Women's Health Archive

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 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.

Research we're watching

For many women with breast cancer, hair loss is the most distressing side effect of chemotherapy. Although cooling the scalp with ice packs has been tested, the technique has had limited success. However, a newer approach — wearing a cap connected to a cooling system that gradually reduces scalp temperature — has been more successful, according to two reports in the Feb. 14, 2017, Journal of the American Medical Association.

In one study, 67 of 106 women with stage I or stage II breast cancer who used the FDA-approved DigniCap during their treatment with taxane (Taxol and others) lost less than half of their hair. In comparison, 16 women who underwent the same treatment but did not wear the cooling cap lost all of their hair.

Research we're watching

Although hormone therapy was once thought to help preserve cognitive function after menopause, there is mounting evidence to the contrary, including a recent report from the Kuopio Osteoporosis Risk Factor and Prevention Study.

Researchers in that project sent questionnaires to all women ages 47 to 56 who lived in the Finnish province of Kuopio in 1987. The women completed questionnaires every five years, providing information about their lifestyles, medication use, and illnesses. The researchers checked the information in the questionnaires against prescription registries and medical records up to 2009.

Data from several surveys indicate that the percentage of women who drink has been increasing for decades. The numerous health effects associated with alcohol consumption mean that women should be especially attentive to how much they drink.

Ask the doctor

Q. I've heard that bioidentical hormone pellets injected near the hip are more effective than bone-building drugs in stopping bone loss and preventing hip fracture. Is this true?

A. The FDA hasn't approved hormone pellets for preventing or treating bone loss. Moreover, there are no randomized controlled trials on record, so we don't know whether hormone pellets are more effective — or even as effective — as the FDA-approved medical therapies. Finally, there aren't any published reports explaining how the hormones are metabolized in the body or the side effects they may have.

Ask the doctor

Q. I have been smashed, squashed, pulled, and tugged annually for 25 years. Why isn't there a better way to take a mammogram?

A. We hear you! Compression mammography has been the "gold standard" for decades for one reason — it works. Flattening the breast makes ductal tissue easier to distinguish and reduces the amount of radiation required to do so. Studies have demonstrated that it is the most effective approach to breast cancer screening.

Hemorrhoids won't go away, but some simple measures can help to prevent and ease flare-ups.

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By some estimates, about half of people over age 50 have hemorrhoids — swollen blood vessels on the outer rectum and anus. Women are more likely than men to develop hemorrhoids, probably because hemorrhoids commonly occur during pregnancy. However, they are less likely to seek medical treatment for them.

Not all hemorrhoids cause problems. One study of people undergoing colonoscopy found that more than half of people whose tests revealed hemorrhoids were unaware that they had them. However, when hemorrhoids become inflamed, they can make bowel movements — and even sitting — quite painful.