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SPR 2016

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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1 1 w w w. s p i r i t o f w o m e n . c o m S P R I N G 2 016 S P I R I T O F W O M E N SHUTTERSTOCK S ometimes it seems as if there's a new guideline every month about how to reduce breast cancer risk. But one of the best ways to protect your breast health is a strategy you already know: Schedule an annual mammogram. "We know from research that women who have regular mammograms are more likely to find early cancers, to need less aggressive treatment and to find a cure than women who don't have regular mammograms," says Dr. Sunny Nelson, a family medicine physician at Community Memorial Hospital in Hamilton, N.Y. TIMELINE GUIDELINES Although the American Cancer Society recently rolled back its recommended screening age from 50 to 45, Dr. Nelson says some women might consider an even earlier start date. "A woman who's 40 should definitely have a conference with her physician and decide if that time is right for her," she says. Dr. Giustino "Justin" Albanese, an attending diagnostic radiologist at Winona Health in Winona, Minn., says he follows the guidelines of the American College of Radiology. "If she doesn't have a higher risk, a woman should be screened once a year, every year, between the ages of 40 and about 77," says Dr. Albanese. FACTORING IN RISK The more risk factors you have, the greater the risk that you may develop breast cancer. The challenge is that many of these contributing factors can't be controlled, says Dr. Albanese. And although some lifestyle decisions such as smoking have correlative effects to breast cancer risk—meaning they are seen more frequently in breast cancer cases—the medical community has established no direct cause and effect. Ultimately, the best way to gauge your breast cancer risk is to consult your primary care physician, who can assess your risk factors and overall health and then recommend appropriate screening for your personal health profile. "For high-risk patients, [we recommend that you] start screening at age 35, or 10 years before the age that a first-degree relative contracted breast cancer," says Dr. Albanese. GETTING THE MOST FROM YOUR SCREENINGS Newer breast imaging technology, such as 3D mammography, has made routine mammograms even more patient-friendly by providing greater first-time accuracy for test results. "The 3D technology looks at more images from different angles than [does] traditional mammography," says Dr. Nelson. "That increases detection rates and decreases the number of false positives." Your annual breast cancer screening is also an ideal time to ask your physician about testing for other medical conditions, including those that pose a heightened risk to women, says Dr. Albanese. "Continue your Pap smears and start screening for ovarian cancer," he advises. "Other general health guidelines include blood tests for high cholesterol and diabetes, and screening for colon cancer after age 50." • TOP RISK FACTORS for breast cancer If you've always had good breast cancer screening results, you might wonder whether monthly self-exams could take the place of a mammogram some years. But physicians caution against putting too much stock in self-exams as a screening tool. "There isn't much evidence of the effectiveness of women conducting their own breast exams," says Dr. Sunny Nelson, a family medicine physician at Community Memorial Hospital in Hamilton, N.Y. "But they should be aware of what their breasts normally feel like so they can tell if there's an abnormality." Dr. Giustino "Justin" Albanese, an attending diagnostic radiologist at Winona Health in Winona, Minn., recommends doing self- checks throughout the year, but only in association with physician care. "If you're an average-risk woman and you have your physician checking during physical exams, you self-examine once a month and get a mammogram once a year, you're doing all you can to protect yourself," he says. • Being female • Age 50 or older • Having changes in certain breast cancer genes (BRCA1 and BRCA2) • Long-term use of hormone replacement therapy • Personal history of breast cancer or non-cancerous breast diseases • Family history of breast cancer • Being overweight or obese after menopause • Never giving birth or having your frst child after age 30 • Treatment with radiation therapy to the breast/chest • Exposure to diethylstilbestrol (DES) • Having dense breasts • Drinking alcohol Sources: Centers for Disease Control and Prevention, American Cancer Society Should you still do breast self-exams? g

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