Healthy Habits ... every woman should adopt

Mammography is the most widely used form of breast cancer screening worldwide, with other methods like ultrasound and magnetic resonance imaging (MRI) typically conducted for further evaluation, or in conjunction with mammography – particularly for those women at high risk.

Both methods have their own distinct purposes, advantages and limitations – which is why breast cancer screening has been a source of controversy for decades. Some medical experts and patients question whether the benefits of mammography outweigh the risks – exposure to radiation, for instance. Others question whether or not ultrasound is an effective enough screening tool on its own.

Singapore-based breast surgeon DR GEORGETTE CHAN, for one, recommends MRI scans only in combination with mammograms for certain groups of patients. These include young women with dense breasts, those with a strong family history of breast cancer and those with breast implants. Mammography, she says, has an accuracy rate as high as 90 to 95 percent, and has proven effective in detecting cancers early.

Regardless of where you stand in the mammography versus ultrasound debate, one thing’s for sure: getting screened is a must, as early detection is key. In fact, early discovery is associated with a 20 percent drop in breast cancer mortality, says Dr Chan.

She recommends starting yearly screenings from the age of 40, or earlier if there’s a family history of breast cancer.

From routine health checks to nutrition, here are five things women can do to maximise their health.

#1 Go for routine medical breast screenings

Do monthly self breast-checks #2

Not only should women start going for medical breast examinations (mammogram and/or ultrasound), says Dr Chan, but it’s important to do monthly self-checks, too.

“This check is very important because it allows us to detect even subtle changes – things like lumps, nipple retraction or skin dimpling,” she says. “Young women should ideally start doing this in their twenties to become familiar with how their own breasts feel. Seven to ten days after the start of your menses is the best time to do it, because that’s when the breasts are least sensitive.”

If you do find a lump during a self-exam, don’t panic: 90 percent of lumps detected are benign, says Dr Chan. “If you find one while you’re close to your menstrual period, it could be due to temporary hormonal changes. So, I suggest waiting until after your period to see if it’s still there. If it is, go to see your GP or a breast specialist,” she advises.

Take steps to prevent osteoporosis #3

According to DR CHERYL LATHA GLENN, Medical Director of SATA CommHealth, regular weight-bearing and resistance exercises, a diet high in calcium, vitamin D, and a non-smoking lifestyle are all factors that can help prevent osteoporosis, a condition that affects bone strength.

When the body loses too much bone mass, bones become more fragile and prone to fractures. This can make the patient more susceptible to hip, spine, wrist and other bone fractures.

The bone disease is most common in post-menopausal women and men above the age of 70. However, osteoporosis can still affect younger people, too.

In addition to being female, particularly post-menopausal, other risk factors of osteoporosis can include being Asian or Caucasian, a family history of osteoporosis, low dietary calcium intake, smoking, lack of exercise, and having a thinner, smaller body frame, explains Dr Glenn.

The disease is typically silent in the early stages; there are often no symptoms until the first fragility fracture happens. Tell-tale signs that you can look out for are:

• Developing a stooped posture. (This occurs due to multiple vertebral fractures causing the loss of normal spinal curvature, and leading to your back hunching forward.)

• Progressive loss of height. (As the vertebral bones weaken and collapse, there will be loss of height, and this may occur even in the absence of a “hunchback”. Losing more than 3cm in height may signal that osteoporosis is present.)

• Back pain

• Oral health conditions (for example, the loosening and loss of teeth) due to loss of bone in the jaw.

If you do find a lump during a self-exam, don’t panic!

The disease is typically silent in the early stages

Assessing your risk

A bone mineral density test (also known as a DEXA scan), which uses x-rays to assess the density of one’s bones, can detect signs of osteoporosis. While this type of screening does not identify actual fractures, it can help predict the risk of sustaining fractures, along with other risk factors. If the scan shows evidence of bone thinning or osteoporosis, advice on lifestyle changes and treatment will be offered to help the patient strengthen her bones, and reduce the risk of fractures.

Dr Glenn recommends getting tested every two years from menopause, unless specifically indicated otherwise by one’s doctor.

“With early detection and proper treatment, the progression of osteoporosis can be reduced and even halted,” she says.

Bone mineral density tests are available at SATA CommHealth’s Bedok, Boon Lay and Potong Pasir medical centres.

Schedule a pap smear #4

A pap smear test is a method of detecting precancerous or cancerous lesions on the cervix (the entrance of the uterus) in order to prevent cervical cancer, which, in many cases, has no symptoms at all.

This type of screening test involves collecting a sample of cells from the cervix during a pelvic exam. The doctor will insert a device called a speculum into the vagina. The speculum holds the walls of the vagina apart and allows access to the cervix. Once the speculum is in place, cervical cells are gently scraped away with a swab, then sent to the lab for evaluation. There might be slight discomfort during the procedure but it should not be painful.

Depending on the lab results and any abnormalities found, the doctor will recommend the next appropriate step. Dr Glenn says this can range from a repeat pap smear to further evaluation by a gynaecologist.

The detection of early cervical cancer improves the chance of a cure, she says. Therefore, getting tested every three years once a woman is sexually active, or when a woman reaches 21 years old (whichever is first) is highly recommended.

Make healthier diet choices #5

Food-related allergies, coeliac disease and gastrointestinal problems have substantially increased in recent years. According to gastroenterologist DR ANDREA RAJNAKOVA, this increase could be linked to factors such as dietary changes, gluten-rich dietary patterns, processed foods, food additives and changes in microbiota. That’s why it’s important to get in all the valuable nutrients you can, avoiding artificial processing, artificial sweeteners, colouring and flavouring, additives, chemicals, too much sugar and saturated fat.

So, what are some healthier choices? “These could include regular meals divided into five servings per day, each one containing small amounts of complex carbohydrates, lean protein, healthy fat in the form of

Early detection improves the chance of a cure

omega-3 fatty acids – so, plenty of vegetables in any form, and some fruit,” says Dr Rajnakova.

“Hydration is very important, too. People often have too many sweetened drinks and diet sodas, which introduce extra sugar, colouring, artificial flavouring and sweeteners. It’s better to have either water or herbal caffeine-free teas or infusions.”

She adds, “Food selection must be sustainable and for the long-term. There’s no point in ‘dieting’ for a few weeks or months and then returning to your original eating habits. That will only create a yo-yo effect, not just in weight, but in health as a whole.” People are able to comply with healthy diets only when they feel satisfaction from the foods they take in. “Starvation is the biggest enemy of healthy diet and lifestyle. It never brings good results!”

Starvation is the biggest enemy of a healthy diet!

What about supplements?

“There is a common misconception that the food we eat is not able to satisfy the daily requirements for micro- and macronutrients, and, therefore, these must be supplemented,” says Dr Rajnakova. “The truth is that a well-balanced diet is sufficient to maintain a well-nourished body.”

Having said that, there are some groups of people who might need to support their diets with supplements due to their age or physiological conditions. Different phases of life will likely require special attention to specific nutrients.

During pregnancy, for instance, a woman requires more attention in relation to folic acid, vitamin B12, calcium, vitamin D, iron, omega-3 and protein. “Her diet has to be balanced but, when necessary, it’s important to use dietary supplements due to the elevated nutritional requests from the growing baby,” says Dr Rajnakova. “And, during menopause, calcium and vitamin D requirements are increased due to the drop in oestrogen production, so it’s usually deemed necessary to use supplements.”

Adolescence is also an important period. It’s a time when food has to provide all the building blocks for the formation of new tissues, hormones and enzymes. The intake needs to be balanced, with a special attention to protein, iron, calcium and vitamin D intake. Insufficient intake of iron and calcium especially can lead to anaemia and reduced mineralisation of the bones, creating the basis for osteoporosis in the future.

It’s in this delicate phase of life when girls sometimes start to follow unhealthy diet trends, notes Dr Rajnakova – trends that may increase their risk of malnutrition. It’s always a good idea to speak with your doctor about whether dietary supplements are appropriate for you.

“Self-administering supplements can be dangerous and should be done by a physician to avoid any potential side effects,” she says.