Detecting Breast Cancer Early with Breast Awareness and Mammography

Written by Adella Brown

Many women grew up hearing that monthly self-breast exams can protect them from breast cancer. In recent years, however, as screening technology advances and mammography screening becomes more widespread, some began to doubt the usefulness of self-breast exams. From clinical experiences, we see that breast awareness and mammography are both essential to detecting breast cancer early.

Breast awareness means knowing what our breasts normally look or feel. Regular self-breast exams increase our breast awareness and help us notice any unusual changes to the breast. While doctors may perform a clinical breast exam during annual checkups, it is recommended for women to begin performing self-breast exams regularly in their early 20s:

1. Feel for lingering lumps or pain in the breasts or underarm.
2. Observe for changes in the size and shape of the breasts, in the skin color or texture on the breasts, and in the direction the nipples are pointing or unusual discharge from the nipples.
3. Contact your doctor right away for a checkup if there are abnormal changes in the breasts or underarms.

Breast awareness is especially important for younger women who do not have significant risk factors for breast cancer.  Younger women without significant breast cancer risk factors are generally not the target group recommended for mammography screening. Significant risk factors include having a family member already diagnosed for breast cancer, or having a positive test result for breast cancer-related genetic mutations.

Every woman should talk to her doctor about her risks for developing breast cancer.  Based on these discussions, she and her doctor can decide at what age screening should begin, and how often screening should take place. Mammography is a screening test that takes x-ray images of the breasts. It is the most widely used screening technology and current standard of care. There are two kinds:

• Screening mammography detects abnormal breast tissues that are too small to see or feel.
• Diagnostic mammography focuses on certain areas of the breasts. This may be offered to women if something unusual is found in the breasts.

Here is what to expect during a screening mammography:

1. You will be asked to undress from the waist up, and wear an exam gown. If you are pregnant, you will get a lead apron to protect your belly.
2. A technician will help position your breasts on a sensor that receives the x-ray.
3. You will be asked to hold your breath for a few seconds while the technician captures images of your breasts.

The results are usually available in two weeks. Sometimes a mammogram may show abnormal tissues that are not cancerous. Based on the results, your doctor may recommend follow up tests and/or management plans.

Together, breast awareness and regular mammography screenings offer women the best chance to detect breast cancer early. If you are 40 or older or are at a higher risk of developing breast cancer, be sure to talk to your doctor about breast cancer screening. Also, continue to pay attention to your breasts and inform your doctor promptly when you notice anything unusual.  Learn more steps on how you can lower your risk here.

The Charles B. Wang Community Health Center offers comprehensive, high quality primary care services at convenient locations in Manhattan and Queens. The Health Center is open seven days a week and serves all patients regardless of their ability to pay. To learn more about OB/GYN services offered at the Health Center, please call (212) 966-0228 (Manhattan), (718) 886-1287 (37th Avenue, Queens), and (929) 362-3006 (45th Avenue, Queens), or visit our OB/GYN webpage.

Adella Brown is a Health Educator in the OB/GYN Department at Charles B. Wang Community Health Center. One of her current roles is providing one-on-one reproductive health education. She graduated from Brigham Young University with a Bachelor’s Degree in Neuroscience. She is also a Certified Lactation Counselor and passionately promotes breastfeeding in the Chinese American community.

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Hepatitis B Team Releases Clinical Findings and Comic Book to Encourage Hepatitis B Virus (HBV) Testing

Universal childhood vaccination programs since the 1980s have successfully reduced new hepatitis B virus (HBV) infections in endemic countries by increasing immunity and protection against HBV infection.  However, approximately one-third of the world’s population has been infected and most do not know their status. An estimated 257 million people world-wide have chronic HBV infection, and may live without symptoms for decades before developing serious liver complications.

For some individuals, HBV remains inactive in the liver, but may reactivate to cause liver damage. Reactivation occurs if the immune system becomes weakened by medications commonly used to treat cancer and certain chronic diseases. HBV screening is essential to identify and counsel infected individuals about risks to their health.

At Charles B. Wang Community Health Center, over 25,000 adults, mostly foreign-born and from China, were screened with three blood tests to detect chronic or prior infection, and immunity status.  The Health Center found the following trends:

• Over half of all adults screened for HBV had either chronic (13%) or prior (38%) HBV infection.
• Adults who lived with someone with chronic HBV had the highest rates of infection: 21% with chronic HBV and 49% with prior HBV infection.
• Foreign-born adults were about 7 times more likely to have chronic or prior HBV infection compared to U.S. born adults (55% vs. 8%).
• Adults born before 1980 were significantly more likely to have chronic or prior HBV infection compared to adults born after 1980 (59% vs. 38%)

To celebrate World Hepatitis Day on July 28, 2017 and raise awareness about the importance of HBV screening in our community, the Health Center’s Hepatitis B Program and Health Education Department partnered with renowned NYC-based comic book writer, Amy Chu, and Chinatown-raised illustrator, Louie Chin, to create, “The Test”, a comic book about a nurse practitioner who encourages members of her community to get tested for HBV.  The story follows each character as they receive and interpret their test results.

The Health Center hopes this fun and new visual educational material will engage readers of all ages to better understand HBV screening results and the importance of getting their family and community members tested. Download your digital copy here.

Development of this material is made possible with a grant funded by Miranda Wong Tang.

What You Can Expect During a Breast Biopsy

If your doctor finds a breast lump or sees a suspicious area in a mammogram or sonogram, he or she may recommend that you get a breast biopsy. You might wonder, what is a breast biopsy? Biopsy is an effective way to find out if the area is cancerous.

A breast biopsy removes a suspicious area in the breast, and cells are sent to a lab for testing. It may take more than a week to get results. There are three main types of biopsy: fine needle aspiration biopsy, core needle biopsy, and surgical biopsy. Your doctor will recommend the type of biopsy based on your situation.

During a fine needle aspiration biopsy, your doctor will use a thin needle to take out a sample of cells or fluid from the suspicious area. This biopsy can be done in a clinic.

Core needle biopsy is similar to the fine needle aspiration biopsy, but with a slightly larger needle. Your doctor may use X-ray equipment, ultrasound, or MRI to find the location of the suspicious area. This biopsy can be done in a clinic where you may have local anesthesia.

In a surgical biopsy, your doctor will remove part or all of the breast lump. This is usually done in a hospital where you will be put under local or general anesthesia.

What do the results mean? If the final results come back negative, this means the cells are not cancerous, but you may need early follow-up or intervention. If the results are inconclusive, you may need another biopsy. The results could come back positive, which means the cells are cancerous. Your doctor will help you determine the next steps based on the nature of the cancer cells.

It is important to understand the need to have a biopsy does not mean you have cancer. A biopsy sample is the most accurate way to diagnose cancer cells.

Talk to your doctor about any abnormal changes you have experienced and what preventive measures are suitable for you. You can make an appointment at our OB/GYN Department by calling (212) 966-0228 (Manhattan), (718) 886-1287 (37th Avenue, Queens) and (929) 362-3006 (45th Avenue, Queens). Learn more by visiting our OB/GYN webpage.

Birth Control Methods Myths and Facts

Written by Adella Brown

As an OB/GYN health educator at Charles B. Wang Community Health Center, much of what I do is help women understand the benefits of pregnancy planning and birth control options.  When it comes to choosing a birth control method, many women are afraid of using hormonal methods or methods that need to be inserted into the body. Here are the most common myths women have brought up during our encounters, and what the facts are.

Myth: Women need to have menstrual period regularly to remove toxins from the body. It is harmful to use birth control methods that may stop one’s period.

Fact: While having regular menstrual period is an indicator of reproductive health for women, using birth control methods to stop having periods is harmless. In fact, women who have more than the average menstrual cycles in their lifetime are more likely to suffer from ovarian cancer and uterine diseases. The use of hormonal birth control methods is shown to lower risks of these diseases and relieve the symptoms of uterine fibroids and endometriosis.

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Myth: Birth control pills will lead to weight gain.

Fact: Many studies showed that birth control pills rarely cause weight gain. When weight gain does happen, it is usually due to fluid retention and goes away within 2 to 3 months, along with other side effects.

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Myth: The hormones in birth control can increase risk of getting breast cancer.

Fact: Most studies have shown that hormonal birth control use is not associated with increased risk of breast cancer. Also, women who have used these methods over many years have lowered rates of ovarian and uterine cancer. Discuss your health history with a healthcare provider to decide if hormonal birth control methods are right for you.

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Myth: Fertility awareness is effective in preventing pregnancy and has no side effects.

Fact: 12-24% of women will get pregnant in a year using fertility awareness method.  Many factors, such as stress and changes in diet or lifestyle, can change a woman’s menstrual cycle, making ovulation hard to predict. Although other birth control methods may have side effects, they are usually temporary and mild. An unplanned pregnancy will have more impact on your health and lifestyle.

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Myth: Use of IUD increases the risk of getting uterine injuries or gynecological infections.

Fact: Some types of IUD were known to have caused uterine injuries and gynecological infections. However, IUDs currently available in the U.S., such as progestin IUDs (Mirena, Skyla, and Liletta) and non-hormonal IUD (ParaGard) have been extensively tested for safety and effectiveness. Large studies have proven that modern IUDs do not cause gynecological infections.  Keep in mind that women who are at high risk of getting sexually transmitted infections (STIs) should continue to use condoms after IUD insertion.

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Myth: Getting an IUD is painful and it will feel weird inside the body.

Fact: IUD insertion is a quick procedure that usually does not require anesthesia. Some women may take pain medicine before the insertion. Some spotting and cramping are common in the first few days following the insertion. After that, most women don’t feel anything in their body. Their partners usually don’t feel the IUD either. If pain or spotting persists or worsens, see your provider for a check-up.

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Myth: Using birth control methods may lead to infertility.

Fact: All reversible birth control methods will help prevent pregnancy while you’re using them, but none have long-lasting effects on your ability to get pregnant when you stop. If a woman has difficulty getting pregnant after stopping a birth control method, it may be due to 1) an undiagnosed condition prior to the birth control use; 2) natural decrease in fertility due to older age; or 3) sexually transmitted infections such as Chlamydia and Gonorrhea that can damage the reproductive system.

Trying a new birth control method can be intimidating. Remember, you can stop using these methods if you are not satisfied or change your plan. Come talk to our health educators and providers to learn more about your options. The Charles B. Wang Community Health Center offers comprehensive, high quality primary care services at convenient locations in Manhattan and Queens. The Health Center is open seven days a week and serves all patients regardless of their ability to pay. To learn more about the Health Center’s family planning services, please call (212) 966-0228 (Manhattan), (718) 886-1287 (37th Avenue, Queens) and (929) 362-3006 (45th Avenue, Queens), or by visiting our OB/GYN webpage.

Adella Brown is a Health Educator in the OB/GYN Department at Charles B. Wang Community Health Center. One of her current roles is providing one-on-one reproductive health education. She graduated from Brigham Young University with a Bachelor’s Degree in Neuroscience. She is also a Certified Lactation Counselor and passionately promotes breastfeeding in the Chinese American community.

We Are Here to Serve Everyone – Seek Health Care When You Need It

The Charles B. Wang Community Health Center has been serving the Asian American community for more than 45 years. We want our patients and community members to know that they should not be afraid to visit their doctors. We will do our best to make sure that you have good health care, and care for you with respect and compassion.  We will never release your personal information unless we have your written approval or we are required to do so by law. Our staff is trained to keep your information private and confidential. We will not turn you away because you do not speak English, do not have a social security number, or do not have health insurance.

The Charles B. Wang Community Health Center is here to serve all New Yorkers regardless of your immigration history or ability to pay. We believe that health care is a basic right and everyone should receive care when they are in need.

Our health centers in Lower Manhattan and in Flushing, Queens are open seven days a week. Our doctors, nurses and staff care about you.  Many of them are immigrants or children of immigrants.  We speak Chinese, Korean and Vietnamese and will provide translation in other languages to make sure that we understand  your needs.  You have a right to interpretation at no cost to you.

There are other services in New York City to help you if you need health care.  These services are available to everyone:

• Emergency room care.
• Public and safety net hospitals (NYC HHC hospitals).
• Public health services such as immunizations, mental health, screening and treatment for communicable diseases such as HIV, STD and tuberculosis.
• Programs providing health services necessary to protect life and safety such as emergency medical, food or shelter, domestic violence, crime victim assistance, disaster relief.
• Emergency Medicaid including labor and delivery for pregnancy.
• Charity care at hospitals and sliding fee scale services at community health centers.
• Children’s Health Insurance Program (CHIP) coverage for children and youth.

Many services do not cost a lot of money. To learn more, please call 311 which provides information about New York City government services.  You can also ask one of our social workers.  Our staff are available to answer any questions you have and help you find the services that meet your needs.

We want to help everyone in the community to live the healthiest life possible.

Learn more about the Charles B. Wang Community Health Center at http://www.cbwchc.org.

Immigrants are America’s Past, Present, and Future

Written by Jane Eng, CEO

I grew up in an immigrant family.  My parents operated a hand laundry in Poughkeepsie, New York.  Sadly, my father passed away when I was in high school.  My mother was left with the responsibility to raise four children.  Despite the challenging circumstances, she made sure that all of her children went to college and beyond.  Today, my siblings and I are contributing members of our communities.

Jane Eng’s brother in front of Eng’s Hand Laundry.

My family’s immigration history is not unique.  People from around the world have come to this country seeking freedoms and opportunities woven into the American dream.  The first generation works hard, and many make great sacrifices to secure a better future for their children.  In doing so, immigrants contribute to the rich diversity of cultures, backgrounds, skills and experiences that makes this nation great.

In New York City, immigrants have helped revitalize neighborhoods such as Coney Island, Jackson Heights, Flushing and Sunset Park, and account for about $250 billion of economic activity annually.  About 20% of Fortune 500 companies in the United States are founded by immigrants.  Many of these firms have a strong presence in this city.

Immigrants are also playing an important role in helping New York meet its healthcare workforce gaps.  One in three physicians in New York graduated from a foreign medical school, a sign that they were born outside the United States.

Immigrants are bringing vibrancy to the cultural life of this city through food, songs, dance, music, and other performing arts.  Their economic and cultural contributions have made New York a truly international city.

Jane Eng with her mother and brother inside Eng’s Hand Laundry.

Today, I am proud to give back to immigrant communities by working at the Charles B. Wang Community Health Center.  The Health Center provides high quality primary health care to all patients regardless of language, culture, age, disability, gender, sexual orientation, immigration history, or ability to pay.  More than 85% of our patients prefer to be served in a language other than English.  I truly believe that the Health Center’s success is due to our staff’s unwavering commitment to excellence and our ability to deliver linguistically accessible and culturally effective services.

2016 Grand Opening of CBWCHC 45th Ave site in Flushing, Queens. CEO Jane Eng is 8th from left.

The Charles B. Wang Community Health Center has served a vital role in meeting the health care needs of Asian Americans and other immigrant communities for more than 45 years.  My hope is that we will continue to be a vital force in building healthy immigrant communities for many more decades to come.

Jane Eng is the chief executive officer of the Charles B. Wang Community Health Center. A graduate of Harvard Law School, Jane has been involved with the Health Center since 1975. She is a board member of the Association of Asian Pacific Community Health Organizations (AAPCHO) and Community Health Care Association of New York State (CHCANYS).

Talk to Your Doctor about Colorectal Cancer

Colorectal cancer affects men and women equally, regardless of race and ethnicity. It is most often found in people who are 50 years old or older. However, there is an increasing rate of colorectal cancer in those who are under 50, because of physical inactivity and an unhealthy diet. It is important for younger adults to start paying attention to their colorectal health.

According to Dr. Robert Andrew Heyding, a physician at the Charles B. Wang Community Health Center, “Colorectal cancer causes almost one out of every ten cancer deaths in the United States. Fortunately it can be prevented. You can lower your risk by choosing healthy habits and getting regular screening”.

It’s never too early to start living healthy. Here are some good health habits to lower the risk of developing colorectal cancer:

• Do not smoke – quit smoking and try avoid second hand smoke. Talk to your doctor about smoking cessation resources. Charles B. Wang Community Health Center has bilingual quit smoking resources, you can view those here.
• Reduce alcoholic drinks – limit to one drink a day or less.
• Eat a healthy diet – limit high fat or sugary foods, preserved foods, and red meat. Add more fruits and vegetables to your plate.
• Exercise regularly – walk, jog, swim, or dance. Strive to be active for at least 30 minutes a day, 5 days a week.
• Keep a healthy weight – talk to your family doctor about what is a healthy weight for you.

Other than having healthy habits, getting screened is very important to prevent cancer. When detected early, there are more treatment options and fewer complications. The most commonly used screening methods include:

• A Fecal Occult Blood Test (FBOT) checks for blood in stool. Blood in stool may indicate presence of diseases and a colonoscopy may be needed for a diagnosis.
• A colonoscopy is a thin, flexible tube with a small camera and light on the end is used to examine the colon. It may also have a tool to remove abnormal tissue to be checked under a microscope for signs of disease.

In general, it is recommended that men and women of average risk levels begin screening at age 50. However, some individuals may need to begin screening earlier, such as those who have family or personal history of colorectal cancer or chronic colorectal diseases, and those who are experiencing symptoms of colorectal diseases, such as persistent abdominal pain or changes in bowel habits for at least two weeks.

Discuss with your primary care doctor about when to start screening, which screening method to use, and how often you should get screened. Also speak to your doctor regarding your risk factors or anything unusual in your body. You can make an appointment to see a primary care provider here at Charles B. Wang Community Health Center by calling (212) 379-6998 for Manhattan, and (718) 886-1200 (37^th Ave) or (929) 362-3006 (45^th Ave) for Queens.