2022 Issue 3, Quarterly Newsletter


A newsletter from El Camino Women’s Medical Group

2022, Issue 3www.ElCaminoWomen.comJuly 1, 2022

Happy July 4th!   I hope everyone was able to enjoy the long holiday and time with loved ones.   With the major events in the news, it’s an important time to reflect on the history of this country and the famous words that have marked this day in history: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” As beautiful as these words are, it has been two centuries of Americans fighting to make sure that “all men” includes each one of us. May we all be a part of the cause of equal and full rights for every American, that the pursuit of happiness truly be within reach of each one of us.

After a very rough start to 2022, we’re looking forward to summer and the leisure time it brings.  With high rates of vaccination and changing strains of COVID19, we’re seeing so much more openness this summer.  I hope everyone takes advantage of an almost normal summer!  Please remember to stay up to date on COVID19 vaccination and booster shot recommendations as well as testing quickly when you have any symptoms.

As you are out and about, please don’t forget your sunscreen and hats!  In past articles, Dr. Soohoo, Board Certified Dermatologist has written on the importance of sunscreen for our skin, and Dr. Singhal, Board Certified Surgical Oncologist has written about the value of hats to protect our hair.

Visitors continue to be welcome in the office and hospital.  You can read more in our Practice Updates and the Hospital Visitors Policy sections.

Between summer schedules and the common challenges of health and family, we are having some fluctuation with our physician schedules this summer.  We appreciate everyone’s flexibility with schedule adjustments and on-call physician schedules.

On a more serious note, it’s been a little over a week since the release of the Supreme Court’s ruling in Dobbs vs Jackson.  There are a lot of very strong emotions around the outcome of this ruling and we at El Camino Women’s Medical Group fully stand behind every woman’s right to full autonomy over her own body.  There are many formal statements from physician groups, nursing groups, and medical organizations, we’ve compiled several of them on our blog.  We are grateful to be in California where this ruling does not currently impact our patients’ access to the full range of women’s health care services.

Finally, please follow us on social media to stay up-to-date on health care issues affecting women and news from our practice. You can find us on Facebook, Twitter, LinkedIn, or Instagram.

As always, feedback is welcome regarding our practice, customer service, and even this newsletter!

Wishing you a restful and joyful summer with your family and loved ones.

Sarah Azad, MD

In this issue:

Practice Updates

Online Prenatal Classes

Research at ECWMG

Asian Skin Care

What Exactly is Ramsay Hunt Syndrome

COVID-19 and Pregnancy Update

Common Myths About Breast Cancer

Vulvar Pain–Vulvodynia

El Camino Hospital Visitor Policy Updates

Highlights from our Women’s Health Blog

Practice Updates

Physician Schedules

Due to summer vacations and other leaves of absences, our summer schedules may be tighter than usual this summer.  We appreciate your patience as we try to balance the needs of our patients with our staff’s personal and family needs.

Office Visitor Policy Updates

We are continuing to welcome one visitor at patient appointments.  Please remember visitors must be fully vaccinated against COVID19, including a booster (if it’s been more than six months since 2nd COVID19 vaccine).   Though this is stricter than the guidelines at the hospital, visits to our office are not as acute or emergent as what happens in the hospital.  Our priority remains the health and safety of our pregnant and immunocompromised patients.   We appreciate everyone’s patience and understanding over the last two years.   Masking is still required in Santa Clara County in all healthcare facilities.


Don’t forget to follow us on social media to stay updated on office information and women’s health topics.  You can follow us on Facebook, Twitter, LinkedIn, or Instagram.  Your feedback on our office practices and physician and staff communication is always welcome.

Barb Dehn, NP

Just a reminder that Barb Dehn, NP is no longer working directly under El Camino Women’s Medical Group but has a new business structure allowing her to focus more on longer, more education-based appointments.  You can read more in our January newsletter.

Online Prenatal and Women’s Health Classes

Prenatal Classes

We are now offering four virtual prenatal classes a month online.    These classes cover preparing for childbirth, breastfeeding, and newborn care.   These classes have been very popular, and we plan to have them every month.  They are also available for women interested in signing up, though we prioritize our patients.

Virtual Breastfeeding Class

This is a 2-hour class presented by Nadia, RN, our lactation educator.  The class is a virtual, in-depth review of breastfeeding.  Learn how to get the best start, avoid pain, make sure your baby is getting enough, and when to ask for help!

 Virtual Newborn Care & Safety Class

2.5-hour class presented by Nadia, RN

Practical tips for caring for a newborn

  • Appearance of newborn
  • Normal skin conditions
  • bathing & diaper changing
  • safe sleeping
  • Newborn safety:
    • Car seat safety
    • Choking hazards
    • Poison control
    • Childproofing your home

Childbirth Preparation Part One

2.5-hour class presented by Nadia, RN:

  • The last month of pregnancy
  • Preparing for the hospital
  • Laboring at home, when to call and when to come in
  • Admission to the hospital
  • Active labor
  • Pain management

Childbirth Preparation Part Two

2.5-hour class presented by Nadia, RN:

  • The last stage of labor: pushing
  • Vaginal delivery
  • Cesarean delivery
  • Initial recovery in the hospital
  • The postpartum period

You can learn more about these classes or register here.

Pregnancy Q&A Webinars

We started hosting these in July of this year, and they have been very successful.  We will continue these once every 1-2 months for our pregnant patients.   Every webinar will start with 1-2 common topics that are important to understand in pregnancy and most the session is just open Q&A for women who have questions, general or specific.  No personal questions will be answered during the Q&A and they do not replace the wonderful prenatal classes that are offered every 1-2 months.

Research at ECWMG

Materna Study

We’re well into our trial with the MaternaPrep device!  In the planning stages for a few years, we’ve had several patients successfully complete the process on Labor and Delivery.  It is exciting to help study the possibility of helping women preserve their pelvic floor function. This NIH-funded trial will look at the device’s safety and ability to reduce pelvic floor injuries and the length of labor in first-time mothers.  We are actively enrolling women now.  Reach out to moc.n1709359324emowo1709359324nimac1709359324le@of1709359324ni1709359324 if you are interested in more information.


Next Gen Jane

Another interesting new technology is being developed by NextGen Jane, a research company based in the Bay Area, to build a safer, more accurate method for non-invasive prenatal testing that can be done as early as six weeks of gestation. The study involves wearing an organic tampon for 20-60 minutes.   Wearing tampons during pregnancy is safe and does not carry any adverse effects. To participate in their study, scan the QR code below or contact NextGen Jane directly, and they will help you start the process. They will ship you a kit with all the instructions and assist you with the consent process. To thank you for your participation, NextGen Jane will provide you with a $25 amazon gift card for every sample tampon you send in.

Asian Skin Care

Lillian Soohoo, MD
Board Certified Dermatologist

In this article, I will share my experience treating Asian patients over the years and examine some of the specific concerns regarding Asian skin. The topics will include a discussion of the characteristics of Asian skin, sun protection, and specific tips to improve the appearance of aging skin.

The US Census in 2020 reported nearly 20 million people of Asian descent in the US.  An additional 4 million respondents identified as being Asian in combination with another race.  Thus, the total Asian American population in 2020 was about 24 million people or 7.2% of the total US population. This represents an increase of over 2 million Asian Americans compared to the 2018 US census (Figure 1).

Image of Asian Population in US

(Figure 1, 2018 US Census)

The US government predicts that Asian Americans will total 40 million people by the year 2050. Although typically classified as a largely homogenous population in US political discourse, Asian Americans represent many nationalities and cultures. General physical characteristics of Asians are well-known and recognized worldwide as dark brown to black hair and dark eye color. These are gross generalizations that are rapidly becoming less relevant due to interracial mixing and fashion trends. There is also much diversity in the degree of skin pigmentation in Asians and this ranges from very light, pale skin to more medium and deeper brown skin tones.

So…what is different about Asian skin?

Characteristics of Asian Skin

Asian skin has an increased amount of melanin (or dark brown pigment) as well as the melanin-producing cells known as melanocytes.  Asians in general have more melanin and more numerous melanocytes in the skin compared to Caucasian skin. Even fair-skinned Asians have more melanocytes than most Caucasians.  These pigment-producing cells or melanocytes in Asians tend to be more sensitive to ultraviolet light (UV), such as the sun and tanning booths.

In Asians, pigment-producing melanocytes are also more easily stimulated to make brown pigment in response to any type of skin irritation or inflammation such as pimples, insect bites, rashes, cuts, and scratches. So all of these factors: sunlight, irritation, inflammation, and trauma, will result in more brown pigment (darkening) in Asian skin as compared to Caucasian skin.

This tendency for Asian skin to produce more brown color is noticeable as the unwanted brown spots are caused by pimples, bug bites, and other sources of skin irritation.  This is known in dermatology as post-inflammatory hyperpigmentation (PIH).  Asians and other darker skin types share this skin characteristic of post-inflammatory hyperpigmentation whenever there is skin trauma and inflammation.

Another big difference in Asian skin as compared to Caucasian skin is in the dermis. This is the second layer of skin below the topmost layer, known as the epidermis. The dermis is the deeper second skin layer that contains most of the collagen-producing cells and also contains blood vessels.

Asians have thicker skin because we have a thicker dermis due to larger and more numerous collagen-producing cells (known as fibroblasts) in this second layer of our skin. All those extra fibroblasts produce extra collagen which helps to preserve our skin’s elasticity.  This means less obvious wrinkling and sagging from aging and sun damage.  This also helps explain why sun damage typically appears 10 to 20 years later in Asians as compared to Caucasians.

The downside to having more collagen-producing fibroblasts in the dermis is the increased tendency in Asians to form thick, rubbery keloid scars after skin injury, such as surgery. These thicker keloid scars can grow to be even larger than the original wound and can become extremely itchy and unattractive. In Asian women, for example, the surgical scar from childbirth after a cesarean section is quite common and may be unsightly and itchy for years.

Types of Skin Aging

Aging is a biological reality. Asians show signs of skin aging much later, about 10-20 years later than Caucasians. The changes appear early on as brown spots and discoloration of the skin.  It progresses to rougher skin with uneven texture.  Sagging of the skin is due to loss of skin elasticity and gravity results in the descent or “falling down” of the midface.  In Asians, this results in further flattening of the cheeks under the eyes and sagging of both the upper and lower eyelids. This commonly causes jowls or sagging at the jawline and upper and lower eyelid bags. Eyes also gradually appear smaller in size due to drooping of the upper eyelids.  Wrinkles form as a much later sign of aging in Asians.

There are two types of skin aging. The first type of skin aging is called chronologic or intrinsic aging which occurs naturally with just the passage of time.  Usually, the skin is unblemished with only fine wrinkles and loss of fat or thinning of the skin. This type of skin aging is often delayed in Asians, mostly because of a thicker dermis. An example of purely chronologic or intrinsic aging on your own body is easy to see. Look at the clothing-covered areas of your body such as the buttocks or in women, the breasts. Since these areas are not exposed to the sun or environment, your skin may look the same in these areas as you did in childhood.

The second type of skin aging is environmental or extrinsic aging, which is primarily due to environmental factors such as health status and lifestyle habits such as sun exposure, tobacco, alcohol use, and diet. These environmental or external factors are by far the most important determinants of skin aging.  Environmental factors such as sun exposure and smoking significantly accelerate the aging of the skin. The face can look decades older than covered areas of the body which are protected from daily sun exposure.

It is estimated that 90% of the skin changes associated with aging are due to ULTRAVIOLET or UV exposure to sunlight.

So how can you prevent most skin changes associated with aging? Avoiding the sun is the best way.

Protecting Your Skin from the Sun

The most effective way to protect your skin from the effects of sun exposure are all of the following:

Clothing: UPF  is the measure of how much ultraviolet protection is given to clothing, hats, and fabrics.  This number indicates what fraction of the sun’s UV rays can penetrate the fabric. A shirt labeled UPF 50 allows 1/50th of the UV radiation to reach your skin. The higher the UPF, the better. In general, The darker the fabric color and the tighter weave of your clothing fabric is best.  A white t-shirt that is light in color and has a relatively loose weave only provides a UPF of 4 to 6 and when it gets wet, and the fibers stretch out, even more, its UPF is reduced to about 2. Appropriate clothing with at least a UPF of 50 will always be superior to sunscreen for skin protection since it is a more consistent and effective barrier to UV.

Shade is the obvious best choice for sun protection, but not always considered.  If possible, schedule your outdoor activities (such as children’s pool parties and swim lessons) outside the peak daylight hours of 10 am to 4 pm.  Even outside these peak times, you will be exposing your skin to damaging UV rays.  If you can see light through your shade, you are still receiving UV radiation.

Sunscreen affords important sun protection but is not as effective as most people believe. SPF stands for sun protective factor and refers only to protection from UVB rays, not UVA rays, which are also present in sunlight and can cause premature aging and skin cancer. Daily sunscreen use has been shown to reduce the risk of developing all forms of skin cancer by 50%. A broad-spectrum sunscreen blocks both UVB and UVA. Using one with an SPF of at least 30 is the best and you should reapply every 2 hours or after sweating or toweling off when swimming. Most people do not apply enough to receive the actual SPF on the label since it takes a shot glass full of sunscreen (six teaspoons) to adequately cover the body. Sunscreen should never be considered complete skin protection.

Sunscreen ingredients can be confusing, but knowing the difference is important so you can select the right one for you. Zinc-oxide-containing sunscreens are better for sensitive skin. Zinc-oxide is a non-irritating mineral that covers the skin like a blanket to block the sun’s rays.  This is different from chemical sunscreen ingredients such as oxybenzone, avobenzone, and others (eg, octisalate, octocrylene, homosalate, and octinoxate). These chemical sunscreen ingredients actually absorb UV rays away from skin cells. Chemical sunscreens should be applied at least 20 minutes before sun exposure so that they can be adequately absorbed into the skin. Many of these chemical ingredients can be irritating or cause allergic rashes in people with sensitive skin.

Remember that wearing sunscreen, whether mineral (zinc-oxide) or chemical, is better than not wearing sunscreen at all. It is well-established that sunlight is cancer-causing and that protection from all forms of UV will reduce the chances of developing skin cancer.  Also, it is not known if there are any long-term consequences of using chemical sunscreen ingredients. My personal preference has always been to stick to zinc-oxide-only sunscreens, if available.  Zinc-oxide is as effective as chemical sunscreen ingredients and is formulated such that it cannot be absorbed through the skin. There are many brands of zinc-oxide-only sunscreens that you can Google, just be sure to read the label to make sure you know what you’re applying to your skin.

And finally, always go see your dermatologist for an annual total body skin check.  This is recommended by The American Academy of Dermatology for all adults.  Skin cancer is the most common type of cancer in humans and early detection can be lifesaving.

Improving Skin Appearance

The number one anti-aging tip is to protect your skin from all sources of UV light, especially the sun. Remember that 90% of aging changes in the skin such as freckles, wrinkling, and roughness are due to photodamage from sunlight.

Avoiding skin irritation is also advisable since post-inflammatory hyperpigmentation or darkening can occur easily in Asian skin. Remember that it is important to use non-irritating skin products for routine and cosmetic skin care. You should also treat common inflammatory skin conditions such as acne to avoid undesirable brown spots.

Asian individuals frequently seek cosmetic skin treatments to achieve smooth skin and flawless complexions, but careful consideration to prevent scarring and hyperpigmentation due to irritation is essential.

Avoid fads and always consult an experienced dermatologist for skin care guidance to ensure that you are using the right products for your skin.

Many over-the-counter skin care products aimed at removing unwanted brown spots and other signs of skin damage just don’t contain sufficient levels of active ingredients to provide the most effective results.  For example, most skin-lightening products available at the dermatologist’s office are far stronger in concentration while also formulated to be gentler to the skin than the products you find at high-end department stores or online. Dermatologists can create an individualized skin care plan for you to target your specific skin concerns while taking into consideration your Asian skin type and skin sensitivities as well as your lifestyle.

Procedures such as chemical peeling, laser or light treatments (Fraxel, Clear and Brilliant, PiQO4 laser, Intense Pulsed Light of IPL), and even liquid nitrogen (freezing) are all effective in improving brown spots, but only when performed under the direction of an experienced dermatologist who has extensive knowledge of Asian skin and the risks for post-inflammatory hyperpigmentation.

In most cases, pretreatment of the skin with the use of prescription-strength topical fading products both before and after the chemical peel or laser treatment is strongly recommended in Asians to ensure the longest-lasting results. It is important to remember that meticulous sun protection of your skin is as important as any treatment choice when considering the removal of brown spots in Asian skin.

Dr. Lillian Soohoo is a board-certified general and pediatric dermatologist who has been practicing in Silicon Valley for over 25 years.

Lillian Soohoo, MD
Board Certified Dermatologist
The Menkes Clinic, Medical, Surgical, Pediatric & Cosmetic Dermatology
2490 Hospital Drive Suite 201,
Mountain View, CA 94040

What Exactly is Ramsay Hunt Syndrome

By Katrina Chaung, M.D.
Board Certified ENT

By now, you have probably heard of a certain famous singer recently afflicted with Ramsay Hunt Syndrome.  But what exactly is this syndrome with the funny name?

Through his work in the early 1900s, Dr. James Ramsay Hunt contributed significantly to our understanding of the nervous system.  He described symptoms of paralysis of the face associated with a specific rash by the ear or mouth which became known as Ramsay Hunt Syndrome.

Ramsay Hunt Syndrome is caused by the same virus that causes chickenpox (varicella-zoster virus).  After you recover from chickenpox, the virus continues to live in the body along nerves.  The virus can reactivate and cause a shingles outbreak.  With Ramsay Hunt Syndrome, this reactivation occurs along the facial nerve (the nerve that helps you close your eyes, raise your eyebrows and move your forehead, smile, pucker your lips, and wrinkle your nose), causing one side of the face to become weak or even paralyzed.  This is usually accompanied by a painful blistering rash in our around your ear, face, and/or mouth.  Sometimes, you can also have other symptoms including hearing loss, ringing in the ears, ear pain, dizziness or vertigo, and change or loss of taste.  Anyone who has had chickenpox could develop Ramsay Hunt Syndrome but it is usually seen in older adults over age 60.

The rash will resolve after some time; the paralysis of the face and other symptoms including hearing loss can be temporary but in some cases may be permanent.   Starting antiviral medications and oral steroids as soon as possible, ideally within 72 hours, can help to decrease potential long-term complications and improve the chance of recovery.

While Ramsay Hunt Syndrome itself is not contagious, if you have an active rash, you can cause chickenpox in people who have not had it previously or have not been vaccinated against it.  This can be dangerous in newborns, pregnant women, and those with weakened immune systems.  Fortunately, vaccination against chickenpox is now routine in children which decreases the chance of becoming infected with the chicken pox virus and the shingles vaccine is also recommended for those over age 50.

Katrina Chaung, M.D.
Board-certified, Otolaryngology-Head and Neck Surgery
2495 Hospital Dr.
Suite 450
Mountain View, CA 94040
(650) 988-4161

COVID19 and Pregnancy Update

Sarah Lee, MD
Maternal-Fetal Medicine Specialist

It is year 4 of COVID-19, and we are now in the phase of the numerous variants and sub variants of the SARS-CoV-2 virus. With each subsequent variant, the virulence of the SARSCoV-2 virus is declining.

Pregnant women are not at increased risk to contract SARS-CoV-2 than non-pregnant women, but pregnancy is a risk factor for severe illness from COVID-19. Fetal congenital anomalies do not appear to be increased with maternal COVID-19 illness.

Vaccination including booster is the best defense against COVID-19 in pregnancy. Women should receive this vaccination at any time preconception or at any trimester in pregnancy.

Routine precautions as mandated by local county guidelines such as mask and hand hygiene are always prudent. A word of caution however on wearing gloves. Gloves are supposed to be used as one time and used in the healthcare setting. There are some in the general public who continue to wear gloves in grocery stores or at doctor’s visits and may falsely believe that this prevents disease. Gloves may facilitate transmission in the general public setting. Frequent hand hygiene is the best.

Treatment for COVID-19 continues to evolve.

  • For the great majority of patients who are asymptomatic or have mild upper respiratory symptoms, supportive measures such as Tylenol for fever and other over-the-counter medications to manage symptoms are sufficient and safe. Medications in the category of non-steroidal anti-inflammatory drugs (NSAID) such as Motrin and Advil should be avoided and not used during pregnancy without the advice of an OBGYN.
  • During the Delta and Omicron variant, monoclonal antibody therapy (Sotromivab) was available for pregnant women with mild to moderate COVID-19.
  • The dominant variant in the United States currently is Omicron (B.1.1529). Sotromivab is not effective against this variant. There is a newer monoclonal antibody therapy (Bebtelovimab), but the National Institute of Health (NIH) guideline is to use Bebtelovimab as a second-line agent when Paxlovid or Remdesivir is not available.
  • Paxlovid is safe in pregnancy and recommended for pregnant patients with mild-moderate COVID-19.
  • Local pharmacy websites on Paxlovid are often not up to date. It is best to contact the nearest pharmacy to confirm Paxlovid availability.
  • All pregnant women managed at home for COVID-19 should seek immediate help if there is shortness of breath, continued fever despite Tylenol or other worsening symptoms including decreased fetal movement.

Pregnancy follow-up post-COVID-19 is usually routine prenatal care. For those with moderate-severe COVID-19 such as those who were hospitalized or required initial evaluation at the hospital, fetal assessment via ultrasound is advised usually 1 to 2 weeks after recovery.

Sarah Lee, MD
Maternal-Fetal Medicine Specialist
Obstetrix Medical Group
Campbell, CA

QR Code leading to Obstetrix Website

Common Myths About Breast Cancer

Denise Johnson Miller, MD, FACS
Breast Surgeon and Surgical Oncologist
Medical Direct of Breast Surgery at El Camino Health

Summertime is here and we wanted to provide some “light” summer reading about breast cancer in a format that is easy to follow.   These are statements and questions we breast cancer specialists often receive after giving an educational seminar.


Myth: If I eat a healthy diet , exercise  and do not smoke or drink alcohol , I will not get breast cancer
Fact: There are many things you can do to reduce your risk of breast cancer, but even if you do everything right, there’s no guarantee that you won’t get the disease. Breast cancer is largely due to random mutations that happen when cells divide

Myth: Breast cancer is only a problem for women over the age of 50.
Fact: While the majority of breast cancer cases are diagnosed in women over the age of 50, this disease can affect women of any age. In fact, breast cancer is the most common type of cancer diagnosed in women under the age of 40.

Myth: Only women with a family history of breast cancer are at risk.
Fact: While having a family history of breast cancer does increase your risk, the majority of women who are diagnosed with breast cancer do not have a family history of the disease. In fact, only about 15% of women who are diagnosed with breast cancer have a family history of the disease.

Myth: Breast cancer is caused by exposure to chemicals
Fact: While some chemicals may increase your risk of developing breast cancer, the vast majority of cases are not caused by exposure to chemicals. Radiation called mantle field radiation is associated with the treatment of Hodgkin’s lymphoma

Myth: Breast cancer is contagious
Fact: Breast cancer is not contagious. You cannot catch it from someone else.

Myth: Mammograms cause cancer
Fact: Mammograms do not cause cancer. In fact, they are an important tool in the early detection of breast cancer. Early detection is key to successful treatment.

Myth: All breast lumps are cancerous
Fact: Not all lumps in the breast are cancerous. In fact, most lumps are benign (non-cancerous). However, if you have a lump in your breast that is new, persistent, and/or growing, you should see a doctor to have it checked out.

Myth: Breast cancer is a death sentence
Fact: While breast cancer can be a serious disease, it is not always fatal. In fact, the five-year survival rate for women with breast cancer is about 90%. With early detection and treatment, the survival rate for breast cancer increases to 99%.

Myth: If you have dense breasts, you are more likely to develop breast cancer
Fact: While dense breasts do increase your risk of developing breast cancer, the vast majority of women with dense breasts do not develop the disease. In fact, only about 20% of women with dense breasts will develop breast cancer.

Myth: Breast implants cause cancer
Fact: There is no evidence to support the claim that breast implants cause cancer. However, some studies have suggested that women with breast implants may be at a higher risk of developing a rare type of cancer called anaplastic large cell lymphoma (ALCL).

Myth: Wearing deodorant causes breast cancer
Fact: There is no scientific evidence to support the claim that wearing deodorant causes breast cancer. However, some studies have suggested that exposure to certain chemicals found in deodorants and antiperspirants may increase your risk of developing breast cancer.

Myth: Underwire bras cause cancer
Fact: There is no scientific evidence to support the claim that underwire bras cause cancer.

Myth: Breast cancer is always detected through screening mammograms
Fact: While mammograms are the best tool we have for detecting breast cancer, they are not perfect. In fact, about 20% of breast cancers are not detected by mammograms.

If you have any concerns about breast cancer, be sure to talk to your doctor. Early detection is key to the successful treatment of breast cancer. mammograms are the best tool we have for detecting breast cancer, but they are not perfect. There are other imaging techniques such automated breast ultrasounds, targeted breast US ( focussed on a palpable lump ) and breast Magnetic Resonance Imaging which aid in detecting breast cancer.

Myth: You can’t do anything to prevent breast cancer
Fact: While there is no surefire way to prevent breast cancer, there are some things you can do to reduce your risk. For example, you can limit your alcohol intake, maintain a healthy weight, and exercise regularly. You can also talk to your doctor about taking certain medications, such as tamoxifen or raloxifene, which have been shown to reduce the risk of breast cancer if you have an increased lifetime risk of developing breast cancer because of family history, prior breast biopsies showing atypical ductal hyperplasia for example.

Myth; Biopsy spread cancer cells
Fact: There is no evidence to support the claim that a biopsy can spread cancer cells. A biopsy is a medical procedure in which a small sample of tissue is removed from the body for examination.

Biopsies are important because they can help confirm whether or not you have cancer. However, it is important to remember that biopsies are not perfect. In some cases, a biopsy may fail to detect cancer. In other cases, a biopsy may incorrectly detect cancer.

While there are some risks associated with biopsies, they are typically very small. In most cases, the benefits of a biopsy far outweigh the risks.

Myth: Eating sugar will cause cancer to grow

Fact: There is no scientific evidence to support the claim that eating sugar will cause cancer to grow. However, some studies have suggested that a high-sugar diet may increase your risk of developing certain types of cancer.

Breast Cancer Prevention- Reducing your breast cancer risk

The best way to reduce your risk of breast cancer is to live a healthy lifestyle. Eating a healthy diet, getting regular exercise, and maintaining a healthy weight are all important ways to reduce your risk of developing cancer. In addition, avoiding alcohol and limiting your exposure to certain hormones can also help reduce your risk. By making these lifestyle choices, you can help keep yourself healthy and reduce.

  • Early detection is key – get breast cancer screening regularly and know your family history
  • Avoid alcohol and smoking
  • Eat a balanced diet with plenty of fruits and vegetables
  • Breastfeed your baby if you can
  • Consider taking supplements such as vitamin D and calcium
  • Diet and exercise can help reduce your risk of breast cancer
  • Avoid processed foods and sugary drinks because they add weight
  • Exercise regularly – at least 30 minutes per day
  • Get enough sleep each night
  • Genetic Testing

We hope this article has helped to clear up some common misconceptions about breast cancer.   We want you to reduce the risk of developing breast cancer by modifying lifestyle changes in areas that we can control.

Remember, if you have any concerns about your risk for breast cancer, be sure to speak with your doctor.

All information obtained from American Cancer Society and National Cancer Institute.

Denise Johnson Miller, MD, FACS
Breast Surgery
Surgical Oncology
Medical Director of Breast Surgery
El Camino Health
2500 Hospital Dr. Bldg 15 Suite 1
Mountain View, CA 94040
O: 650-641-7861
F: 650-963-5071

Vulvar Pain–Vulvodynia


A common problem affecting women is pain in the area of the vulva.  Often noted when trying to insert a tampon or have sex, many women don’t realize this is an actual disorder with a medically standardized name: vulvodynia. Vulvodynia is defined as “pain that lasts for 3 months or longer and is not caused by an infection, skin disorder, or other medical condition.”

Women commonly describe the pain as raw, itching, burning, or stinging.   Other ways the pain may be experienced can be swelling, soreness, or irritation.   These symptoms may be there all the time, or only on contact.  Vulvar symptoms alone are not sufficient for a diagnosis.  Pain is a symptom that needs to be evaluated by a gynecologist.  If evaluation yields no discernable cause, and the pain continues for more than three months, that’s when it’s important to consider vulvodynia as a diagnosis.

The vulvar pain of vulvodynia may only affect the vulva in a specific place, it may affect the entire vulva, or it may also affect the area between the vulva and the anus, this is called vestibulodynia.

Evaluation includes an examination of your vulva and vagina.  There may also be a test done on your discharge.  Sometimes a biopsy of the vulva is needed.

Some of the causes of vulvodynia include nerve damage, inflammation, changes from chronic infections, genetic disorders, disorders that also affect muscles and bones, and rarely a genetic disorder or food sensitivity.

If this sounds like something affecting you, please reach out to your gynecologist.  There are a lot of treatment options from medications to physical therapy to injections.  Sometimes evaluation by a urogynecologist or vulvar dermatologist can be helpful.

The National Vulvodynia Association and the International Society for the Study of Women’s Sexual Health are both wonderful resources for more information.

El Camino Hospital Visitor Policy Updates

General information on visitor’s policy (effective June 13, 2022)

For the main hospital, El Camino Health is now allowing two visitors in nearly all inpatient units.  Check the link above before you plan to come to the main hospital for any new updates.

All visitors must be over the age of 16 (18 for the ED), have proof of COVID19 vaccination status, or proof of a negative COVID19 test performed no more than 48 hours prior.  For complete details, click here.

Masking is still required in all health care facilities in Santa Clara County.

Information for Labor & Delivery, NICU, and the Mother-Baby Unit:
Last updated June 13, 2022

Since December 2021, only one visitor (in addition to a doula) is being allowed on L&D, and it must be the same visitor for the entire time on L&D.   However, two visitors are now allowed on the postpartum unit.  The NICU continues only to allow the parents of the newborn to visit.   All visitors must have proof of vaccination or proof of a negative COVID19 test performed no more than 48 hours prior (24 hours if it’s an antigen test).   There is a one-time exemption for an unstable situation (for maternal health or newborn health) until the patient is stable, at which time a visitor not meeting requirements will be asked to leave and return with a negative test.

For more complete details, click here.

As we all know, this pandemic has been in several different phases with several different recommendations, so these visitor policies may change.  At no point during the pandemic has El Camino Hospital prevented laboring or postpartum women from having at least one visitor with her that met requirements.


Our Women’s Health Blog remains a very popular part of our website, attracting at least a thousand readers a month worldwide.  We find it helpful to put out up-to-date information on women’s health issues.  Most recently we’ve shared formal statements on the Supreme Court’s June 24th ruling on Dobbs vs Jackson case.  Showing that in healthcare, physicians and nurses remain steadfast in our support of a woman’s right to full autonomy over her body.  Last quarter, our two most popular articles are the same as the previous quarter, likely boosted by this same highlights section from last month.  The first by guest author Dr. Shyamali Singhal on avoiding cancer-causing chemicals in cosmetics.  The second another blog favorite: Stop Eating all The Time: Snacking and Intermittent Fasting. The third was also by Dr. Singhal, on Keeping your Self-Esteem up after a Mastectomy.

We update our blog at least a few times a month with information on all kinds of women’s health issues.  Follow us on Facebook, Twitter, LinkedIn, or Instagram to be informed when we post new articles and stay updated on the latest in women’s health.


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Mountain View, CA 94040



pop up imaging stating that ECWMG is not accepting new patients starting 3/1 and you can ask to be put on a wait list.