BREAST CANCER AWARENESS MONTH

We all have genes that decide the way in which our cells will grow and divide. Mutations occur when the genes don’t work the way they should. Mutations can be spontaneous or inherited. Every day, cells grow, divide and die in your body. Most cells grow in an orderly manner, but sometimes they grow out of control and form cancer cells. When they do this, they can form a lump or mass called a tumor and are named after the part of the body where the tumor originated from. Breast cancer originates in the breast tissue. Breast tissue is made up of glands for milk production called lobules, and the ducts that connect lobules to the nipple. Fatty, lymphatic and connective tissue makes up the rest of the breast.

WHO GETS BREAST CANCER

About 90-95% of breast cancers are caused by spontaneous mutations. The cause of these mutations are unknown. The other 5-10% of breast cancers are caused by inherited mutations. These are mutations you are born with. BRCA1 and BRCA 2 are specific mutations for genes that increase a woman’s risk of developing breast cancer and other cancers.

 The older the woman, the higher the risk.

 Lifetime risk is 1 in 8 women will develop breast cancer

 Excluding skin cancer, breast cancer is the most common cancer among women, accounting for nearly 1 in 4 cancers diagnosed.

 White women are more likely to get breast cancer than any other ethnic or racial group. African American women are more likely to die from breast cancer.

 1 in 100 cases of breast cancer will occur in men.

RISK FACTORS

 family or personal of history of breast or ovarian cancer. Family history of prostate cancer

 starting menopause after age 55

 having your first child after 35

 being a female, and getting older

 never having children

 having an inherited mutation in BRCA1 or BRCA2 breast cancer gene

 being overweight after menopause, or being obese as an adult

 use of menopausal hormones including use of estrogen and estrogen plus progestin

 history of breast biopsy showing atypical hyperplasia, or history of lobular carcinoma in situ

 radiation exposure or frequent x-rays in youth

 high bone density

 early menarche

WARNING SIGNS AND SYMPTOMS TO SEE YOUR PROVIDER ABOUT

Breast cancer, when the tumor is small, does not usually produce symptoms. When it has grown to a size that can be felt, it is usually a painless mass. See your provider if you notice any of the following:

 lump, or hard knot inside the breast or the underarm area

 change in the size or shape of your breast

 dimpling, pulling in or puckering of your skin, breast or nipple

 swelling, warmth, redness or darkening of the breast

 itchy, scaly rash or sore on the nipple

 nipple discharge, especially if it is spontaneous or bloody

 new pain in one spot that does not go away

SCREENING TESTS

Talk to your provider about which screening tests are right for you.

 Mammogram-is the best screening tool to detect early breast cancer. All women age 40 and older should have a yearly mammogram. If younger than 40, with a family history of breast cancer, talk to your provider about when to start screening.

 Clinical breast exam- done by your health care provider

 Self Breast Exam- all women should be familiar with the feel and appearance of their breasts.

 MRI (magnetic resonance imaging)- recommended for certain women at high risk for breast cancer

 BRCA1 and BRCA2 analysis- genetic testing recommended for women with strong family history of breast or ovarian cancer

 BREVAGen- provides a 5-year and lifetime risk assessment for women in determining breast cancer risk

PATIENT RESOURCES

www.komen.org   (Susan G. Komen for the Cure)

http://www.cancer.org   (American Cancer Society)

www.cancer.gov   (National Cancer Institute)

http://brevagen.com   (For information on BREVAGen)

www.myriadtests.com   (For information on BRCA1 and BRCA2 testing)

**You too can help fight against breast cancer. Join thousands of women and men on NOVEMBER 15th in Austin for “THE RACE FOR THE CURE”. Go to www.komen.org to register.

Pregnancy and the Flu Vaccine

 

Flu season is around the corner.  Seasonal flu vaccines protect against the most common influenza viruses circulating during the upcoming season.  A recent recommendation was issued by the CDC and American College of Obstetrics and Gynecology encouraging all pregnant and post partum patients to be vaccinated.  Due to the immune system changes during pregnancy, women can be at risk for serious complications if they develop the flu.

*Influenza vaccine can be given to pregnant women at any time during their pregnancy

*If vaccinated during pregnancy, protection has been shown for both the mother and infant.

*Pregnant women should receive the flu shot (inactivated vaccine) but should NOT receive the nasal spray (live attenuated vaccine).

*Postpartum women, even if they are breastfeeding, can receive either type of the vaccine.

*Side effects can include: soreness, redness at site of injection, low grade fever, aches.  You cannot get the flu from the flu shot (inactivated/ dead virus).

*Vaccination can occur as early as October and as late as May.  Vaccination before December is best to ensure protective antibodies are in place.

*Do not take the flu vaccine if you are allergic to chicken eggs, had a severe reaction to the flu vaccine, developed Guillain-Barre’ Syndrome within 6 months of the flu vaccine, or you are currently ill with a fever.

FAQs about Endometriosis

What is endometriosis? The inside lining of the uterus that produces a monthly period is called the endometrium. Endometriosis is when this type of tissue grows on the outside of the uterus in the pelvis or abdomen. It can be anywhere such as the ovaries, fallopian tubes, bladder or bowel. Your hormones each month will stimulate the endometriosis just like the endometrium. Your body was not made to handle this tissue and stimulation outside of the uterus.

What are the symptoms and how do I know if I have endometriosis? The most common symptoms are painful periods, pelvic pain, painful intercourse, abnormal bleeding, and infertility. Having any of these symptoms doesn’t necessarily mean you have endometriosis, and you could have endometriosis without any symptoms at all. A normal ultrasound of the uterus and ovaries does not rule out endometriosis since it is usually flat like a freckle or mole. Sometimes, a large amount can build up and be seen by ultrasound. Most of the time, you and your doctor may suspect you have endometriosis but an accurate diagnosis can only come after seeing it in your pelvis during surgery.

How is endometriosis treated? If you do not want to get pregnant, the first line treatment is birth control pills. Taking them continuously to avoid a menstrual cycle will be best. Other options include progesterone agents such as Depot Provera, Implanon, and progesterone pills. The best medical therapy is Depot Lupron, an injectable medication given for about 6 months at a time. This temporarily stops your monthly cycles to allow the endometriosis to heal. Some physicians will give a progesterone pill daily during this treatment to prevent side effects. Surgery is an option to remove endometrial implants using laser or cautery. This can improve symptoms dramatically, but without further medical therapy, it will likely come back. This may be a good option if you are trying to get pregnant. For severe, refractory cases, a hysterectomy with removal of the ovaries may be necessary. Menopause is generally a cure since the hormonal stimulation ceases.

If you think you may have endometriosis, discuss your symptoms and fertility desires with your personal ob/gyn. A personalized treatment plan will be tailored to your individual symptoms, needs and desires.

Foods to Avoid During Pregnancy

Certain foods can affect your baby’s health or yours during pregnancy.  Eating well balanced meals are important, but knowing what is not safe can help you make healthy choices.

* UNDERCOOKED MEAT, POULTRY AND EGGS-these can cause food-borne illnesses due to coliform bacteria, salmonella, and toxoplasmosis

* UNPASTEURIZED FOODS- -which includes most imported soft cheeses, Mexican-style cheeses (queso blanco and fresco), Brie, Blue cheese, Feta, Camembert.  These contain bacteria called listeria, which has the ability to cross the placenta and can lead to miscarriage, and possible  infection or blood poisoning in the fetus.

* SEAFOOD HIGH IN MERCURY—Some may contain dangerous levels of mercury which can damage your baby’s nervous system.  Higher amounts of mercury are found in the bigger and older fish.  Avoid swordfish, shark, Tilefish and King mackerel.  You can eat up to 12 ounces or two small servings of fish weekly ,  like tuna, catfish, cod and shrimp.

* CAFFEINATED BEVERAGES—Try to avoid caffeine during the first trimester to reduce the chance of miscarriage.  Moderation is the key and caffeine should be limited to no more than 300mg per day while pregnant. Refraining from caffeine is the safest thing.

* DELI MEAT AND SMOKED SEAFOOD—Both found at the deli counters, they can be contaminated with listeria.  They are safe to eat when they have been cooked in a meal.

* FRUITS AND VEGETABLES—Always wash them to prevent possible exposure to toxoplasmosis.  The soil in which the fruits and vegetables are grown can be contaminated by toxoplasmosis.

For more information, go to: www.americanpregnancy.org