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Health Matters: Providence Holy Cross Medical Center | 11 A PHYSICAL EXAM Regularly seeing an internist or family medicine doctor is about identifying warning signs while a problem is preventable. Discovering you have high blood pressure or are prediabetic are just two examples where the solutions are much simpler when you catch it early. "For the past 18 months, we doctors have had to do more telemedicine, and many women have missed those physical exams," says Dr. Chu. "I'm hoping we can get a handle on that very soon." A MAMMOGRAM Research shows that exercising regularly and losing weight helps prevent not only heart disease— the No. 1 killer of women—but also breast cancer. But when it comes to successful treatment of breast cancer, nothing is more important than early detection. "Of all the imaging modalities, a mammogram is, by far, the best and most specific test to identify changes in the breast that could be cancer long before they can be seen or felt," Dr. Chu asserts. "Breast MRIs are difficult to tolerate for some patients," she adds, "but sometimes necessary. Really, the mammogram is the fastest and easiest, and gives us the most information quickly." Dr. Chu advises that women over 40 get an annual mammogram. "If you are younger and your risk factors are low, you can probably go every other year starting at 40. However, please discuss the decision with your doctor." Many doctors are recom- mending 3D mammography, which detects 40% more invasive cancers than traditional mammography, while also reducing false positives. A COLONOSCOPY Colorectal cancer is the third most common and deadly cancer for women (behind lung and breast). And the recommended age at which you should start getting screened has recently fallen: The American Cancer Society now suggests people at average risk get their first colonoscopy at age 45 instead of 50. Colonoscopies are the only cancer screening capable of both identifying and treating a potential problem in an early stage. If a precancerous polyp is discovered, it's immediately removed—thereby preventing a malignancy before it even develops. THE WELL-WOMAN VISIT All women should get a well- woman exam very year. This exam includes a Pap smear. Pap smears have dramatically reduced the number of cervical cancer cases and deaths in the U.S. and continue to be an incredibly important tool in women's health. The majority of invasive cervical cancers are seen in women who have not had regular Pap smears. A well-woman visit includes a breast and pelvic exam that allows your OB-GYN or primary care physician to check for uterine masses, pelvic floor issues, infections, cervical polyps, breast cancer and more. A pelvic exam can help identify cysts or other issues early. It's also a great opportunity to talk to your doctor about any concerns, such as incontinence or urinary tract infections. "Also," says Dr. Chu, "most women will not see a breast specialist for a well-woman exam, but the appointment with their regular doctor or gynecologist will reinforce getting a mammogram done and looked at in a timely fashion." As a retired project manager and businesswoman, Grace Miller says, her career taught her how to assert herself. "We women are so used to just listening to men, but if I had listened to my first doctor—who was a fine surgeon, but not an oncologist and certainly not a breast specialist—I would never have gone elsewhere and found Dr. Chu. She leads with her heart, and it really shows." A pplying the age-old saying "What you don't know can't hurt you" to your health isn't just a mistake. It can be deadly. Santa Clarita resident Grace Miller, 50, can attest to that. Two weeks before Christmas 2020, she felt a pain in her left breast just as she was falling asleep. "There was a hardness, too," says Miller. "I forgot about it. But I told my husband, and he stayed on me to get it checked," Miller recalls. "I battle seizures (I have a service dog, Riley) and I was busy with the holidays. But I finally called." The news wasn't good. "They didn't have an opening until February 2021!" Miller's husband told her to call back and tell them she had a mass. "I got an appointment at Providence Facey Medical Group, in Valencia, within 45 minutes," she says. Miller got a mammogram and an ultrasound. The surgeon she was initially referred to told her he was ordering a biopsy, because "it looked like the real deal" on her left breast. "But I had a feeling there might be more to it," Miller says. "I also wondered if I should get genetic testing, since there is breast cancer in my family. So in February, I found another surgeon at Providence Holy Cross Medical Center, Dortha Chu, MD, PhD." Chu is also a breast specialist and surgeon at City of Hope, a world-renowned NCI-designated comprehensive cancer center. "Dr. Chu agreed I should get the genetic test, and she did a breast MRI, because she said sometimes mammograms can miss cancer," says Miller. "The MRI confirmed the mass in the left breast and caught one in the right breast as well. When the genetic testing came back, I was positive for the BRCA gene mutation." "On March 18, Dr. Chu performed a double mastectomy," says Miller. "And fortunately, I was able to have Riley with me in the hospital (right next to my bed), because we had to manage my seizures." "I feel enormously lucky and grateful, because I trusted my instincts and found the right team. Dr. Chu did exactly what needed to be done and explained everything in so much detail. She was amazing," says Miller. Knowledge is power. And for women, that means scheduling four very important exams on a regular basis:

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