Not All Breast Cancer Has a Lump

Courtesy Shaunak Mukherjee(NEW YORK) -- Sandra Bishnoi wasn't worried when she went to her gynecologist about some breast soreness in 2011.  She was 37 and had just finished breastfeeding her new baby daughter, so Bishnoi, who has a PhD in chemistry, figured she was just experiencing one of the many bodily changes that come with pregnancy and new motherhood.

Bishnoi's gynecologist sent her to a nearby hospital for more testing that day, but Bishnoi never saw a breast cancer diagnosis coming.

"The light bulb never came off that it was serious," said Bishnoi, adding that she never thought to ask her husband to come with her to the doctor's office for support.  "A surgeon actually came in to see me and said, 'We need to do a biopsy...Dr. Bishnoi, you can't leave this room without knowing you have breast cancer.'"

Doctors ultimately diagnosed Bishnoi with stage 4 inflammatory breast cancer that had metastasized to her bones.

Bishnoi was not only devastated, she was baffled. Wasn't breast cancer supposed to involve a lump?  Wasn't she too young? Didn't she need a family history?

The short answer is that inflammatory breast cancer is different from other breast cancers. Since inflammatory breast cancer only accounts for between 1 percent and 5 percent of breast cancers, patients -- and some doctors -- often don't know what to look for.

"It's often not associated with a lump," said Dr. Mark Kelley, chief of surgical oncology and endocrine surgery at Vanderbilt-Ingram Cancer Center in Tennessee.  (Kelley has never met Bishnoi.)  "These patients just come in with red, swollen, possibly tender breasts."

It often looks more like an infection than cancer, so some doctors will prescribe antibiotics, giving the cancer more time to grow before it's caught, Kelley said.

An infection called mastitis is common in women who are breastfeeding and is to blame for breast swelling and discoloration most of the time, said Dr. Sandhya Pruthi, a breast cancer specialist and professor at the Mayo Clinic in Rochester, Minn.  Doctors will often prescribe antibiotics for seven to 10 days to see what happens.  If the symptoms don't go away, doctors should know it might be more than an infection and request more testing.

"You don't want to miss inflammatory breast cancer," Pruthi said. "Inflammatory breast cancer is uncommon and unfortunately it's not always a classic presentation. That's what makes it challenging.  If you haven't seen it several times in your practice to know what you're looking for, you can miss it."

Even if a doctor suspects inflammatory breast cancer, it won't necessarily show up on a mammogram, Kelley said.  It might show up on an ultrasound, but the best way to diagnose it is to do a skin biopsy.  Unlike other breast cancers, inflammatory breast cancer starts in the milk ducts and spreads quickly via lymphatic vessels in the breast skin.

Bishnoi looked back and realized she actually had symptoms earlier but dismissed them. She remembered that her daughter didn't feed as well from the breast that had cancer, but she figured it was a clogged milk duct.  She remembered that the same breast had some redness and dimpling but she thought it was thrush, which is also associated with breastfeeding.

It wasn't until Bishnoi stopped breastfeeding and realized that one breast hadn't returned to its normal size and firmness that she even considered going to a doctor.

"It was starting to cause me a lot of pain, but that's not normal for breast cancer either," Bishnoi said.

She never imagined that she had a rare breast cancer that spreads more easily than typical breast cancer and is harder to treat.

Copyright 2013 ABC News Radio


Night Shift Work May Increase Women's Risk for Breast Cancer

Comstock/Jupiterimages(NEW YORK) -- If you're a woman who works nights, new research from Canada says your hours may be increasing your risk of breast cancer.
The latest study to find a connection between breast cancer, the second-most common form of the disease in U.S. women, and working nights appears online in Occupational and Environmental Medicine.  
Researchers at the Queen's Cancer Research Institute at Queen's University in Kingston, Ontario, compared over 1,100 breast cancer patients with a like number of women who had no history of breast cancer.
They found that about a third of the women worked at jobs where they spent at least half their time on evening or night shifts. The breast cancer risk was more than twice as high for women with 30 years or more of night-shift work. For women who worked in health professions, the risk was higher still.
But what's the explanation?
Scientists suspect it involves melatonin, which regulates our daily body rhythms. Increased light exposure on night shifts may depress melatonin production and increase cancer risk.

Copyright 2013 ABC News Radio


Are Americans Eating Too Much Take-Out Food?

Photodisc/Thinkstock(NEW YORK) -- Americans apparently like their food “to go.”  According to a survey by CouponCodes4u, the average person in the U.S. spends more than $900 a year on take-out food.

Researchers polled 2,503 U.S. adults, asking how often they order take-out and how much they spend on it. All respondents had eaten take-out within the week of taking part in the survey.

Additional findings:

  • Fifty-seven percent of those polled said they prefer take-out food to a home-cooked meal, and of that number, a third claimed they did not have time to cook from scratch.
  • Twenty-three percent admitted they did not know how to cook and 23 percent said they had no interest in cooking.
  • Nine percent of respondents admitted to getting food delivered every day.
  • Thirty-eight percent of respondents order take-out once a week, and 45 percent admit to doing so every two weeks.
  • Of the respondents who admitted they preferred take-out food to home-cooked meals, 72 percent admitted they were overweight.

If this survey's findings are true, it gives explanation to another recent study that showed Americans are still getting fatter, despite more physical activity. According to the study published in Population Metrics, calorie-rich diets may be contributing to Americans' slide into obesity.

Copyright 2013 ABC News Radio


US Lagging Behind Other Wealthy Nations in Life Expectancy Gains

Keith Brofsky/Photodisc(NEW YORK) -- The good news: life expectancy rose steadily in the U.S. from 1990-2010. The bad news: even though the U.S. spends the most per capita on health care in the world, relative to other wealthy nations it has failed to keep up with the advances in population health.

For the study, which is part of a series of reports by the Global Burden of Disease Study, researchers found that U.S. life expectancy for both sexes increased from 75.2 years in 1990 to 78.2 years in 2010; healthy life expectancy increased from 65.8 years to 68.1 years.

But among 34 examined countries between 1990 and 2010, the U.S. rank for the age-standardized death rate changed from 18th to 27th; for the age-standardized years of lives lost due to premature mortality rate from 23rd to 28th; for the age-standardized years lived with disability rate from 5th to 6th; for life expectancy at birth from 20th to 27th, and for healthy life expectancy from 14th to 26th.

In fact, illness and chronic disability now account for nearly half of the health burden in the U.S.

According the to report, poor eating habits appear to be behind many U.S. health problems. American diets often include too much sodium, processed meat and trans fatty acids, and too little fruits and vegetables.

The study's findings were published online this week in the Journal of the American Medical Association.

Copyright 2013 ABC News Radio


Students Downplay, Underestimate Female Intoxication: Study

iStockphoto/Thinkstock(NEW YORK) -- A new study suggests that college students are more likely to downplay or underestimate intoxication in women than in men.

“Our participants were more likely to say that women are only tipsy even when they are actually heavily intoxicated,” Ash Levitt, 32, a research scientist at the Research Institute on Intoxication at SUNY Buffalo, who published the study, told ABC News.

“On the contrary, our participants were able to accurately say how drunk a male was,” Levitt added.

Participation in the online survey was open to the entire student body; almost one in three of those who participated were in a fraternity or sorority, and they received academic credit for participating. So, Levitt’s study is limited, but according to the Institute for Alcohol Abuse, a division of the National Institute of Health, young adults ages 18 to 24 have a higher risk for alcohol abuse than older adults.

“It’s possible that people simply do not know how to tell if a college-aged woman is moderately or heavily intoxicated,” Levitt said. “Or it could be the case that they do know how intoxicated a college-aged woman is, but they are trying to minimize it.”

This could be especially true for women determining how intoxicated their female friends are.

“Our study showed that women are less likely than men to accurately tell how intoxicated other women are,” Levitt said.

In addition, “research shows that a double standard exists here. In one case women feel pressure to drink just as much as men. But at the same time women feel pressure to appear as though they do not drink too much,” Levitt said.

Levitt and a team of researchers collected data from 139 college students who were asked to describe the intoxication level of fictional characters.

“We had the participants read a fictional story about a character going to a bar to celebrate their birthday. The story described the character’s gender, how much they drank, and how they behaved,” Levitt explained.

Then the participants had to describe the character from a list of words researchers have found people naturally use to describe intoxication levels.

“The words either described moderate intoxication, like ‘tipsy,’ or heavy intoxication, like ‘hammered,’” Levitt continued.

Levitt is conducting further tests to see how well these words describe intoxication compared to actual blood alcohol content.

“If our findings show that words like ‘hammered’ describe high blood alcohol content and words like ‘tipsy’ describe low blood alcohol content, then we would suggest that future alcohol education programs targeted at college students use these words in their lessons,” Levitt said. “Research shows that the more tailored alcohol education programs are towards individuals the more effective they become.”

Copyright 2013 ABC News Radio


House to Vote Next Week to Delay Individual Mandate

iStockphoto/Thinkstock(WASHINGTON) -- House Speaker John Boehner announced Thursday that the House will take votes next week on a one-year delay to both the employer mandate and the individual mandate in the president’s signature health care law.

Boehner’s vow was instigated by the Obama administration's decision last week to postpone implementation of the mandate for businesses.

Thursday, the speaker ticked off examples of the types of people who would have to overcome the burden of the mandate – young professionals with student loans, single parents and families – and contrasted their struggle with financial companies, government contractors and big banks who stand to benefit from the administration’s decision to delay the mandate for employers.

“It's unfair and indefensible,” Boehner, R-Ohio, said. “Is it fair for the president to give American businesses an exemption from the health law's mandates without giving the same break to individuals and families across the country? Hell no, it isn't!”

The House is taking the second vote on the employer mandate not only because some lawmakers question whether the administration has the unilateral authority to delay the regulation, but also to put Democrats on the record “for their hypocrisy” over support for the delay for businesses, according to a senior Republican leadership aide.

“We remain committed to repealing Obamacare,” Boehner reiterated. “It's wide open to fraud and abuse. In short, it's a train wreck.”

Earlier this week, Boehner joined several GOP leaders and committee chairmen in a letter to the president asking him to justify delaying the employer mandate while leaving in place the mandate on individuals and families.

"We agree with you that the burden was overwhelming for employers, but we also believe American families need the same relief," the Republicans wrote Tuesday. "Each provision you delay continues to demonstrate that the entire law is unworkable."

Asked whether Boehner’s move is appropriate given the administration’s decision regarding employers, House Minority Leader Nancy Pelosi completely rejected the necessity to delay implementation of the individual mandate.

“No, absolutely not,” Pelosi, D-Calif., said. “I don't think it's virtuous at all.”

Pelosi, who counts the law’s passage among the cornerstones of her speakership, also asserted that the interpretation of the administration’s move is inaccurate. She explained that a “certain reporting” requirement by businesses that “could be perceived as onerous” was delayed in order to review “how it would work and how it could be better.”

Pelosi indicated that employers are still encouraged to maintain or expand coverage during the 2014 transition period and the new start date in 2015 does not affect employees’ access to the premium tax credits available under the ACA or any other provision of the law.

“It was not a delay of the mandate for the businesses, and there shouldn't be a delay of the mandate for individuals,” she said.

A senior Democratic leadership aide noted that Democrats “do not expect employer behavior to change” as a result of the delay, and added that just four percent of businesses were subject to the requirement.

In the wake of the delay for employers, Sen. Jerry Moran, R-Kan., has introduced legislation in the upper chamber that would further disrupt the law’s implementation.

Moran has introduced two amendments to an appropriations bill that would rescind $15 million from the law’s Individual Payment Advisory Board, and also transfer $1.35 billion allocated to implement health insurance exchanges to Centers for Medicare & Medicaid Services Program to implement health insurance exchanges required by the health care law. Instead, Moran would redirect that money to the National Institutes of Health to support biomedical research.

Copyright 2013 ABC News Radio


For a Healthier Newborn, Wait to Cut the Cord

Comstock/Thinkstock(NEW YORK) -- It turns out that not cutting the umbilical cord immediately after birth might be best for the baby. A new study suggests that waiting a few minutes to cut the umbilical cord can help newborns receive an influx of nutrients that can benefit their health even months later.

In the United States, the umbilical cord is usually clamped and cut within one minute of birth. In theory, this helps to diminish the chance of postpartum hemorrhaging and other complications. But a study of nearly 3,911 mother and newborn pairs found that waiting to clamp the cord for one to three minutes after birth meant newborns received an influx of nutrient-rich blood.

In births where there was a one to three minute delay in clamping the umbilical cord, newborns had higher hemoglobin concentrations 24 to 48 hours after birth and had higher iron stores three to six months later. They also tended to have higher birth weights.

Babies who had their umbilical cord clamped within one minute of  birth were twice as likely to have iron deficiencies when they were three and six months old.

In both cases, there was no statistical difference in the amount of maternal postpartum hemorrhaging. Babies who received the extra influx of blood through the delayed cord clamping had slightly higher rates of jaundice. Newborn jaundice is caused by a bilirubin, a byproduct of hemoglobin.

Dr. Joanne Stone, director of Maternal Fetal Medicine at Mount Sinai Medical Center in New York, said the findings were important, but she still hoped additional research would be done to see if the health effects lasted longer than a few months.

“I think the important thing is what [are] the results of the long- term studies. What is the increase in iron stores in babies down the road?” said Stone. “If [delayed cord clamping] is associated to larger birth weight, is it [also] going to mean better neurological development?”

Stone also said that delaying the cord clamping will only work for low-risk pregnancies. Complicated deliveries or those done via cesarean section would likely include early cord clamping to diminish potential risks to the mother and baby.

But for healthy low-risk pregnancies, Stone said she would consider waiting an extra minute or two to cut the cord.

“This is going to be something that patients are going to be asking about all the time,” said Stone.

Copyright 2013 ABC News Radio


I Do, Again: More Couples Opting for Multiple Ceremonies

Brand X Pictures/Thinkstock(LOS ANGELES) -- Whether it’s to accommodate different religions, different geographical locations or just different style ceremonies, an increasing number of couples are opting to say more than one set of “I Do’s.”

One of the hottest trends when it comes to weddings, first reported in the Wall Street Journal, is for nearly-weds to plan for multiple wedding ceremonies.

Monisha Akhoury, of New York City, needed four wedding dresses for three different wedding ceremonies at three different venues, two in California and one in New Jersey.

With a dress budget of $15,000, she said ‘Yes’ to three of the four dresses on TLC’s show, Say Yes to the Dress.

“The idea of couples having more than one wedding is out there,” Anja Winikka, site director for TheKnot.com, told ABC News. “There are often families with very different ideas with what a wedding should look like, and so that’s what it comes to. A couple has to decide, ‘Am I going to do it my way?’ or ‘Am I going to do another wedding and please the rest of my family?’”

Chris Fava popped the question to Akhoury last March, but they quickly learned weddings are not just about what the bride and groom want.

“It was about families,” Akhoury explained. “I never thought it was going to be three ceremonies, but because of all the different wants of people, it ended up just naturally occurring like that.”

Fava admits he was a bit overwhelmed, but says, “I just went with it.”

With different cultural and religious backgrounds, their East-meets-West tri-wedding included a traditional Hindu ceremony, a church wedding and a personalized intimate wedding in a vineyard.

But for a lot of brides and grooms, doubling or tripling the planning can mean double or triple the headache.

“You have to have the party planner in you, and you have to have the ability to handle stress,” Akhoury said. “There’s a lot of pressure. I think you really do have to have the personality for it. I wouldn’t recommend it for everybody.”

This is something to consider for those thinking about making multiple trips down the aisle.

“If you want to have more than one wedding, no matter how you splice and dice it, you’re going to end up spending more money,” said Winikka. “You’re going to want to budget for that.”

As for Akhoury and Fava, they managed to tie the knot three times, all while staying within their one budget.

“It is an extravagant thing to do, but it was done for the best intentions,” Akhoury said. “It was done to make everybody in our family happy, and we accomplished that.”

Copyright 2013 ABC News Radio


Company Makes Baby Wigs for Bald Baby Girls

Baby Bang(NEW YORK) -- One company seems to think bald babies need hair -- at least based on the product it's selling: Baby wigs.

BabyBangs claims on its website to be the first and only ready-to-wear "hairstyle headbands" ever made.

"Our patent pending HAIR+band accessory combination allows baby girls (with little or no hair at all) the opportunity to have a beautifully realistic HAIR style in a SNAP!!" the description reads.

Lisa R. Campbell, the creator of BabyBangs, told ABC News the product is "geared towards toddlers and little girls who have not been blessed with any substantial hair growth of their own as of yet."

But not every mom thinks their bald baby girl needs hair.

Sarah True's daughter, Phoebe, had no hair until she was about 2.

"I never would have put a wig on her.  I think bald babies are the cutest," True said.  "I didn't even do headbands."

BabyBangs are hair and headband all in one.  The "hair" is made from "silky strands of Monofiber Kanekalon," according to the website.  They come "pre-customized & size appropriate, cut, styled and ready for immediate wear.  The wispy hair strands have been arranged in the cutest most adorable elfish coiffure!"  They cost $29.95 each.

Lauren Jimeson, a mom of two bald baby girls, thinks the product might be born out of moms having their hairless baby girls be mistaken for boys.

"If some parents let that get to them, they might look to these wigs for a solution," she said.  "I personally think it's just breeding insecurity at a very young age."

Campbell said BabyBangs ensures no baby girl needs to be mistaken for a boy again.

"Just think about it.  There's always going to be bald baby girls.  And some mothers of bald baby girls may want their daughters to look extra nice for a special occasion or two.  That is when my product line will prove itself," Campbell said.

She said she was recently contacted by one of the producers of the ABC show Shark Tank.

"I never knew it would be this difficult for BabyBangs to be accepted as a valid product and not looked upon as a stupid and worthless piece of junk," Campbell said.

BabyBangs, she said, are not intended to be worn all day.  They're a novelty item used for "fashion and fun."

Copyright 2013 ABC News Radio


Americans Exercising More but Still Getting Fatter

Hemera/Thinkstock(NEW YORK) -- When it comes to exercise, Americans seem to be getting more of it.  But obesity is still on the rise nearly everywhere in the country.

The new data comes from the Institute of Heath Metrics and Evaluation (IHME), which took a county-by-county look at self-reported physical activity levels and obesity rates across the United States.  They found that, despite the fact that more Americans are at least saying they are getting more physical activity, nearly all U.S. counties registered a steady increase in obesity rates between 2001 and 2009.

As far as why this might be happening, the authors of the report note that an active lifestyle may be just one piece of the obesity puzzle.  Other factors -- calorie-rich diets, for example, or a lack of community programs promoting or incentivizing healthy lifestyles -- may make or break Americans’ abilities to slow their slide into obesity.

Still, the findings on self-reported exercise -- as well as some of the successes certain counties have had in slowing obesity rates locally -- are promising, according to Dr. Christopher Murray, director of IHME and one of the report’s lead authors.

“People have shown that they are able to make changes,” Murray said.  “There are communities that have had great success and we can learn from them.”

Among these communities are Teton, Wyo., which in 2011 boasted the most active male population in the country.  In all, 77.5 percent of the men there reported that they performed “sufficient physical activity” -- a level defined as 150 total minutes of moderate activity or 75 minutes of vigorous activity per week.  Routt, Colo., claimed the most active women, with 74.7 percent of them reporting sufficient physical activity.

The biggest gains in self-reported physical activity levels were seen among counties in Kentucky, Georgia and Florida.  The county with the highest increase for men was Concho County, Texas -- up from 41.4 percent in 2001 to 58.2 percent in 2009.  Meanwhile, women in Morgan County, Ky., saw the largest increase in physical activity -- up from 25.7 percent in 2001 to 44 percent in 2009.

Yet, the researchers found that obesity trends in all but nine counties were definitely on the rise -- and even in these nine holdouts, they could not say for sure whether the obesity picture was actually improving or not, since the slight improvements they saw there did not reach what scientists call statistical significance.

Clearly, increasing physical activity alone is having a small impact on our nation’s obesity levels, said Dr. Lou Aronne, director of the Comprehensive Weight Control Program at New York Presbyterian Hospital.

“There are several other factors to consider,” he said.  “One of the main ones being the availability of too much food.”

In addition to diet, Aronne noted several other potential contributing factors -- everything from lack of sleep to the effects of certain medications on weight gain.  Even changes in the microorganisms in our intestines may play a part, he said.

“At an individual level, the energy balance is what is important and that boils down to increasing physical activity and reducing overall food intake,” Aronne added.

Whatever the reason, America’s ballooning weight problem appears to be a crucial reason why -- according to a separate report published Wednesday by Murray and his group in the Journal of the American Medical Association -- the U.S. lags behind other wealthy nations in terms of improvements in life expectancy.  This report identified increased body mass index as the third-leading risk factor contributing to years of healthy life lost in 2010.

Copyright 2013 ABC News Radio