Thursday Health Report: American Cancer Society tool helps women understand their personal breast cancer risk

Most breast cancers occur in women without a family history of the disease, and the American Cancer Society estimates that over 30 percent of breast cancers could be prevented through healthy lifestyle choices. According to recent data, about 85 percent of breast cancer cases are diagnosed in women who have no family history of the disease.

While many women are aware of ways to reduce their breast cancer risk, they often don't act on that knowledge. For example, about 9 out of 10 women surveyed knew that physical activity was important for lowering cancer risk, but only 27 percent actually met the American Cancer Society's exercise guidelines, which recommend 150 to 300 minutes of moderate-intensity activity or 75 to 150 minutes of vigorous activity per week.

Other important risk factors include alcohol consumption, which increases breast cancer risk, and breastfeeding, which can help lower risk. However, breastfeeding remains the least well-known protective factor, with only about half of women surveyed aware of its benefits.

To help women better understand their personal breast cancer risk, the American Cancer Society has created a free online tool called ACS Cancer Risk 360. This tool allows women to assess their individual risk level and identify opportunities to make healthier lifestyle choices.

Breast cancer awareness month | Mammogram, ultrasound or MRI: Which breast test is used when?

Overview of Breast Imaging Tests

Breast imaging plays a crucial role in detecting and diagnosing breast cancer early. However, different imaging tests serve different purposes and are used based on factors like age, breast density, symptoms, and cancer risk. Understanding when each test is appropriate helps women monitor their breast health and seek timely medical care.

Mammography for Routine Screening

Mammograms use X-rays to detect small changes in breast tissue, including lumps, distortions, and calcium deposits. This is the primary tool for routine breast cancer screening in women without symptoms. Women at average risk typically begin mammography screening at age 40, though those with strong family history or high risk may need earlier or personalized screening schedules. While mammography may be less effective in women with very dense breast tissue, it remains a valuable screening tool regardless of age when clinically appropriate.

Ultrasound for Evaluating Lumps

Breast ultrasound uses sound waves to create images without exposing patients to radiation. It is particularly useful for assessing specific lumps and determining whether they are fluid-filled cysts or solid masses requiring further investigation. For women under 40, ultrasound is often the first imaging choice since younger women typically have denser breast tissue. While ultrasound has limitations—such as depending on operator skill and not detecting microcalcifications as effectively as mammograms—it complements other imaging methods well.

MRI for Detailed Investigation

Breast MRI provides highly detailed images and is used when other standard tests don't fully explain findings, when determining cancer extent, or for screening women at high genetic risk. Although MRI is highly accurate, it can sometimes detect benign abnormalities that require follow-up testing. MRI should complement, not replace, mammography or ultrasound and is reserved for specific clinical situations.

Screening vs. Diagnosis

Screening detects potential cancer in asymptomatic women early, while diagnostic imaging investigates specific symptoms like lumps or changes in breast appearance. Self-examinations and clinical breast checks are helpful but cannot replace routine mammography screening. The appropriate imaging schedule should be tailored to individual risk factors and medical history.

Vaginal estrogen use may be associated with perioperative hip fracture complications

Vaginal Estrogen and Hip Fracture Surgery Risks

Postmenopausal women face increased health risks, including hip fractures and urinary tract infections (UTIs), because of lower estrogen levels. Vaginal estrogen is commonly used to prevent recurring UTIs by thickening and rebuilding the tissues of the vagina and urethra. However, a new study suggests that using vaginal estrogen before hip fracture surgery may be associated with complications, particularly perioperative UTIs.

Study Findings

Researchers studied 375 postmenopausal women who had hip fractures. About 9% of the women were using vaginal estrogen before surgery, with most having used it for at least six weeks. Nearly 26% of all women in the study experienced a UTI around the time of surgery. Women using vaginal estrogen were more likely to have a history of recurrent UTIs (36% versus 13% of non-users). The study found that vaginal estrogen use was associated with a higher risk of perioperative UTI, even when accounting for age and UTI history. However, vaginal estrogen use did not increase other complications like hospital readmission or death.

Implications and Next Steps

Researchers were surprised that vaginal estrogen did not prevent UTIs in hip fracture patients, despite its known effectiveness in other settings. They believe this may be due to poor compliance or the timing of use. The study authors recommend further investigation into different delivery methods for vaginal estrogen to better understand its role in preventing complications before and after hip fracture surgery.

Upstate NY requires better breast cancer care

Access to quality breast cancer care in upstate New York is significantly limited, particularly in rural communities. Patients in these areas face serious challenges including shortages of healthcare professionals, long distances to treatment facilities, and financial barriers that make it difficult to receive necessary care.

A breast cancer diagnosis becomes even more complicated in regions with these healthcare access issues, as the combination of limited resources and geographical obstacles can have serious consequences for patient outcomes and treatment options.

Women's use of peptides exposes another health care gap

A significant knowledge gap exists about how performance and image-enhancing drugs (PIEDs) affect women's health. While steroids, peptides, and stimulants are increasingly used by women in fitness and bodybuilding, most medical research and clinical guidelines focus exclusively on men's experiences. This gap creates unique health risks for women, including virilising effects, hormonal disruption, and reproductive health changes that remain poorly understood.

Women who use these substances face stigma and barriers to healthcare. Research interviews with nine women from Australia, the US, and Canada revealed that many felt dismissed or judged by health professionals. Some doctors refused to provide appropriate monitoring like hormone profiles, assuming women were using PIEDs without addressing their actual health needs. As a result, women often take responsibility for their own health management rather than receiving proper clinical support.

The fitness industry and social media have driven increased use among women. Performance-enhancing substances are becoming more common outside traditional bodybuilding circles, as wellness influencers promote peptides and other drugs online. Women tend to use these substances quietly due to stigma, unlike men who are more open about their use.

Researchers call for improved healthcare approaches. Medical professionals need to build better relationships with patients, ask non-judgmental questions about substance use, and develop evidence-based guidelines specific to women's health rather than relying solely on male-focused research.

'Enormous' mental health toll for women with endo

Women with endometriosis and ovarian cysts are experiencing high rates of depression and anxiety. Research by Women's Mental Health Australia found that almost half of women with endometriosis reported anxiety, and women with polycystic ovary syndrome showed depression and anxiety rates between 1.6 and 2.2 times higher than women without these conditions. Additionally, suicide and self-harm rates were significantly elevated in these groups compared to the general population.

There are major gaps in Australia's healthcare system. Many women are not seeking mental health support due to financial constraints and stigma. The research reveals that physical and mental health issues are closely connected, particularly for women with female-specific health conditions, yet these areas are often treated separately.

Experts are calling for integrated mental health support. Women's Mental Health Australia recommends that mental health assessments and support should be automatically offered to all women attending government-funded endometriosis and pelvic pain clinics. This would help women manage their physical and mental health together rather than navigating two separate healthcare journeys during their most vulnerable moments.

43% of Ohio counties lack labor and delivery services for pregnant women, report says

Maternity Care Access Crisis in Ohio

Nearly half of Ohio's counties lack hospitals or birth centers that offer labor and delivery services, according to a new report from the March of Dimes. Specifically, 43.2% of counties do not have these facilities, forcing pregnant women to travel farther for care. The problem is especially severe in rural areas, where 80% of counties have no labor and delivery facility available.

The report identified one in five Ohio counties as "maternity care deserts," where pregnant women have limited access to prenatal, postpartum, and other maternal health services. This affects approximately 78,000 women and 5,000 births annually in the state. While the average Ohio woman travels about 15 minutes to reach a hospital with labor and delivery services, roughly 118,000 women live more than 30 minutes away from one. Women in maternity care deserts spend 2.3 times longer traveling for care compared to women in counties with full access.

Northern Ohio generally has better access to maternity care than southern parts of the state. The report recommends that Ohio improve access through expanded Medicaid coverage, increased providers, and policies that allow midwives to serve low-risk patients more independently. Despite these challenges, Ohio performs better than the national average—about one-third of U.S. counties are maternity care deserts, compared to about 18% in Ohio.

Alabama is nation’s most dangerous state for pregnancy and childbirth, according to report

Alabama has been identified as the most dangerous state in the nation for pregnancy and childbirth, according to a report from the ACLU of Alabama. Black women face particularly severe risks, being three times more likely to die from pregnancy complications than other groups. Alabama has the highest maternal mortality rate in the country at 65 deaths per 100,000 births—nearly double the national average—while Black women in Alabama experience a rate of 100 deaths per 100,000 births.

A major barrier to safe maternal care is the lack of access to healthcare facilities. Approximately 43 of Alabama's 64 counties have little to no maternity care access, predominantly affecting rural areas with economically disadvantaged populations. Hospital closures have worsened the situation, with Shelby County losing all of its labor and delivery units two years ago, leaving 230,000 residents without local birthing options. On average, pregnant Alabamians must travel more than 17 miles and 23 minutes to reach the nearest birthing hospital.

The ACLU report identified seven key barriers preventing safe maternal healthcare: limited access in rural areas, transportation delays, financial instability, undermined patient autonomy, inadequate mental health and postpartum support, lack of health education, and insufficient community infrastructure. Additional contributing factors include Alabama's decision not to expand Medicaid and limited maternity leave policies. The report recommends solutions including insurance coverage for doulas, midwifery expansion, improved postpartum depression screening, implicit bias training for healthcare providers, and increased funding for maternal health initiatives.

AOC reveals egg freezing decision, blasts Trump on women's health

Rep. Alexandria Ocasio-Cortez announced she is freezing her eggs through Instagram videos posted Saturday. She explained that she had been considering and saving for the procedure for years and decided to move forward with it to have more control over her future and family planning.

Ocasio-Cortez said she wanted to be open about the process because women are not taught enough about their reproductive health and the various options available to them. She acknowledged that being a young congresswoman means navigating major life decisions publicly, and she hopes sharing her experience will help normalize conversations about fertility, pregnancy, menopause, and other women's health issues that are often overlooked.

The New York Democrat also used the announcement to criticize the Trump administration's policies on women's reproductive rights, arguing that it has created a hostile environment for women's choices and made pregnancy more dangerous. She called on women to reclaim their power by discussing these issues openly.

The announcement drew criticism from some conservatives on social media, who argued that her decision reflects a progressive message prioritizing careers over starting families. Ocasio-Cortez plans to document parts of her egg-freezing process, including hormone injections, for her followers.

Stop Doing “Moderate” Exercise: New Research Argues for a Personalized, Vigorous Approach for Women Over 50

Exercise intensity matters more than previously thought for improving fitness in midlife women. Research tracking over 11,000 Australian women found that those meeting exercise guidelines in their 50s and 60s cut their premature death risk by roughly half. A new study of 73 women ages 50-65 compared recreational runners to inactive women and found that measuring exercise intensity relative to each individual's fitness level explained 70% of the variation in cardiovascular fitness, compared to only 53% for standard intensity guidelines.

One-size-fits-all exercise guidelines may not work for everyone. The study revealed an "intensity paradox": a less fit woman works harder physiologically at the same absolute exercise level as a fitter woman, yet standard guidelines treat them identically. This becomes especially important after age 50 when cardiorespiratory fitness naturally declines and lower fitness is linked to higher mortality risk.

You don't need special equipment to find the right exercise intensity. Simple self-assessment tools like the "talk test" can indicate whether you're working hard enough. At vigorous intensity, you should find it difficult to hold a full conversation, speak only a few words at a time, and notice a substantial increase in breathing rate. Short bursts of harder effort—such as 30-60 seconds of faster walking or adding incline to your routine—can provide the necessary cardiovascular stimulus without requiring a complete fitness overhaul.