����������������������������������������������������������������������������������������������������
��ammograms—diagnostic
imaging tests that
help doctors spot potentially
cancerous lumps within
the breast—are one of the most
important screenings women
receive during their lifetimes.
When to begin screening, however,
isn’t always clear-cut,
especially for women who recently
turned 40.
Each woman’s personal
breast cancer risks affect when
they should begin screening,
how often screenings are
needed and if mammograms
should be supplemented with
other imaging methods like
breast magnetic resonance
imaging (MRI) or ultrasound.
James Rucinski, M.D., breast
surgeon and director of surgical
education in the Department of
Surgery at NewYork-Presbyterian
Brooklyn Methodist, recommends
that women follow
the American Cancer Society’s
(ACS’s) screening guidelines.
These guidelines advise that
women with an average risk of
breast cancer:
���� ������������ �������������� ����������-
grams at 45
����������������������������������������������������������
mammograms at 55
COURIER L 38 IFE, OCT. 4-10, 2019
���� ������������������ ���������������������� ������
long as they are healthy
���� ������ ������������ ������ �������� ���������� ������������
doctors about breast changes
Additionally, the ACS notes
that women should have the
choice to begin having mammograms
at age 40 and continue
annual screenings past
age 55.
“The majority of women
with breast cancer don’t have a
family history of the disease,”
says Yael Fuchs, M.D., gynecologist
at NewYork-Presbyterian
Brooklyn Methodist. “That’s
why it’s important for all
women to visit their doctors,
become aware of their risk and
develop a plan for screening.”
All women are at some risk
for breast cancer—one in eight
women develops the disease.
Doctors diagnose the majority
of breast cancers in women
over age 55. However, age is
only one consideration. A variety
of things can influence
breast cancer risk. When a
woman meets with her doctor
to develop her breast cancer
screening plan, her doctor will
likely perform an exam and
take a detailed personal and
family medical history. The
findings from this visit help
women understand if they fall
into average or higher risk categories.
Women with an average
risk, according to Dr. Rucinski,
have no confirmed or suspected
genetic mutation associated
with breast cancer and
no previous personal history of
breast cancer or radiation therapy
to the chest. They also have
no significant family history of
the disease. Those with a family
history have a higher than
average risk, particularly if
women have one or more firstdegree
relatives who’ve had
breast cancer.
“When women have a family
history, we recommend starting
annual mammograms and
breast exams 10 years before
the age at which their first-degree
relative was diagnosed or
at age 40, whichever is earlier,”
says Hani Ashamalla, M.D.,
chief of NewYork- Presbyterian
Brooklyn Methodist Hospital’s
Department of Radiation Oncology.
In some cases, a strong
family history of breast cancer
can suggest mutations in
certain genes that are passed
through families. These genes
raise a woman’s risk for multiple
cancers, including breast
cancer. The most common
gene mutations associated
with breast cancer occur in
the BRCA1 or BRCA2 genes.
Women with a BRCA gene mutation
have a 70 percent likelihood
of developing breast cancer
by their 80th birthdays.
“If women have family members
with a BRCA gene mutation,
we recommend genetic
testing to see if they also carry
the mutation,” Dr. Fuchs says.
“I advise women with a BRCA
mutation to get a clinical breast
exam every six months and a
yearly mammogram, breast ultrasound
and breast MRI.” Outside
of personal and family history,
doctors may also consider
these factors when assessing a
woman’s breast cancer risk:
����������������������
���� ���������� ������ ������������ �������� ������������
menstruating, gave birth to
her first child and, if applicable,
completed menopause
������������������������������������������������������������
biopsies in the past
������������������������������������������
���� ������������ �������������� ��������������������-
ties, such as the presence of benign
tumors or multiple cysts
within the breast
To schedule your mammogram
or breast exam, please call
the Women’s Diagnostic Center
at NewYork-Presbyterian
Brooklyn Methodist Hospital at
718-780-5029.
Diabetes affects 23.6 million
people in the United
States and close to three
million people in Canada.
While diabetes can be accompanied
by many different
symptoms, some people are
surprised to learn that diabetes
can affect the eyes and vision.
Changes in vision are
sometimes the earliest warning
signs of the presence of
diabetes or prediabetes. Diabetic
eye disease is its own
stand-alone condition, and the
National Eye Institute points
out that diabetic eye disease
comprises a group of eye conditions
that affect people with
diabetes. These may include
retinopathy, macular edema,
cataracts, and glaucoma. All
forms of eye disease can potentially
cause severe vision loss
or blindness.
Those with diabetes also
can experience xanthelasma,
or yellowish collections of cholesterol
around the eye area.
What’s more, diabetes can put
individuals at risk of developing
conjunctival bacterial infections
(pink eye), as well as
corneal erosions, corneal defects,
and subsequent dry eyes.
According to the American
Diabetes Association, people
with diabetes are at a 40-percent
greater risk of suffering
from glaucoma than people
without diabetes. The longer
someone has had diabetes, the
more common glaucoma is.
Diabetics also are 60 percent
more likely to develop cataracts.
Vision checkups and
care are an important part of
living with diabetes.
Routine eye examinations
can head off potential vision
problems and have been known
to alert doctors to the presence
of diabetes before patients
know they have it. During a
comprehensive dilated eye
exam, eye doctors will examine
all areas of the eye to check
for illness. Pressure on the eye
will be tested, as glaucoma can
cause elevated pressure. The
doctor also will check for any
clouding of the eye lens.
When an eye is dilated, doctors
can examine the retina at
the rear of the eye. Points that
will be checked include:
• changes to blood vessels,
including any leaking blood
vessels or fatty deposits
• swelling of the macula
• damage to nerve tissue
• health of the retina, and
whether there are any tears or
detachments
While many of the vision
loss problems associated with
diabetes are irreversible, early
detection and treatment can
reduce the risk of blindness
by 95 percent, advises the National
Eye Institute. Controlling
diabetes slows the onset
and worsening of visual symptoms.
People with diabetes
may need to see their eye doctors
more frequently and have
a greater number of dilated exams
to ensure eyes are still in
good health.
How diabetes
affects vision
Routine eye examinations can help doctors diagnose diabetes early. Such examinations also are important in
the management of the disease and the prevention of vision loss.
Health