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'Women's Health' posts

Do Docs Miss Breast Cancer Warning Signs in Breastfeeding Mothers?

In the haze of joy and sleeplessness during the months after childbirth, thoughts about breast cancer are the last thing on a new mother’s mind. Her body is undergoing so many changes that, of course, she and her doctors would naturally assume any breast changes are related to breastfeeding.

Probably, they are. However, there is a small but real incidence of women who develop breast cancer during and following pregnancy. Often, they end up having delays in seeking evaluation and getting a diagnosis, because they or their doctors may not appreciate that risk!

So, what things should prompt an evaluation?

  • Lumps most often will be changes in the breast tissue as it revs up milk production. A distinct lump or “dominant mass” could be a clogged duct, galactocele, cyst or a common benign tumor called a fibroadenoma, but if it doesn’t resolve within a few weeks with treatment, it needs imaging.
  • Redness most often will represent infections like mastitis or an abscess, but if it doesn’t resolve within a few weeks with treatment, it will also need imaging and possibly a biopsy. At the very least, that could determine if the right antibiotics are being used. An uncommon form of breast cancer called inflammatory breast cancer can present this way.
  • Bloody milk or baby refusing one breast  most often will be due to nipple trauma, latch issues, or positioning; if so, seeing a board-certified lactation consultant is appropriate. But rarely, this can represent a form of breast cancer within the milk ducts.
  • “Something’s not right”. You are the most knowledgeable person about your own breasts. Even if it doesn’t neatly fit one of the categories above, if something really seems wrong to you, your doctors should take that seriously.

What evaluation should be done?


Health Disparities and Breast Cancer

Just as all breast cancers are not alike, the impact of breast cancer is not the same for all women. African American women are less likely to get breast cancer than Caucasian women, but they are about 40% more likely to die of it when they do get it. African American women are also more likely to be diagnosed with breast cancer at a younger age than Caucasian women and to have more advanced cancers at diagnosis.

There appear to be multiple reasons for these disparities - including cultural beliefs / misperceptions about screening and cancer; lack of access to screening; inequities in healthcare delivery and treatment; concerns about being exposed to racism by healthcare institutions; and biological differences in the cancers themselves.

Let’s look at some of these more closely.

  • Cultural beliefs / misperceptions about ....

Swedish Foundation Raises $100 Million to Help Meet Increasing Demand for Regional Health-Care Services

SEATTLE, Oct. 26, 2012 – Swedish Medical Center's seven-year fund-raising initiative, called The Campaign for Swedish, has raised $103 million, exceeding its initial $100 million fund-raising goal in approximately five-and-a-half years. The Campaign, launched to help improve patient care and treatment options throughout the Swedish system, is the largest fund-raising effort undertaken by the private, non-profit health system to date.

Fall Arts Showcase Slated for Nov. 1 at Swedish/Issaquah

ISSAQUAH, WASH., Oct. 23, 2012 – The public is invited to ‘A Night Out at Swedish: Fall Arts Showcase’ on Thursday, Nov. 1 from 6-8 p.m. This free evening event, which will take place in the first-floor lobby of Swedish/Issaquah (751 N.E. Blakely Dr.), will feature a community concert by the Sammamish Symphony String Quartet.

Becoming a Breast Surgeon

Surgeons are often Type A personalities, the ones who sit in the front of the class, who volunteer for everything, who stay scrubbed in the OR all day with appendicitis and do a post-op check before checking themselves into the emergency department (yes, that was me.) As such, surgeons are often dismissive of the subspecialty of breast surgery. The surgeries are not as complex as cardiac bypass surgery or Whipple procedures for pancreatic cancer. In fact, it’s often a rotation for interns. I was a Type A personality. I had no plans to do breast surgery.

Then, a funny thing happened. I had my first son during residency. Planned with military precision, of course, to coincide with the beginning of my designated research years, as I had hoped to squeeze another baby in there somewhere. After his birth, I would breastfeed, because that is what Type A mothers do these days. It’s the best! Of course, I would do the best! However, like many mothers out there, we had an incredibly rocky start. Poor latch with inadequate weight gain. Triple feeding with pumped milk. Cracked nipples leading to mastitis. As a Type A person, I threw myself into research in an effort to solve the problems. Not just the many, many baby books out there, but Medline searches on breastfeeding management. I learned more than I ever had in my surgery textbooks about the breast, the physiology of lactation that is both incredibly simple and enormously complex, and most importantly, miraculous. I was reminded constantly in my reading of the importance of preserving this ability to breastfeed my son, for his and my health, and how challenging that could be.

I would sit in my office, working on surgical infections research, as I pumped and read about normal breasts and infected breasts and cancerous breasts. Antibiotic rotations in ICUs and glucose control became less exciting than being able to offer targeted medical advice to a frustrated friend in Boston, whose refractory mastitis was being met with shrugs from some of her local doctors until we correctly identified MRSA as the source. Maybe it wasn’t saving lives, but it saved her breastfeeding relationship with her child. Who knows, maybe in the end it would be saving lives! I read more ....

Swedish to Host OB Speed Dating Session at Ballard Campus Oct. 23

OB-Speed-Dating-photo.jpgSEATTLE, Oct. 15, 2012 - If you’re pregnant or thinking about having a baby, finding the right provider is a pretty good place to start this incredible journey. When you come to OB Speed Dating, you’ll get the chance to meet several Obstetricians and Certified Nurse Midwives (CNMs) who deliver at Swedish Ballard's Family Childbirth Center and get to know them in a fun, low-key environment.

Do self breast exams matter?

Self breast exams: to do or not to do?

Remember when there were monthly emails you could sign up for to remind you and your friends to do your self breast exams at home? Remember seeing the news anchors talking about their monthly self breast exams in an attempt to remind you to do your breast “due diligence?” What happened to self breast exams and are they still important?

Initially, self breast exams were recommended as a screening tool to help early detection of breast cancer. Unfortunately long-term studies have not confirmed that they actually live up to their hype. Two large studies looking at over 200,000 women in both Russia and China didn’t show any difference in breast cancer mortality after 15 years between the women who were performing routine self exams and those who were not. In fact, the women that were practicing self exams found more lumps and underwent more biopsies for benign reasons. Reviews of several other studies failed to show a benefit of regular breast self-examinations including no benefit of early diagnosis, or reductions in deaths or stage at diagnosis. Hence in 2009, the US Preventative Services Task Force advised that clinicians no longer recommend routine self breast examination as a screening tool for breast cancer detection.

Even though you don’t need to be doing a monthly self exam, you should...

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