Breast Cancer Archive

Ask the doctors

Q. I have fairly thick hair in the summer, but it seems to thin out in late fall. Is there anything I can do now to prevent losing hair in a few months?

A. Sadly, no. What you've experienced is common to all of us. On average, about 90% of the hairs on our heads are in the growing phase and about 10% are in the resting phase. After a few months in the resting phase, the hairs are shed. It's normal to shed up to 100 hairs a day.

By Hope Ricciotti, M.D., Editor in Chief

If you've come to expect a pelvic exam as a routine part of your annual well-woman physical, you may be surprised to learn that health experts disagree over whether it is necessary. The exam — in which the clinician inserts gloved fingers into the vagina to examine the cervix, uterus, and ovaries — has been routine for decades, but recently its benefits have been called into question.

In 2014 the American College of Physicians — an influential group of internal medicine specialists — issued a recommendation against routine pelvic examinations for women who aren't pregnant and have no unusual risk for or symptoms of pelvic diseases. However, the American College of Obstetricians and Gynecologists (ACOG) has stood by its longstanding policy recommendation — annual pelvic exams for women ages 21 and older — based on expert opinion. In March 2017, the U.S. Preventive Services Task Force — the pre-eminent medical guidelines organization — ruled that there is insufficient evidence to recommend either for or against annual screenings.

Research we're watching

A new study from researchers at the National Institutes of Health indicates that the rate of drinking in general, and binge drinking in particular, is rising faster among women ages 60 or older than among their male contemporaries. When the researchers analyzed data from National Health Interview Surveys from 1997 through 2014, they found that the proportion of older women drinkers increased at a rate of 1.6% a year, compared with 0.7% for older men. Binge drinking — defined as imbibing four or more drinks within two hours — increased by 3.7% annually among older women, but held steady among older men. The results were reported online March 24, 2017, by Alcoholism: Clinical and Experimental Research.

The researchers speculated that baby boomers, who tended to drink more than earlier generations did in youth, have continued their habits as they've aged. Whatever the reason, the trend doesn't bode well for older women's health. Because of biological differences, at any level of alcohol consumption, women have a higher blood alcohol concentration than men, putting them at greater risk of cognitive impairment and falls. It's a good idea to limit alcohol consumption to seven drinks a week, with no more than three drinks at a sitting.

Research we're watching

Previous studies have suggested that being somewhat overweight or even slightly obese may not be associated with a shortened life span. Some studies have suggested that being a bit overweight might even be healthier than being at normal weight. This has been referred to as the "obesity paradox."

A recent analysis of data from the Nurses' Health Studies I and II and the Health Professionals Follow-up Study has helped bring clarity to this paradox. Researchers from the Harvard T.H. Chan School of Public Health and Boston University School of Public Health assessed the maximum body mass index (BMI) over 16 years for more than 190,000 postmenopausal women and 35,000 senior men. They then tracked who died over a follow-up period averaging 12 years. They found that people with a maximum BMI in the normal range (18.5 to 24.9 kg/m2) throughout life had the lowest risk of death. Those whose highest recorded BMI fell into the overweight or obese category were at elevated risk of dying from any cause, as well as dying specifically from cardiovascular disease, cancer, or respiratory disease, during the follow-up period.

Research we're watching

The FDA's medical device reporting program recently announced that as of February 1, it had received 359 reports of anaplastic large cell lymphoma (ALCL), a rare type of non-Hodgkin's lymphoma, in women who had received breast implants. Nine women had died of the disease. The FDA uses such reports to alert clinicians about potential significant side effects from approved drugs and devices, and as it gathers more information, the data may change. Many reports contained details of the implants, including whether the outside surface was smooth or textured and whether the filling was silicone gel or saline.

ALCL is usually found within a capsule of fibrous scar tissue that forms around an implant, not in the breast tissue itself. It appears to develop more frequently in women with textured implants, regardless of filling type.

The recommended guidelines for whether men should have the prostate cancer screening test have changed in recent years. A man considering the test should talk with his doctor and understand all the pros and cons involved.

Ask the doctors

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Q. I like gel manicures because the polish doesn't chip easily, but I've heard that they may cause cancer. Is this true?

A. The gel polish itself hasn't been associated with an increased risk of cancer. However, lamps and light boxes, which are used to seal the polish during professional manicures, have raised concern. That's because many emit fairly high levels of UVA radiation, which plays a major role in the development of cancer. The level of risk depends on the frequency of manicures. A 2014 study in JAMA Dermatology indicated that the level of UVA exposure associated with a gel manicure every two weeks probably isn't high enough to increase the risk of skin cancer significantly.

The decision depends on several factors, including your breast cancer risk, life expectancy, and personal preferences.

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As you get older, your body isn't the only thing that's changing. So are the guidelines for taking care of it. Breast cancer screening guidelines are a case in point. The current U.S. Preventive Services Task Force (USPSTF) guidelines recommend a mammogram every two years for women ages 50 to 75 with an average risk of developing breast cancer. For older women, the USPSTF said there isn't enough evidence of the potential risks and benefits of mammography on which to base a recommendation.

Although breast cancer is a leading cause of death in older women, women over 75 haven't been included in studies of mammography. However, there is evidence that most breast cancers detected in older women are relatively slow growing and easily treated. While a mammogram performed today might detect a cancer that would not spread or metastasize for several years, the percentage of women who survive to that point decreases with each passing year.