twice a week. That means there's less to remember with a patch, fewer interruptions in your schedule, and more flexibility.
The dose and length of estrogen therapy is based on your individual symptoms, health risks, and treatment goals. It's important to schedule follow-up visits with your doctor every 3 to 6 months to discuss your progress.
Genetic Cancer Risk
OCTOBER 1, 2010
Cancer is a common disease, and most families have members who have had some
kind of cancer. This, however, does not mean that the cancer is necessarily
genetic. Cancers that are not genetically based are considered "sporadic" and
account for 90% of all cancers. Experts believe that only 10% of all cancers are
The medical community uses the term "genetic susceptibility" to describe the
high risk for cancer in people with an inherited mutation.
According to FORCE (Facing Our Risk of Cancer Empowered at
www.facingourrisk.org), there are
some signs of a hereditary breast-ovarian cancer syndrome in a family.
Any family member with:
- Ovarian or fallopian tube cancer at any age
- Breast cancer at age 50 or younger
- Breast cancer in both breasts at any age
- Both breast and ovarian cancer
- Male breast cancer
- Ashkenazi Jewish heritage and breast cancer before age 60
More than one relative on the same side of the family with any of these
- Breast cancer
- Ovarian or fallopian tube cancer
- Prostate cancer
- Pancreatic cancer
Several different cancer syndromes have been identified, each with a
particular set of signs. If the cancer in your family may be hereditary, it is
important to consult with a genetics expert.
For those who are concerned about the Breast Cancer and Ovarian Cancer genetics,
discuss your family history with a genetics specialist. The test for BrCa1 and
BrCa2 requires a sample blood test, cheek swab, or tissue test and may be
covered under your health insurance. The decision to undergo testing for the
breast cancer gene is a personal one, with different benefits and limitations
depending on your circumstances. Additionally, the test results are often not
straight-forward; they require a medical professional with a genetics background
to explain the results and help you determine your future options.
Consider seeking medical help from a genetics specialist. For more information,
please visit Facing Our Risk for Cancer Empowered:
Early Diagnosis=More Options: One Member's Story
OCTOBER 1, 2010
Surferbabe, a HysterSisters hostess, has had to
learn a great deal about breast health since her hysterectomy. She shares
her story with us here.
What brought you to HysterSisters?
I found Hystersisters by doing a google search
for information on prolapse while I was home recovering from my hysterectomy in
2002. I had searched once before, when I was diagnosed, and had found a couple
of pelvic floor sites, but since I really didn't have any choice about the
surgery I didn't really pursue the search - I only had ten days to prepare
myself and my kids and was pretty busy running around getting things ready in
terms of the house, child care, transportation, meals etc. Once I was home
recovering, I slowed down, took a deep breath and started reading. I found
Hystersisters right away, and joined at ten days post op on Valentine's Day,
2002. I'd had to go home with a catheter (my DR had warned me it might happen)
so I felt that maybe I could share my experience there with others who were
afraid of the catheter.
What can you tell us about your experiences
with breast health?
I had had my first mammogram, a baseline, at age
39, and had been having them annually, including the year I had the hysterectomy
(I was 45 then). All had been clear. At age 47, two years post hysterectomy, I
was called back for "additional views". That then turned into a recommendation
that I have a stereotactic biopsy to investigate suspicious-looking
microcalcifications in my right breast. The radiologist who recommended the
biopsy told me that, at that particular facility, about 20% of women are called
back for additional views after a routine mammogram, that about 20% of those
women end up having a biopsy and, of those biopsied, only about 15-20% turn out
not to be benign, so I was hopeful.
Can you tell us about your cancer diagnosis?
Well, when I met with the surgeon, even before
the biopsy, he told me that based on the configuration of the calcifications, he
was 99% sure they were not benign, and he turned out to be correct. I was
diagnosed with ADH (atypical ductal hyperplasia), ALH (atypical lobular
hyperplasia), LCIS (lobular carcinoma in situ) and "borderline DCIS" (ductal
carcinoma in situ). Since the area was very small, and it was obviously very
early, my doctors recommended just doing a lumpectomy and watching carefully
after that, and possibly taking Tamoxifen, so that's what we decided to do.
However, I could not tolerate the side effects of the Tamoxifen and had to
discontinue it after only six days.
How was your cancer treated, and how are you
I was then put on a schedule of mammograms every
six months for two years. For those two years, the first three mammograms were
fine, but the last one was not - I was diagnosed with DCIS in the right breast
again, in a small area near where the initial microcalcifications had been. The
doctors believe it was a spot that had been present but too small to show up in
the mammograms two years earlier, rather than a new development, but in any
case, I was faced with a decision on how to proceed. My doctors recommended
breast-conserving therapy as the standard of care for DCIS and I agreed, though
some women who have LCIS elect prophylactic double mastectomies because, while
it's not actually cancer, LCIS is a risk factor that increases a woman's
likelihood of recurrence in either breast.
I had a much larger lumpectomy the second time,
and at the time of surgery the surgeon created a large empty cavity in the
incision site where a catheter could later be inflated so that I could have
Mammosite radiation - internal brachytherapy delivered by a robotic catheter
system. I had complications from surgery in that I developed two hematomas,
which later became seromas and which both delayed the radiation and made the
placement of the catheter extremely painful, but I proceeded with the plan
anyway. It ultimately went very well and I'm glad I elected Mammosite -- it's
very concentrated, but minimizes potential side effects that can result from
radiation being scattered to the heart and lungs.
How has your life changed (or not) as a
result of having breast cancer?
After the radiation, I was once again put on a
schedule of mammograms every six months for two years, transitioning to once a
year after that. It's now been four years, and so far (knock on wood) I have
been cancer-free. However, never does a day go by that I don't think about the
fact that I've been diagnosed twice already and wonder when the third time will
come. It's not something that, at least in my experience, ever goes away
What is next in your life?
In between my hysterectomy and the two
experiences with breast cancer, I also had a colectomy because of recurring
diverticulitis which had also caused a perforation of the colon and abscess.
That surgery has physically been difficult to deal with, as opposed to the
breast cancer, which has been much easier physically but tougher emotionally.
The result of all that has been that it's taken me quite a while to pick up the
pieces and try to move on, but it's finally happening. I've just gone back to
school full time in preparation for a career change and am, for the first time
in a looooong time, hopeful for the future. :)
Based on your experience, what advice do you
have for other women when it comes to breast health?
My #1 recommendation for women regarding breast
health is, get those mammograms. Don't be afraid - the technology has improved,
and it really isn't as painful as it used to be. In fact, in my breast which
hasn't had surgery, it's not painful at all; it only hurts in the one which had
surgery, because I have scar tissue there from the two lumpectomies. Don't
assume that because you don't feel a lump, you're fine - I never had any lump or
pain either time, and many women who are diagnosed with early breast cancer do
not feel a thing. Conversely, don't panic if you do feel a lump or have pain -
there are plenty of benign conditions that can cause pain and lumps, and the
odds are that you'll find out you are OK, but don't assume anything - get it
If you can't afford a mammogram, consider how you'd pay for treatment in the
unlikely event that you do have breast cancer and it's diagnosed later, as
opposed to earlier, because you didn't go for the mammogram. There are
affordable programs, even free ones, out there -- look into it. I feel lucky
that in both cases, mine was caught so early that I had treatment options to
consider and the odds of survival were excellent.
From the HysterSisters Forums
OCTOBER 1, 2010
I am just wondering if there is anybody here with BRCA1+ ? I am planning on doing hysterectomy soon and straggling to decide if I should keep my cervix or not.
Would love to hear other woman opinions and any advice is welcome.
Also , I hope I am not doing the surgery too soon ( I am 34 and not planning to have more children) . My Dr recommends waiting until 40, but I am scared and feel like I am playing with fire keeping my ovaries.
Join the Discussion
More Discussions to join about breast health:
How often to get a mammogram?
New lady in waiting with concerns about tender breasts