As a frum woman, your health   —
and therefore your family's future — is in your hands.
It's time to make your health a top priority.
Have questions about common women's health concerns?
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Life is busy for all of us.
There are so many things that take priority over taking care of your health.
Your family, and their immediate, day-to-day needs, always seem to come first.
But - being proactive about your health is the best way to protect both yourself and your family.
Each of us needs to find our own reason.
The reason that finally compels you to take action and go to that annual checkup. To schedule a scan. To learn more about your family's medical history. To educate yourself on the warning signs of prevalent health issues.
LRBC's new project, the Women and Wellness Health Initiative, is here to help you find that reason.
W&W is a Lev Rochel Bikur Cholim initiative dedicated to spreading knowledge and awareness of women's health to the greater Lakewood community.

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All the answers — in one place.

As women, we’ve all had questions about our health, but never had a comprehensive, reliable resource to turn to.
Here are the answers you’ve been looking for:

Breast Checks and Self-Examinations

The questions below have been answered by Dr. Manpreet K. Kohli M.D., FACS Director of Breast Surgery and Breast Program Leader, Monmouth Medical Center.
How often should I do a breast check? Does this pertain to a specific age bracket?
A clinical breast exam by a healthcare provider should occur at least once a year. While you do not need to perform examinations on yourself, it is important to know what is normal for you, and let your healthcare provider know if there are any changes from this baseline. As far as imaging goes, we advise starting screening mammograms at age 40 and continuing them once a year. If there is a family history [of breast cancer] or other risk factors, we may need to start earlier, and we may want to use additional tools like ultrasound or MRI to get the most thorough evaluation. All women should check in at age 30 to see if their doctor thinks they should start imaging earlier than 40.
What's considered normal when it comes to breast structure? What are some indications that something is wrong?
Each person has their own “normal.” Some women have firmer, denser breast tissue; others may have nipple inversion that has been there for years. If your mammogram is clear, it’s fair to consider this “your normal,” but we want to know if any changes occur from this baseline.
Some changes to look out for are:
  • • Swelling, warmth, redness, or darkening of the breast
  • • Change in the size or shape of the breast
  • • Dimpling or puckering of the skin
  • • Itchy, scaly sore, or rash on the nipple
  • Nipple discharge
  • • Pain
Should I be concerned about changes I find while pregnant or nursing?
Many changes can occur to the breast during both pregnancy and lactation due to hormonal changes. If any localized findings are noted like a spot of redness, a lump, or significant one-sided findings, they should be brought to your doctor’s attention. The latest recommendations by the ACR advise to continue screening mammograms if they are due even while pregnant because the radiation exposure is so minimal that it will not harm the baby, but the testing will benefit the patient. Not all changes in the breast are cancerous. Sometimes, there are benign growths that are stimulated by hormones, or clogged ducts that can turn into a breast infection.
Is having pain or no pain an indication of anything specific?
While breast cancer doesn’t typically cause pain, if the pain is new for you, get it checked out. Pain can sometimes indicate the presence of an infection that would need antibiotics. There are also natural ways to fight infection, like Vitamin E or evening primrose oil, or eliminating dietary irritants like caffeine.
Does finding a lump or something unusual mean I probably have breast cancer?
No, don't panic! 80-85% of lumps turn out to be benign or non-cancerous when they are imaged. A few possible explanations for lumps are cysts or fibroadenomas, which are not risky. Now, this only refers to lumps that are felt. It’s better to just stay on track with screening imaging to prevent a lump from developing. If someone is called back for additional imaging after a screening, it’s important to remember the risk of the lump being a cancer is very low. Getting a mammogram callback can trigger anxiety in just about any woman. But out of all women called back after an inconclusive mammogram, less than 0.5% will have cancer.
About 4 out of every 100 women screened are recalled. Out of four people recalled, three will not have breast cancer. They might just be experiencing a normal breast change or a benign condition. Also, there's a slightly higher change of being recalled after your first mammogram than subsequent screenings.
How long after finding something I'm concerned about can I wait to see my doctor? Is finding a lump considered an emergency?
See your doctor and get a scan within a week. You need to get seen even sooner if there is redness, fever, pain, and concern for infection. If your doctor’s office is closed, you might need to go to the ER because treating breast infections early with antibiotics helps prevent it from turning into an abscess.

Mammography and Scanning

The questions below have been answered by Dr. Alexander B. King, MD, Breast Radiologist at Jacqueline Wilentz Breast Center.
At what age can I rely on breast self-exams alone to be sure I am cancer free?
Never! While self-exams are important for overall breast health, they can never replace screening mammography. Screening mammography aims to detect breast cancer as early as possible — before you feel it during self-examination.
If I had a mammogram done this year, how often should I do a self-check?
While noticing changes in your breast is important, self-exams have not been shown to decrease mortality from breast cancer. It’s important that you notify your healthcare provider if you notice changes in the breast, including lumps, skin/nipple changes, or nipple discharge.
How often should I be getting a mammogram?
For average-risk women, you should have a mammogram done once a year starting at age 40. For women at increased risk of breast cancer, screening should begin earlier. We recommend all women undergo risk assessment by age 30 to know whether they will benefit from screening before age 40.
What's the difference between doing a mammogram, an ultrasound, and an MRI?
A mammogram is an x-ray of the breasts. Screening mammography is recommended for all women, once a year. Ultrasound is a different way to view the breasts, and some women with dense breast tissue may benefit from adding ultrasound to their screening mammogram. MRI is the most sensitive screening exam and is recommended for women at increased risk of developing cancer (lifetime risk greater than 20%).
What is dense breast tissue?
When viewed on a mammogram, breasts are composed of fibroglandular tissue and fat. As the ratio of fibroglandular tissue increases relative to fat, the “density” of the breast tissue increases. All breasts are scored on a scale of 1-4, with 4 being the most dense. Dense breast tissue can hide breast cancer on a mammogram. This is the reason we recommend ultrasound for certain women. A breast ultrasound may find additional cancers in women with dense breast tissue.


The questions below have been answered by Aliza Zidell, MGC, Genetic Counselor at Hackensack University Medical Center.
Who should consider genetic testing for hereditary cancer?
Anyone with a history of cancer that stands out compared to the average person. Examples include:
  • • Diagnosis of cancer at an age that is younger than most people who have the same cancer (e.g. breast cancer or colon cancer before age 50.)
  • • Multiple family members with the same type of cancer or types that tend to come together (e.g. breast and ovarian cancers or colon and uterine cancers.)
Is it too late for me to undergo genetic testing if I was already diagnosed with cancer?
It's not too late - it's actually preferable to start testing with a family member who had cancer. If a mutation is found in that person, other family members can be tested for the specific mutation.
Several people in my family had cancer, but some aren't interested in the testing, and others aren't available. Should I consider genetic testing?
Yes. If a genetic mutation is found in you, it would be used to guide your care.
Is genetic testing costly?
Genetic testing is usually covered by insurance, similar to other lab work. For those who don't have insurance coverage, testing costs are usually around $250 (depending on the lab).
Is genetic testing painful?
No. The tests are usually done with a small amount of blood (less than an ounce) or saliva.
The women in my father's family had cancer. Can I inherit a mutation from my father?
Yes. You can inherit a predisposition to cancer (even gynecologic cancer) from your father and/or your mother. Men can also inherit a genetic mutation from either parent.
If I'm already on top of my cancer screenings, what is the purpose of finding out if I have a genetic mutation?
A person at average risk should follow the regular screening guidelines (e.g. mammogram, colonoscopy). If a person has a mutation, the guidelines for screening may be changed. For example, screening may start at an earlier age, be performed more frequently, or include a broader range of options.
I've heard about BRCA1 and BRCA2. How are those genes relevant to me?
There are many genes that have the job of protecting a person from developing cancer. BRCA1 and BRCA2 are two of those genes. If a person has a mutation in one of those genes, their chance of cancer is higher.
Which genes should I have tested?
The answer is individual and depends on your medical history, family history, and how you want to use the information.
At what age should I consider genetic testing?
The answer is individual. If you are unsure, start by speaking with your doctor.
How is a genetic counselor involved in genetic testing?
Genetic testing can be ordered by doctors, genetic counselors, and certain other medical providers. In a consultation with a genetic counselor, you will be asked for your personal and family history. The genetic counselor will provide education and discuss options for genetic testing. Once you decide you are ready for testing, the genetic counselor can order the test and explain the result when it is available.
Do all people with a genetic mutation develop cancer?
No. Genetic testing aims to identify a person's likelihood of getting cancer, but the tests don’t predict or diagnose cancer.
Is genetic testing information kept private?
Information about a genetic test result is sent from the lab that performs the test to the provider who ordered the test. The information is sent to the patient as well. Like any other medical information, by Federal law, the lab and the provider cannot share the information without your consent. Discussing the result with your family members and others is your decision.
My doctor advised both my sister and me to undergo genetic testing because there is a history of cancer on our mother's side of the family. My sister had genetic testing done, and the result was normal. Do I still need to go for testing?
Yes. It is possible for a genetic mutation to be passed to one child but not another.
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