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Health Care

According to the World Health Organization, "Breast cancer is the top cancer in women both in the developed and the developing world." Many doctors believe that early detection has played a large role in saving the lives of thousands of women in the early stages of breast cancer.

October is Breast Cancer Awareness month and Courtney Miller WHNP, BC, of Elite Women's Health, answered questions for FredParent readers about early detection, BRCA testing and awareness.

Courtney MillerBefore joining Elite Women's Health in 2014, Miller worked as a lead nurse practitioner at a Chicago, Illinois, breast health clinic. During her time there, she received specialized training in benign and malignant breast diseases. Miller specializes in identifying patients who are at "high risk" for breast cancer.

Tell us a little about Elite Women's Health. What areas do you specialize in?

Elite Women's Health is an OB-GYN Practice in Fredericksburg, Virginia. We were voted the Best OB-GYN practice in Fredericksburg for 2015. We pride ourselves in giving exceptional care to every one of our patients, regardless of age.

I am a women's health nurse practitioner, so I specialize in the health care of women of all ages. I have a specialty in breast conditions, both benign conditions and breast cancer. I use my breast health knowledge and skill to identify our OB-GYN patients that may be at increased risk for breast cancer.

At what age should women start doing breast self-exams, and how often should they do them?

I encourage women at a very early age to start checking their breasts to become familiar with what is normal to them. Starting in your teens, I recommend patients check their breasts on a monthly basis. It may be helpful to check your breasts the week after your cycle due to hormonal changes.

What steps should I take if I find a lump in my breast?

If you find something new or out of the ordinary on your self breast exam (SBE), I encourage patients to call your OB-GYN. Your provider will then do a clinical breast exam (CBE) and will often order imaging of the breast.

At what age should women start getting mammograms?

The American Cancer Society recommends that women start yearly screening mammograms at the age of 40. If you are at "high risk" or have a strong family history of breast cancer, your provider may start imaging at the age of 35 or younger.

If I have a history of breast cancer in my family, should I start getting mammograms earlier?

The first thing you should do if you have a family history of breast cancer is let your OB-GYN provider know. The answer truly depends on your personal family history and how old those family members were when they were diagnosed with breast cancer.

What is BRCA Testing?

The BRCA gene test uses DNA analysis to identify harmful changes (mutations) in either one of the two breast cancer susceptibility genes — BRCA1 and BRCA2. Women who have inherited mutations in these genes face a much higher risk of developing breast and/or ovarian cancer compared with the general population.

Who would benefit from BRCA testing?

The BRCA gene test is typically offered only to people who are likely to have an inherited mutation; based on personal or family history, those patients or family members who have specific types of breast cancer, or certain types of ethnic populations.

How do I know if I am at increased risk for breast cancer?

Again, talking with your OB-GYN provider will get the conversation started and identify if there is family history. If your OB-GYN provider feels it is necessary, you may be referred to a breast specialist for further counseling and/or testing.

What happens if the BRCA test comes back positive? What is the next step?

A positive test result indicates that a person has inherited a known harmful mutation in BRCA1 or BRCA2 and, therefore, has an increased risk of developing certain cancers. However, a positive test result cannot tell whether or when an individual will actually develop cancer. Further steps should be taken after a positive test result and might include taking specific measures to reduce your cancer risk. What you choose to do depends on many factors — including your age, medical history, prior treatments, past surgeries and personal preferences.

Elite Women's Heath is an OBGYN office that offers a full range of gynecological, surgical and obstetric care for women in the Fredericksburg and Woodbridge areas. If you have questions or would like to make an appointment with Elite Women's Health, visit www.elitewomenshealthva.com or call (540) 940- 2000.

Would you like to ask Courtney Miller WHNP, BC, a question? She will be with us during our Ask The Expert live chat on October 15, 2015, on our Facebook page at 8:00 pm. Come join the conversation!

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