Dr. Cynara Coomer

I am outraged with the recommendations from the U.S. Preventive Services Task Force. Not only does it send a mixed message to women about the benefits of a screening mammogram, it is also a dangerous practice to not screen women between the ages of 40-49 without an alternative test. Furthermore, early detection of breast cancer by mammograms has shown to have a significant decrease in the number of deaths. Although the numbers are more impressive for women over the age of 50, there is still a large impact for women in the 40-49 age group. For every 1,300 women screened between the ages of 50-59, one woman’s life is saved. For every 1,900 women screened between the ages of 40-49, one woman’s life is saved.  Is the difference in the ratio really worth denying women in their 40s a chance of survival?

Proponents of the task force’s recommendation argue that screening women in their 40s has led to a high number of false negatives, needless biopsies and unnecessary anxiety. However the impact of saving a woman’s life in my perspective outweighs these problems. Ultimately, we need to find more appropriate tests to screen women, but the mammogram is our best available modality at this time.

Because of the number of women under the age of 50 that I personally treat in my practice for breast cancer, I will not go against the American Cancer Society guidelines of starting mammograms at the age of 40. Depending on their risk factors, some women may need a baseline mammogram at the age of 35. The impact of these guidelines is not only about survival outcomes, it is also about the treatment options that are available when breast cancer is found early. When breast cancer is found at an early stage, there are more surgical options and it usually does not require the addition of chemotherapy. On the other hand, when cancer is found at a later stage, surgical options become more limited and treatment will most likely include radiation and chemotherapy. The prognosis is also worse when cancer is found at a later stage. So to think that costs will be lowered by decreasing the number of screening tests does not make sense when we risk diagnosing breast cancer at a later stage. In the end, the cost of treating advanced breast cancer is far more expensive.

I hope the task force reconsiders and reverses their recommendation so that women will continue to understand that mammograms starting at the age of 40 save lives.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

If I’m confused, I can only imagine what women are thinking throughout America this morning. As recently as Monday morning, I saw some 40-year-old patients in my office and talked to them about the benefits of mammograms. I based my recommendations on the analysis that the American Cancer Society and the American College of Obstetrics and Gynecology have said for the last 5-7 years. And I have seen the benefits of early detection and screening in my own experience with a significant amount of cancers being prevented in women in the 40-49 age group.

I have also seen young patients die of breast cancer, so it was very surprising to me that this federally appointed panel came out with the recommendation that women start getting mammograms at age 50 and then every two years after that without even considering the impact that it could have on preventive medicine. So far, the only thing I can conclude from their statements is that they’re playing a numbers game and based on their theoretical statistical analyses and data from some European countries such as Sweden, the cost-benefits ratio in their mathematical calculations made it more beneficial at the age of 50 than it would be at the age of 40.

Saving someone from cancer should not be a numbers game, but unfortunately, this seems to be the trend coming to America. Save dollars, and make it cost effective. I don’t mind that medical policies change, but what I do mind, is when these decisions are made by bureaucratic panels without considering the impact that it can have on the patients and the physicians treating them. As of today, it appears that the American Cancer Society disagrees with these new recommendations, so I can only imagine what insurance companies are going to be saying in the very near future.

Finally, I really want to express my discontent with the advice being given to younger women not to bother doing self exams. We teach women about the importance of becoming familiar with their bodies. Self examination can yield lesions in a woman’s breast that if recognized and worked-up could prevent death and disease. It does not cost anything, and it can only provide vital information that is important to health care professionals. But as I said earlier, it’s always a numbers game. I just hope my daughter doesn’t become one of those statistics, that at least to some people, do not seem to matter.

Dr. Cynara Coomer

The most common surgery for breast cancer these days is a lumpectomy, which is considered breast-conserving therapy. If patients choose to undergo this surgery, it has to be combined with radiation therapy, which can be administered in the form of external radiation, where the whole breast is radiated, or partial breast radiation called brachytherapy.

Another option for surgically treating breast cancer is by mastectomy. Mastectomies remove all the breast tissue, but nowadays, most women are candidates for immediate breast reconstruction done during the same operation.

When reconstruction is used, women can have either a skin-sparing, areola-sparing, or nipple-sparing mastectomy. This is where the skin and/or the areola and nipple are preserved, which improves the cosmetic outcome dramatically. The type of breast cancer that a woman has will determine which of these procedures is appropriate.

Reconstruction can be performed by using implants or tissue transplanted from other areas of the body. Most commonly, abdominal fat is used, which results in a tummy tuck.

Some patients may need to have chemotherapy prior to surgery. Although this is not proven to improve the survival outcomes, it increases the surgical options and may potentially decrease the risk of local recurrence in the breast.

There are so many more options for women these days for surgically treating breast cancer, and they should be discussed with a breast surgeon.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

Dr. Cynara Coomer

When a woman is told that she has an abnormality on her mammogram and/or breast ultrasound, it’s often a very frightening and emotional experience. Most commonly, a woman may be told that the results are benign, and that she needs to return in 6 months for a repeat study. Generally this means that the finding on the mammogram or the ultrasound is most likely non-cancerous, and the radiologist just wants to confirm that by monitoring the lesion.

But sometimes, the recommendation from the radiologist is that the lesion be biopsied. Obviously this is even more anxiety-provoking, but women should remember that 80 percent of the lesions we biopsy are non-cancerous.

These diagnostic biopsies should almost always be performed as a minimally-invasive needle biopsy as opposed an open surgical procedure. Currently, too many women are undergoing surgery to obtain a diagnosis. Surgery should be generally reserved for therapeutic reasons. Many women undergoing a needle biopsy will not need to have surgery because the results are usually benign.

The most common reasons for undergoing surgery after a needle biopsy is if there is a finding of atypical cells, cancer, a benign lesion that has the potential of having a malignancy associated with it – meaning it may develop or have cancer cells near it. Another reason might be if there is discrepancy between the biopsy and radiology results.

Once there is a need for surgery, you should talk to a breast surgeon/specialist about the different surgical options available to you. Never be afraid to get a second opinion from a surgeon and/or a pathologist.

Next week we’ll talk about surgical options for women once they’ve been diagnosed with cancer.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

If your goal is to lose weight without hunger, improve your energy, and reduce your risk of disease the solution is here.  Two-thirds of American adults are overweight, half of them obese.  After a decade of low-fat and low-carb diets, Americans are heavier than ever. With The F-Factor Diet, you won’t focus on which foods you must omit, instead you focus on adding food into your diet in order to lose weight and keep it off. 

What is fiber and why should we eat it?
Fiber has zero calories (it’s the indigestible part of carbohydrates).  After a decade of banishing carbs from your diet, The F-Factor Diet teaches you how to eat carbs and still lose weight!  While the calories on the F-Factor Diet are low (which is ultimately what leads to weight loss), you would never know it because the fiber-rich foods keep you feeling so full. 

There are numerous benefits to eating more fiber beyond just losing weight. Studies show that fiber-rich foods not only help you to lose weight but increase your chances of longevity. High-fiber diets alleviate constipation and reduce the risk factors for cardiovascular disease, adult onset diabetes, colon cancer, breast cancer and hypertension. 

Dietary fiber comes in two forms: soluble and insoluble.  Although you should get both soluble and insoluble fiber in your diet every day, there is no need to fixate on one type or the other. Because most whole plant foods contain both types of fiber, just increasing your intake of foods high in total fiber will provide you with beneficial amounts of both.  Soluble fiber swells in your stomach, providing bulk and giving you a feeling of fullness. Good sources of soluble fiber include dried beans and legumes, oatmeal, oat bran, barley and citrus fruits. Soluble fiber also has cholesterol-lowering properties because it acts like a sponge, absorbing cholesterol and pulling it out of your body.  Insoluble fiber, usually referred to as roughage, includes the woody or structural parts of plants such as broccoli, apples, wheat bran, and whole-grain cereals. Insoluble fiber tends to speed up the passage of material through the digestive tract and help reduce the risk of colon cancer and diverticular disease. It is often referred to as “nature’s broom.”

How much fiber should we be consuming?
Despite the ADA (American Dietetic Association) recommendation that Americans eat 30-35g of fiber per day, the typical American only eats 9-11g of fiber per day.  People often think of fiber as dry and tasteless, but currently fiber is being touted as a wonder-nutrient. Now, one could integrate fiber into their diets by choking down tall glasses of Metamucil, but that’s certainly not the most pleasant — or tasty — way to get one’s fiber. Take a look below at a before and after sample day of delicious meals with fiber:

                                                            Calories          Fiber (g)

BREAKFAST

Typical Breakfast

Granola (1/2 cup)                                  230                   3

Sliced banana                                            90                    2

Total                                                          320                  5

High-Fiber Breakfast

Fiber One cereal (1/2 cup)                60                     14

Blueberries (3/4 cup)                          60                     5

Total                                                         120                  19

 Fight food cravings with high-fiber cereal.

 LUNCH

Typical Lunch

Turkey sandwich on white

bread with mayonnaise                          265                   0

Potato Chips (1 oz)                                    150                   0

Total                                                             365                  0

High-Fiber Lunch

Turkey sandwich on whole-

wheat bread with

lettuce, tomato and

mustard                                                  195                   10

Soy chips (1 oz)                                     70                     2

Total                                                    265                  12

 Fiber and protein at every meal makes losing weight no big deal.

SNACK

Typical Snack

2 oz. pretzels                                      230                   0

Total                                                    230                  0

 High-Fiber Snack

1 oz. pistachios                                  65                   3

8 dried apricot halves                   60                     4

Total                                                   225                  7

 High-fiber snacks fill you up without filling you out.

DINNER

Typical Chinese Takeout

Wonton Soup                                        125                   0

Kung Pao Chicken                                1170                 4

White Rice (1 cup)                                240                   1

Total                                                    1535                5

High-Fiber Chinese Takeout

Vegetable Soup                                     40                     2

Chicken and Broccoli                          250                   6

Brown Rice (1 cup)                               240                   4

Total                                                        530                  12

 Avoid late-night snacking with a high-fiber dinner.

 TOTAL DAY (From meals above)

Typical Day                                         2450 Calories             10g Fiber

High-Fiber Day                                   1140                            50g Fiber

 The more fiber a food has, the fuller you feel, making you less likely to overeat throughout the day.  In addition, most high-fiber foods have few calories.  Eating high-fiber foods is the secret to losing weight without hunger.

Tanya Zuckerbrot, MS, RD is a nutritionist and founder of www.Skinnyandthecity.com.    She is also the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

Not only does calcium support healthy bones, especially in women, new studies find that a calcium-rich diet may also lower their risk of developing many types of cancer.  A new study, conducted by the National Cancer Institute, found a direct link between calcium intake and reduced risk of colorectal and other digestive system cancers. 

Study:
• This 7 year study of nearly half a million participants in the NIH-AARP Diet and Health Study focused on calcium from food as well as supplements.
• Yikyung Park, ScD and colleagues analyzed data from over 290,000 men and 198,000 women ages 50-71.
• Half the men and 57 percent of the women reported taking a multivitamin containing calcium. Fourteen percent of the men and 41 percent of the women took calcium supplements.

Results:

• WOMEN: The women with highest calcium intake were at 23 percent less risk for all digestive system cancers than those with the lowest intake, and 28 percent less prone to colorectal cancer in particular. The risk decreased in women with intake of up to 1,300 milligrams per day.

• MEN: The men decreased their risk by 16 percent for all digestive cancers and 21 percent less risk of colorectal cancer. The risk decreased in men with an intake of up to 1,530 milligrams per day.

Conclusion:
• Calcium has been shown to reduce abnormal growth and induce normal turnover among cells in the gastrointestinal tract and breast.
• Calcium also binds to bile and fatty acids, potentially reducing damage to the mucous membrane in the large intestine.
• The Institute of Medicine calls for 1,200 milligrams of calcium daily for adults. The 2005 federal dietary guidelines recommended three cups per day of low-fat or fat-free dairy products.

Surprising Sources of Calcium:
Skim Milk (1 cup): 302 milligrams
Non-Fat Yogurt (6 ounces):415 milligrams
Low-fat Cottage Cheese: 138 milligrams
Canned Salmon (3.5 ounce can): 277 milligrams
Broccoli (1/2 cup cooked): 68 milligrams
Spinach (1/2 cup cooked): 84 milligrams
White beans (3/4 cup): 120 milligrams
Orange (1 large): 74 milligrams
Strawberries (1 cup): 24 milligrams

Tanya Zuckerbrot, MS, RD is a nutritionist and founder of www.Skinnyandthecity.com.    She is also the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.

Today I want to comment on a news piece from the New York Post about Dr. Malcolm Lloyd, a physician who seems to be recommending daily alcohol consumption as a preventative for a variety of ailments from the common cold to Alzheimer’s and certain cancers. He also seems to be indicating that people who drink regularly in moderation seem to live longer than those who don’t. Give me a break!

I know that there have been numerous publications exploring the correlation between alcohol consumption and heart health. For example, we all know that a chemical compound found in wine called resvesterol, is a potent antioxidant that has been shown to complement the stability of a healthy heart.

However, there have been many other studies that have clearly demonstrated increased cancer rates ― especially breast cancer ― in women who consume moderate amounts of alcohol.

Now trust me, I am not, by a long shot, a person who doesn’t enjoy a good drink once in a while. And I do acknowledge that there are cultures in various parts of the world where alcohol is an integral part of the local cuisine. However, these are also the cultures where healthy servings of vital nutrients, vegetables and proteins play a key role in their daily eating habits. They tend to be more physically active, and place a lot of importance on maintaining healthy sleep patterns.

But here in the U.S., we are a “fast-food nation.” For the last 3-5 years, we’ve been hearing about how the obesity rate has reached epidemic proportions – affecting both adults and our children.

Obesity significantly raises the risk for many diseases and conditions like:
          o          Coronary heart disease

          o          Type 2 diabetes

          o          Cancers (endometrial, breast, and colon)

          o          Hypertension (high blood pressure)

          o          Dyslipidemia (high total cholesterol or high levels of triglycerides)

          o          Stroke

          o          Liver and Gallbladder disease

          o          Sleep apnea and respiratory problems

          o          Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)

          o          Gynecological problems

 
Americans also deal with high rates of depression — another disease that when coupled with the effects of alcohol can have disastrous results.

We also have to remember that alcohol has addictive properties that for some folks can completely ruin the chances of future health and longevity.

I know that everyone is looking for an excuse to justify their daily cocktail, but I find it irresponsible for one physician to give us a free pass to drink myself to “an everlasting life.”

When Suzanne Penney was diagnosed with leukemia after she battled breast cancer, she decided to undergo an injection of umbilical stem cells – and the procedure saved her life, KNSD-TV reported Thursday.

Penney, who lives in Carlsbad, Calif., contracted leukemia as a result of the aggressive chemotherapy she received for her breast cancer.

“When information about stem cells first came out I was against it,” Penney told KNSD-TV. “I always thought, ‘don’t mess with Mother Nature, and there’s going to be a bunch of cloned people walking around.’”

But, today, as Penney recovers in the hospital, doctors tell her that her leukemia is in remission.  

Australian researchers say the same gene that puts women at a high risk for breast cancer also may give men a heightened risk for prostate cancer.

Men from families where the women have high rates of breast cancer are about four times more likely to develop prostate cancer, according to research funded by Australia’s National Breast Cancer Foundation and conducted by kConFab, an Australian and New Zealand consortium for research into familial breast cancer.

A new study found that breast cancer patients with low levels of vitamin D are more likely to die of the disease or have it spread than patients getting enough of the nutrient. 

The skin makes vitamin D from ultraviolet light. Too much sunlight can raise the risk of skin cancer.  But some doctors say small amounts – 15 minutes or so a few times a week without sunscreen – may be beneficial.