Understanding the role
insulin plays in the body
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��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:
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grams at 45
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mammograms at 55
COURIER L 34 IFE, OCT. 4-10, 2019
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long as they are healthy
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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:
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menstruating, gave birth to
her first child and, if applicable,
completed menopause
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biopsies in the past
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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.
Insulin plays a key role in
metabolic functions in the
body. People with diabetes
have an intimate knowledge of
insulin, particularly if they do
not produce enough naturally.
However, the rest of the public
may be less knowledgeable about
the role of insulin and its impact
on overall health.
Insulin is produced in the
pancreas of the human body. Its
most important function is the
way it interacts with glucose
(blood sugar) to allow the cells
of the body to use that glucose
as energy.
Insulin can be viewed as a
type of key that unlocks the
cells and enables glucose to enter.
The pancreas senses when
there is a spike in glucose in
the bloodstream and reacts by
producing insulin.
According to the Hormone
Health Network, insulin also
works to ensure the liver stores
excess glucose so that it is not
actively in the blood. Stored
glucose is called glycogen.
This glycogen can be converted
into fat when it is needed.
Insulin also affects other metabolic
processes, such as the
breakdown of protein or fat.
If insulin is not being produced
in the right amounts, the
result is high blood sugar, or
hyperglycemia.
Chronic hyperglycemia is
the hallmark of diabetes mellitus.
Complications of high
blood sugar include damage to
the nervous system, kidneys,
eyes, and the extremities.
Type 1 diabetes occurs when
the pancreas fails to produce
enough insulin. Supplementation
with insulin will be necessary
to avoid drastic changes in
blood glucose levels.
When a person has type 2 diabetes,
cells fail to respond to
insulin properly.
This is referred to as insulin
resistance. As the disease progresses,
a lack of insulin may
also develop.
Typically with this type of
diabetes, excessive body weight
and not enough exercise are the
culprits in insulin resistance.
Eating a healthier diet and
becoming more physically active
can help reverse the condition.
Too little glucose in the
blood (hypoglycemia) can make
a person feel irritable, tired, or
confused. Low blood sugar can
lead to loss of consciousness.
That is why it is crucial that
blood sugar concentrations remain
relatively stable.
Without insulin, the body
could not effectively make use
of the energy obtained through
eating and drinking.
Health