Breast cancer is one of the most common cancers in the United States, yet there are many misconceptions about the disease. Improving your knowledge is one way you can fight it.
Can you separate myth from fact? Take the quiz below, then click “Done” to see your score and correct answers.
The following quiz is based on Seven Common Misconceptions About Breast Cancer published in Mount Sinai Today.
You may know well that feeling of frequently running to the bathroom to urinate or waking up at night and making your way to the toilet. You’re not alone.
Overactive bladder is a condition that causes sudden urges to urinate in both men and women that may be hard to control, often resulting in urinary incontinence, another name for losing control of your bladder.
Urinary incontinence affects women twice as often as men, as pregnancy, childbirth, and menopause can affect the bladder, urethra, and other muscles in women, according to the Office on Women’s Heath of the U.S. Department of Health and Human Services.
“If you’re having these symptoms, don’t be embarrassed to schedule an appointment with your physician to discuss your concerns,” says Feven Getaneh, MD, a urogynecologist at Mount Sinai. “We see these kinds of symptoms all the time and are here to help you and point you in the right direction so that we can help improve your quality of life.”
Feven Getaneh, MD
In fact, there are many treatment options available for overactive bladder, such as pelvic floor muscle exercises, medication, and bladder injections.
In this Q&A, Dr. Getaneh, who is also Assistant Professor in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and ReproductiveScience at the Icahn School of Medicine at Mount Sinai, explains common symptoms of overactive bladder, how the condition is diagnosed, and treatment options for women.
What is overactive bladder?
Overactive bladder, also known as OAB, is characterized by bothersome urinary symptoms. This can include urinary urgency, frequency of running to the bathroom, waking up at night to use the bathroom, and even having incontinence episodes when you’re on your way to the bathroom.
Can you prevent overactive bladder?
While we don’t know whether overactive bladder is preventable, there are certain things in your behavior that you can modify to help with bothersome urinary symptoms. These include:
How is overactive bladder diagnosed?
Patients who have bothersome urinary urgency, where they’re running to the bathroom frequently and often having accidents on the way, should talk with their physician. Their physician may refer them to a specialist, such as a urogynecologist, to evaluate their symptoms and determine the best treatment options that are available. Diagnosis may involve a physical exam and diagnostic tests, such as a urine analysis; tests that measure bladder function; or a cystoscopy, a procedure that examines the inside of the bladder using a thin, flexible tube with a camera.
What are the treatment options?
We have many treatment options for women with bothersome urinary symptoms. Sometimes we will refer women to physical therapists to strengthen their pelvic floor muscles. Sometimes we’ll start a bladder medication so that you have more time to make it to the bathroom. If these measures aren’t helpful, we have a lot of advanced therapies to deal with overactive bladder. We do bladder Botox® injections in our office. We also implant pacemakers for the bladder, which are done in the operating room. We even offer an outpatient acupuncture treatment for overactive bladder.
At Mount Sinai, we have a team of specialists that can find the treatment plan that’s right for you. Call 646-412-9897 to schedule an appointment with a urogynecologist.
Egg freezing is popular among women looking for options and balancing family planning with other important responsibilities. Thanks to significant scientific advancements in the laboratory, success rates are higher than ever.
In this Q&A, Alan Copperman, MD, Director of the Division of Reproductive Endocrinology and Infertility and Vice Chair of the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at the Mount Sinai Health System, explains the process of egg freezing and its benefits. Dr. Copperman is also Managing Director and Chief Executive Officer of RMA of New York.
“Fertility preservation has the potential not only to safeguard fertility, but also to empower women to choose parenthood on their terms, at their own pace, aligning with personal and professional aspirations,” says Dr. Copperman. “It enables informed decisions about future family planning.”
Why should I freeze my eggs?
Egg freezing halts the biological clock, which is crucial for women whose age may mean they are facing possible declines in egg quality and quantity. Preserving eggs at a younger age enhances the chances of future conception and reduces risks of chromosomal abnormalities in offspring. It safeguards a woman’s fertility timeline while optimizing her prospects of having biological children later in life.
When should I freeze eggs?
Freezing eggs at a younger age is advisable, ensuring eggs are preserved at their peak quality and minimizing age-related reproductive challenges.
How does the process work?
Over a two-week period, the ovaries are stimulated to release multiple mature eggs for retrieval. Patients self-administer fertility medications, attend monitoring appointments, and then undergo a brief egg retrieval procedure under light sedation. Eggs are frozen and securely stored for future use.
How many eggs are frozen?
The number of eggs to freeze varies based on a woman’s age and family-building goals. Some may require multiple rounds of egg freezing to collect an adequate number of eggs.
What happens next?
When you are ready to conceive, your frozen eggs are thawed and fertilized with sperm, leading to embryo transfer into the uterus to achieve pregnancy.
While pregnancy brings joy and excitement for many people, it can also cause quite a few headaches. Headaches are common during pregnancy, especially early on. However, there are ways to manage the pain. Most often, headaches are not serious and do not cause harm. But it is important for you and your physician to monitor your headaches, as headaches can be associated with pre-eclampsia, a condition that can become serious and lead to complications. In this Q&A, Mount Sinai obstetricians Bruno Caridi, MD, and Jian Jenny Tang, MD, explain the different types of headaches you may experience, how to ease and prevent headaches, and how to know if you should be concerned.
Bruno Caridi, MD
How common are headaches during pregnancy?
Headaches are a very common medical condition, especially among those who are pregnant. There are three different types of headaches: tension headaches, cluster headaches, and migraine headaches. Almost 26 percent of pregnant patients will experience tension headaches, a mild-to-moderate pain that is often described as having a tight band around the head. Pain may also be located toward the neck with tension headaches. Cluster headaches are characterized by intense pain, often concentrated around one eye or on one side of the head, and occurring frequently. Cluster headaches are very uncommon in women, occurring less than one percent of the time. A migraine headache is usually unilateral, which means it is concentrated on one side of the head. During pregnancy, about 10 percent of people will have experienced some type of migraine headache. With migraine headaches, an individual may be more sensitive to light, to certain types of noise, and to certain smells. Migraine headaches can also be accompanied by other symptoms, such as nausea. After 20 weeks of pregnancy, careful attention needs to be paid to headaches to ensure they are not a symptom of pre-eclampsia. Headaches associated with pre-eclampsia are usually global tension headaches, occurring all around the head.
What is pre-eclampsia?
While the causes of pre-eclampsia are not understood, the condition may be related to placenta and maternal vascular dysfunction. However, high blood pressure and protein in the urine are the most common signs. In rare cases, the condition causes seizures. If you are experiencing frequent headaches, it is important to have your vitals checked by your physician to see if your blood pressure is elevated. Also, be aware of any headache that is different from what you’ve previously experienced. Changes in vision, such as spots or blurriness, or right upper quadrant abdominal pain or epigastric pain are all signs of pre-eclampsia.
Jian Jenny Tang, MD
What are the best over-the-counter and non-pharmacological treatments for alleviating pregnancy-related headaches?
The first line of treatment recommended is Tylenol®. Patients may take three regular strength Tylenol (975 milligrams total), or two extra strength Tylenol (1000 milligrams total). Tylenol can be taken every six to eight hours, and must not exceed 3000 milligrams per day. This medication is an excellent initial line of over-the-counter treatment for headaches. We do not recommend migraine medicines that you may have been taking pre-pregnancy, such as sumatriptan. Besides Tylenol, caffeine is a great way to help alleviate headaches. Caffeine is fine to use in moderation, and should not exceed 200 milligrams per day. If the headache persists, then the patient should contact their physician. Other non-pharmacological treatments include drinking plenty of fluids to stay well hydrated, keeping your blood glucose levels up by snacking or eating light meals every few hours throughout the day, getting adequate rest, moving to a dark room to avoid light, or placing a damp washcloth over your forehead and relaxing. Other stress reduction or relaxation techniques, such as taking a shower to relax your muscles, listening to soothing music, and aromatherapy can help. Deep mindful breathing and light exercise, such as yoga, are other common non-pharmacological methods that help with headaches. Prevention is key.
How can I prevent pregnancy-related headaches?
Experiencing headaches during pregnancy does not mean you have pre-eclampsia. Other common causes can include dehydration, low blood glucose levels, lack of sleep, and anemia. As such, staying well hydrated and getting enough food and sleep are good ways to prevent headaches. Also, if you consume a lot of caffeinated beverages before pregnancy, abruptly scaling back on caffeine could trigger headaches related to withdrawal. If you plan to give up caffeine, easing yourself off of these beverages gradually can prevent headaches. Your pregnant body is going through a lot of changes, especially during the first trimester. Knowing how to adapt to these rapid changes will help put both your body and mind at ease, so you can focus on your baby.
Midwives are health professionals who are best known for providing critical support and care for many expectant mothers, but their role is often little-known or understood. Patients may wonder if you can have a midwife and an OB/GYN, how their roles differs from a doula, and how to locate a reputable midwife.
In this Q&A, Rochelle Lipshutz, CNM, Clinical Director of Midwifery at The Mount Sinai Hospital, explains how midwives support patients before, during, and after childbirth and discusses how midwives work with consulting physicians at Mount Sinai to offer integrated care.
Midwives are licensed independent health care providers, meaning they provide care without the supervision of a physician. Certified nurse midwives are trained in both nursing and midwifery while certified midwives have graduated with a master’s-level degree in midwifery but do not have nursing training.
They offer a full range of reproductive and primary health care services for patients from adolescence through menopause. These services include independent provision of primary care, gynecological care, and family planning services; preconception, pregnancy, and postpartum care; and care of healthy, full-term infant for the first 28 days of life.
Both midwives and doulas are trained professionals. Midwives care for clients throughout the life cycle, especially during prenatal care, delivery, postpartum care, and gynecological care as well as primary care. Doulas provide non-medical physical, emotional, and informational support to a woman before, during, and shortly after the process of childbirth. A doula is an additional support during the birth process who—like a midwife—helps a woman achieve the healthiest, most satisfying experience possible.
If you are interested in working with a doula, Mount Sinai has partnered with Oula, a modern maternity care center that provides similar care.
Midwives are best known for attending childbirth. But that is not all they do. About 76 percent of midwives provide reproductive care and about 46 percent offer primary care. Reproductive care can include annual gynecological exams, Pap smears, and prescriptions including contraceptive methods, patient education, and reproductive health visits.
Midwives also treat the partners of patients in cases of sexually transmitted infections. They can also diagnose and offer initial and ongoing comprehensive care for many common health care problems as well as admit, manage, and discharge patients from hospitals. When appropriate, midwives prescribe use of medical devices, such as breast pumps. Midwives also promote health education, disease prevention, and personal wellness programs to patients and their families. They work in a variety of settings, including ambulatory care centers, hospitals, community and public health care arenas, and homes and birth centers.
Midwives are experts in ‘normal.’ For the most part, they respect and enjoy observing the natural birth process. Midwives encourage women to use their inner strength to cooperate with this process. If a woman in labor requests pain relief, midwives support her decision-making skills. In fact, the relationship between the midwife and patient focuses on shared decision making. If medical intervention is necessary, midwives will discuss the risks, benefits, and any alternatives. Together, midwives and patients reach a decision that will guide the care in a safe and comfortable manner. And, if necessary, the midwife will work closely with doctors and nurses to ensure safety throughout the birthing experience.
Midwives participate in hospital births as well as home births and those at birth centers. In general, the midwife will focus on basic care, however, if complications develop, the midwife will work with the physician to ensure a comfortable, rewarding, and safe experience.
Midwifery services are available at The Mount Sinai Hospital and Mount Sinai West. Additionally, the Mount Sinai Health System partners with several well-established local midwifery groups including Central Park Midwifery, Community Midwifery Care, and Nettle Wellness.
You can also check with the American College of Nurse-Midwives to find a local midwife. This national organization lists midwifery practices and private groups in most communities. Many patients go by word of mouth. In addition, many websites that focus on local reproductive care provide information about midwives.
There have been many significant advances in the treatment of breast cancer that have helped patients to diagnose cancer earlier and to provide a range of treatment options. But patients still have many questions about what’s best for them.
In this Q&A, Michael Zeidman, MD, Assistant Professor of Surgery at the Icahn School of Medicine at Mount Sinai and a breast surgeon at Mount Sinai Brooklyn, answers some of the most common questions he gets from patients, including why it is critical to get regular mammograms, how doctors determine the stage of disease, and, if you are looking for a second opinion, the importance of visiting a leading medical center such as Mount Sinai.
Michael Zeidman, MD
How do mammograms help patients and doctors?
Mammograms are the only imaging method that’s been proven to save lives. If we go back to the early 1970s, before screening mammograms were widely implemented, the only way that a patient could discover that she had breast cancer is if she felt it. Now that we have the capability to diagnose breast cancer before it becomes symptomatic, we’re catching it much sooner. So it’s not surprising that survival rates have dramatically improved, while at the same time, we’ve been able to significantly cut back on the amount of treatment needed, which results in a better quality of life after breast cancer.
Why is it important not to delay a mammogram because of concerns about COVID-19?
We are only now starting to see the effects of the public’s general hesitancy of getting mammograms during the pandemic. It’s unfortunately increasingly common for patients who were normally very regular about getting their screening mammograms to skip getting one last year, and now they’re presenting to me with breast cancer that’s likely at a later stage than it would have been if it were discovered a year earlier. If there’s one message I want to get across is, come in, get your screening. The sooner we catch this, the sooner we can deal with it, the less treatment you need, and the better your prognosis will be.
How do you determine what stage breast cancer a patient has?
A very common question that I get from patients with a new diagnosis of breast cancer is “What’s my stage?” I explain that I can’t tell you your stage until after surgery. Determining the stage is made up of a three items: the size of the tumor, whether or not the cancer has spread to the lymph nodes under the armpit, and whether or not the cancer has spread to a distant part of the body. The pre-operative imaging does a fairly good job of estimating the size. But we won’t know the precise size of the tumor until it’s been removed. In fact, unfortunately sometimes the imaging can significantly overestimate or underestimate the true size of the tumor. The only way to tell whether or not the cancer has spread to the lymph nodes is to actually sample a few of them during the operation. We do that with a technique called a sentinel lymph node biopsy. In the operating room, we are able to determine if cancer were to spread to the lymph nodes, what are the few lymph nodes that would be the first to receive that cancer. So we identify and remove those nodes. And if the pathologist tells us that there’s no cancer in those nodes, we can safely assume that there’s no cancer in the rest of your nodes.
What do I need to know about the different stages of breast cancer?
I just had a COVID-19 vaccine. Should I delay getting my mammogram?
You do not have to delay your mammogram if you are receiving the vaccine, but you should make your radiologist aware which arm got the shot. There has been a lot of talk in the news about how the vaccine can mimic breast cancer. This is not entirely true. The purpose of the vaccine is to activate your immune system to produce antibodies that fight the virus. The cells that make these antibodies are located in small organs throughout your body called lymph nodes. The closest group of lymph nodes to where the vaccine is administered is in the armpit. These are called the axillary lymph nodes, and they are the first group of lymph nodes where breast cancer will typically spread. After receiving the vaccine and activating the cells in the axillary lymph nodes, they will grow in size. This may result in the radiologist wanting a closer look at the lymph nodes with an ultrasound to better delineate if these nodes are large due to the vaccine or if they are concerning for cancer.
What is the difference between a biopsy and surgery?
When we talk about a biopsy, we’re mainly talking about a core needle biopsy. This is where we get a small snippet of tissue in the area of concern, as discovered by the imaging. It’s usually done under the guidance of imaging, such as an ultrasound guided biopsy or something called a stereotactic biopsy, which is done under mammographic guidance. Usually the needle biopsy is done before we do the surgery because it helps us guide what type of surgery the patient needs and because it allows us to determine if chemotherapy is the first step, rather than surgery. For surgery, you are actually coming to the operating room and we remove a large area of tissue around the cancer. If we already know that it’s a very large cancer, we may perform mastectomy to remove the entire breast.
If I am looking for a second opinion, why is it important to go a leading medical center like Mount Sinai?
The treatment of breast cancer has become increasingly complex, as we’ve learned more about it, and so it’s now more important than ever to have a team that works in a collaborative way to tailor a specific treatment program for you. The Dubin Breast Center at Mount Sinai is a true multidisciplinary Cancer Center with specialists concentrating on one problem, breast cancer. The facility is beautiful, and that produces a sense of calmness that translates to patient care and to the patients themselves. While I generally recommend that patients go for a second opinion, because of how complex breast cancer treatment is, I think it’s imperative to go to a center where that’s the primary focus, where that’s all they do.