SIMEDHealth

Breast Cancer with Dr. Jenny Chen

Family Medicine Physician, ​Dr. Jenny Chen discusses the risk factors, diagnosis, and treatment for breast cancer.

 

 

1.) What are the risk factors for developing breast cancer? Does age, gender, or race affect risks?

Globally, breast cancer is the most frequently diagnosed malignancy and the leading cause of cancer death in women, and in the US, it is the second leading cause of cancer death in women, trailing only lung cancer. While men can also get breast cancer, women are approximately 100 times more likely to get breast cancer than men. The highest breast cancer risk occurs among white women, although breast cancer remains the most common cancer among women of every major ethnicity and racial group. There are many other risk factors for breast cancer, including postmenopausal obesity, aging, family history, alcohol use, smoking, and menopausal hormone replacement therapy. In addition, earlier age at starting periods, and later age of menopause are also associated with an increased risk. Conversely, breastfeeding, increased physical activity and a diet rich in fruits, vegetables, fish and olive oil (Mediterranean diet) are associated with a decreased risk of breast cancer. Lastly, a meta-analysis showed dietary fiber intake was associated with a 12 percent relative risk reduction in breast cancer incidence.

 

2.) What are early signs of breast cancer?

A breast lump or mass is a common early sign of breast cancer. In countries with established breast cancer screening programs, most patients present due to an abnormal mammogram. However, up to 15 percent of women are diagnosed with breast cancer due to the presence of a breast mass that is not detected on mammogram. Other signs include breast skin changes such as dimpling and red discoloration, nipple retraction or inversion, localized pain or swelling, or enlarged axillary lymph nodes.

 

3.) Do self-breast exams make a difference in early diagnosis of breast cancer? What about breast exams by physicians?

Trials evaluating clinical breast examination (CBE) and breast self-examination (BSE), with or without mammography have not demonstrated efficacy in early cancer detection or improved outcomes. Therefore we no longer suggest using clinical breast examination (CBE) or breast self-examination (BSE) as part of screening of average-risk women. Screening CBE may be helpful, however, in resource-limited settings where there is limited mammogram imaging availability. Mammography is the recommended modality of breast cancer screening for the vast majority of women. The starting age and frequency of screening mammography depends on the individual’s risk, including genetic risk. No screening guideline recommends routine

screening for average-risk women (defined as less than 15 percent lifetime risk) who are under 40 years of age. Most United States expert groups encourage shared decision-making for women in their 40s for average-risk women, although European screening guidelines recommend starting screening at age 45. Regular mammograms are recommended for all women ages 50-75.

 

4.) 1 out of 8 women will develop breast cancer, and most of them survive the disease. What treatments are contributing to breast cancer survival?

Breast cancer mortality has dropped dramatically since the 1980s, and both earlier detection through screening and improvements in breast cancer treatment are responsible for this reduction in mortality. Medical treatment of breast cancer using endocrine therapy, and chemotherapy have increased the survival rates of breast cancer patients in the past few decades. For example, estrogen receptor-positive breast cancer patients benefit from the use of endocrine therapy with anti-estrogen drugs. More recently, advancement in genetic testing and immunotherapy are also transforming the way we treat breast cancer. Immunotherapy is a type of cancer treatment that helps our immune system fight cancer. These modern medical treatments, along with advances in surgical technique and radiation oncology equipment have helped more, and more women become breast cancer survivors.

Staying Physically and Mentally Healthy This Winter

With hundreds of thousands of vaccines being administered per day, the end of COVID-19 feels near. But it is further away than we think, and it’s never been more critical to prevent unnecessary illness. We talked to Primary Care Physician Jenny Chen, MD, about what we can all do to stay physically and mentally healthy during this winter season.

What are the main things Dr. Chen recommends for staying physically healthy? “Wash your hands. Though the main mode of transmission for COVID-19 is respiratory droplets, washing your hands especially after being in public is vital.” If you do need to go out in public, stay away from large crowds and stay six feet away from others. Dr. Chen says, “Wear a mask when you go outside. And stay up to date on your vaccinations, including your flu shot. And when it is available to you, get the COVID-19 vaccine.” Following these tips will keep you healthy and protect the health of your loved ones and society as a whole.

Why are wearing masks so important, in any case? Dr. Chen responds, “Masks may be cumbersome for some of us to wear, but they give us protection from getting COVID-19 by blocking some of the spread of respiratory droplets. More importantly, if a sick person who has a cough is wearing a mask, then the mask decreases the chance the sick person will spread the virus to you.”

As vaccinations start to be circulated, it may feel unnecessary to get one for yourself when everyone around you has one. Dr. Chen disagrees, “The vaccines currently available are over 90% effective, but not 100% effective. Although less likely, it is still possible for a person who is vaccinated to catch the virus and spread it to you. Also, it is not possible to know in public that everyone around you is vaccinated. If you go to the grocery store, there might be other people there who are not vaccinated. You can help stop the spread by greatly reducing the chances you will be a carrier yourself if you get vaccinated.”

Not being able to do all the things people want to do has been tough on many people. Any tips for how to mentally stay fit during this period? Dr. Chen advises, “Exercise gives you a boost of endorphins and can help you stay mentally healthy. Also, any form of social contact can help. Make a point to talk to your loved ones regularly, even if it’s only through the phone or Zoom.” She adds, “Consider starting a gratitude journal. Every day making a list of things you are thankful for. Doing this simple task has been shown to lessen symptoms of depression for some people. If you are feeling overwhelmed by your depression or anxiety, if it is interfering with your daily life, it is important to seek professional help.”

Lastly, Dr. Chen adds, “This is hard to predict, but some experts believe that if we all do our part and enough people get vaccinated, we can get back to some normalcy by the end of 2021. Pandemics have happened throughout human history, and they did not stay forever. The virus may be around for a while beyond 2021, but daily new cases may drop to a very low level by that time. There is a light at the end of the tunnel once we get through this winter.”

Click here to schedule an appointment with Dr. Chen.

American Heart Month with Dr. Jenny Chen

Did you know 1 in 3 deaths are caused by cardiovascular disease every year in the United States? February is American Heart Month and aims to shed light on the dangers of cardiovascular diseases. We sat down with SIMEDHealth's Primary Care Physician Jenny Chen, MD, to discuss the most prevalent of the heart diseases, coronary artery disease.

1. What is Coronary Artery Disease?

"Coronary artery disease (CAD) is the most common type of heart disease and is caused by atherosclerosis plaque building up inside the heart arteries (coronary arteries). The plaque is composed of cholesterol, fatty deposits, and other material on the inner walls of the arteries", explains Dr. Chen. "These inner artery wall deposits result in narrowing or potential obstruction of the space for the flow of blood."

"A heart attack occurs when a coronary artery supplying your heart muscle is blocked, leading to loss of blood flow and oxygen to the muscle cells. If the blockage lasts too long, that part of your heart muscle dies." 

2. What are the factors that could lead to CAD?

Dr. Chen says, "Many factors can contribute to coronary artery disease. These risk factors include but are not limited to high cholesterol, diabetes, high blood pressure, sedentary lifestyle, smoking, obesity, family history/genetics, and aging."

3. What are some ways to prevent CAD?

"There are many ways to prevent or slow the progression of CAD," says Dr. Chen. "If you are a smoker, there is nothing more important in preventing the progression of CAD than stopping smoking. For those with diabetes, its very important to keep glucose under control through diet, exercise, and possibly medication. Eating a healthy diet, including numerous fruits and vegetables per day, minimizing trans-fat, saturated fat, and refined carbohydrates, can all help prevent developing CAD. Also, keeping one's blood pressure well-controlled can help reduce the risk. This means periodically monitoring one's blood pressure and following doctors' instructions on diet, and taking the correct medications if needed. Cardiovascular exercise, if one is healthy enough to do so, can also reduce the risk of CAD. The goal is at least 10 min per session and at least a combined 150 minutes per week of aerobic activity."

4. What are the symptoms of a heart attack in men and women? Why are some of the symptoms different in women?

"Classic symptoms of a heart attack which both men and women can experience include chest pain, an aching sensation in your chest or left arm that may spread to your neck or jaw. Patients can also experience sweating, shortness of breath, palpitations, severe fatigue, nausea, upset stomach, or abdominal pain," says Dr. Chen.

She also adds, "Women are more likely than men to report non-classic symptoms of a heart attack. For example, a woman having a heart attack may complain only of nausea, vomiting, and abdominal discomfort rather than chest pain."

5. What else can I do?

A visit with your primary care physician can help you identify the CAD risk factors that may apply to you. If not done recently, lab testing can be done to evaluate your cholesterol and glucose. Together you can then develop a plan to lower your CAD risks over time. By taking control of the risk factors, you can do a lot to prevent your chances of developing heart disease. 

 

Click here to schedule an appointment with Dr. Chen or one of our other Primary Care physicians and nurse practitioners. 

What You Need to Know About Donating Blood

Did you know a single car accident victim can require as many as 100 pints of blood? January is National Blood Donor Month, and to spread awareness, we talked to Jenny Chen, MD of SIMEDHealth Primary Care in Ocala. We discussed the benefits and the process of donating.

 

1. Why is it important to give blood?

"Blood donation is essential for saving lives!" explains Dr. Chen. "Having stored blood available is necessary for surgeries, cancer treatment, certain blood disorders, and traumatic injuries. Benefits for donors include a free medical check-up satisfaction of helping others, and free cookies, juice, and sometimes promotional items."

 

2. What are the requirements to give blood?

  • According to the US Food and Drug Administration (FDA) regulations, donors are eligible to donate no sooner than 56 days (eight weeks) after their previous donation. However, not all donors qualify at this minimum interval, as it depends upon how rapidly the person's body can replenish its red blood cells.
  •  You must be in good health and feeling well
  • You must be at least 16 or 17 years old in most states
  • You must weigh at least 110 lbs

3. How long does the donation process last?

Dr. Chen says, "The entire process takes about 1 hour and 15 minutes, but the actual blood donation takes 8 to 10 minutes. However, the time varies slightly with each person depending on several factors, including the donor's health history." 

During the donation, a needle is put into a vein in the upper extremity. This is done by skilled medical personnel in such a way to minimize possible symptoms such as lightheadedness. One pint of blood is withdrawn, approximately 500 mL, which is equivalent to one "unit". The donor is monitored during the donation and for a few minutes afterward. Juice and snacks are provided to help decrease post-donation symptoms.

 

4. Are there any side effects of donating blood?

According to the National Center for Biotechnology Information, 1.2% of donors suffered from an adverse reaction. Dr. Chen assures, "The vast majority had mild reactions such as agitation, sweating, pallor, cold feeling, sense of weakness, nausea. Only 0.2% had more severe disorders, including vomiting, loss of consciousness, and fainting."

"It is important to note that, donating removes iron from the body, and can result in a temporary iron deficiency if the lost iron is not replaced," explains Dr. Chen. "The risk of iron deficiency is highest in teenage donors, menstruating women, and individuals who donate frequently." For some, just eating iron-rich foods is not sufficient to replenish lost iron. Many donation organizations recommend taking an iron supplement or a multivitamin for 60 days to replace the iron lost through each donation.

 

Schedule an appointment with Dr. Chen or one of our other SIMEDHealth Primary Care physicians today!