Showing posts with label Women's Health. Show all posts
Showing posts with label Women's Health. Show all posts
Several methods may be used to remove tissue for the pathologist to examine. The choice of which biopsy method is used depends on the size and location of your abnormality, and whether is can be felt or not.
- • Fine Needle Aspiration: A type of biopsy that is performed with a small needle and syringe. Cells are removed that can be examined under the microscope.
- • Core Needle Biopsy: A type of biopsy that is performed using a larger, hollow needle and a spring loaded instrument. Several cores of tissue are removed for examination under the microscope. Additional information can be obtained with these slightly larger pieces of tissue.
- Excisional Biopsy: A type of biopsy that is performed in an operating room. A small incision is made on the skin above the lump. The area of concern is then removed for examination under the microscope. The incision is closed with stitches.
- Ultrasound Guided Core Needle Biopsy: A type of biopsy that is performed using a larger, hollow needle and a spring loaded instrument. Using ultrasound guidance, the area of concern is found. Several “cores” or samples of tissue are removed and then examined under the microscope.
- Mammotome Biopsy: A type of biopsy is done by using a larger, hollow needle. The area of concern is found by using ultrasound as a guide. Several samples or cores of tissue are removed to be examined under the microscope.
- Stereotactic Biopsy: A type of biopsy that utilizes a special computerized mammogram and instrument. Lying face down, the breast hangs through an opening in this special table. A needle apparatus is inserted into the breast; an additional needle withdraws tissue from the area of concern. This tissue is then examined under the microscope.
- Needle Localization Biopsy: A type of biopsy that uses radiology guidance to insert a needle close to the area of concern. A small incision is made on the skin near this needle. The area of concern is then removed for examination under the microscope. The incision is closed with stitches.
Sourch University Medical Center
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Breast Tissue
The breast is made up of various types of tissues. These tissues change over a woman's lifetime as her hormones change. Before menopause, a woman's breasts are mostly made of dense, fibrous tissue and fat. As a woman passes through menopause, this fibrous tissue often turns to fat. This causes the breasts to feel much softer and less lumpy. If a woman takes estrogen after menopause, her breasts may often remain fibrous.
Fibrous tissue can sometimes hide a small cancer making it more difficult to feel or find on a mammogram. It is still important to obtain annual mammograms and examine your breast regularly. As you become older with less hormonal influence on your breast tissue, visibility on a mammogram should improve.
There are several types of breast cancers.
- Infiltrating Ductal Carcinoma (most common type) is a breast cancer that starts in the milk duct and spreads through the ductal wall into surrounding tissue. Once that invasion has occurred, the cells can enter lymph vessels and blood vessels. These vessels are pathways that can carry cancer cells to other parts of the body. For this reason, breast cancer is often described as a system wide disease.
- Ductal Carcinoma in Situ (DCIS) is a non-invasive type of breast cancer. It cannot spread. It is important to surgically remove all traces of the DCIS to improve local control of the cancer.
- Infiltrating Lobular Carcinoma is a cancer that starts in the lobule of the breast. It has microscopic projections that can break through the lobule wall and start moving into the surrounding tissue, often making this a more difficult cancer to diagnose at an early stage. It is treated the same as infiltrating ductal carcinoma, although sometimes clear lumpectomy margins are more difficult to obtain. It is also considered a system wide disease.
- Inflammatory Breast Cancer is characterized by redness and swelling of the breast with skin changes. This breast cancer can grow very rapidly. It has a higher chance of spreading elsewhere in the body and must be treated more quickly. It is treated first with chemotherapy, followed by surgery and radiation therapy.
Sourch University Medical Center
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- 1. Maintain your ideal body weight.
- 2. Participate in regular (3-4 times per week) aerobic exercise.
- 3. Avoid exposure to tobacco products. Do not smoke. If you do smoke, seek assistance in quitting.
- 4. Be moderate in the use of alcohol. For women, one drink per day is considered within acceptable alcohol consumption limits.
- 5. Adopt a healthy diet which emphasizes fresh fruits and vegetables, and reduces the consumption of animal fat and beef.
- 6. Prevent exposure to sexually transmitted diseases by practicing safe sexual behavior.
- 7. Avoid excessive sun exposure. Do not get sunburned.
- 8. Follow general health guidelines related to screening for other diseases such as cervical cancer and colon cancer.
Cardiovascular Health Maintenance
- Monitor your blood pressure regularly (it should be less than 120/80), and treat high blood pressure if it is found.
- Maintain your ideal body weight (your body mass index* should be less than 25).
- Monitor your blood lipid levels (LDL cholesterol should be less than 100; HDL cholesterol target: 50-60), and treat unacceptable cholesterol levels.
- Monitor your blood sugar periodically, and treat diabetes if it is found.
- Keep your waist circumference less than 32 inches.
- Participate in regular (3-4 times per week) aerobic exercise.
- Do not smoke! If you do smoke, seek assistance in quitting.
Bone Health Maintenance
- Participate in regular (3-4 times per week) weight-bearing aerobic exercise.
- Monitor your bone density: Ask you doctor for a baseline bone density test, Repeat the scan periodically. Treat bone loss aggressively: Take calcium and vitamin D after undergoing RRSO.
Consider other medications, such as pamidronate, risedronate, tamoxifen or raloxifene, if your bone density continues to decline. Estrogen is also effective in the treatment of osteoporosis, but its safety for women who are at increased genetic risk of breast cancer is uncertain. - Do not smoke! Smoking can also increase the risk of osteoporosis. If you do smoke, seek assistance in quitting.
Breast Health Maintenance
- Consult your physician regarding breast self-examination, since all the women who participate in this study are at increased risk of breast cancer.
- Seek medical attention promptly if you detect an abnormality in your breast.
- Have a clinical breast exam by your health care provider twice a year.
- Undergo screening mammograms at least once per year.
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Although monthly self breast examination (SBE) is recommended, it has not been shown to lower the mortality from breast cancer. Advising women to be aware of their breasts and report any masses or skin changes immediately may be more realistic.
Clinical breast examination
It is difficult for clinicians to become proficient at physical examination of the breast. Unlike auscultation of the chest or assessment of cranial nerves, where normal findings do not vary among normal patients, normal breasts look and feel different among normal women. Similarly, normal mammograms look different from one woman to the next. It takes a long time before a doctor is comfortable stating that a woman’s clinical breast examination (CBE) is normal, and even when they do, the fact remains that CBE is not a very sensitive tool for detecting early-stage cancer.
One can approach CBE by trying to detect a finding in one breast such as a mass, that is not present in the other. Breasts should first be inspected with patients sitting with their hands at their side, then on their hips, and above their head. Breast size and any asymmetry, visible masses, and skin changes, such as ulceration, erythema, dimpling, skin thickening, or edema, should be noted. Clinicians should look for nipple inversion, retraction, discoloration, or dryness. Patients then recline to supine and the entire breast is systematically palpated. A circular, vertical, or horizontal approach can be used as long as the entire breast is palpated, including the nipple areolar complex, the retroareolar area, axillary tail of Spence, and the axilla. Large breasts
can be difficult to examine and in these cases it may be helpful to position the patient on her side and palpate the breast when it has fallen away from the chest wall. There is no need to squeeze the nipple to look for discharge unless the patient is concerned about nipple discharge. Fluid can be expressed from most nipples if enough pressure is applied, and this is considered normal.
Clinicians often use the term fibrocystic to describe a breast that is tender, nodular, or dense on clinical examination. Fibrocystic disease or fibrocystic changes is a pathologic term and should not be used to describe clinical findings. Most breasts are not smooth, soft, or homogeneous in texture; they may be nodular, hard, or dense, and all of these findings are within the spectrum of normal. Because normal breasts vary greatly among patients, often what a clinician describes as fibrocystic is a variation of normal breast tissue. Furthermore, most women report tenderness during CBE; it may be focal or generalized, unilateral or bilateral. Pain and tenderness associated with a palpable mass or erythema warrants investigation, but breast tenderness alone is not a sign of disease.
Screening mammogram
Adult women at normal risk for developing breast cancer should undergo baseline mammography at age 35 years and yearly screening mammogram beginning at age 40 years. This evaluation should be combined with CBE examination by a trained clinician.
Sources Elsevier
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There is wonderful news because there are treatment options available. So do not hesitate discussing with your healthcare team your concerns. It is possible for you and your partner to have an intimate relationship.
Therapy
For the woman who can no longer have sexual intercourse you may grieve deeply for this loss. A psychologist, counselor or sex therapist can help you and your partner through this loss and perhaps help you find other ways to become intimate and regain the closeness and pleasure of one another. A trained
professional with expertise in this area should provide this therapy. For sex therapy, you may want to find an
AASECT certified therapist at www.AASECT.org. It is important for you and your partner to keep communication open if changes in your sexual function are causing you distress.
Loss of desire
Ask your doctor if any of the medications that you are on may be causing decreased desire. This includes chemotherapy, hormone therapies, and antidepressants.
Pain can cause loss of desire. This may be due to dryness and over the counter lubricants or vaginal estrogens could help. Also a pelvic floor physical therapist consult should be considered.
Lack of energy can cause a decreased interest in sex. Talk to your partner about having sex when your energy level is up, perhaps in the morning. Ask you physician to check if your testosterone is low. Women need some testosterone for good sexual function. However, if you had breast cancer, using replacement testosterone may not be appropriate.
If all physical causes for low desire have been eliminated, then ask to see a counselor. Your loss of desire may be related to depression, anxiety or body image concerns.
Decreased arousal
A decreased ability to become aroused may be due to medications or how one feels about their body. If this has to do with body image concerns, a consult with a mental health provider could be helpful. If it is due to medications, ask your doctor if she/he could switch your medication to one that does not have this side effect.
Vaginal Dryness, Tightness, and Pain
See a gynecologist who has expertise in pelvic and vaginal pain. Talk to this provider about lubricants and vaginal estrogens. You may want to ask for a referral to a physical therapist with expertise in pelvic floor problems. Also, if you have had gynecological surgery and radiation therapy, a pelvic floor physical therapist with expertise in rehabilitation post pelvic surgery and radiation should be considered.
Difficulty reaching climax
Medications may cause this, so ask your doctor if the medications you are on or have been on could be causing this difficulty. Antidepressants or anti-anxiety medications can make reaching climax more difficult. Some women complain that chemotherapy impacted their ability to have an climax. Other women will express that after having their uterus removed their climax are less intense.
Conclusion
What is most important is that you continue to seek help. If your doctor cannot assist you, then do not hesitate to ask for a referral or speak with other women in cancer support groups who may know of a doctor or therapist who has helped them.
Article by Lisa Martinez
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There may be various reasons why sex may not be enjoyable after cancer. There can be emotional and physical reasons. Cancer is stressful for many to manage from a financial, relationship, family and employment perspective. Day to day life for many women is filled with plenty of stress, but when the diagnosis of cancer and its treatments are added to this mix, the stress can be overwhelming. This stress can interfere with one even considering having an intimate relationship.
Certain surgical procedures such as a mastectomy or colostomy may make a woman feel unattractive and create body image concerns. A mastectomy will also create a complete loss of sensation in the chest area from a sexual function perspective. Typically the nipple is removed which may impact sexual desire.
Surgery, radiation, chemotherapy, and hormonal therapy can affect a woman’s sexual enjoyment. Also, other medications that are used to treat anxiety, pain or depression may interfere with sexual function.
Article by Lisa Martinez
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Cancer survivorship rates are increasing significantly, shifting the focus of oncology care from just managing the disease and treatments to identifying the psychosocial needs of patients with the goal of directly improving quality of life issues (Tan, Waldman, Bostick, 2002; Helgeson, 2005;Katz, 2005;Zabora, BrintzenhofeSzoc, Curbow, Hooker, Piantadosi, 2001).
Approximately, 10 million people are living with the effects of cancer, and 40% to 100% of these individuals will experience some form of sexual dysfunction (American Cancer Society, 2007; Derogatis & Kourlesis, 1981). Sexuality and intimacy are quality of life issues impacted by cancer and its treatments, regardless of age, race, gender or socioeconomic background (Shell, 2002; Katz, 2005; Zabora, 2004; Derogatis, 2000).
Sexual dissatisfaction, whether physical, psychological or emotional, not only impacts the person being treated
for disease, but also their partner and overall relationship (Svetlik et al., 2005). Although there is substantial literature supporting the experience of sexual problems in persons with chronic illness, like cancer, there is a
significant lack of evidence-based sexuality assessments and interventions (Fronek, et al. 2005; Shell, 2002;
Haboubi & Lincoln, 2003).
Chemotherapy, radiation and surgery are the common treatments utilized to treat cancer and often impact a person’s physiological, emotional, psychological and sexual well being (Schover, 1999; Hughes,2000; Pelusi, 2006). Cancer treatments not only impact the physiological, but also heighten areas of distress like pain, fatigue, depression and anxiety (Zabora et al., 2001). Unfortunately, many treatments used to manage the distress of depression, pain or anxiety also create significant changes in the sexual response cycle, complicating or exacerbating symptoms of sexual dysfunction (Pelusi, 2006; Ananth et al. 2003;Frumovitz et al., 2005;Spagnola et al., 2003; Hughes, 2000).
Cancer survivors often experience “long term changes and obstacles, such as impaired immune response, vital organ dysfunction, hormone changes resulting in infertility, altered sexual function, cognitive changes, ongoing fatigue, depression, anxiety, family distress and economic challenges, to mention only a few” (Curtiss & Haylock, 2006) p 4.
All of these changes have the possibility of impacting a woman’s perception of her self and how she gains meaning of her world, experiences, and new limitations brought on by the cancer and its treatments.
Article by Sage Bolte
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The best option depends on a variety of lifestyle factors and individual preferences, and women are encouraged to consider several things before settling on one, including:
- How healthy are you?
- Do you have sex often?
- Will it protect you from sexually transmitted diseases?
- Do you want children in the near future?
- What side e‰ ects might you experience?
- Is it practical and a‰ ordable for you?
Types of birth control
Pills, rings, patches, sponges, condoms, abstinence, implantable devices…the list of birth control options goes on and on, and choosing the right one can be overwhelming. But national director of education initiatives for Planned Parenthood Federation of America, says there are two big categories of birth control that can work for most women—hormonal and barrier.
“Hormonal methods like the pill and the patch work by preventing ovulation and, thus, pregnancy. Barrier methods like condoms and the sponge work by preventing sperm from meeting the egg—they are easy to get and can also serve as STD prevention.”
Be proactive
The best time to choose a birth control method is before you need it, and it is important for women to know how to use their contraception properly, and to understand the potential consequences when used incorrectly.
“We love to see someone who may just be thinking about having sex and they want to explore what birth control might be best for them.”
Article by Jill Smits
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As a result of this normal condition, the body produces lower hormone levels, which may cause symptoms including hot flashes, insomnia and mood swings. However, while menopause does mark the end of fertility, it is not the end of sexuality.
Physical changes
The myth that women stop being sexual at menopause may be rooted in the physical changes her body goes through when hormone levels drop. Lower estrogen levels cause the vagina to narrow and produce less lubrication, which can make sex painful. At the same time, reduced testosterone can a‰ ect sex drive.
But studies show that some women report that sex is more enjoyable after menopause, and decreased sexual
desire can often be explained by reasons like depression or poor body image. However, if a physician confi rms menopause is the cause, a woman may want to discuss the pros and cons of hormone replacement therapy.
A beginning, not an ending
Sexuality expert Carolyn Braddock, MA, says the most important thing for women to remember is that menopause is a time of beginnings.
“Menopause is a magical time because we have wisdom and can let our hair down. We naturally want to express ourselves sexually, but we may need a little help staying lubricated and keeping our organs healthy.”
Article by Jill Smits
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