The second of the breast cancer risk screening tests or risk assessment tests that we will discuss is the BREVAGen Breast Cancer Risk Assessment Test. We have seen that it is uniquely powerful to identify those women at high risk because it includes your genetics and personal information http://drwinsett.blogspot.com/2012/04/more-personalized-breast-cancer.html.
The BREVAGen gives both a 5-year and lifetime risk, so we can make recommendations according to American Cancer Society (ACS) and the American Society of Clinical Oncologists (ASCO) published guidelines.
The two results, which align with the guidelines, give us information that allows us to make a breast health plan for you, both for diagnostic studies and for treatment recommendations.
If the 5-year risk is high you may fit the ASCO guidelines, derived from a large breast cancer prevention trial, to be offered an estrogen receptor blocker, which has been shown to reduce breast cancer risk by 50%. This, of course would be in addition to being active, being lean, regular exercise, cruciform vegetables and, alcohol and meat limitation.
If the lifetime risk is high you might fit the ACS guidelines for increased surveillance with breast MRI or other study in addition to mammography and sonography.
You will be empowered with the knowledge. The BREVAGen results give you and your doctor the option to make a plan for breast cancer risk reduction that is personalized to you.
Call 512-451-5788 to get the BREAVAGen or check online for a doctor near you offering the test at http://brevagen.com/find.
Together we can prevent 75,000 breast cancer cases each year!
This content is general medical information and not personal medical advice.
Tuesday, July 31, 2012
Monday, July 30, 2012
The good news about the HALO test!
Last week we blogged about the HALO Breast Pap test covering the how to, who to and why to. Today we will discuss what the results mean and what to do about it. That's the good news about the test. We have a plan if you find out that you are high risk and we can help you reduce that risk.
We have known for more than 20 years that atypical ductal cells are different from normal ductal cells and that women whose breasts make these atypical ductal cells are at increased risk for breast cancer. The pathologist can tell which kind of ductal cells are in the specimen and then we can estimate breast cancer risk for that individual. Women with atypia and no family history have been found to have 3-4x more breast cancers in the next 15 years. Women with atypia and a mother, daughter or sister with breast cancer may have 10x more breast cancers in the next 15 years when compared to the risk of women without atypia and family history.
Fortunately, the majority of women don't have atypia; but the HALO allows us to find those few women who do and to intervene before the cancer happens.
The intervention may be both nonprescription and prescription. Be lean, be active, exercise, more cruciform vegetables...you all remember the benefits of a healthy lifestyle from the previous blogs. The prescription that may be offered is tamoxifen, but this is a medication that has risks and benefits, so we only offer it to those few women for whom the benefits far exceed the risks. Estimates are that about 5 million women in the US may benefit from taking this estrogen receptor blocker, because it reduces the risk of getting breast cancer in appropriately selected patients by 50%.
Imagine that you can find out something about yourself, that you are at high risk, and that we can offer something to you to reduce that risk! Call us at 512-451-5788 or find a doctor near you at http://www.halohc.com/doctorfinder/doctorfinder.aspx.
Together we can prevent 75,000 breast cancer cases each year!
This content is general medical information and not personal medical advice.
We have known for more than 20 years that atypical ductal cells are different from normal ductal cells and that women whose breasts make these atypical ductal cells are at increased risk for breast cancer. The pathologist can tell which kind of ductal cells are in the specimen and then we can estimate breast cancer risk for that individual. Women with atypia and no family history have been found to have 3-4x more breast cancers in the next 15 years. Women with atypia and a mother, daughter or sister with breast cancer may have 10x more breast cancers in the next 15 years when compared to the risk of women without atypia and family history.
Fortunately, the majority of women don't have atypia; but the HALO allows us to find those few women who do and to intervene before the cancer happens.
The intervention may be both nonprescription and prescription. Be lean, be active, exercise, more cruciform vegetables...you all remember the benefits of a healthy lifestyle from the previous blogs. The prescription that may be offered is tamoxifen, but this is a medication that has risks and benefits, so we only offer it to those few women for whom the benefits far exceed the risks. Estimates are that about 5 million women in the US may benefit from taking this estrogen receptor blocker, because it reduces the risk of getting breast cancer in appropriately selected patients by 50%.
Imagine that you can find out something about yourself, that you are at high risk, and that we can offer something to you to reduce that risk! Call us at 512-451-5788 or find a doctor near you at http://www.halohc.com/doctorfinder/doctorfinder.aspx.
Together we can prevent 75,000 breast cancer cases each year!
This content is general medical information and not personal medical advice.
Thursday, July 26, 2012
HALO, BREVAGen and density!
These are the three important words for 90% of the women who don't want to wait for breast cancer. Two noninvasive tests and one mammographic finding give us a clearer picture of a woman's individual risk for breast cancer.
The HALO Breast Pap Test (http://www.halohc.com/halonaf/NAF-Collection.aspx) is routine breast health monitor of cellular changes that may happen in the breast ducts long before the cancer appears. Fluid from the nipple is obtained by an office procedure that is safe, noninvasive, takes only 5 minutes and is especially useful for women between 21 and 35 years. The result tells us who is at higher risk for developing cancer in the nest 8 years allowing us to intervene before cancer happens.
The BREVAGen Breast Cancer Risk Assessment (http://brevagen.com/home) is a one-time, noninvasive office procedure. A woman's genetic information from a cheek swab is combined with clinical data to arrive at a personalized 5 year and lifetime risk for breast cancer. It is an ideal study for women from 35 to 64 years.
The mammogram report includes the density of the breast tissue and studies have demonstrated that breast cancer develops 5x more often in dense breasts than in the least dense breasts as judged by mammography.
These three words should be important to any woman who wants to know more about her own risk for breast cancer. In future blogs we will discuss the options, given the results, for a personalized breast health plan.
Together we can prevent 75,000 breast cancer cases each year!
Remember that this blog content is general information and not personal medical advice, so ask your doctor how each may help you.
The HALO Breast Pap Test (http://www.halohc.com/halonaf/NAF-Collection.aspx) is routine breast health monitor of cellular changes that may happen in the breast ducts long before the cancer appears. Fluid from the nipple is obtained by an office procedure that is safe, noninvasive, takes only 5 minutes and is especially useful for women between 21 and 35 years. The result tells us who is at higher risk for developing cancer in the nest 8 years allowing us to intervene before cancer happens.
The BREVAGen Breast Cancer Risk Assessment (http://brevagen.com/home) is a one-time, noninvasive office procedure. A woman's genetic information from a cheek swab is combined with clinical data to arrive at a personalized 5 year and lifetime risk for breast cancer. It is an ideal study for women from 35 to 64 years.
The mammogram report includes the density of the breast tissue and studies have demonstrated that breast cancer develops 5x more often in dense breasts than in the least dense breasts as judged by mammography.
These three words should be important to any woman who wants to know more about her own risk for breast cancer. In future blogs we will discuss the options, given the results, for a personalized breast health plan.
Together we can prevent 75,000 breast cancer cases each year!
Remember that this blog content is general information and not personal medical advice, so ask your doctor how each may help you.
Tuesday, July 24, 2012
Continuous update on breast cancer prevention research!
Imagine a group of scientists sifting through breast cancer prevention research and recording the findings of those studies meeting rigorous standards and you have the AICR/WCRF's Continuous Update Project (CUP), reporting regularly since 2007. The most recent report is at http://preventcancer.aicr.org/site/News2?page=NewsArticle&id=21773&news_iv_ctrl=2302.
These scientists at Imperial College London carry out this systematic review. They have reviewed and added to the CUP, for breast cancer, 334 new studies for a total of 651 relevant studies overall.
The updated findings FURTHER conclude that a woman may reduce her risk for breast cancer by being physically active, being lean, not having extra abdominal fat (the kind put on after 50), limiting alcohol and nursing her children.
Together we can prevent 75,000 breast cancer cases each year.
Share the word with your friends and family!
This is general medical content and not personal medical advice, but it does make you want to get up from the table and take a walk!
These scientists at Imperial College London carry out this systematic review. They have reviewed and added to the CUP, for breast cancer, 334 new studies for a total of 651 relevant studies overall.
The updated findings FURTHER conclude that a woman may reduce her risk for breast cancer by being physically active, being lean, not having extra abdominal fat (the kind put on after 50), limiting alcohol and nursing her children.
Together we can prevent 75,000 breast cancer cases each year.
Share the word with your friends and family!
This is general medical content and not personal medical advice, but it does make you want to get up from the table and take a walk!
Monday, July 23, 2012
Why I tell people who want to lose weight to eat protein for breakfast.
A great way to kick start a diet is to have a protein shake in the morning after exercise. We now have evidence for how and why the protein makes you feel full.
Recent research, published in Cell, online abstract at http://www.cell.com/abstract/S0092-8674(12)00760-X, may explain this known effect of proteins, not yet explained. It is part of the communication between gut and brain leading to that feeling of satiety after a protein meal that is explained by the new findings.
When you eat a protein meal, the proteins are broken down into peptides for absorption. It has been recently discovered that these peptides block receptors located in the portal vein, the major vein draining the gut after a meal. These receptors are called mu-opiod receptors or MOR's. Stimulating these receptors enhances food intake, but blocking them makes you feel full. Peptides block these receptors, which causes the brain to send a signal back to the gut to release glucose (gluconeogenesis), which suppresses the desire to eat. It may be that controlling this normal feed-back mechanism may lead to obesity treatment.
Together we can prevent 75,000 breast cancer cases each year!
This is general medical information and not personal medical advise.
Recent research, published in Cell, online abstract at http://www.cell.com/abstract/S0092-8674(12)00760-X, may explain this known effect of proteins, not yet explained. It is part of the communication between gut and brain leading to that feeling of satiety after a protein meal that is explained by the new findings.
When you eat a protein meal, the proteins are broken down into peptides for absorption. It has been recently discovered that these peptides block receptors located in the portal vein, the major vein draining the gut after a meal. These receptors are called mu-opiod receptors or MOR's. Stimulating these receptors enhances food intake, but blocking them makes you feel full. Peptides block these receptors, which causes the brain to send a signal back to the gut to release glucose (gluconeogenesis), which suppresses the desire to eat. It may be that controlling this normal feed-back mechanism may lead to obesity treatment.
Together we can prevent 75,000 breast cancer cases each year!
This is general medical information and not personal medical advise.
Wednesday, July 18, 2012
Some experts agree about hormone replacement therapy!
The consensus of opinion at a recent (07-09-2012) gathering of experts is that "short-term, low dose hormone replacement therapy (HRT) is acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women. Details and a list of all participants can be found at the "statement of agreement" link in the final paragraph at http://www.endo-society.org/media/press/2012/Ten-Years-after-WHI-Doctors-Say-Patient-Concerns-and-Misinformation-Impede-Treatment-of-Menopausal-Women.cfm.
The new guidelines were endorsed by the North American Menopause Society, the Endocrine Society and the American Society of Reproductive Medicine among others.
They reiterated two major vascular risks of estrogen-alone or estrogen and progesterone combined therapy:
- cardiovascular events (more strokes and heart attacks)
- venous thromboembolism (more clots in the legs and lungs)
and then noted that these risks were "rare" in younger women (50-59 years).
They also reiterated the increased risk of breast cancer with combined HRT (estrogen and progesterone) use more that 5 years.
The specific recommendations suggest that for younger, healthy, immediately postmenopausal women, who have menopausal symptoms, HRT may be safe. The dose should be the lowest and given for the shortest time needed, but certainly less than 5 years.
Again, note that this is individualized! Symptomatic women, 50-59 years, who are low risk for blood clots, heart disease or strokes may safely take short-term, low dose hormone replacement therapy according to this consensus.
The American College of Obstetricians and Gynecologists did not endorse the new guidelines, citing their own opinions already posted online that those women of low risk for cardiovascular outcomes should be considered for HRT for "menopausal vasomotor symptoms" http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Gynecologic_Practice/Hormone_Therapy_and_Heart_Disease.
For some, who are not helped by those actions suggested in the prior bog, short-term, low dose HRT may be safe to relieve menopausal symptoms and not increase breast cancer risk.
Together we can prevent 75,000 breast cancer cases each year.
This is general medical content and not personal medical advice. Talk to your doctor, if you think you would benefit from HRT, to find out if it is safe for you.
For some, who are not helped by those actions suggested in the prior bog, short-term, low dose HRT may be safe to relieve menopausal symptoms and not increase breast cancer risk.
Together we can prevent 75,000 breast cancer cases each year.
This is general medical content and not personal medical advice. Talk to your doctor, if you think you would benefit from HRT, to find out if it is safe for you.
Tuesday, July 10, 2012
And what about a HOT FLASH?
Well, I think it is safe to say, "most women don't want one!"
I blogged about hot flashes in general earlier this year http://drwinsett.blogspot.com/2012/05/so-you-dont-want-hot-flash.html and now let's look at one study in particular.
Although, generally hot flashes are reduced in those who regularly exercise, there are some fine points illustrated by a recent study from Penn State http://live.psu.edu/story/60192 and published this month in Menopause.
What is unique about this study is that the researchers measured not just subjectively reported hot flashes but measured skin conductance, which changes with moisture, to get an objective number of hot flashes as well. You can read the particulars in the link, but the important point is that on average the women who walked on the treadmill 30 minutes had FEWER hot flashes objectively and subjectively in the next 24 hours!
The greatest reduction in vasomotor symptoms (by both measures) was among the more fit and the leaner. Those overweight and obese or those with a lower level of fitness noticed a smaller reduction in symptoms.
The physiologic benefits of exercise seem clear. But to examine the needs of the menopausal woman further; EXERCISE seems the perfect prescription for decreasing hot flashes, reducing the risk for diabetes, heart disease and osteoporosis and reducing the number of breast cancers. Check out http://drwinsett.blogspot.com/2012/06/maybe-youve-heard-exercise-reduces.html again.
Together we can prevent 75,000 breast cancer cases each year!
This content is information and not personal medical advice.
I blogged about hot flashes in general earlier this year http://drwinsett.blogspot.com/2012/05/so-you-dont-want-hot-flash.html and now let's look at one study in particular.
Although, generally hot flashes are reduced in those who regularly exercise, there are some fine points illustrated by a recent study from Penn State http://live.psu.edu/story/60192 and published this month in Menopause.
What is unique about this study is that the researchers measured not just subjectively reported hot flashes but measured skin conductance, which changes with moisture, to get an objective number of hot flashes as well. You can read the particulars in the link, but the important point is that on average the women who walked on the treadmill 30 minutes had FEWER hot flashes objectively and subjectively in the next 24 hours!
The greatest reduction in vasomotor symptoms (by both measures) was among the more fit and the leaner. Those overweight and obese or those with a lower level of fitness noticed a smaller reduction in symptoms.
The physiologic benefits of exercise seem clear. But to examine the needs of the menopausal woman further; EXERCISE seems the perfect prescription for decreasing hot flashes, reducing the risk for diabetes, heart disease and osteoporosis and reducing the number of breast cancers. Check out http://drwinsett.blogspot.com/2012/06/maybe-youve-heard-exercise-reduces.html again.
Together we can prevent 75,000 breast cancer cases each year!
This content is information and not personal medical advice.
Monday, July 9, 2012
Which exercise for what?
I have fielded a lot of questions about exercise and will try to answer them today.
As we have explored in many previous blogs, there are may benefits for exercise and being active from heart health to cancer prevention to reduction in muscle and join aches and pains. Type "exercise" in the box at the right and press the search box to find a list and link to each blog.
Many cardiologists recommend a brisk 15 minute walk for heart health. For cancer reduction any exercise or activity leads to a reduction in the number of cancers, but the most recent study cited notes that the number of breast cancers prevented increases with the amount of exercise up to 10 hours a week. In women who regularly exercise 90 minutes a day thee are 30% fewer breast cancers! Remember duration is more important than intensity. Just move!
Studies have shown that most successful weight loss programs include exercise.
Resistance, such as lifting weights, is not just "exercise" but also builds bones. The first treatment for low bone density includes weight bearing exercise.
Can you exercise too much? Studies have shown that those who exercise intensely for more than 90 minute each day have more infections. Taken as a group, marathon runners have more respiratory tract infections.
If I have not answered your question, please let me know.
Be lean! Be active! Exercise!
Together we can prevent 75,000 breast cancer cases each year.
This content is information and not intended as personal medical advice. See your doctor or me for a personal exercise regimen.
As we have explored in many previous blogs, there are may benefits for exercise and being active from heart health to cancer prevention to reduction in muscle and join aches and pains. Type "exercise" in the box at the right and press the search box to find a list and link to each blog.
Many cardiologists recommend a brisk 15 minute walk for heart health. For cancer reduction any exercise or activity leads to a reduction in the number of cancers, but the most recent study cited notes that the number of breast cancers prevented increases with the amount of exercise up to 10 hours a week. In women who regularly exercise 90 minutes a day thee are 30% fewer breast cancers! Remember duration is more important than intensity. Just move!
Studies have shown that most successful weight loss programs include exercise.
Resistance, such as lifting weights, is not just "exercise" but also builds bones. The first treatment for low bone density includes weight bearing exercise.
Can you exercise too much? Studies have shown that those who exercise intensely for more than 90 minute each day have more infections. Taken as a group, marathon runners have more respiratory tract infections.
If I have not answered your question, please let me know.
Be lean! Be active! Exercise!
Together we can prevent 75,000 breast cancer cases each year.
This content is information and not intended as personal medical advice. See your doctor or me for a personal exercise regimen.
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