Breast Cancer Screening

Breast cancer is best treated at reputable centers with combined disciplines attending tumor boards and individualized for each patient’s needs.
Breast cancer is one of the most common types of cancer in women. One in eight women will develop breast cancer.
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Breast cancer does seem to have both genetic and hormonal risk factors:

  • Genetic causes: Immediate family history increases your risk 2-3 times.
  • Hormones: Extra exposure to estrogens after menopause if taken more than five continuous years
  • Having first child after the age of 30.
  • Earlier than age 12 onset of menarche
  • Late menopause after the age of 55
  • Abnormally short or long menstrual cycle.
  • Increasing age over 50
  • Being overweight

Warning signs of Breast Cancer:

  • New lump in the breast or armpit
  • Pain or tenderness in the breast
  • Alteration of size or shape of the breast
  • Alteration of the breast skin or in the nipple
  • Itching or burning nipples, or ulceration of the nipples
  • Abnormal bloody or clear discharge from the nipple

Do not use any center for imaging techniques, ask your physician for recommendation and follow up with your results and future appointments better pricing not always has reliable quality.
Diagnosing Breast Cancer
Visit us with any concern

A screening test is used to find conditions in people who do not have signs or symptoms. This allows early treatment.
In the United States, one in eight women will develop breast cancer by age 75 years. Regular breast screening can help find cancer at an early and more curable stage. Screening also can find problems in the breasts that are not cancer.
Mammography is the primary tool used to screen for breast cancer and other problems. Mammography uses X-ray technology to view the breasts. The images created are called a mammogram. A physician called a radiologist reads the images.
Mammography is done for two reasons: 1) as a screening test to check for breast cancer in women who do not have signs or symptoms of the disease, and 2) as a diagnostic test to check lumps or other symptoms that you have found yourself or that have been found by an obstetrician–gynecologist (ob-gyn) or other health care professional. This FAQ focuses on screening mammography.
The day of your test you should not wear powders, lotions, or deodorants. Most of these products have substances that can show on the X-ray. They can make your mammogram hard to interpret.
You will need to completely undress from the waist up and put on a gown. You will be asked to stand in front of an X-ray machine. One of your breasts will be placed between two flat plastic plates. You will feel firm pressure on your breast. The plates will flatten your breast as much as possible so that the most amount of tissue can be viewed. These steps will be repeated to take a side view of the breast. The test then is done on the other breast.
The pressure of the plates often makes the breasts ache. This discomfort is brief. If you are still having menstrual periods, you may want to have the test done in the week right after your period. The breasts often are less tender after your period.
Radiologists use a system called BI-RADS to classify mammography results. Your screening mammogram result will be given a score. Scores range from 0 to 5 and mean the following:

0—More information is needed. You may need another mammogram before a score can be given.
1—Nothing abnormal is seen. You should continue to have routine screening.
2—Benign conditions, such as cysts, are seen. You should continue to have routine screening.
3—Something is seen that probably is not cancer. A repeat mammogram should be done within 6 months.
4—Something is seen that is suspicious for cancer. You may need to have a biopsy.
5—Something is seen that is highly suggestive of cancer. You will need to have a biopsy.
Fibrous tissue and fat give breasts their shape. When breasts are dense, they have more fibrous tissue and less fat. Breast density is a normal and common finding on a mammogram, but breast density may make it harder for a radiologist to see cancer. If your report says you have dense breasts, your ob-gyn or other health care professional may discuss other screening tests in addition to mammography.
A woman may be at high risk of breast cancer if she has certain risk factors. These risk factors include a family history of breast cancer, ovarian cancer, or other inherited types of cancer; BRCA1 and BRCA2 mutations; chest radiation treatments at a young age; and a history of high-risk breast biopsy results. Women without these risk factors are at average risk.
For women at average risk of breast cancer, screening mammography is recommended every 1–2 years beginning at age 40 years. If you have not started screening in your 40s, you should start having mammography no later than age 50 years. Screening should continue until at least age 75 years.
Like other screening tests, mammography is not perfect. Mammography may miss cancer even when it is present. If results do not show cancer but you do in fact have cancer, it is called a false-negative result. False-negative results can lead to delays in treatment. Mammography also may show something that is thought to be cancer, but when results of follow-up tests are read, they show that you do not have cancer. This is called a false-positive result. Follow-up testing can be inconvenient and uncomfortable, and it can cause anxiety.
Your ob-gyn or other health care professional may examine your breasts during routine checkups. This is called a clinical breast exam. The exam may be done while you are lying down or sitting up. The breasts are checked for any changes in size or shape, puckers, dimples, or redness of the skin. Your ob-gyn or other health care professional may feel for changes in each breast and under each arm.

For women who are at average risk of breast cancer and who do not have symptoms, the following are suggested:

  • Clinical breast exam every 1–3 years for women aged 25–39 years
  • Clinical breast exam every year for women aged 40 years and older
Breast self-awareness focuses on having a sense of what is normal for your breasts so that you can tell if there are changes—even small changes—and report them to your ob-gyn or other health care professional.
Breast cancer often is found by a woman herself. This happens in almost one half of all cases of breast cancer in women aged 50 years and older. In women younger than 50 years, more than 70% of cases of breast cancer are found by the women themselves.

If you are aged 40 years or older, you can start the conversation with these questions:

  • What are my chances of having breast cancer?
  • When should I start getting regular mammograms?
  • How often should I get them?
  • You can ask more specific questions based on your age. If you are aged 40–49 years:
  • What are the pros and cons of getting mammograms before I turn 50?
  • If you are aged 50–75 years:
  • What are the pros and cons of getting mammograms every 2 years instead of every year?
  • If you are older than 75 years:
  • Do I need to keep having mammograms?

You and your ob-gyn or other health care professional should share information, talk about your wishes, and agree on when and how often you will have breast screening.

Cervical Cancer

Pap smears are screening tests with lower cost, easy accessibility and compromised accuracy. It is imperative to discuss with your OB/GYN your risk factors, history and customize not standardize your examination.

Routine forms of Cervical cancer should be eliminated with routine & not excessive evaluations in my professional view.

Cervical cancer rarely presents with symptomatology unless advanced.

The cervix is the opening of the uterus, located at the top of the vagina. When the abnormal cells of the cervix begin to divide at an accelerated rate they will penetrate deeper into the layers of the cervix and spread to other tissues and organs.

Causes of Cervical Cancer:

The most causative etiology is the high-risk category types of human papillomavirus (HPV) which can also cause cancer in other parts of the body, including the anus, vagina, vulva, neck, and head.

These are some risk factors for HPV infection:

  • Early initiation of sexual activity
  • Multiple sexual partners
  • Having a sexual partner, especially a male partner, who has multiple sexual partners
  • History of dysplasia

Family history of cervical cancer

  • Some sexually transmitted infections (ex: chlamydia)
  • Smoking
  • Immunodeficiency
  • Mother who took DES (diethylstilbestrol) during her pregnancy with you

Some warning signs of cervical cancer include:

  • Spotting or abnormal vaginal bleeding
  • Heavy menstrual bleeding
  • Bleeding after sex
Cervical cancer screening is used to find changes in the cells of the cervix that could lead to cancer. The cervix is the opening to the uterus and is located at the top of the vagina. Screening includes cervical cytology (also called the Pap testor Pap smear) and, for some women, testing for human papillomavirus (HPV).
Cancer occurs when cervical cells become abnormal and, over time, grow out of control. The cancer cells invade deeper into the cervical tissue. In advanced cases, cancer cells can spread to other organs of the body.
Most cases of cervical cancer are caused by infection with HPV. HPV is a virus that enters cells and can cause them to change. Some types of HPV have been linked to cervical cancer as well as cancer of the vulva, vagina, penis, anus, mouth, and throat. Types of HPV that may cause cancer are known as “high-risk types.” HPV is passed from person to person during sexual activity. It is very common, and most people who are sexually active will get an HPV infection in their lifetime. HPV infection often causes no symptoms. Most HPV infections go away on their own. These short-term infections typically cause only mild (“low-grade”) changes in cervical cells. The cells go back to normal as the HPV infection clears. But in some women, HPV does not go away. If a high-risk type of HPV infection lasts for a long time, it can cause more severe (“high-grade”) changes in cervical cells. High-grade changes are more likely to lead to cancer.
It usually takes 3–7 years for high-grade changes in cervical cells to become cancer. Cervical cancer screening may detect these changes before they become cancer. Women with low-grade changes can be tested more frequently to see if their cells go back to normal. Women with high-grade changes can get treatment to have the cells removed.
Cervical cancer screening includes the Pap test and, for some women, an HPV test. Both tests use cells taken from the cervix. The screening process is simple and fast. You lie on an exam table and a speculum is used to open the vagina. The speculum gives a clear view of the cervix and upper vagina. Cells are removed from the cervix with a brush or other sampling instrument. The cells usually are put into a special liquid and sent to a laboratory for testing:
  • For a Pap test, the sample is examined to see if abnormal cells are present.
  • For an HPV test, the sample is tested for the presence of 13–14 of the most common high-risk HPV types.
How often you should have cervical cancer screening and which tests you should have depend on your age and health history:
  • Women aged 21–29 years should have a Pap test alone every 3 years. HPV testing is not recommended.
  • Women aged 30–65 years should have a Pap test and an HPV test (co-testing) every 5 years (preferred). It also is acceptable to have a Pap test alone every 3 years.
You should stop having cervical cancer screening after age 65 years if
  • you do not have a history of moderate or severe abnormal cervical cells or cervical cancer, and
  • you have had either three negative Pap test results in a row or two negative co-test results in a row within the past 10 years, with the most recent test performed within the past 5 years.
    If you have had a hysterectomy, you still may need screening. The decision is based on whether your cervix was removed, why the hysterectomy was needed, and whether you have a history of moderate or severe cervical cell changes or cervical cancer. Even if your cervix is removed at the time of hysterectomy, cervical cells can still be present at the top of the vagina. If you have a history of cervical cancer or cervical cell changes, you should continue to have screening for 20 years after the time of your surgery.
    Yes. Women who have a history of cervical cancer, are infected with human immunodeficiency virus (HIV), have a weakened immune system, or who were exposed to diethylstilbestrol (DES) before birth may require more frequent screening and should not follow these routine guidelines. Having an HPV vaccination does not change screening recommendations. Women who have been vaccinated against HPV still need to follow the screening recommendations for their age group.
    Many women have abnormal cervical cancer screening results. An abnormal result does not mean that you have cancer. Remember that cervical cell changes often go back to normal on their own. And if they do not, it often takes several years for even high-grade changes to become cancer. If you have an abnormal screening test result, additional testing is needed to find out whether high-grade changes or cancer actually are present. Sometimes, only repeat testing is needed. In other cases, colposcopy and cervical biopsy may be recommended to find out how severe the changes really are. If results of follow-up tests indicate high-grade changes, you may need treatment to remove the abnormal cells. You will need follow-up testing after treatment and will need to get regular cervical cancer screening after the follow-up is complete.
    As with any lab test, cervical cancer screening results are not always accurate. Sometimes, the results show abnormal cells when the cells are normal. This is called a “false-positive” result. Cervical cancer screening also may not detect abnormal cells when they are present. This is called a “false-negative” result. To help prevent false-negative or false-positive results, you should avoid douching, sexual intercourse, and using vaginal medications or hygiene products for 2 days before your test. You also should avoid cervical cancer screening when you have your menstrual period.

    Endometriosis:

    The endometrium (inside lining of the uterine cavity) responds to hormones by thickening in preparation for pregnancy. In absence of fertilization, it sloughs and becomes your period.

    Endometrial tissue grows outside the uterine cavity, It can implant on the fallopian tubes, ovaries, the external surface of the uterus, the rectum, intestines, and urinary organs. The implants can become inflamed, irritated, and scarred. the adhesions can cause organs to stick together, which can be painful. Affecting around 10 percent of women in their childbearing years mostly diagnosed between the ages of 30-40.

    Signs & Symptoms of Endometriosis:

    • Chronic pelvic pain
    • Heavy bleeding
    • Painful intercourse
    • Painful bowel movements or urination (if implants are affecting these organs)
    • Infertility

    Diagnosis:

    • Laparoscopy & biopsy: Definite
    • History & Exam plus Imaging: Suggestive

    Endometriosis & treatment options:

    • Hormonal Therapies: birth control pills, GnRH agonists, and progestin medications.
    • Surgery & excision or fulguration: With fertility desires.
    • Hysterectomy

    Executive Woman Exam

    American Board Certified Consultant OB/GYN is trained to be primary gatekeepers for all women’s health issues, most like a subspecialist family practitioner with added skills in Obstetrics and Gynecologic procedures.

    We recommend that women have their first well woman exam at age 21 or three years after beginning intercourse, whichever comes first.

    Talk with your physician about your mental, sexual, reproductive, physical and specific medical conditions during annual exams expect:​

    • Contraception & Family planning
    • OCP Choices
    • Barrier techniques
    • IUD types
    • Family history
    • Social changes(work, stresses, smoking, alcohol, drugs, and marital status)
    • Your medications
    • Sexual life desires and changes
    • Bowel & bladder
    • Menstruations
    • Mental well being or concerns
    • Cancer screening9 Pap test, Breast exam and imaging, Colonoscopy)
    • STD testing
    • Hormonal changes
    • Vaccinations
    • Cardiac risk factors
    • Blood test and vitamin checks
    • Pelvic & Breast exams
    • Pelvic Ultrasound
    • Use the opportunity to prevent diseases and maintain your youth.