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2 | Health Matters: Providence St. Joseph Hospital To schedule a mammography appointment at the Center for Breast Imaging and Diagnosis, call 714-734-6282. Mammography and Covid Breast screening rates declined during the early pandemic months. It's time to get them back up. There's no question that mammography is the most effective way to detect breast cancer. But screening rates dropped sharply during the pandemic, and that worries experts like Providence St. Joseph Hospital radiologist Kenneth Meng, MD, medical director of the Center for Breast Imaging and Diagnosis at Providence St. Joseph Center for Cancer Prevention and Treatment. "A recent study," Dr. Meng says, "found breast cancer screenings declined by 87% in April 2020." According to the study, rates rebounded in June 2020 but were still 39% lower than five-year averages. "Which, of course, made sense. It was a very unsure period." Now rates have pretty much returned to normal, Dr. Meng says, but we might not know the full effect of the gap for years. "Randomized studies have shown that if you find a cancer that is small, it's much less likely to have gone into the lymph nodes," he says, "and you can have a cure rate approaching 90%. There is no better way for a woman to take care of her health than to get her mammogram." One in eight women will have a breast cancer diagnosis in their lifetimes. "And about 75% of women have no identifiable risk factors," Dr. Meng estimates. "Over age 40, the curve starts to rise and you need to start regular screenings," he says. "Only about two-thirds of women eligible for mammograms have had one within the past two years; to me, that's too low." Currently, Dr. Meng and his colleagues recommend that women age 40 and older get a mammogram every year, which is the recommendation of the National Comprehensive Cancer Network (NCCN), the American College of Radiology (ACR) and the American Society of Breast Surgeons. "The data shows that you get the highest mortality and risk reduction," he says. "St. Joseph supports that." Pregnancy and Covid Pregnancy is a crucial time for a woman to protect her health and the health of her unborn baby. One thing to keep in mind is that recent studies show that Covid vaccines present no risk of miscarriage, preterm birth or birth defects. "At first there was confusion and hesitancy regarding vaccinations for pregnant women, because we didn't have as much data," says Karen Hsu, MD, an OB-GYN on the medical staff at Providence St. Joseph Hospital. "But now, the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal- Fetal Medicine (SMFM) all agree that pregnant and lactating women who haven't already been vaccinated should be. Since pregnant women are considered immunocompromised and at higher risk for Covid, they should also get a booster if it has been more than six months from completion of their original vaccine series." There is compelling data that Covid is worse in pregnant women. Dr. Hsu says that pregnant women are three times as likely to be admitted to the ICU if they contract the disease, two to three times more likely to need advanced life support and breathing assistance and 70% percent more likely to die of Covid than non-pregnant women. "Those numbers are really scary," says Dr. Hsu. "It's a no-brainer: Anyone who is pregnant or considering getting pregnant should get a Covid vaccination. And if they have already been vaccinated, they should get a booster, as recommended by ACOG." Dr. Karen Hsu Dr. Kenneth Meng

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