Breast Cancer Awareness Month is a great time to ensure that the risks, signs and basic facts of the disease remain top of mind for women. It is also the perfect time to begin a proactive approach to breast health for women of a certain age, and to let them know that they have access to detection and treatment options that are second to none, right here in Queens.
What is breast cancer and what causes it?
Cancer cells really have to do with our DNA molecules. Without bogging readers down in too much biology, occasionally there is an abnormality – a mistake, if you will – in the way a DNA molecule is made, which can cause cells to divide rapidly. That mass of cells can become a lump or swelling. So, breast cancer is a disease occurring when cells in the breast grow out of control.
If they are not treated in time, those cancer cells can metastasize, which means travel to other parts of the body. Left untreated in any location, cancer can become lethal. At the EMU Breast Center, we encourage people to be proactive with their breast health so we can try and catch cancers early. In the early stages, cancer can be more easily treated.
So, when dealing with breast cancer, early detection is the key.
What are some risks for breast cancer? Can they be reduced?
Some risk factors for breast cancer are beyond our control; among them are:
- Family history
- Previous radiation exposure
- Prior breast biopsy with benign or high risk results
- Genetic mutations such as BRCA
But, there are some risk factors that we can affect.
Estrogen & Hormone Therapy
We know that estrogen, the molecule that controls female hormones, can be fuel to the fire for breast cancer. So, being vigilant when under hormone replacement therapy is important.
Maintaining a Health Weight
We also tend to see higher estrogen levels in obese or overweight people, so maintaining a healthy weight is important.
Smoking & Drinking Alcohol
There is data that smoking, as well as drinking alcohol, can both contribute to developing breast cancer. Quitting smoking and tempering drinking are both highly recommended.
Staying Healthy & Regular Check-ups
The best practice you can undertake to reduce your risk of having breast cancer also happens to be the best practice you can undertake for overall health – maintain a healthy diet and make sure to get daily exercise. The next best step, and this goes back to staying proactive, is to make and keep a schedule of regular check-ups with your doctor. That way, if a cancer is there, we can detect it early.
When should a woman begin to get mammograms?
There has been some debate in recent years, but at the EMU Breast Center we recommend beginning breast cancer screening at age 40. That means having a mammogram and physical exam at age 40 annually thereafter. Breast cancer becomes more common as women reach their late forties and early fifties, but even women in their early forties can develop breast cancer. And, since they’re younger, they have more estrogen circulating which can exacerbate the condition.
Again, it comes down to making sure we catch cancer as early as possible. Getting patients to visit annually gives us the chance to detect cancer at its smallest and most treatable state. If the cancer cells are dividing but we catch it early on, treatment is much easier.
We’re fortunate to have some of the latest and greatest equipment for detecting breast cancer available to us at EMU. Just one example is 3-D mammography, a huge advancement over 2-D for detection that has led to us seeing cancers being caught earlier. Patients need to understand that a cancer diagnosis is not a “life sentence” anymore. In fact, the disease is almost 100% treatable when caught early.
All this said, a woman should consult with her physician, someone who knows her personal medical history and health status, to devise the best course of action for them.
How does early detection affect treatment?
When we catch cancer early, those patients can be cured much more effectively than before, using less invasive surgery and less toxic chemotherapy. Not only have mammograms come a long way, but our colleagues in the oncology world have come a long way in terms of targeting the cancer cells with better treatments.
One example is the use of therapies that activate the body’s immune system to attack cancer cells. So, instead of administering a toxic chemical that would stop all cells from dividing, it is targeting cancer cells and leaving the rest of the body’s cells unharmed.
Patients can also undergo a lumpectomy, where just the lump is removed rather than all of the breast tissue. Early detection can also help them avoid having chemotherapy, which can have toxic side effects. Even more developments will be coming out in the next few years, and we are very excited to be a part of that at Orange Regional Medical Center.
Visit EMU and see what we have to offer.
At the EMU Breast Center we are very proud to introduce the community to our doctors, the surgeons, the staff, and our latest technology, including:
- 3D mammogram
- Stereotactic buided breast biopsy with the Affirm upright biopsy system, which employs advanced, proprietary imaging technology to visualize even hard to see lesions
- Ultrasound guided breast biopsy process with Bard core biopsy system, which uses real-time ultrasound imaging for instant verification of needle position and automated biopsy specimen sampling.
This is technology on the leading edge, and we’re very excited to offer it to our community in Queens at EMU.
EMU’s Breast Center is home to a dedicated and passionate team focused on breast cancer. We provide access to new technologies that can help women be proactive with their breast health, both in detection and treatment. We’re happy to be here for our patients in the community.
EMU Health is proud to announce its partnership with Mount Sinai to provide cardiology services in its Glendale, Queens multispecialty medical center. Mount Sinai, Ranked 9th nationally for Cardiology & Heart Surgery by U.S. News & World Report, is celebrated internationally as a world leader in all facets of cardiology care, cardiac surgery, and advanced research.
Mount Sinai’s team of award-winning physicians has invigorated the science of cardiovascular medicine, pioneering treatments for arrhythmias, coronary artery disease, heart failure, valvular disease, and vascular disease. Dr. Joseph Tawil of Mt.Sinai’s Cardiology Department will be providing cardiac services at EMU Health. He is board certified in cardiovascular disease holding certification from the National Board of Echocardiography and the Certification Board of Nuclear Cardiology. He is an active member of the American College of Physicians and the American College of Cardiology.
Dr. Tawil earned his medical degree from the State University of New York, Downstate Medical Center. He advanced his training with a residency in internal medicine and a fellowship in cardiovascular disease at Beth Israel Medical Center. He obtained his bachelor’s degree from Yeshiva University.
Daniel Lowy, CEO and Founder of EMU Health, said that “this partnership brings EMU another step closer to fulfilling my dream of bringing world class Medicine to the borough of Queens, eliminating the need for residents to travel to Manhattan for the highest quality of care.”
About EMU Health: Queens is the most diverse urban area in the entire world and home to two and a half million people. Yet, its residents are often compelled to seek quality healthcare outside the borough. Why is this? Because that’s just the way things have always been. But Daniel Lowy, EMU’s Founder and Chief Executive Officer, is not content with how things have always been, or how they are. He sees how things should be, and he makes them happen. Like the indigenous Australian bird, the Emu that cannot walk backwards, Daniel is an Aussie that is always moving forward. He founded EMU to provide patients with the highest quality healthcare possible, and move healthcare forward to benefit every resident of Queens. Visit www.emuhealth.com for more information.
Vinita: It is now for Morning Rounds at CBS News contributor Dr. Holly Phillips, and Orthopaedic surgeon, Dr. Neil Roth. Neil is sports medicine specialist and has served on the medical staff for several teams. First up, football and concussions. Concern over head injuries is dominating all levels of the sport and the CDC plans a rigorous evaluation of the risks of tackling in youth football.
One study found that 1 in 30 players ages 5 to 14 will suffer a concussion during any one season. I still think despite all of these talks, some people don’t really know how to evaluate if they’ve had a concussion. What is it?
Doctor Holly: Concussions actually can be confusing, but I’m so glad there’s increased awareness. It’ll help our young people, it’ll help athletes, it’ll clear up a lot of misconceptions. Concussion actually comes from a Latin term that means to shake violently and that’s essentially what it is. Concussions happen after a sudden and violent blow to the head.
Our brain is made of soft tissue. It is cushioned by a strip of spinal fluid inside of the skull. The impact from a sudden blow to the head can jolt the brain or sometimes physically move it within the skull. That results in bruising, damage to blood vessels, damage to nerves. The ultimate effect of that is that the brain doesn’t function normally whether that’s for a period of days, weeks or month. There can be a huge number of symptoms ranging from nausea, or vision disturbances.
We’re understanding more and more that concussions can affect your mood or even your personality. We see depression, we see changes in the way people behave.
Anthony: Neil, I know from having had a concussion that didn’t really show itself the effect for about a week to ten days later that it can be complicated to know whether you had. Have you actually diagnosed a concussion?
Doctor Neil: It’s a great question. Concussions are like snowflakes. They’re different all the time, there’s really no two that are alike. As we will look into the brain which basically controls every function of our body it can manifest itself in a lot of different ways. You can have some dizziness, you can have headaches which are some of more obvious, but you can have more subtle findings with mood changes and things along those lines.
The real way to diagnose it is to, number one, know your kid, know your athlete and if something just does not seem right, then that’s a pretty good indication that something could be wrong and you could have a concussion. Doesn’t mean you necessarily have to, but it certainly would warrant having it worked up and being looked at.
The best way to really diagnose it is we do these preseason evaluations. We do baseline testing, there are a lot of neurocognitive tests, there are balance tests that are done preseason so in the event that an athlete gets a concussion, we can evaluate it to where they were at their baseline and monitor their progress and additionally monitor the severity of the concussion itself.
Vinita: I have to, though as a parent, it makes me nervous that I should notice certain things and that the symptoms could always be different. Is there a way for there to be some definitive diagnostic tools? Is that something in the works?
Doctor Holly: There’s a lot of work going on in that area. Just this past week at the American Academy of Neurology conference, ome researchers presented a small,but very promising study using something called a transcranial doppler. They developed basically a device where you can put it on the head, it does a Doppler ultrasound of the brain which measures blood flow.
What they found was that it was 83% accurate in distinguishing between high school students that had concussions and high school students that had healthy brains. The point of all of this and other research like it is to try to develop some type of device or diagnostic tool that is fast, that’s portable and it’s accurate and it can be used right on the sidelines of the game.
Neil, I know you were a team doctor for the LA Lakers, if you just a quicky device right there on the sidelines, I’m sure that would have been a big help.
Doctor Neil: Of course, in an ideal world if we had these portable devices that were reliable and gave us instant information that would be fantastic. The fact remains that concussions are very subtle, tough sometimes findings. Athletic trainers, parents, and coaches need to know your athlete and be able to see what’s going on.
Obviously, we’ve spoken about how the brain is a metabolic type of organism and if it basically has a concussion, the metabolism is altered and a brain flow study or something in those lines would be the crux of being able to diagnose that.
Anthony: Okay. Next up, a problem that sidelines many elite athletes. Of course, back spasms don’t only affect the pros, millions of Americas suffer from the painful muscle contractions each year. Neil, what actually causes this?
Doctor Neil: Back spasm is an end result of irritating one of the nerves in your lower back. It can happen from our everyday activities, from an impact, from an athletic maneuver, from doing something very strenuous and in turn the nerve will send an impulse to the muscle and the muscle sees this constant on signal and goes into spasm, because it’s basically turning it on, like you are flicking the light switch on and off, it seems as though the light switch is on, that the light is on all the time. The muscles go to spasm and becomes very painful and debilitating.
Vinita: I’m convinced led to my back spasms.
Because I also get a massage when it was really intense, what are the best treatments? What should you be doing?
Doctor Holly: Right, massage is a very good one, my oldest childhood friend called me everyday to switch. She was suffering from terrible back spasms. She said, “What’s the treatment?” There’s really isn’t a quick fix, what I can say is that using heat and cold therapy is important. Medications we use very judiciously just some anti inflammatories, muscle relaxants. We try by all means necessary not to use heavy duty medications like the opioid, pain killers or anything else. Massage, acupuncture, stretching, yoga, all of these things are really keys to getting better. Then, strengthening your core and your lower back muscles is critical so you don’t re-injure yourself.
Vinita: Well spasms are just one symptom from those who suffer from chronic back pain. A study of 342 patients by researchers in Seattle points to a potentially helpful treatment; meditation. It found those who engage in yoga and mindfulness based meditations had a 61% improvement in the activities they could do compared to 44% who stuck to their normal routines. The meditation group also reported 55% improvement in pain compared to just 27% in normal care mind over matter a little bit of that.
Doctor Holly: Very much so.
Doctor Neil: We’re talking about how the brain, how it affects concussions. It would certainly follow that you have a complete connection on the physical nature of back issues that are tied to your brain, that are tied to your mood, your stress levels, there are hormonal changes that occur with stress levels that will affect your entire muscular approach to things. It’s a great connection and one that obviously should be incorporated into any type of therapeutic regiment.
Anthony: Doctor Neil Roth, Doctor Holly Phillips, thank you both very much for being with us.
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