by H. Zis Weisberg, M.D.

    Therefore, the risk of breast cancer increases dramatically with age. This is true for approximately 90% of breast cancer cases. For women with hereditary breast cancer, the risk is much higher and at an earlier age. Five to ten percent of breast cancer cases are caused by inheriting a faulty, or mutated gene. This gene is called BRCA for breast cancer. If a woman inherits this gene, her lifetime risk for developing breast cancer is around 85%. This mutated gene also increases the risk for ovarian cancer. Women with BRCA mutations are young at diagnosis, typically 30’s and 40’s. Women with Central or Eastern European Jewish ancestry have an increased risk of BRCA mutations. The gene can be inherited from one’s mother or father, and is associated with male breast cancer.

    When possible, women should investigate their family history of cancer. Try to find out who had cancer. What kind was it? How old were they when it was diagnosed? A history of breast cancer in close relatives (such as mother, sister, and daughter) is most relevant, especially if it occurred at a young age. If you discover such a history in two or more close relatives, discuss this with your doctor. Genetic testing is available. Women who test positive for BRCA mutations have options that can decrease their risk of developing cancer. Options include prophylactic removal of breasts and ovaries. While prophylactic surgery can dramatically decrease the risk of breast and ovarian cancer, the decision to do so carries important health consequences.

    Issues such as breast reconstruction, the treatment of menopausal symptoms, and osteoporosis prevention need to be addressed. While performing self-breast examination is important, it is critical that all women know their family history of cancer. This history could save your life. •

by Marilyn Seiger

Too many checkups, too little time? You owe it to yourself to get the recommended screenings. Partner with your doctor to determine the preventative tests you need and when you need them, based on your personal health profile.

As a woman, you have many reasons- birth control, pregnancy, menopause, and protection against potentially fatal conditions, such as cervical and breast cancer- to see your family doctor or gynecologist regularly. These visits typically include pelvic and breast exams. But if you’re at high risk for certain diseases, your doctor may recommend additional tests, or want you to be screened more frequently or at a younger age. Those factors may include family history; smoking; and your age, sex or ethnic group.

In any case, you need to play an active role. If you’re not sure how to do a breast self-exam, for instance, ask your doctor to show you. And make sure these vital preventive tests are part of your health routine:

Pelvic check. During a screening pelvic exam, your doctor checks your cervix, ovaries and uterus, and performs a Pap test, or Pap smear, unless you’ve had a hysterectomy. A Pap smear helps detect changes in the cells of the cervix, the opening of your uterus, which could lead to cancer. Over the past 50 years, the Pap smear has lowered the number of deaths from cancer of the cervix by 70% in the United States. Your doctor gently scrapes the surface of your cervix to collect a sample of cells for evaluation. Discuss with your doctor when to start having Pap smears and how often to have them. Generally, you should have your first Pap smear when you start having sex or by age 21. Continue once a year until you’ve had at least three normal results. After that, have a Pap smear at least every three years until age 65, unless your doctor thinks you should have one more often due to risk factors or previously abnormal smears.

Breast health exams. About one in nine women develops breast cancer, and the risk increases with age. Finding and treating breast cancer early can save your life. About 90% of breast lumps are found during breast self-exams, which you can do regularly, beginning at about age 20. Your doctor should also check your breasts regularly for lumps and irregularities. Despite some controversy about its benefits in women under age 50, mammography, a breast x-ray, is still considered the gold standard for early detection of breast cancer by leading cancer organizations. The American Academy of Family Physicians recommends that, starting at age 40, you should have a mammogram every one to two years, after your family doctor has counseled you about potential benefits and risks.

Osteoporosis screening. After age 30 to 35, women begin to lose bone mass. This loss speeds up after menopause, unless estrogen hormones are taken. At age 65, or at age 60 if there are extra risk factors, women should have a screening osteoporosis scan. Your family doctor can arrange this. If you have osteoporosis, treatment can be started that will help prevent further thinning of your bones and even improve bone strength in some cases.

Plan your checkups. For a healthier you, let your family doctor be your guide to detecting and preventing problems. Take time to make checkups and screenings a part of your health routine for a lifetime. You’re worth it.