Bright Pink in Action-Know Your Risk!

No woman expects to be diagnosed with cancer at the age of 20. But, when Melissa’s pelvic pain refused to go away, she couldn’t write it off as a painful period or intense ovulation any longer. She knew her body, and something wasn’t right. The vague discomfort in her pelvis, the odd pain at the end of urination…all strange symptoms that just didn’t make sense.Beautiful young woman in bed, with hot water bag on her tummy

Blood work (CA125), ultrasounds, and finally a biopsy confirmed what Melissa had feared; She had ovarian cancer. Yes, the tumor was considered one of the most favorable types of ovarian cancer, but just the word “cancer” left her stunned. Moments before she had been a typical college student. Now, she was scheduling surgery to have her right ovary and half of her left ovary removed. The oncologist’s description of worst-case scenarios swirled in her head. Chemotherapy? Part of the tumor was attached to her colon. Without chemotherapy the cancer could potentially spread to her gut. What option did she really have?Woman Suffering From Stomachache On Sofa

Battling cancer once is enough for anyone, but one year after her daughter was born Melissa was diagnosed with a recurrence of ovarian cancer. Although the remainder of her left ovary was removed, making her cancer free, Melissa’s mother and aunt were diagnosed with breast cancer. Was this just a coincidence or was something else going on? With such a strong family history, she decided that it was time to meet with a genetic counselor. Melissa felt obligated, not just for her own sake but for that of her sister and her daughter to know if a genetic mutation such as a BRCA 1 or 2 (which can increase the risk for breast and ovarian cancer) ran in her family. If she tested positive she could potentially prevent breast cancer in her own future with a bilateral mastectomy; and, with increased screening and preventative steps her sister and daughter could potentially be spared the cancer diagnosis that she had received at the age of 20. Whatever she needed to do to stay healthy, to continue being a mom, and to protect her family…that was what she would do.Mother breastfeeding the little baby

Becoming a mom in the first place had been hard enough. Even though she was no longer a cancer patient, cancer had forced her into the role of infertility patient. With only ½ of one ovary, low estradiol levels, and high FSH and LH levels, Melissa was told that she could not get pregnant on her own. Donor eggs and In Vitro Fertilization were her only options for getting pregnant. Her sister had volunteered to donate eggs without hesitation, and the embryo transfer was a success! As a mom, Melissa felt an even stronger urge to get genetic testing. She wanted to make knowledgeable decisions. She wanted all of the information. She wanted peace of mind. The benefits of knowing her body even down to the smallest genetic mutation could guide her decision-making, her sister’s and her daughter’s.Concept Of Aging And Skin Care

Knowing is power. Knowing is prevention. Knowing is possibly life saving. Do you know your risks? If you are a woman with a personal or strong family history of breast or ovarian cancer it may be time to KNOW more about your genetic risks for cancer. By getting tested for gene mutations such as BRCA, you can take your health into your own hands. Be your best advocate, and let Bright Pink’s amazing resources guide you in your journey toward health. Take this Assess Your Risk quiz by clicking on this hyperlink to see if you would be a good candidate for genetic screening. This tool is a great resource for all women. Not only does it assess your genetic risks, it also looks at how your lifestyle choices may be impacting your breast and ovarian health. Could some simple lifestyle changes prevent you from developing breast or ovarian cancer? Take the Bright Pink Assessment to learn more.Woman Showing Pink Ribbon To Support Breast Cancer Cause

Melissa took the necessary steps to know her risks, including her genetic risks. She now has peace of mind knowing that her genetic testing came back normal. Do you have peace of mind? Even if you were to test positive for a genetic mutation, you too could find peace of mind knowing that preventative options for breast and ovarian cancer do exist for you and others in your family. Ignorance is never bliss, but a cancer free future can be!



How Safe are Your Breasts…in your 20’s and 30’s?

Breast Cancer Awareness Month is here! And while all of us are reminded to get our routine mammograms and breast exams, many of us who are younger than 40 dismiss the idea that breast cancer could affect us anytime soon. Since we don’t require mammograms yet we aren’t really at that much risk…right? Although the risk for breast cancer increases with age, certain genetic components (BRCA Gene Mutations) can put even young women at risk for breast and ovarian cancer. Knowing your risk can help you make informed decisions even before a breast cancer diagnosis. It may even change your breast cancer screening routine and prevention options.Portrait of confident female volunteers participating in breast

So, this October, if you are in your twenties or thirties, instead of just wearing a pink ribbon, racing for the cure, or making sure that you have had your annual breast exam (all of which are great!), take the time to know your genetic risk for breast and ovarian cancer. Since routine ovarian cancer screening isn’t recommended, knowing your genetic risk may be even more important for this type of cancer. Here are 3 things you need to know.

1. What are BRCA Gene Mutations and how do they increase my risk for Cancer?

Everyone has BRCA Genes, BRCA 1 and BRCA 2. These genes are actually designed to protect the body from cancer, but if a genetic mutation (negative change) occurs in either of these genes, they are unable to prevent breast, ovarian, and other cells in the body from dividing too quickly or in an uncontrolled way. This lack of regulation increases the risk for cancer. Most cases of cancer are not due to BRCA gene mutations. Only 5-10% of breast cancers and 10-15% of ovarian cancers are linked to BRCA mutations. And, while most cases of breast cancer are not due to BRCA mutations, if you have a mutation you are much more likely to develop breast and ovarian cancer (50% of women with a BRCA 1 or 2 mutation will develop breast cancer and 30% will develop ovarian cancer by the time they are 70 years old).Woman Showing Pink Ribbon To Support Breast Cancer Cause

2. How can my family history help me decide if I am at increased risk for a BRCA Mutation and should be tested?

Most people do not need genetic testing to determine if they have a BRCA mutation, but if after reviewing your family history you find a strong pattern of breast and ovarian cancer, you may want to meet with a genetic counselor to discuss your testing options. If you already know that your mother or a sibling has a BRCA mutation, you have a 50% chance of having one as well. So, while it isn’t guaranteed, the likelihood is high. The only way to truly know if you have a BRCA gene mutation is to have a genetic test done.

If you are diagnosed with a BRCA mutation it isn’t because of anything that you have done. Drinking too much soda, avoiding the gym, carb loading, smoking…none of these poor choices have given you a damaged BRCA gene. Unfortunately, you inherited your damaged gene (BRCA 1 or 2 or both) from either your father or your mother. YES, I SAID FATHER! Many women think that they only need to know their maternal breast cancer history, but this is not the case. Knowing the breast cancer history on your father’s side is equally important.

Here are some of the important things to look for in your family history:

-Multiple Relatives with Breast Cancer

-Any Relatives with Ovarian Cancer

-Relatives with Breast Cancer before the age of 50

-A Relative with breast cancer in both breasts

-A Male relative with breast cancer (yes, men have boobs too!)

-A Relative with a BRCA mutation

3. What if I do have a BRCA Gene Mutation…What then?

If you are diagnosed with a BRCA Gene Mutation you have options for additional screening tests, more frequent screening, and cancer risk reducing medications and surgeries. While finding out that your risk for breast and ovarian cancer is high may be scary, it can also be life saving. Knowing this information has allowed many women to detect cancer at earlier stages, allowing for better outcomes. In other women, risk reducing surgeries have prevented them from developing breast and ovarian cancers at all.

Bigstock_71110093The Centers for Disease Control and Prevention Division of Cancer Prevention and Control and Bright Pink have created a great website, KNOW BRCA, that allows women to self-assess their BRCA risk. You can create an online account for free (it is a secure/confidential page), log in your family history, and answer some easy questions. The assessment will then create a BRCA mutation risk score specifically for you that you can discuss with your family physician or OB/GYN. Simply click on the link above to get started. Don’t just cross your fingers and hope for the best. Take your health into your own hands and encourage other women in your life to do the same. It’s never to early to be proactive about your health!

From The Mom in Me, MD


Women Should STOP Doing Self Breast Exams????

In a world were PINK equals cancer survivor, and early detection means “feel your boobies” is it possible that self breast exams are harming more than they are helping? The United States Preventative Services Task Force thinks so, causing them to recommend against self breast exams. Although this recommendation has been around for several years, most women and even physicians that I meet aren’t aware of this change. I find that some women are enraged by the idea of eliminating self breast exams; It saved their lives! To be honest, although I usually follow the USPSTF recommendations, this one made me cringe and question for a moment. After reading their rationale and looking at the data, I understand their reasoning; but, recommending against self breast exams is not simply a change in my clinical practice, it is an upheaval of women’s health, medicine, beauty concept - naked woman with breast cance

For years, the medical community and amazing advocates for breast cancer prevention and early treatment (such as the Susan G. Komen Foundation) have been distigmatizing breast cancer and improving survival rates. They have done this by encouraging women to speak openly about their breasts, to become self-aware of their breast tissue, and to advocate for their own healthcare. If self exams are actually doing more harm than good, then how can we as women still self-advocate for healthy breasts and for early breast cancer detection? Are there still ways to take things into our own “hands”? Considering that I have a grandmother, two aunts, and numerous friends who have battled breast cancer, the answer better be a resounding, “YES”…and it is!

Here are some ways that you, your mother, your daughters, and your friends can continue to wave your pink ribbons high!Portrait of confident female volunteers participating in breast


All breast cancer cannot be prevented. Unfortunately, some of us just have it in our genes! However, for many of us there are some steps that we can take to decrease our chances of getting breast cancer. Check out the hyperlinks below for more detailed information (compliments of The Susan G. Komen Foundation!).

Fit woman wearing towel around shoulders showing thumbs up at th1. Get Active

Regular exercise has been linked with a 10-20% decrease in breast cancer risk. Not only does physical activity help you maintain a healthy body weight (which has been associated with decreased breast cancer risk), it also boosts the immune system, and it may lower estrogen levels (which can be protective against breast cancer).

2. Stay at a Healthy Weight

A healthy BMI after menopause is associated with lower risk of breast cancer. If you are overweight, start working on achieving a healthy BMI. If you are already at a healthy weight, keep eating a healthy diet and exercising to keep yourself there.

3. Limit Your Alcohol

Higher amounts of alcohol consumption have been linked to increased risk for breast cancer. Drinking in moderation is always a good choice.

4. Breastfeed if possible

Breastfeeding is known to decrease your risk for breast cancer later in life. Not only is it great for your baby, it may protect you from cancer!Young Mother Breastfeeding A Baby In Nature

5. Limit Menopausal Hormone exposure

Many of the estrogen/progesterone containing hormones used for menopausal symptoms have been linked to increased risk for breast cancer. Limit these and ask your physician about other options for treating hot flashes and vaginal dryness.

Early Detection

1. Know Your Risks!

Know your risk factors! If you are at higher risk due to your family history you may need additional screening steps such as MRI’s and genetic testing. Click here for a family history risk factor check list. Talk with your doctor about your overall risk for breast cancer based on your family history and other risk factors combined.

2. Know Your Boobs!

Although self breast exams are getting a thumbs down, this doesn’t mean that you should ignore your boobs! Instead, you should be familiar with what your breast tissue normally feels like so that you will be able to recognize concerning changes such as lumps, dimpling, nipple discharge, and pain. For a full list of concerning changes click here.

3. Let Someone Who Knows Breasts (don’t over think this!) Examine Your Boobs! 

Although breast exams in the doctor’s office may not catch all breast cancer early and have gotten a, “neither here nor there” from the USPSTF, they are still a reasonable screening tool according the American Cancer Society. Since mammograms aren’t recommended for most women until they turn 40, breast exams by a physician offers a screening option to younger women. Current recommendations from the American Cancer Society are for breast exams in the office yearly by a physician if you are 40 years old or older and at least every three years if 20-39 years old.

4. Get Your Mammogram

Some controversy also arose over when to start getting mammograms and how often. I still tend to agree with the stricter protocols until we have more research to say otherwise. So for now, I would follow the American Cancer Society recommendations. If you are at normal risk for breast cancer start getting your mammogram every year starting at age 40.Woman Showing Pink Ribbon To Support Breast Cancer Cause

Taking these steps toward prevention and early detection may just save your life! Although monthly self breast exams may not be the key screening tool against breast cancer, the overall message for women is still the same. Kick breast cancer in the “—“. Knowing your boobs, talking openly about breast cancer and its risks, advocating for your own health as a woman, and encouraging other women to do the same will continue to increase early detection and thus survival rates. So, whether you keep feeling your boobies, or you decide to just get really well acquainted with them…you are advocating for your own health and that’s what really matters!

For more on reasons why self breast exams are no longer recommended by the USPSTF please check out these link from The United States Preventative Services Task Force on self breast exam. Other organizations are not taking such a strong stance against self breast exams, but many are saying that they are not encouraging them (as documented in the linked article above). However, even the Susan G. Komen Foundation is not recommending them.

And, to all of you who have a personal story with breast cancer, please feel free to share your comments. Your insight is priceless!

From The Mom in Me, MD