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Breast Cancer Awareness – Not Just for October

Since October was Breast Cancer Awareness month, I thought it would be best to discuss a breast topic. A positive sign that I can report is that Breast Cancer rates have been dropping since the year 2000 (American Cancer Society (ACS), 2014). The rate of decline has been associated with improved screening tools and more informed decisions regarding hormonal therapy for menopausal women (ACS, 2014). However, our fight against Breast cancer continues and I would encourage you to perform periodic breast self-exams and to obtain a yearly screening mammogram.

Other findings such as fibro-glandular densities, fibrocystic changes, breast cysts, fibro-adenomas, and micro-calcifications are also found on mammograms that often result in calling a woman back for further testing. Further testing may include a Diagnostic mammogram where they simply take more pictures of targeted areas within the breast and/or a Breast ultrasound. Either way, that call can be scary and lead to anxiousness until results are known. It is important to know that screening mammograms are just that-screening. It is a basic tool to evaluate the breast tissue in order to rule out any abnormality not just breast cancer. There are many other breast issues or symptoms that women or men may have that may or may not need treatment.

*Fibro-glandular Densities are often seen in younger men and women. Breast tissue is denser in this subset of the population (premenopause) since the breast is primarily made up of fat. After menopause, the breast tissue loses its fatty bulky composition as a result of hormonal change and skin/musculoskeletal changes. Dense breast are harder to evaluate though and require more images to examine.

*Fibrocystic changes are another common finding in premenopausal women and menopausal women who are taking HRT (Hormone Replacement Therapy). Fibrocystic changes often trigger pain throughout the month. Our breasts besides fat are also made up of tiny ducts, lobes, and lobules that assist in milk production following childbirth. These areas are hormonally influenced not only after childbirth but cyclically with our menstrual cycle and as a result of contraception and HRT. Hormonal influence can create changes in the fluid in the breast triggering pain. Caffeine is often an overlooked culprit of breast pain as well. It can influence fluid shifts intensifying fibrocystic pain that already exist.

*Breast Cysts are fluid filled sacs that often feel like lumps. The fluid within the cyst may fluctuate depending on the time of the month. As the cyst increases in size it puts pressure on the surrounding tissue creating more pain. Depending on the size of the cyst, your provider may suggest you have drained.

*Fibro-adenomas are lumps of fibrous/milk gland tissue. These lumps are solid and defined and often create great fear. It is often suggested you have these biopsied to confirm they are benign or not cancerous. If found to be a fibro-adenoma they can be left alone or removed based on your comfort.

*Micro-calcifications are small deposits of calcium that develop over time. We all have calcium circulating in the body as a result of food that we eat and supplements we may take. Calcium we know is good for bone health. Most micro-calcifications are benign. Large groupings or patterns often require further imaging to ensure it is not an underlying cancer (ACS, 2014).

I hope you have found this review helpful. I know since starting to obtain mammograms myself the results and findings can be complicated. If ever in doubt, please ask us or your provider for clarification.

Thank you, Elizabeth

Domestic Abuse and Violence

Every 9 seconds in the U.S. a woman is assaulted or beaten. One in four women will experience domestic violence in her lifetime and an estimated 1.3 million women are victims of physical assault by an intimate partner each year according to the National Coalition Against Domestic Violence or NCADV. Females between 20-24 years of age are at the greatest risk of nonfatal intimate partner violence and according to NCADV, most cases are never reported to the police

Recent sporting events have made domestic abuse and violence a hot topic in the media. It can happen to anyone and it is usually excused, or overlooked, or even denied. Often, it starts as small little blows to your ego or subtle comments that are demeaning. Over time, the words start affecting your psyche and all of a sudden a previously strong willed individual has succumb to the emotional and psychological insults and you have no idea how you got here. The abuse becomes psychological and often turns violent. Love is never violent, and no one should ever fear the person they love.

Domestic abuse occurs when one partner tries to control or dominate the other partner. When this domination becomes violent, it is now called domestic violence. The abuser often uses guilt, fear, shame, and intimidation to wear down the victim and gain control over them, and this can often lead threats to the victim or those around. This behavior is never acceptable. Everyone should feel respected, valued, and safe.

There are many signs of an abusive relationship, most telling if you fear your partner. Feeling the need to tip-toe around on eggshells to avoid a blow-up, or feeling belittled, or controlled is unhealthy. This can lead to your own feelings of helplessness, self-loathing, manipulation, or desperation. Over time, the abuse can become physical when the abuser uses physical force against you in a way that injures or endangers you. This physical assault is a crime and police have the authority to protect you. Any situation in which you are forced to participate in unwanted, unsafe, or degrading sexual activity is sexual abuse.

Emotional abuse is a big problem that is often minimized or overlooked. The aim of the abuse is to slowly chip away at the victims independence and self-worth until he or she feels that there is no way out of the relationship or no way to survive without the abuser. Emotional abuse can leave scars that run so deep, it can often be even more damaging than physical abuse. There are many excuses that people use to stay in this type of relationship.

The abuser apologies and showers the victim with love, making it difficult to want to leave. They may even make you believe you are the only one who can help them stop and that things will be different; however the dangers of staying are very real. Often the abuse escalates, and can sometimes end in tragedy. Studies have found that children who witness any form of abuse have a much greater chance of being abusers themselves. Boys who witness domestic violence are twice as likely to abuse their own partners and children when they become adults (NCADV). Sadly, 30-60% of perpetrators of intimate partner violence also abuse children in the home (NCADV.) Studies suggest that up to 10 million children witness some form of domestic violence annually as reported by Domestic Violence Statistics.

Getting help is often scary for victims of abuse. Remember that the abuse is not your fault and there is never a good reason for the abuse. There are shelters and supports systems in all communities. Prepare for emergencies to try and keep safe. Come up with excuses to leave the house day or night if you sense trouble is brewing. Identify safe areas in the house that have windows/doors and phones, stay away from rooms with weapons or without exits. Establish a code word to signal to your kids, friends, or neighbors that you are in trouble. Be ready to leave at a moment’s notice with the car fueled and always facing the driveway exit with a spare key hidden but easily accessible. Practice escaping quickly and safely, and have your children practice too. Memorize emergency contacts who would be willing to give you a ride to a safe place.

If you decide to stay in the relationship, there are some options that can try and make to situation better or safer for you and your children. Contact the domestic violence program to get emotional support, peer counseling, and safe emergency housing if you ever should need it. Build as strong a support system as your partner will allow by getting involved in the community and activities outside the home. Encourage your children to get involved in activities also. Be kind to yourself and develop positive words of affirmation in your own vocabulary about yourself to counter the negative comments from the abuser. Please always consider your safety and the safety of your children.

Local help:

Hope Ministries – 532 S. Michigan St. South Bend IN (574)-288-4842

The Center for the Homeless – 813 S. Michigan St. South Bend, IN 46601 (574)282-8870

YWCA Women’s Shelter South Bend – 1102 Fellows St. South Bend, IN 46601 (574)233-9558

*New Hope Sexual Assault program at YWCA – (574)233-9491

*24 hr crisis line 1-866-YES-YWCA

National help:

The National Domestic Violence Hotline – 1-800-799-7233

The National Sexual Assault Hotline – 1-800-656-4673



National Coalition Against Domestic Violence –

Domestic Violence and Child Advocacy Center –

Domestic Violence Awareness Project –