Issue link: https://blog.providence.org/i/1470096
6 | Health Matters: Providence Cedars-Sinai Tarzana Medical Center Once she has gone through menopause, a baseline bone scan can determine whether a woman's bone density is low. If so, hormone replacement therapy (HRT) can help prevent more bone loss and also help with things like vaginal dryness, hot flashes and low libido. "The best time to begin HRT is while going through menopause or shortly after," Dr. Wong says. "There will be more benefits and fewer side effects." SIXTIES AND BEYOND Women should continue getting annual Pap smears until age 65 but can stop then if the tests have been normal, according to Dr. Wong. They should continue with annual pelvic exams throughout their lives. MAMMOGRAM MUDDLE Mammogram recommendations—when to start, how often and when it's safe to stop—have changed over the years at a dizzying pace, but breast surgical oncologist Nimmi Kapoor, MD, medical director of the Breast Cancer Program at Providence Cedars-Sinai Tarzana Medical Center, says we now have the tools to recommend the best course of action. "Previous recommendations were based on older mammography methods, such as film," she explains. "But now we have digital and 3D mammography, which are far better." Most women should have a screening mammogram every year starting at age 40. Breast cancer risk rises with age, so there is no "right" age at which to stop. "Keep having mammograms as long as you are healthy and have an expected life span of at least 10 more years," Dr. Kapoor says. "But if you are elderly and have no risk factors for breast cancer, it might be safe to wait two years between them." Factors that can put a woman at increased risk for developing breast cancer include: • A family history of breast cancer or having the BRCA genes (especially common in Ashkenazi Jewish families) • Having very dense (as opposed to fatty) breasts • Obesity • Previous abnormal breast biopsies "In some cases, mammograms should be started at age 35, and other types of imaging like ultrasound (preferably 3D) or even MRI can be added," Dr. Kapoor says. Regardless of your age, regular breast exams by your doctor and self-exams are essential. "Mammograms do not replace the need for these," Dr. Kapoor says. "Women find their own breast cancers all the time." To learn more about our women's health services, visit providencecedars-sinaitarzana.org.