Mammogram

What is a mammogram?

A mammogram is an X-ray test that produces an image of the inner breast tissue on film. This technique, called mammography, is used to visualize normal and abnormal structures within the breasts. Mammography, therefore, can help in identifying cysts, calcifications, and tumors within the breast. It is currently the most efficient screening method to detect early breast cancer. Breast self-examination (BSE) on a monthly basis and examination by a doctor are still important, but physical examinations typically find breast cancers when they are much larger than those detected by mammography.
Mammography can be used to discover a small cancer in a curable stage; however, it is not foolproof. Depending a woman's age and other factors, approximately ten to fifteen percent of breast cancers are not identified by mammography, and these cancers are often found by physical examination. It is essential for a woman to perform monthly BSE and have a breast examination by her doctor in addition to the mammogram in order to most effectively screen for breast cancer. For more information, please see the Breast Cancer article.
The American Cancer Society recommends that a woman obtain her first baseline mammogram between the ages of 35 to 40. After the age of 40, she should receive a yearly mammogram. Women who are at high risk for developing breast cancer may need to obtain mammograms earlier than these recommendations and at more frequent intervals. Medicare, Medicaid, and most private insurance companies cover the cost of mammography.

What are the risks of mammography?

Because x-ray procedures use radiation, there is some small risk of radiation side effects to the body. The amount of radiation that is administered in mammography is exceptionally low and is approved by national and international regulatory agencies as well as the National Department of Health and Human Services. However, patients who are pregnant or may be pregnant are advised to notify their requesting practitioner and radiology staff, because radiation can pose a risk to the developing fetus.

How is a mammogram performed?

A brief medical history and a history of specific problems related to the breast, such as pain or a palpable lump (one that is felt), is obtained prior to the mammogram. A small x-ray marker may be taped on the breast overlying the palpable lump. This will help in determining whether any other special mammogram views need to be done beyond the standard views. All jewelry and clothing in the chest and breast area are removed prior to the mammogram. The patient's breasts are then placed on a firm flat panel and a gentle, but firm pressure is applied to the breast with another panel, resulting in compression of the breast between the two panels. This compression causes a degree of discomfort that lasts only for a few seconds. The compression of the breast is necessary to obtain quality mammograms and spreads the breast tissue out so that the x-ray image displays the inner breast tissue with good resolution. If compression is not used, the mammograms may be blurry, breast tissue may not be well delineated, and small lesions can be overlooked.
Antiperspirants, deodorants, and powders should not be worn during mammography and should be removed prior to the procedure, as these substances may make interpretation of the results more difficult. Antiperspirants can cause the images to appear foggy, and powders can sometimes simulate the appearance of microcalcifications (an abnormal finding that is sometimes associated with breast cancer).
Generally, two x-rays are obtained of each breast. More views may be obtained if the breasts are large, the woman has had a breast augmentation, or there is an area on the initial mammography views that needs to be further examined. Special magnified or localized mammograms of a specific area of the breast can then be done.
A radiology technologist is responsible for performing mammography. Once the x-ray pictures are taken, they are developed and examined by a radiologist (a doctor who specializes in the interpretation of x-rays and other imaging studies). In most mammography centers, these radiologists have also had extra training dedicated to interpreting mammograms.

How does a patient receive the results of the mammogram?

The results of the mammogram can be given to the patient either by the radiologist at the completion of the mammogram or by the patient's doctor who ordered the mammogram. In many cases, it will be by both doctors. In some cases, the patient will receive a card in the mail with the results of the mammogram. The report of the mammogram generally takes a few days to reach the referring doctor by mail. However, when there is a suspicious area on the mammogram, this information is usually relayed directly to the referring doctor by phone so that further evaluation of this area can be done expeditiously. A patient should call the doctor if she has not received the results of a mammogram in a reasonable period of time. The patient should not just assume the mammogram was normal.

What if the mammogram is abnormal?

Do not panic if you are told that your mammogram is abnormal or that there is a "spot" on your mammogram. An abnormal mammogram does not mean you have cancer. The overwhelming majority of abnormal mammograms are caused by benign (harmless) processes. In some cases, it may just be an area of thicker or more dense breast tissue, a cyst, or a benign lump such as a fibroadenoma. When a mammogram detects a suspicious area, the patient may be advised to obtain further mammograms of that area, to have an ultrasound or other imaging study of the breast, to see a specialist in diseases of the breast (this is usually a general surgeon), or to have a biopsy performed of the suspicious area.
A breast biopsy is the removal of a piece of breast tissue for examination under a microscope. The biopsy can be performed surgically, in which an incision is made and the area removed, or it can be done as a stereotactic core biopsy. Stereotactic core biopsy is a technique of removing samples of the suspicious area without the need of traditional surgery. In this technique, the doctor, with the aid of a special mammography machine and a computer, can identify precisely the abnormality in the breast and then obtain very thin core samples of breast tissue with a special needle. This biopsy test is done with only a local anesthetic in the area of the needle puncture and is generally painless.
Fortunately, most breast biopsies give benign results. While mammography is not sufficiently accurate to diagnose or exclude breast cancer alone, it is currently the best method available to screen for breast cancer. Since its more widespread routine use, breast cancers are found when they are significantly smaller and more curable. More women are surviving breast cancer as a result of mammography and early cancer treatment. Continued use of routine mammography should be encouraged until a better alternative in breast cancer detection has been found. For more information, please Breast Cancer Prevention article.

Mammograms At A Glance

• Mammograms are images of the breast tissue produced on x-ray film.

• Mammograms are the most efficient screening method to detect early breast cancer.

• Monthly breast self-examination and regular doctor's examinations are combined with mammography for optimal breast cancer screening.

• An abnormal mammogram does not necessarily mean that a cancer is present, Other tests, including biopsy, may be performed for further clarification of an abnormal mammogram.

• A normal mammogram does not exclude the presence of cancer.

SOURCE:MEDICINENET.COM

WEIGHT LOSS TIPS

Weight Loss Pictures Slideshow: 24 Ways to Lose Weight Without Dieting

Reviewed by Louise Chang, MD on Monday, August 08, 2011

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Time Your Meals

Set a timer for 20 minutes and reinvent yourself as a slow eater. This is one of the top habits for slimming down without a complicated diet plan. Savor each bite and make it last until the bell chimes. Paced meals offer great pleasure from smaller portions and trigger the body's fullness hormones. Wolfing your food down in a hurry blocks those signals and causes overeating.

Sleep More, Weigh Less

Sleeping an extra hour a night could help a person drop 14 pounds in a year, according to a University of Michigan researcher who ran the numbers for a 2,500 calorie per day intake. His scenario shows that when sleep replaces idle activities – and the usual mindless snacking – you can effortlessly cut calories by 6%. Results would vary for each person, but sleep may help in another way, too. There's evidence that getting too little sleep revs up your appetite, making you uncommonly hungry.

Serve More, Eat More Veggies

Serve three vegetables with dinner tonight, instead of just one, and you'll eat more without really trying. Greater variety tricks people into eating more food – and eating more fruits and vegetables is a great way to lose weight. The high fiber and water content fills you up with fewer calories. Cook them without added fat. And season with lemon juice and herbs rather than drowning their goodness in high-fat sauces or dressings.

When Soup's On, Weight Comes Off

Add a broth-based soup to your day and you'll fill up on fewer calories. Think minestrone, tortilla soup, or Chinese won-ton. Soup's especially handy at the beginning of a meal because it slows your eating and curbs your appetite. Start with a low-sodium broth or canned soup, add fresh or frozen vegetables and simmer. Beware of creamy soups, which can be high in fat and calories.

Go for Whole Grains

Whole grains such as brown rice, barley, oats, buckwheat, and whole wheat also belong in your stealthy weight loss strategy. They help fill you up with fewer calories and may improve your cholesterol profile, too. Whole grains are now in many products including waffles, pizza crust, English muffins, pasta, and soft "white" whole-wheat bread.

Eyeball Your Skinny Clothes

Hang an old favorite dress, skirt, or a smokin' pair of jeans where you'll see them every day. This keeps your eyes on the prize. Choose an item that's just a little too snug, so you reach this reward in a relatively short time. Then pull out last year's cocktail dress for your next small, attainable goal.

Skip the Bacon

Pass on those two strips of bacon at breakfast or in your sandwich at lunch time. This simple move saves about 100 calories, which can add up to a 10 pound weight loss over a year. Other sandwich fixings can replace the flavor with fewer calories. Think about tomato slices, banana peppers, roasted red bell peppers, grainy mustard, or a light spread of herbed goat cheese.

Build a Better Slice of Pizza

Choose vegetable toppings for pizza instead of meat and you may be able to shave 100 calories from your meal. Other skinny pizza tricks: Go light on the cheese or use reduced-fat cheese and choose a thin, bread-like crust made with just a touch of olive oil.

Sip Smart: Cut Back on Sugar

Replace one sugary drink like regular soda with water or a zero-calorie seltzer and you'll avoid about 10 teaspoons of sugar. Add lemon, mint or frozen strawberries for flavor and fun.
The liquid sugar in soda appears to bypass the body's normal fullness cues. One study compared an extra 450 calories per day from jelly beans vs. soda. The candy eaters unconsciously ate fewer calories overall, but not so the soda drinkers. They gained 2.5 pounds in four weeks.

Sip Smart: Use a Tall, Thin Glass

Use a tall, skinny glass instead of a short, wide tumbler to cut liquid calories -- and your weight -- without dieting. You'll drink 25%-30% less juice, soda, wine, or any other beverage.
How can this work? Brian Wansink, PhD, says visual cues can trick us into consuming more or less. His tests at Cornell University found all kinds of people poured more into a short, wide glass —- even experienced bartenders.

Sip Smart: Limit Alcohol

When an occasion includes alcohol, follow the first drink with a nonalcoholic, low-calorie beverage like sparkling water instead of moving directly to another cocktail, beer, or glass of wine. Alcohol has more calories per gram (7) than carbohydrates (4) or protein (4). It can also loosen your resolve, leading you to mindlessly inhale chips, nuts, and other foods you'd normally limit.

Sip Smart: Go for Green Tea

Drinking green tea may also be a good weight loss strategy. Some studies suggest that it can rev up the body's calorie-burning engine temporarily, possibly through the action of phytochemicals called catechins. At the very least, you'll get a refreshing drink without tons of calories.

Slip Into a Yoga State of Mind

Women who do yoga tend to weigh less than others, according to a study in the Journal of the American Dietetic Association. What's the connection? The yoga regulars reported a more "mindful" approach to eating. For example, they tend to notice the large portions in restaurants but eat only enough to feel full. Researchers think the calm self-awareness developed through yoga may help people resist overeating.

Eat at Home

Eat home-cooked meals at least five days a week to live like a thin person. A Consumer Reports survey found this was a top habit of "successful losers." Sound daunting? Cooking may be easier than you think. Shortcut foods can make for quick meals, such as pre-chopped lean beef for fajitas, washed lettuce, pre-cut veggies, canned beans, cooked chicken strips, or grilled deli salmon.

Catch the "Eating Pause"

Most people have a natural "eating pause," when they drop the fork for a couple of minutes. Watch for this moment and don't take another bite. Clear your plate and enjoy the conversation. This is the quiet signal that you're full, but not stuffed. Most people miss it.

Chew Strong Mint Gum

Chew sugarless gum with a strong flavor when you're at risk for a snack attack. Making dinner after work, at a party, watching TV, or surfing the Internet are a few dangerous scenarios for mindless snacking. Gum with a big flavor punch overpowers other foods so they don't taste good.

Shrink Your Dishes

Chose a 10-inch lunch plate instead of a 12-inch dinner plate to automatically eat less. Cornell's Brian Wansink, PhD, found in test after test that people serve more and eat more food with larger dishes. Shrink your plate or bowl to cut out 100-200 calories a day – and 10-20 pounds in a year. In Wansink's tests, no one felt hungry or even noticed when tricks of the eye shaved 200 calories off their daily intake.

Get Food Portions Right

The top habit of slim people is to stick with modest food portions at every meal, five days a week or more. "Always slim" people do it and successful losers do it, too, according to a Consumer Reports survey. After measuring portions a few times, it can become automatic. Make it easier with small "snack" packs and by keeping serving dishes off the table at meal time.

Try the 80-20 Rule

Americans are conditioned to keep eating until they're stuffed, but residents of Okinawa eat until they're 80% full. They even have a name for this naturally slimming habit: hara hachi bu. We can adopt this healthy habit by dishing out 20% less food, according to researcher Brian Wansink, PhD. His studies show most people don't miss it.

Eat Out Your Way

Restaurant meals are notoriously fattening, so consider these special orders that keep portions under control:

• Split an entr�e with a friend.
• Order an appetizer as a meal.
• Choose the child's plate.
• Get half the meal in a doggie bag before it's brought to the table.

Complement a smaller entr�e with extra salad for the right balance: half the plate filled with veggies.

Reach for the Red Sauce

Choose marinara sauce for pasta instead of Alfredo sauce. The tomato-based sauces tend to have fewer calories and much less fat than cream-based sauces. But remember, portion size still counts. A serving of pasta is one cup or roughly the size of a tennis ball.

Go Meatless More Often

Eating vegetarian meals more often is a slimming habit. Vegetarians tend to weigh less than meat eaters. While there are several reasons for this, legumes may play an important role. Bean burgers, lentil soup, and other tasty legume-based foods are simply packed with fiber. Most Americans get only half of this important nutrient, which fills you up with fewer calories.

Burn 100 Calories More

Lose 10 pounds in a year without dieting by burning an extra 100 calories every day. Calories burned per activity will vary depending on a person's weight. Try one of these activities:

• Walk 1 mile, about 20 minutes.
• Pull weeds or plant flowers for 20 minutes.
• Mow the lawn for 20 minutes.
• Clean house for 30 minutes.
• Jog for 10 minutes.

Celebrate

When you've kicked the soda habit or simply made it through the day without overeating, pat yourself on the back. You've moved closer to a slimming lifestyle that helps people lose weight without crazy or complicated diet plans. Phone a friend, get a pedicure, buy new clothes -- or on occasion, indulge in a small slice of cheesecake.

Non Surgical Liposuction

Non surgical liposuction is a popular phrase to remove fat with the similar results as liposuction but it does not include surgical cutting on your body as traditional lipo requires. For this reason, "non surgical liposuction" has become a very desirable alternative to liposuction for those people who aren't confident with an actual surgery.
There are some obvious positives to going with this specific health procedure, just as there are some drawbacks too. You should seriously do some investigating such as consulting with a surgeon when you are thinking about any kind of weight loss surgery.
How Does Non Surgical Liposuction Work?

  There are various types or procedures of non-surgical liposuction (also known as non-invasive lipo) and each one of them are distinguishable from one another. All of them are going to involve various devices, expenses, recuperating period, and actual body contouring from the surgeons. For the most part, non surgical liposuction uses a couple of popular methods for getting optimal results.
The first popular technique involves the use of very fine thin needles to injecting proteins, enzymes and minor medications which together melt and flush the excess fat from your body. This may also be called mesotherapy or lipodissolve. The second most common method performed using non surgical liposuction is using a laser to "melt the fat out ". This method is state-of-the-art and modern, and it also resembles the same kind of procedure doctors use for a non-surgical face lift.
What Are the Average Costs of Non Surgical Liposuction?

  The cost for Non surgical liposuction costs is going to be different based on the amount of fat to be removed, as well as what area of the body it will come from. For example, the back and chest area are more fibrous for men than women, so this procedure will normally cost more for males.
In general, non surgical liposuction procedures will range in prices from $1,200 to $8,000. The arms, backs, hips, waists, and butts normally tilt towards the lower fee range, while treatments that involve the breasts, chest, stomachs, the neck and facial areas usually cost more. Areas not mentioned usually are in the mid-price range. The costs from non surgical liposuction will differentiate, so it is recommended you confirm the price with local liposuction doctors and the services they provide.
Reasons to use Non Surgical Liposuction

  There are multiple factors one should think about prior to choosing non-surgical liposuction. A question you may need answered by friends or a medical professional is that liposuction isn't a miracle potion for substantial weight loss. It may come as a surprise to many but to be eligible for non-invasive liposuction, a person has to be considered healthy. If you're looking to lose that last difficult 20 pounds that won't come off with normal diet and exercise or even heavy exercising, then it is possibly time to discuss your procedure with a professional as non-invasive liposuction seems to be a legitimate choice to rid you of that last area of fat that you're struggling to conquer.

Types of Liposuction

Liposuction techniques include :

• Suction Assisted
• Tumescence
• Ultrasound
• Power Assisted
• Laser Assisted
• Water Assisted

The Various Types of Liposuction
|Suction-assisted liposuction (SAL)| Tumescence | Utltrasound | Power Assisted Liposuction | Water Assisted | Laser Assisted
Practically any type of liposuction is based on suction-assisted lipectomy (SAL) which is the body fat removal via the suction help. The removal of fat works with a cannula ,a thin tube, that is inserted beneath the skin to loosen the fat. A liposuction practitioner will use a uniquely made vacuum-powered tool to remove the fat from the body.
The field has had progressive enhancements in SAL that include the use of smaller cannulas, ultimately leading to mini incisions and more accurately sculpted contouring of the body. When combining SAL with custom methods it becomes possible from using primarily tumescence and ultrasound techniques.

Tumescence

Tumescence is a treatment applied right before liposuction, in the same surgical meeting. it has also been known to be called the "wet" or "super-wet" technique, it requires soaking the area to be treated with sterile saline to assist corpulent the fat cells and differentiate the fat layer from outer soft tissue and interior muscle and organs.
Basically, tumescence enhances the fat layer, thereby creating the process of removal is easier. The saline is usually merged with the proper balance of lidocaine, and sometimes another local anesthetic, for the patient's comfort in the session and just right after liposuction. Bleeding and bruising is not uncommon so the use of , epinephrine is used to assist.
By merging the tumescence method with liposuction, your surgeon is able to make miniature incisions, using just lite sedation if necessary and have fuller management of the area being sculpted. Moreover, tumescence may decrease recovery period, discomfort, bruising, swelling and the chances of post-surgery bleeding.

Ultrasound-assisted liposuction (UAL)

Ultrasound assistance is a method used as well as suction-assisted liposuction. Some practiotioners conclude that it improves your results. UAL (ultrasound-assisted lipoplasty) uses high-frequency energy from ultrasound to directly break fat cells and knock them loose before the act of suctioning. The procedure can be achieved internally or externally.
* Internal UAL can be a single series of actions when the ultrasound device is in the tip of the canulla. However, more often than not, UAL is done in a two-phase series, where an ultrasound probe is initially put inside to melt the fat prior to the canulla being inserted into the same incision to remove it.
* - External UAL: A device placed outside the body diffuses energy through the skin and soft tissue to the fat. External UAL is typically used as a partner to SAL.
Practitioners who administer UAL find it useful for areas of more fibrous or dense fatty tissue, like the back, upper abdominal area or male breast area. Some plastic surgeons also find it is beneficial as a supplementary or repetitive procedure, for treating wider fat areas, or in mixture with other invasive body-contouring procedures.

Power-assisted liposuction (PAL)

Power-assisted liposuction (PAL) is not considered a separate technique, like tumescence or UAL. PAL is generally suction-assisted lipectomy (SAL), with additional depth. It involves unique equipment to give the cannula the power required to remove fat instead of using the physician's manual force and energy. PAL in essence, provides your specialist with less physical strength necessary. It may be a preferred choice, but it does not necessarily improve the results.

Laser-assisted liposuction (LAL)

The most recent addition to the liposuction world is laser assisted liposuction (LAL). This technique uses laser energy to agitate the fat cells to help in the removal process. The laser itself is introduced within a specialized suction cannula. A very good scientific study compared this method, LAL, to traditional SAL. critics say there was no major difference in the results or the recovery period. They claim, the only real distinction noticed was that the laser assisted liposuction took a little more time in the operating room. As you might expect, there has also been some marketing hype with this technology. The proponents of this have termed this "Smart Lipo." The machine itself, for this type of liposuction, is on the costly side, as the whole group of lasers are.

Water Asissted Liposuction

Water-jet assisted liposuction (WAL) also known as the body-jet®  procedure is a type of traditional liposuction, which yields incredible results for patients. The procedure can be performed with a local anesthetic. The body-jet® liposuction machine pumps high-pressured fluid into the individual's fat with a cannula. The pressure of the fluid breaks up the fat so a greater amount of fat can be sucked out than with conventional liposuction. By utilizing water-jet assisted liposuction (WAL) with the body-jet®  little manual pressure is required to take out the fat. In order to decrease the amount of blood lost, adrenalin is pumped into the fluid which makes the blood vessels smaller.

The Final Analysis
So what should one conclude of all these different technologies? Which is the best out there, and whose claims of superior liposuction technique should you be listening to? Honestly, you can have a positive result from any of these techniques, and you can have less than optimal results with any of these techniques.
What is most important is how well the technique is performed which is ultimately dependent upon the doctor using the suction cannula. What you should be looking for, when considering liposuction, is a board certified plastic surgeon with an abundance of liposuction experience. It is this experience that will guide the surgeon in knowing how much fat to remove from which area(s), which technology to use, and whether or not liposuction is the preferred treatment for the area on your body in question.

Liposuction Common Questions

What areas on the body are treated most? The areas most typically treated for women are the stomach and the outer. For men, they normally pick to undergo treatment on the flanks, or "love handles." Additional popular liposuction treatment areas are the hips, upper or lower abdomen (normally both), lower back, knees, calves, legs, neck, upper arms, face and chin.  Due to the flexibility of liposuction, it is a high demand procedure and it is not unusual for it to be performed with other kinds of cosmetic surgery for even more cosmetic outcomes. Doctors can remove excess fat from almost any section a person no longer desires.
Can liposuction remove cellulite? Getting Liposuction to remove cellulite is not fully effective, although it may reduce the look of cellulite. Cellulite is caused by multiple things, most of which liposuction is not able to modify such as: age, gender, genetics and heredity, and your skin’s thickness.
In addition, not drinking enough water, a poor diet (alcohol, processed foods, and caffeine since the toxins get trapped in fatty tissue), smoking (promotes cellulite as it damages your connective tissues), and an inactive lifestyle contribute to growth of cellulite.  Liposuction is said to decrease cellulite by removing fat, but does not get rid of cellulite completely.
While it is true the outcome and benefits of liposuction are most of the time extremely good, one should not go in with a sense of perfection. As an example, having thigh liposuction performed will better the contour, it will not actually remove cellulite.
Does fat return following liposuction? Liposuction gets rid of the fat cells in certain areas of the body which you requested. These fat cells will not return on the patient’s new and slimmer body. However, if the patient does not adhere to a normal exercise schedule or maintain a healthy diet, the existing fat cells may increase and you could experience weight gain through all areas of your body. The good news is that the treated areas which were shaped from liposuction will have a diminished ability to produce fat.
When should I expect to see good results after liposuction treatment? Although it will be from 30 days to 45 days for the majority of swelling to diminish, most patients notice an improved body shape after liposuction.  The best looking outcomes are more noticeable in 90 to 180 days. Liposuction is not meant to be a tool for weight loss, but to contour areas of the body by removing deposits of fat.
When can I return to my job? You can go back to your job will be largely depend on the quantity of areas you had liposuction treatment. There are some patients who may be able to get back to their job right away, but many people return to their work on average of five to seven days. It is not uncommon to experience swelling and bruising following liposuction. He pain is usually not so great that you cannot move around and do normal everyday things such as errands to the market, working, but any strenuous exercising should be delayed and start gradually.
How Long Will a Liposuction Procedure Take? The procedure time for liposuction can vary substantially, but it normally lasts anywhere from one to four hours. It largely connected to the quantity of fat being removed, the kind of anesthesia (local or general) and the exact technique.

Will I have to stay in a hospital?

Most liposuction procedures may be done within one to four hours as mentioned above and on an outpatient basis. Intense or extensive procedures may require a 24 to 48 hour hospital stay.

What Can I Expect After My Liposuction Procedure?
Although the latest ultrasonic, laser and water-assisted methods are said to decrease lots of discomfort, patients can still feel some burning, pain, swelling, bleeding and interim numbness. You will be fitted with a elastic compression garment on the treated areas to manage and alleviate swelling and bruising soon after your procedure. Depending on the procedure and amount of fat removed, drainage on the treated, or tiny incision areas, is not uncommon for a couple of days following treatment. The doctor may prescribe some medicine as well to manage the pain.  Therefore, it is important to not assume you will appear great or feel great immediately after your procedure.
How many types of liposuction are there?
Suction-assisted Liposuction (SAL):
This is the traditional and oldest liposuction technique. The doctor takes out the fat by placing a small tube (cannula) that is connected to a vacuum device, which controls the cannula into the specified areas to be suctioned using tiny incisions.

Power-Assisted Liposuction (PAL):
A cannula with a rotational motion of the tip goes through the skin tissue to suction out fat and fibrous tissue. The advantages are (1) decreased trauma to the tissues and (2) minimal work for the doctor.

Ultrasound-assisted Liposuction (UAL). Vaser Liposuction:
Ultrasonic sound waves  (or energy) are sent to the point of the cannula to disrupt and liquefy fat cells which are then taken out by suction. External ultrasound-assisted liposuction (E-UAL) works by using external ultrasound waves to modify the fat cells in order to liquefy the fat prior to suction removal.

Laser-assisted Liposuction:

• Low Level Assisted Liposuction: the device is an easily movable low-level laser unit (dual-diode laser) that produces a thin beam of red light. Its external application on the skin helps to liquefy the fat, which makes the fat suction process easier and quicker. In addition, the laser usage following liposuction alleviates pain, minimizes bruising, promotes healing, and offers a much quicker recovery. It is a non-surgical laser that will not cause pain while in use to the person.
• SmartLipo Laser. (pulsed, NdYAG laser): A small cannula that includes a laser fiber that is placed into the skin, the cannula is rotated sending the laser's energy to the fat cells making them break apart and drain out. SmartLipo is a treatment that is minimally invasive and able to be performed simple with a local anesthesia. SmartLipo ideal for removing fat from small sections of the neck, arms, face, breasts, and abdomen.

How should I prepare for liposuction? During your first liposuction appointment, typically the physician will hand out instructions on how to prepare for the procedure. Generally, patients are recommended to cease taking aspirin or additional prescriptions and medicines that may affect clotting of the blood. Patients should schedule for someone to give them a ride home following the procedure. Patients need to strictly adhere to the doctor’s orders to guarantee a positive recovery.

SOURCE:MEDICINENET.COM

Fitness At Any Age

Energize Your Life! Who ever said physical activity is all work and no play? In fact, it can be just the opposite! There is no need to think of strenuous workouts that are painful and boring. Instead, imagine doing fun physical activities you enjoy and look forward to. Do physical activity for enjoyment and watch the health benefits follow!

The importance of physical activity

The evidence is growing and is more convincing than ever! People of all ages who are generally inactive can improve their health and well-being by becoming active at a moderate-intensity on a regular basis.
Regular physical activity substantially reduces the risk of dying of coronary heart disease, the nation's leading cause of death, and decreases the risk for stroke, colon cancer, diabetes, and high blood pressure. It also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among older adults; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and medications. Moreover, physical activity need not be strenuous to be beneficial; people of all ages benefit from participating in regular, moderate-intensity physical activity, such as 30 minutes of brisk walking five or more times a week.
Despite the proven benefits of physical activity, more than 50% of American adults do not get enough physical activity to provide health benefits. 25% of adults are not active at all in their leisure time. Activity decreases with age and is less common among women than men and among those with lower income and less education.
Insufficient physical activity is not limited to adults. More than a third of young people in grades 9-12 do not regularly engage in vigorous-intensity physical activity. Daily participation in high school physical education classes dropped from 42% in 1991 to 32% in 2001 (CDC, 2002).
This section explains why you should be active, how inactivity may hurt your health, and how physical activity can benefit everyone.

Why should I be active?

"It's easier to maintain your health than regain it." -Dr. Ken Cooper
Physical activity can bring you many health benefits. People who enjoy participating in moderate-intensity or vigorous-intensity physical activity on a regular basis benefit by lowering their risk of developing coronary heart disease, stroke, non-insulin-dependent (type 2) diabetes mellitus, high blood pressure, and colon cancer by 30-50% (USDHHS, 1996). Additionally, active people have lower premature death rates than people who are the least active.
Regular physical activity can improve health and reduce the risk of premature death in the following ways:

• Reduces the risk of developing coronary heart disease (CHD) and the risk of dying from CHD
• Reduces the risk of stroke
• Reduces the risk of having a second heart attack in people who have already had one heart attack
• Lowers both total blood cholesterol and triglycerides and increases high-density lipoproteins (HDL or the "good" cholesterol)
• Lowers the risk of developing high blood pressure
• Helps reduce blood pressure in people who already have hypertension
• Lowers the risk of developing non-insulin-dependent (type 2) diabetes mellitus
• Reduces the risk of developing colon cancer
• Helps people achieve and maintain a healthy body weight
• Reduces feelings of depression and anxiety
• Promotes psychological well-being and reduces feelings of stress
• Helps build and maintain healthy bones, muscles, and joints
• Helps older adults become stronger and better able to move about without falling or becoming excessively fatigued

Can a lack of physical activity hurt your health? Evidence shows that those who are not physically active are definitely not helping their health, and may likely be hurting it. The closer we look at the health risks associated with a lack of physical activity, the more convincing it is that Americans who are not yet regularly physically active should become active

What are the recommendations for increasing fitness for youth, adults, and seniors?

There is good news for all Americans. Scientific evidence shows that physical activity done at a moderate-intensity level can produce health benefits (USDHHS, 1996). If people have been sedentary, they can improve their health and well-being with regular, moderate levels of activity each day.
Those who participate in moderate- to vigorous-intensity activities regularly should be encouraged and supported in their efforts to continue. While activity at a higher intensity or performed longer offers more health benefits, this level of activity may not be a realistic goal for everyone, at least not to start with. Many Americans, for whom the term "exercise" brings up negative images and emotions, can celebrate the good news by setting a new personal goal-achieving and enjoying the benefits of a regularly active lifestyle that includes a variety of moderate- and/or vigorous-intensity activities.
Adults should strive to meet either of the following physical activity recommendations. See General Physical Activities Defined By Level of Intensity for a chart that lists the intensity levels of many types of activities.

• Adults should engage in moderate-intensity physical activities for at least 30 minutes on 5 or more days of the week.

- Centers for Disease Control and Prevention/American College of Sports Medicine
OR

• Adults should engage in vigorous-intensity physical activity 3 or more days per week for 20 or more minutes per occasion

- Healthy People 2010

More good news is that it's never too late to start an active lifestyle. No matter how old you are, how unfit you feel, or how long you've been inactive, research shows that starting a more active lifestyle now through regular, moderate-intensity activity can make you healthier and improve your quality of life.
This next section provides guidelines for how active you need to be to gain some benefit and general information on activity levels of Americans.
How active do adults need to be to gain some benefit?
Physical activity does not need to be hard to provide some benefit. Participating in moderate-intensity physical activity is a vital component of a healthy lifestyle for people of all ages and abilities. There is no demographic or social group in America that could not benefit from becoming more active.
The table* below provides recommendations on how to increase your physical activity based on your current activity level. Check it out to see where you are and how you can challenge yourself.

If....	Then...
You do not currently engage in regular physical activity,	you should begin by incorporating a few minutes of physical activity into each day, gradually building up to 30 minutes or more of moderate-intensity activities.
You are now active, but at less than the recommended levels,	you should strive to adopt more consistent activity: moderate-intensity physical activity for 30 minutes or more on 5 or more days of the week, or vigorous-intensity physical activity for 20 minutes or more on 3 or more days of the week.
You currently engage in moderate-intensity activities for at least 30 minutes on 5 or more days of the week,	you may achieve even greater health benefits by increasing the time spent or intensity of those activities.
You currently regularly engage in vigorous-intensity activities 20 minutes or more on 3 or more days of the week,	you should continue to do so

*Scientific evidence to date supports the statements above.
What is "moderate-intensity physical activity?"
Moderate-intensity physical activity refers to any activity that burns 3.5 to 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while walking briskly, mowing the lawn, dancing, swimming for recreation, or bicycling.
What is "vigorous-intensity physical activity?"
Vigorous-intensity physical activity refers to any activity that burns more than 7 Calories per minute (kcal/min) (Ainsworth et al., 2000). These levels are equal to the effort a healthy individual might burn while jogging, engaging in heavy yard work, participating in high-impact aerobic dancing, swimming continuous laps, or bicycling uphill.

• On average, regularly participating in one or more moderate-intensity or vigorous-intensity activities is required to burn a minimum of 150 Calories of energy per day, 7 days per week, or total of 1,000 Calories/week (Jones et al., 1998).
• The time needed to burn 150 Calories of energy in a day depends on the intensity of the activities chosen. For example, if someone selects moderate-intensity activities, the time required to meet the minimum recommendation would be generally 30 minutes per day. The more vigorous the activities chosen, the less time needed (22 minutes or less) to burn the minimum of 150 Calories during the day.

Number of Minutes of Activity Required to Burn 150 kcalories

Are there special recommendations for young people?
It is recommended that children and adolescents participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily.¹
Children and adolescents can choose any type of moderate or higher intensity physical activity, such as brisk walking, playing tag, jumping rope, or swimming, as long as it is adds up to at least one hour a day.
For children and adolescents, regular physical activity has beneficial effects on the following aspects of health:

• Weight
• Muscular strength
• Cardiorespiratory (aerobic) fitness
• Bone mass (through weight-bearing physical activities)
• Blood pressure (for hypertensive youth)
• Anxiety and stress
• Self-esteem

Children and adolescents who are just beginning to be physically active should start out slowly and gradually build to higher levels in order to prevent the risk of injury or feel defeated from unrealistic goals. It is important that children and adolescents are encouraged to be physically active by doing things that interest them. This will help them establish an active lifestyle early on.
¹This physical activity recommendation is from the Dietary Guidelines for Americans 2005.
Tips for Parents
As a parent, you have an important role in shaping your children's physical activity attitudes and behaviors. Here are some tips to encourage your children to be more physically active.

• Set a positive example by leading an active lifestyle yourself, and make physical activity part of your family's daily routine such as designating time for family walks or playing active games together.
• Provide opportunities for children to be active by playing with them. Give them active toys and equipment, and take them to places where they can be active.
• Offer positive reinforcement for the physical activities in which your child participates and encourage them as they express interest in new activities.
• Make physical activity fun. Fun activities can be anything the child enjoys, either structured or non-structured. They may range from team sports, individual sports, and/or recreational activities such as walking, running, skating, bicycling, swimming, playground activities, and free-time play.
• Ensure that the activity is age appropriate and, to ensure safety, provide protective equipment such as helmets, wrist pads, and knee pads.
• Find a convenient place to be active regularly.
• Limit the time your children watch television or play video games to no more than two hours per day. Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity (walking, playing chase, dancing).

Are there special recommendations for seniors?
Being physically active can prevent and help treat many of the most common chronic medical conditions associated with old age. Physical activity is one of the most important steps older adults can take to maintain physical and mental health and quality of life. Scientists have proven that being active can help reduce the risk of obesity, high blood pressure, diabetes, osteoporosis, stroke, depression, colon cancer, and premature death. Yet today, more than 60% of older adults are inactive. Older adults face the same obstacles to being more physically active as younger adults but also have special concerns.
The Challenge to Get Moving
Getting older adults to be active is a challenge. The average American lives a long time, but many are sedentary, physically unfit, and experience disability from chronic medical conditions as they age. Physicians and exercise experts hear many reasons from older adults as to why they are not active: It doesn't feel good. It makes my arthritic joints hurt. It takes too much time. It's boring. However, older adults need physical activity like everyone else, at least as much as younger adults. In fact, the loss of strength and stamina often attributed to aging is in part caused by reduced physical activity.
Walking groups and physical activity programs especially designed for older adults can help seniors become-and remain active. For example, senior swim clubs and water aerobic classes are excellent activities for people with arthritis.
The Need for Strength
Strength training is recommended for all adults, but it is a vital link to health for older adults. The reason is that strength training prevents sarcopenia, the muscle deterioration that comes with aging, and also helps maintain bone mass. "Stronger people have better health outcomes," noted Dr. David Buchner, Chief of CDC's Physical Activity and Health Branch and renowned Gerontologist. However, some elderly people avoid physical activity and become sedentary out of fear of falling and fracturing a bone. Dr. Buchner added that emerging data indicate that physical activity can prevent falls by improving strength, balance, and endurance.
Keeping Young at Heart Aerobic activity (also known as cardiorespiratory or cardiovascular endurance activity) is also important. It keeps the heart strong, lowers blood pressure, and relieves anxiety and depression. Older adults can obtain significant health benefits with moderate physical activity, such as walking or gardening.
"We need to make physical activity part of the daily routine for older adults," said Dr. Buchner. Health clubs also provide older adults with a variety of opportunities to improve their aerobic fitness, muscular strength, and flexibility. Dr. Buchner adds, "Traditionally health and fitness facilities have marketed mainly to body-conscious younger adults, who focus on the cosmetic effects. It's great to see that health clubs have developed more programs for older adults, and we hope this trend continues."
*The above information was adapted from: CDC, NCCDPHP. Special focus: healthy aging. Chronic Disease Notes and Reports 1999;12(3):10-11.
Recommendations
The CDC/ACSM recommends that all adults should accumulate at least 30 minutes of moderate-intensity physical activity on five or more days of the week. Cardiorespiratory (aerobic) endurance, strength, balance, and flexibility exercises should all be part of a physical activity program for older adults. No one type of activity will bring about all the benefits of physical activity. It is important to include all of them. Older adults can meet the physical activity recommendation with a combination of these activities using the following sample schedule:

• Cardiorespiratory: Participate in moderate-intensity aerobic activities 3-5 days a week for at least 30 minutes each session.
• Flexibility*: Stretch every day.
• Strength training: Do strength-building activities 2-3 days per week.

*Flexibility refers to how fully one's joints or limbs are able to move. Being flexible allows for easier movements and reduced pain in joints so that it is also easier to perform daily activities of independent living. By adding stretching to your daily physical activity plan, you can help keep your joints flexible which will help you move with more freedom and comfort.
Participating in these types of activities can help you more easily perform many of your day-to-day tasks. For example, being more flexible will help you more easily do things like reaching in your cupboard and tying your shoes. Being stronger and having more balance will help you lift and carry items like sacks of groceries and will make it easier to get in and out of chairs and the bathtub. Improving your cardiorespiratory endurance will allow you to do things like climbing stairs, dancing, or playing with grandchildren without getting out of breath.
The chart below provides ideas of activities in the areas of cardiorespiratory endurance, strength, and flexibility. Many of these activities will also help improve your balance. Most importantly, choose activities that you enjoy. This will make it more likely that you'll keep doing them!

Cardiorespiratory	Strength	Flexibility
Walking	Chair exercises	Stretching
Swimming	Lifting weights or cans	Yoga
Dancing	Carrying laundry or groceries	Tai chi
Skating	Working in the yard
Hiking	Washing the car
Rolling your wheelchair	Scrubbing the floor

When is a medical evaluation necessary?

Experts advise that people with chronic diseases, such as a heart condition, arthritis, diabetes, or high blood pressure, should talk to their doctor about what types and amounts of physical activity are appropriate. If you have a chronic disease and have not already done so, talk to your doctor before beginning a new physical activity program.
If you have symptoms that could be due to a chronic disease, you should have these symptoms evaluated, whether you are active or inactive. If you plan to start a new activity program, take the opportunity to get these symptoms evaluated. Symptoms of particular importance to evaluate include chest pain (especially chest pain that is brought on by exertion), loss of balance (especially loss of balance leading to a fall), dizziness, and passing out (loss of consciousness).

Making physical activity a part of your life

"You can't change where you came from. You can change where you are going." -Anonymous
Just knowing that physical activity is good for us doesn't mean that we'll easily be able to make it part of our daily routines-it's sometimes difficult to adopt new habits. But it's important to remember that you can start out slowly and work your way up to a higher level of activity.
This section provides ideas for how to make physical activity part of your life and how to do it safely.

Components of physical activity

What does it mean to be physically "fit?" Physical fitness is defined as "a set of attributes that people have or achieve that relates to the ability to perform physical activity" (USDHHS, 1996). In other words, it is more than being able to run a long distance or lift a lot of weight at the gym. Being fit is not defined only by what kind of activity you do, how long you do it, or at what level of intensity. While these are important measures of fitness, they only address single areas. Overall fitness is made up of five main components:

1. Cardiorespiratory endurance
2. Muscular strength
3. Muscular endurance
4. Body composition
5. Flexibility

In order to assess your level of fitness, look at all five components together.
What is "cardiorespiratory endurance (cardiorespiratory fitness)?"
Cardiorespiratory endurance is the ability of the body's circulatory and respiratory systems to supply fuel during sustained physical activity (USDHHS, 1996 as adapted from Corbin & Lindsey, 1994). To improve your cardiorespiratory endurance, try activities that keep your heart rate elevated at a safe level for a sustained length of time such as walking, swimming, or bicycling. The activity you choose does not have to be strenuous to improve your cardiorespiratory endurance. Start slowly with an activity you enjoy, and gradually work up to a more intense pace.
What is "muscular strength?"
Muscular strength is the ability of the muscle to exert force during an activity (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). The key to making your muscles stronger is working them against resistance, whether that be from weights or gravity. If you want to gain muscle strength, try exercises such as lifting weights or rapidly taking the stairs.
What is "muscular endurance?"
Muscular endurance is the ability of the muscle to continue to perform without fatigue (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). To improve your muscle endurance, try cardiorespiratory activities such as walking, jogging, bicycling, or dancing.
What is "body composition?"
Body composition refers to the relative amount of muscle, fat, bone, and other vital parts of the body (USDHHS, 1996 as adapted from Corbin and Lindsey, 1994). A person's total body weight (what you see on the bathroom scale) may not change over time. But the bathroom scale does not assess how much of that body weight is fat and how much is lean mass (muscle, bone, tendons, and ligaments). Body composition is important to consider for health and managing your weight!
What is "flexibility?"
Flexibility is the range of motion around a joint (USDHHS, 1996 as adapted from Wilmore & Costill, 1994). Good flexibility in the joints can help prevent injuries through all stages of life. If you want to improve your flexibility, try activities that lengthen the muscles such as swimming or a basic stretching program.

Common physical activity and fitness terms

Calorie: A measure of energy from food. (3,500 kilocalories of food energy = 1 pound of body weight). Also the amount of heat required to raise the temperature of 1 gram of water 1° C (1000 calories = 1 kilocalorie). An interesting fact: When we see "Calories" on a food label it is actually measuring kilocalories
Cardiorespiratory fitness: (also called aerobic endurance or aerobic fitness)
Cardiorespiratory endurance is the ability of the body's circulatory and respiratory systems to supply fuel and oxygen during sustained physical activity.
Exercise: Exercise is physical activity that is planned or structured. It involves repetitive bodily movement done to improve or maintain one or more of the components of physical fitness-cardiorespiratory endurance (aerobic fitness), muscular strength, muscular endurance, flexibility, and body composition.
Household physical activity: Household physical activity includes (but is not limited to) activities such as sweeping floors, scrubbing, washing windows, and raking the lawn.
Inactivity
Inactivity is not engaging in any regular pattern of physical activity beyond daily functioning.
Kilocalorie: The amount of heat required to raise the temperature of 1 kg of water 1° C. Kilocalorie is the ordinary calorie discussed in food or exercise energy-expenditure tables and food labels.
Leisure-time physical activity: Leisure-time physical activity is exercise, sports, recreation, or hobbies that are not associated with activities as part of one's regular job duties, household, or transportation.
MET: The standard metabolic equivalent, or MET, level. This unit is used to estimate the amount of oxygen used by the body during physical activity.

1 MET = the energy (oxygen) used by the body as you sit quietly, perhaps while talking on the phone or reading a book.
The harder your body works during the activity, the higher the MET.

• Any activity that burns 3 to 6 METs is considered moderate-intensity physical activity.
• Any activity that burns > 6 METs is considered vigorous-intensity physical activity.

Moderate-intensity physical activity: Moderate-intensity physical activity refers to a level of effort in which a person should experience:

• Some increase in breathing or heart rate
• a "perceived exertion" of 11 to 14 on the Borg scale
  • the effort a healthy individual might expend while walking briskly, mowing the lawn, dancing, swimming, or bicycling on level terrain, for example.
• 3 to 6 metabolic equivalents (METs); or
• any activity that burns 3.5 to 7 Calories per minute (kcal/min)

Occupational physical activity: Occupational physical activity is completed regularly as part of one's job. It includes activities such as walking, hauling, lifting, pushing, carpentry, shoveling, and packing boxes.
Physical activity: Physical activity is any bodily movement produced by skeletal muscles that result in an expenditure of energy.
Physical fitness: Physical fitness is a set of attributes a person has in regards to a person's ability to perform physical activities that require aerobic fitness, endurance, strength, or flexibility and is determined by a combination of regular activity and genetically inherited ability.
Regular physical activity: A pattern of physical activity is regular if activities are performed:

• most days of the week, preferably daily;
• 5 or more days of the week if moderate-intensity activities (in bouts of at least 10 minutes for a total of at least 30 minutes per day); or
• 3 or more days of the week if vigorous-intensity activities (for at least 20-60 minutes per session).

Note: These are minimum recommendations, greater health outcomes can be achieved by doing additional types activities and/or increasing time spent doing activities.
Transportation physical activity: Transportation physical activity is walking, biking or wheeling (for wheelchair users), or similar activities to and from places such as: work, school, place of worship, and stores.
Vigorous-intensity physical activity: Vigorous-intensity physical activity may be intense enough to represent a substantial challenge to an individual and refers to a level of effort in which a person should experience:

• large increase in breathing or heart rate (conversation is difficult or "broken")
• a "perceived exertion" of 15 or greater on the Borg scale;
  • the effort a healthy individual might expend while jogging, mowing the lawn with a nonmotorized pushmower, participating in high-impact aerobic dancing, swimming continuous laps, or bicycling uphill, carrying more than 25 lbs up a flight of stairs, standing or walking with more than 50 lbs for example.
• greater than 6 metabolic equivalents (METs); or
• any activity that burns more than 7 kcal/ min

Weight-bearing physical activity: Any physical activity that imparts a load or impact (such as jumping or skipping) on the skeleton
source:medicinenet.com

BREAST CANCER

Breast Cancer Pictures Slideshow: A Visual Guide to Breast Cancer

Reviewed by Varnada Karriem-Norwood, MD on Tuesday, September 27, 2011

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Breast Cancer Today

Breast cancer today is not what it was 20 years ago. Survival rates are climbing, thanks to greater awareness, more early detection, and advances in treatment. For roughly 200,000 Americans who are diagnosed with breast cancer each year, there are plenty of reasons to be hopeful.

Breast Cancer Symptoms

There are often no symptoms of breast cancer, but sometimes women may discover a breast problem on their own. Signs and symptoms to be aware of may include:

• A painless lump in the breast.
• Changes in breast size or shape.
• Swelling in the armpit.
• Nipple changes or discharge.

Breast pain can also be a symptom of cancer, but this is not common.

Signs of Inflammatory Breast Cancer

Inflammatory breast cancer is a rare, fast-growing type of cancer that often causes no distinct lump. Instead, breast skin may become thick, red, and may look pitted -- like an orange peel. The area may also feel warm or tender and have small bumps that look like a rash.

Breast Cancer & Mammograms

The earlier breast cancer is found, the easier it is to treat. And mammograms, X-rays of the breast, can detect tumors before they are large enough to feel. The American Cancer Society recommends yearly mammograms beginning at age 40 for women at average risk. While the U.S. Preventive Services Task Force recommends a screening mammogram every two years from age 50 to 74. It also notes that before age 50, each woman should check with a doctor to find out what screening schedule is right for her, considering the potential benefits and harms from screening.

Breast Ultrasound and MRI

Besides a mammogram, your doctor may order additional imaging with breast ultrasound. An ultrasound can help determine the presence of cysts, fluid-filled sacs that are not cancer. An MRI may be recommended along with a mammogram for routine screening in certain women who have a higher risk of breast cancer.

Breast Self-Exams

It was once widely recommended that women check their own breasts once a month. But studies suggest these breast self-exams play a very small role in finding cancer. The current thinking is that it's more important to know your breasts and be aware of any changes, rather than checking them on a regular schedule. If you want to do breast self-exams, be sure to go over the technique with your doctor.

What If You Find a Lump?

First, don't panic. Eighty percent of breast lumps are not cancerous. Lumps often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But you should let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier it's found the better. And if it's not, testing can give you peace of mind.

Breast Biopsy

The only sure way to determine whether a lump is cancer is to do a biopsy. This involves taking a tissue sample for further examination in the lab, sometimes through a small needle. Sometimes surgery is done to take part of or the entire lump for testing. The results will show whether the lump is cancer, and if so, what type. There are several forms of breast cancer, and treatments are carefully matched to the type of cancer.

Hormone-Sensitive Breast Cancer

Some types of breast cancer are fueled by the hormones estrogen or progesterone. A biopsy can reveal whether a tumor has receptors for estrogen (ER-positive) and/or progesterone (PR-positive). About two out of three breast cancers are hormone sensitive. There are several medications that keep the hormones from promoting further cancer growth.
The image shows a molecular model of an estrogen receptor.

HER2-Positive Breast Cancer

In about 20% of patients, breast cancer cells have too many receptors for a protein called HER2. This type of cancer is known as HER2-positive, and it tends to spread faster than other forms of breast cancer. It's important to determine whether a tumor is HER2-positive, because there are special treatments for this form of cancer.
A HER2-positive breast cancer cell is illustrated here, with abnormal growth signals shown in green.

Breast Cancer Stages

Once breast cancer has been diagnosed, the next step is to determine how big the tumor is and how far the cancer has spread. This process is called staging. Doctors use Stages 0-4 to describe whether cancer is localized to the breast, has invaded nearby lymph nodes, or has spread to other organs, such as the lungs. Knowing the stage and type of breast cancer will help your health care team formulate a treatment strategy.

Breast Cancer Survival Rates

The odds of surviving breast cancer are strongly tied to how early it is found. According to the American Cancer Society, 100% of women with Stage 1 breast cancer live at least five years, compared to women without cancer – and many women in this group remain cancer-free for good. The more advanced the cancer, the lower this figure becomes. By Stage 4, the five-year relative survival rate declines to 20%. But these rates can improve as more effective treatments are found.

Breast Cancer Surgery

There are many types of breast cancer surgery, from taking out the area around the lump (lumpectomy or breast-conservation surgery) to removing the entire breast (mastectomy.) It's best to discuss the pros and cons of each of these procedures with your doctor before deciding what's right for you.

Radiation Therapy for Breast Cancer

Radiation therapy uses high-energy rays to kill cancer cells. It may be used after breast cancer surgery to wipe out any cancer cells that remain. It can also be used along with chemotherapy for treatment of cancer that has spread to other parts of the body. Side effects can include fatigue and swelling or a sunburn-like feeling in the treated area.

Chemotherapy for Breast Cancer

Chemotherapy uses drugs to kill cancer cells anywhere in the body. The drugs are often given by IV, but are sometimes taken by mouth or shot. Chemotherapy may be done after surgery to lower the odds of the cancer coming back. In women with advanced breast cancer, chemotherapy can help control the cancer's growth. Side effects may include hair loss, nausea, fatigue, and a higher risk of infection.

Hormone Therapy for Breast Cancer

Hormone therapy is an effective treatment for women with ER-positive or PR-positive breast cancer. These are cancers that grow more rapidly in response to the hormones estrogen or progesterone. Hormone therapy can block this effect. It is most often used after breast cancer surgery to help keep the cancer from coming back. It may also be used to reduce the chance of breast cancer developing in women who are at high risk.

Targeted Drugs for Breast Cancer

Targeted therapies are newer drugs that target specific properties within cancer cells. For example, women with HER2-positive breast cancer have too much of a protein called HER2. Targeted therapies can stop this protein from promoting the growth of cancer cells. These drugs are often used in combination with chemotherapy. They tend to have milder side effects compared to chemotherapy.

Life After Diagnosis

There's no doubt that cancer is a life-changing experience. The treatments can wear you out. You may have trouble managing daily chores, work, or social outings. This can lead to feelings of isolation. It's crucial to reach out to friends and family for support. They may be able to go with you to treatments, help out with chores, or just remind you that you are not alone. Many people choose to join a support group -- either locally or online.

Breast Reconstruction

Many women who have a breast removed choose to undergo reconstructive surgery. This replaces the skin, nipple, and breast tissue that are lost during a mastectomy. Reconstruction can be done with a breast implant or with tissue from somewhere else in your body, such as the tummy. Some women opt to begin reconstruction at the same time as their mastectomy. But it's also possible to have reconstructive surgery months or years later.

Breast Forms

An alternative to breast reconstruction is to be fitted for a breast form. This is a breast-shaped prosthesis that fits inside your bra. Wearing a breast form allows you to have a balanced look when you are dressed -- without undergoing additional surgery. Like reconstructive surgery, breast forms are often covered by insurance.

Breast Cancer: Why Me?

The most obvious risk factor for breast cancer is being a woman. Men get the disease, too, but it is about 100 times more common in women. Other top risk factors include being over age 55 or having a close relative who has had the disease. But keep in mind that up to 80% of women with breast cancer have no family history of the illness.

Breast Cancer Genes

Some women have a very high risk of breast cancer because they inherited changes in certain genes. The genes most commonly involved in breast cancer are known as BRCA1 and BRCA2. Women with mutations in these genes have up to an 80 percent chance of getting breast cancer at some point in life. Other genes may be linked to breast cancer risk as well.

Risk Factors in Your Control

Being overweight, getting too little exercise, and drinking more than one alcoholic beverage per day can raise the risk of developing breast cancer. Birth control pills and some forms of postmenopausal hormone therapy can also boost your risk. But the risk goes back to normal after these medications are stopped. Among survivors, good lifestyle choices may be helpful. Recent studies suggest that physical activity may help lower the risk of a recurrence and it's a proven mood-booster.

Breast Cancer Research

Doctors continue to search for more effective and tolerable treatments for breast cancer. The funding for this research comes from many sources, including advocacy groups throughout the country. Many of the 2.5 million breast cancer survivors and their families choose to participate in walk-a-thons and other fundraising events. This links each individual fight against cancer into a common effort for progress.

Introduction to breast cancer prevention

For so many women, there is no more dreaded disease than breast cancer. Breast cancer elicits fears related to loss of body image and sexuality, surgery, and death. As is the case for most cancers, the exact cause of breast cancer is not clearly known. Furthermore, there is currently no cure for advanced disease, and there is no definitive way of preventing it.
Breast cancer also affects men. Male breast cancer accounts for about 1% of all breast cancers. Around 229,000 new cases of breast cancer are diagnosed each year in women in the U.S., while about 2,200 cases are diagnosed in men.
Our knowledge of how breast cancer develops is expanding rapidly. As a result, new medications are being developed to reduce the risk of breast cancer among those at high risk of contracting this disease. For the majority of women, lifestyle changes, a healthy diet, exercise, and weight reduction can also help reduce the chance of developing breast cancer. To date, the most important strategy in improving survival is still breast cancer screening and early detection. Breast cancer is the second leading cause of cancer deaths among women in the United States. The leading cause is lung cancer. One in every eight women in the United States develops breast cancer. The risk is even higher for women with previous breast cancer, those who have first-degree relatives with breast cancer, those with multiple family members with cancer, and those who have inherited "cancer genes."

What are the biological causes of breast cancer?

Breast cancer cells, like all cancers, initially develop because of defects in the genetic material deoxyribonucleic acid (DNA) of a single cell. The human body is composed of trillions of cells. Inside the inner core (nucleus) of each cell is our DNA located on chromosomes. Every human cell has two sets of 23 chromosomes. Each set is inherited from one parent. DNA exists as long, spiraled strands on these chromosomes. Different segments along the DNA strands contain information for various genes. Genes are blueprints that provide genetic instructions for the growth, development, and behavior of every cell. Human DNA is thought to contain approximately 23,000 genes. Most genes carry instructions for the types and the amount of proteins, enzymes, and other substances produced by the cells. Genes also govern the sizes and the shapes of the organs by controlling the rate of division of the cells within these organs. (During cell division, a cell makes a duplicate copy of its chromosomes and then divides into two cells.) Some genes restrict cell division and limit tissue growth.
Defects on the DNA strands can lead to gene coding errors, which in turn can cause diseases. When genes that normally restrict cell growth and divisions are absent or defective, the affected cells can divide and multiply without restraint. The cells that divide and multiply without restraint enlarge (forming a tumor) and can also invade adjacent tissues and organs. These cells can further break away and migrate to distant parts of the body in a process called metastasis. The ability to multiply without restraint, the tendency to invade other organs, and the ability to metastasize to other parts of the body are the key characteristics of cancers -- characteristics that are due to DNA defects.
The cancer-causing DNA defects can be acquired at birth (inherited) or may develop during adult life. The inherited DNA defects are present in every cell of the body. On the other hand, DNA defects that develop during adult life are confined to the descendants (products of cell divisions) of the single affected cell. Generally, inherited DNA defects have a greater tendency to cause cancers and cancers that occur earlier in life than DNA defects that develop during adult life.
Research has shown that 5%-10% of breast cancers are associated with mutations (defects) in two genes known as breast cancer-associated (BRCA) genes, BRCA1 and BRCA2. These genes function to prevent abnormal cell growth that could lead to cancer. Every cell in the body has two BRCA1 or BRCA2 genes, one inherited from each parent. A woman who has received one defective BRCA1 or BRCA2 gene from one parent and a healthy gene from the other is called a carrier of the defective BRCA gene. Even though only one healthy BRCA1 or BRCA2 gene is needed to help prevent cancerous growth of cells, the one remaining healthy BRCA gene is vulnerable to damage during adult life by environmental factors such as toxins, radiation, and other chemicals such as free radicals. Therefore, women bearing a defective BRCA1 or BRCA2 gene are at an increased risk of developing breast and ovarian cancers. Women carrying defective BRCA1 or BRCA2 genes also tend to develop these cancers earlier in life.
Other rare genetic mutations are also associated with an increased risk for the development of breast cancer, including mutations of the tumor suppressor gene p53, the CHEK-2 gene, and the ATM (ataxia-telangiectasia mutation) gene.
Since inherited DNA defects account for only 5%-10% of breast cancers, the majority of breast cancers are due to DNA damages that develop during adult life. Environmental factors that can cause DNA damage include free radicals, chemicals, radiation, and certain toxins. But even among individuals without inherited cancer-causing DNA defects, their vulnerability to DNA damage, their ability to repair DNA damage, and their ability to destroy cells with DNA damage, are likely to be genetically inherited. This is probably why the risk of cancer is higher among first-degree relatives of breast cancer patients, even among families that do not carry the defective BRCA1 and BRCA2 tumor-suppressing genes.
Some of the errors in the normal control mechanisms allow the accumulation of additional errors in other parts of the system. These errors may lead to gene silencing of critical control genes or the overactivity of other growth-stimulating genes by activation of promoter sites adjacent to these otherwise normal genes.
Other substances such as estrogen (a female hormone) and certain fatty acids may also increase the risk of breast cancer by stimulating the growth and division of cells of the breast tissue.

What is the importance of early breast cancer detection?

The various types of cancers behave differently, with distinct rates of growth and patterns of spreading (metastasis) to other areas of the body. Some cancers are "favorable" and treatable, while others are so aggressive and malignant that almost nothing in modern medicine's arsenal can help.
Compared to other cancers, breast cancer is on the more treatable end of the spectrum if diagnosed early. It is considered a "favorable" cancer because it can be detected early by breast examination or by mammography. Pancreatic cancer, for example, is on the lethal end of the spectrum of cancers. Pancreatic cancer is often difficult to detect until it is very far advanced.
Studies have clearly shown that the smaller the size of the breast cancer when detected, the better the chance of a surgical cure and long-term survival. The likelihood of a cure is also higher if the cancer is removed before it has spread to lymph nodes and other organs such as the lungs, liver, bones, and brain.
Currently, mammography and breast examinations serve as the foundation for screening for breast cancer. It is extremely important for a woman to have regular breast examinations as well as mammograms to detect early breast cancer.

What are the advantages and limitations of mammography?

Mammography is an X-ray examination of the breast that has the ability to detect a cancer in the breast when it is quite small, long before it may be felt by breast examination. Approximately 85%-90% of all breast cancers are detectable by mammography. Early detection by mammography has reduced the mortality rate from breast cancer by 20%-30% in women over 50 years of age.
However, some 10%-15% of breast cancers are not visible on mammography but can be felt on physical examination of the breast. Therefore, a normal mammogram does not exclude the possibility of breast cancer. Breast examination by your health care professional by palpation and visual inspection is also important. During a routine physical checkup, a doctor can conduct an examination of the breast.

How frequently should women undergo mammography and breast examinations?

The American Cancer Society (ACS) recommends a baseline mammogram for all women by age 40 and annual mammograms for women 40 and older for as long as they are in good health.
In women with "lumpy breasts" or breast symptoms, and also in women with a high risk of developing breast cancer, sometimes a baseline mammogram at 35 years of age is recommended. This recommendation is somewhat controversial, and there are other viewpoints.
However, the U.S. Preventive Services Task Force (USPSTF) issued new breast cancer screening guidelines in 2009, which recommend against routine mammography screening for women before 50 years of age and suggests that screening end at 74 years of age.
The new USPSTF recommendations are in opposition to other existing breast cancer screening guidelines from organizations such as the American Cancer Society as described above. The USPSTF guidelines also recommend changing the screening interval from one year to two years and suggest that women 40 to 49 years old who are at high risk for breast cancer consult with their doctor regarding the time to begin regular screening mammography.
It is important for women who are concerned about when to begin mammography to discuss the situation with their health care professional. He or she can help you make an informed decision about breast cancer screening that is appropriate for your individual situation.
Mammograms and young women
There is a special issue regarding mammograms in young women. Since young women have dense glandular breast tissue, routine mammograms have difficulty "seeing through" the dense breast tissue. Therefore mammograms may not be able to detect cancer in the breast because the dense breast tissue around the cancer obscures it. However, this problem can be partly offset by the use of special breast ultrasound, which is now an extremely important additional imaging technique used to supplement mammography in difficult cases. Ultrasound can make visible a lump hidden within dense breast tissue. It may also detect lumps and early breast cancers when mammograms fail to identify a problem. Ultrasound can also help doctors locate specific areas in the breast for biopsy (obtain small samples of tissue to study under a microscope). Sometimes doctors also suggest the use of magnetic resonance imaging (MRI) screening (see below) in younger women with dense breast tissue.
Magnetic resonance imaging (MRI) scanning
Recent research has shown that MRI scanning may be a useful screening tool for breast cancer in certain high-risk populations. In 2004, a team of Dutch researchers published a study of over 1,900 women at high risk for breast cancer in the New England Journal of Medicine. These women underwent breast cancer screening that included physical exams every six months along with yearly mammograms and MRI scans of the breasts. While conventional mammography did detect many cancers at an early stage, some tumors were identified by MRI that were not detected by mammography. Overall, MRI led to the identification of 32 tumors, of which 22 were not seen on the corresponding mammogram. Likewise, some tumors appeared on mammograms that were not visible on the MRI scan. Mammography detected a total of 18 tumors, of which eight were not identified by MRI.
The routine use of MRI, however, has many limitations. While it enabled the detection of some tumors in high-risk women, it also detected more noncancerous lesions (false-positives), which lead to many more follow-up examinations and potentially unnecessary medical procedures. In fact, MRI led to twice as many unnecessary examinations and three times as many unneeded surgical biopsies of the breast than screening by mammography alone. MRI is also approximately 10 times more costly (average cost $1000-$1500) than mammography.
Because of these limitations, experts believe that screening with MRI is impractical for women who do not have an elevated risk of developing breast cancer. However, its benefits appear to outweigh its limitations in certain high-risk populations.
In March 2007, the American Cancer Society Breast Cancer Advisory Group issued breast-cancer-screening recommendations that include MRI scanning along with mammography for women 30-69 years of age who are considered to have an estimated lifetime risk of developing breast cancer of 20%-25%.
Adding a yearly breast MRI was recommended for women who

• have a BRCA1 or BRCA2 mutation, indicative of a strong inherited risk of breast cancer;
• have a first-degree relative with a BRCA1 or BRCA2 mutation but have not been tested for the mutation;
• received chest radiation -- to treat Hodgkin's disease or other cancers, for example -- between 10 and 30 years of age.

The guidelines state that there is at present insufficient evidence to recommend the use of routine MRI screening in women with other risk factors, including a personal history of breast cancer, a history of carcinoma in situ or atypical hyperplasia, or dense breast tissue that makes the interpretation of mammograms difficult. Women with these risk factors may want to discuss their screening program with their physician to better determine whether MRI may be useful in their own case.
It is important to note that MRI should not be considered a substitute for regular mammography, and mammography is the only screening tool for which a reduction in mortality (death rate) from breast cancer has been proved.
Breast self-examination and breast examinations by your doctor
Both the American Cancer Society and the USPSTF do not call for regular self-examination of the breasts in their guidelines. The ACS states that breast self-exam is optional, while the USPSTF states that doctors should not teach women to do breast self-examination. The ACS further recommends a clinical breast exam (CBE) by a health care professional about every three years for women in their 20s and 30s and every year for women 40 years of age and over.

How helpful are BRCA1 and BRCA2 genetic tests in identifying women at risk?

In special circumstances, genetic tests can be very helpful both in identifying exceptionally high-risk patients and reducing the level of concern for others. We also now know that the presence of one of these genetic defects does not cause cancer in every patient. The cancers that do occur may also behave somewhat differently than non-BRCA-associated tumors. There is some evidence that they have a better outcome.
Before genetic tests are conducted, individuals being tested must have thorough counseling. A clear understanding of the limitations of the tests and the problems they may pose must precede the testing. The patient must know the meaning of the possible results, whichever way they may turn out, before testing. They should also have settled on a plan for each possible outcome of the test results. Often, the best way to evaluate a potential genetic risk is to test a relative who has already been diagnosed with breast cancer. If the relative's genetic testing (which must cover a large number of possible mutations) proves negative, then there is no need to perform genetic testing on the concerned individual. But the concerned individual should still undergo close monitoring with breast examinations and mammograms. If the test is positive on the relative, then that specific mutation is the only one that needs to be checked in the concerned individual and the other family members.

What is the link between estrogen and breast cancer?

Estrogen is a female hormone that is produced by the ovaries. During the reproductive years, a woman's body is exposed to high levels of estrogen. After menopause, the production of estrogen by the ovaries decreases. Estrogen is sometimes prescribed to treat some of the problems often associated with menopause, such as hot flashes, night sweats, sleeplessness, and vaginal dryness. Estrogen has the additional benefit of prevention of bone thinning (osteoporosis). However, results from a large clinical trial of postmenopausal women receiving hormone therapy (HT) released in 2002 showed that the overall risks of estrogen plus progestin therapy outweighed the benefits of hormone therapy. Combined hormone therapy with estrogen and progestin was shown to increase the risk of heart disease, stroke, and blood clots.
High levels of estrogen over long periods also increase the risk of developing breast and uterine cancers. Estrogen stimulates the cells of the breast and the uterine lining to grow and divide. Breast cells that are actively dividing are believed to have a greater chance of DNA damage as well as a higher number of cells that already have DNA damage. A higher number of cells with DNA damage elevate the risk of cancer development.
Women who have an early onset of their menstrual period (or menses) and late menopause are more likely to develop breast cancer than women with late menses onset and early menopause. This difference is believed to be attributable to the longer period of estrogen exposure in the first group.

Are there other breast cancer prevention measures?

Antioxidants
Antioxidants are chemicals that prevent a type of chemical reaction called oxidation. Oxidation is a major source of free radical formation. Antioxidants also mop up the free radicals that are formed.
Free radicals are electrically charged chemicals that can attack and damage proteins and DNA, thereby altering genetic information. If enough damage occurs to the DNA segments of a cell that controls cell division and growth, cancer can develop from that single cell. Free radicals can be formed by the normal metabolic activity in the body.
Free radicals also occur when cells are exposed to radiation. The body is regularly exposed to low levels of radiation in the atmosphere. The body also receives radiation during mammography and other X-ray tests. Theoretically, these low levels of radiation can lead to the formation of free radicals. (The amount of radiation in the atmosphere and in carefully performed X-rays tests is generally considered safe.)
Fortunately, a healthy body is well equipped to destroy free radicals and prevent cells with damaged DNA from becoming cancerous. The body is capable of quickly recognizing and destroying free radicals. For example, the body has an enzyme called superoxide dismutase that regularly cleans up free radicals and prevents them from damaging cells and proteins. The body can repair DNA damage caused by radiation or free radicals. The body is also capable of quickly destroying cells that have irreparable DNA damage to prevent them from turning cancerous. The immune system also seeks out cells with DNA damage and destroys them.
Naturally occurring antioxidants include beta carotene, vitamin E, and vitamin C. Fruits and vegetables are safe and rich sources of antioxidants. A somewhat controversial substance is caffeine. In several laboratory studies, caffeine acted like an antioxidant that cleans up free radicals. At present, there is no evidence that caffeine or coffee affects breast cancer risk. Also, some caffeine-containing substances, such as tea, have apparently been shown to decrease cancer risks.
Dietary fats
Early epidemiological studies suggested that high-fat diets might be associated with increased risks of breast cancer. But this relationship has not been confirmed, and results of studies have been mixed. Furthermore, it is clear that some fats may be protective rather than harmful. There are, however, some theoretical concerns about eating overcooked meats and fats.
Diet and lifestyle measures to reduce breast cancer risk
Theoretically, there are dietary and lifestyle measures that can decrease free-radical formation and reduce the risk of developing breast and other types of cancer. These measures include

• diets rich in vegetables and fruits;
• diets low in fats, and red and overcooked meats;
• reasonable intake of antioxidants, such as vitamins E and C;
• regular exercise and weight reduction;
• avoiding cigarettes.

Evidence that these measures reduce the chances of developing breast cancer is largely based on epidemiological data. Epidemiological evidence is derived from comparing two large populations with similar characteristics that have different diets or levels of exercise. Epidemiological evidence can only be suggestive, not conclusive. In fact, concrete proof that diet and exercise actually reduce the risk of developing breast cancer will be difficult to attain.
When firm scientific data is lacking and is unlikely to be available for the foreseeable future, the doctor has to weigh the risks of his/her recommendations against the potential benefits. Long-term risk and benefit considerations are especially important in advising young, healthy women about preventing a disease that they may or may not develop.
In the case of diets low in fat and overcooked meats, diets high in vegetables and fruits, avoiding smoking, and regular exercise, there is enough known benefit and very little known risk, which makes it easy for doctors to recommend them to their patients.
Doctors are also comfortable with recommending one multivitamin a day. However, there is no clinical evidence that taking megadoses of vitamins are of any benefit. Megadoses of certain vitamins can have adverse side effects.
Exercise
There is epidemiological data which show that women who exercise regularly have a lower incidence of breast cancer than women who do not exercise. The reason for such a benefit is unknown, but it may be related to the fact that obese individuals have higher levels of estrogen in the body than nonobese people. The higher levels of estrogen may increase the risk of breast cancer in obese women.

Conclusion

There are two important aspects in breast cancer prevention: early detection and risk reduction. Screening may identify early noninvasive cancers and allow treatment before they become invasive or identify invasive cancers at an early treatable stage. But screening does not, per se, prevent cancer. Breast cancer prevention really must be understood as risk reduction. In extremely high-risk patients, such as those who have BRCA mutations, risk reduction may involve prophylactic surgical removal of the breasts and ovaries. For the average patient, lifestyle modifications (diet, exercise, weight loss, etc.) may be easily recommended and have many other benefits. For patients who have an increased risk based on other factors, the use of hormone-blocking agents, in addition to the usual lifestyle recommendations, may also be considered.

SOURCE:medicinenet.com