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Table of Contents 


Breast Cancer: Risks and Diagnosis


POF - What is it?


Healthy Living: Run for Rob


Meet the Staff


Office Announcements  


Join Our List
Join Our Mailing List


Our Offices


101 Old Short Hills Rd
Atkins-Kent Building, Suite 101
W. Orange, NJ 07052


33 Overlook Rd.
MAC Building
Suite 108
Summit, NJ 07901

731 Broadway
Bayonne, NJ 07002



1119 Raritan Road
Clark, NJ 07066


Robert J. Rubino,

M.D., F.A.C.O.G.


Audrey A. Romero, M.D., F.A.C.O.G.


Lisa Abeshaus,
M.D., F.A.C.O.G.
Jacqueline Saitta, M.D., F.A.C.O.G.

Allan D. Kessel,
M.D., F.A.C.O.G.
Diana Huang,
M.D., F.A.C.O.G.
Priya R. Patel,
Howard D. Fox,
D.O., F.A.C.O.G.
Heavy, Painful Periods?    


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Medical Fact

 "I didn't know that!"


Breast cancer is the most common cancer in women worldwide. It is estimated that more than 1.6 million new cases of breast cancer occurred in women worldwide in 2010 (most recent data available). 

One in eight women will be diagnosed with breast cancer in their lifetime.


It is easy to recognize, with pink ribbons everywhere you look, that October is breast cancer awareness month. We dedicate this issue to all woman who have faced breast cancer either personally or with someone close to them. It is encouraging to know so much effort is being done to support the cause.
In this month's newsletter, Dr. Patel authors an article on breast cancer risks and screening. We also provide information on POF - Premature Ovarian Failure and what it means for reproduction. In our Healthy Living section, we introduce Run for Rob and review the benefits of having a health goal, such as running a 5K for a good cause. In addition, in our Meet the Staff section, we introduce a new medical technician, Yolanda Milan, to the group. And, you'll find a new interesting "Medical Fact". 
If there is topic you would like covered in our newsletter, please e-mail us at


As always, we will continue to provide topics that are current, informative and important to your good health.  

The Rubino OB/GYN Group

Angelina, Gail and Every Woman's Name Here:________Bcancer

By Dr. Priya Patel

In one way or another, it is likely that most women in this country have been exposed to some aspect of breast cancer. Whether it is through a personal struggle or an affected mother, grandmother, sister, daughter, close friend or simply from the pervasive pink ribbon culture that classy-laptop-woman.jpg survivors, caregivers and supporters have so passionately nurtured, awareness is at an all-time high.



While much focus over the last few decades has been on screening to prevent advanced stage disease, awareness should also include understanding risk. This year, Angelina Jolie's op-ed article in the New York Times titled "My Medical Choice" highlights this fact in a significant way. Knowing her family history was strong, genetic testing revealed she was a carrier of the BRCA1 gene. Having it predisposes an individual to an approximately 65% chance of developing breast cancer. However Angelina's personal risk was sharply higher at 87% taking into account additional risk factors. Even though <10% of all breast cancers are a result of these inherited gene mutations, it is an important reminder that awareness of personal risk matters. Who should be tested for the BRCA mutation?


Are you Ashkenazi Jewish?

If yes, and

  • Any 1st degree relative with breast cancer or ovarian cancer
  • Two 2nd degree relatives on the same side of the family with breast cancer or ovarian cancer

If no, and

  • Two 1st degree relatives with breast cancer, 1 diagnosed < age 50
  • More than two 1st or 2nd degree relatives w/breast cancer, regardless of age at diagnosis
  • 1st degree relative w/bilateral breast cancer
  • More than 1 1st/2nd degree relatives w/ ovarian cancer, regardless of age at diagnosis
  • 1st or 2nd degree relative w/ both breast and ovarian cancer
  • History of breast cancer in a male relative


In looking through the multitude of articles in press currently regarding breast cancer, I came across an interesting term: Pre-Vivor. Cancer "previvors" are individuals who have a known predisposition to cancer either through a genetic mutation, family history or any other risk attribute but have not had the disease, often because of preventative measures. In the case of Angelina Jolie, this was achieved through a double mastectomy which reduced her seemingly insurmountable risk to <5%. And so while October is National Breast Cancer Awareness Month, perhaps much less known is that October 2, 2013 is National Previvor Day.


Though the term was born to identify those with some form or hereditary predisposition, in truth if you are a woman, you are living with the risk of breast cancer and the goal is to pre-vive if at all possible. After all, though the risk is dramatic if you have a genetic predisposition, for the remaining 90% of women, 1 in 8 will still develop breast cancer in her lifetime. In 2013, it is estimated that approximately 234,580 women will be diagnosed with invasive breast cancer and 40,030 women will die from the disease. It is the 2nd leading cause of cancer death in women although in fact death rates have been declining since 1990 for several reasons. These include advanced treatment options, earlier detection through refined screening methods and simply put the goal of the month: AWARENESS.



This is where Gail comes in. In order to facilitate awareness of personal risk, several prediction tools have been developed that incorporate risk factors. These tools can then be used to determine optimal screening strategies to help survival as well as possible therapies for even previval. The most commonly used of these is the "Breast Cancer Risk Assessment Tool", more often known as the Gail Model. Using this tool, one can calculate an individual woman's risk of developing breast cancer over the next 5 years and until age 90 based on:

  • Current age
  • Age at first menstrual cycle
  • Age at first live birth
  • Number of 1st degree relatives with breast cancer
    • 1st degree relatives include a Mother/Sister/Daughter
  • Number of previous breast biopsies
  • If any of the breast biopsies showed atypical hyperplasia
  • Race

This tool is intended for women without a strong family history suggesting inherited breast cancer. Therefore it would not apply to women with more than two 1st degree relatives with breast cancer. When the Gail model suggests a higher risk category, or if there is a strong family history of breast and/or ovarian cancer, further risk stratification would be discussed with your physician with the goal of incorporating family history in order to determine need for genetic counseling. It is important to remember the limitations of these types of models, however, as all important risks have not yet been identified and that most of the risk factors are not as strongly associated with breast cancer as age and having the BRCA genes. In addition, it doesn't take into account certain risk factors such as breast density. Hence this is just one of many ways to start the discussion of personal risk however it must end with a thorough discussion with your physician to factor in clinical judgment thus allowing individual counseling.


Every Woman

Breast Cancer Awareness Month in conjunction with National Previvor Day reminds us that every woman is at risk. As discussed in this article, awareness means knowledge of the variables that may increase or decrease that risk. Below, you will find a table that briefly identifies both harmful and protective factors in descending order.  
























Awareness and Beyond

Awareness of risk can extend the quantity of life by decades for some previvors. However as the table above shows, every woman can modify her personal risk and perhaps one of the greatest advents in improving breast cancer has been early detection with mammograms leading to many more survivors as well. Here are some updates and tips regarding our recommendations for screening which are congruent to the guidelines set forth by the American College of Obstetricians and Gynecologists:

  • Breast SELF-EXAM and breast SELF-AWARENESS has always and will always continue to be a way to find changes in your own breasts.
    • The BEST time to perform breast self-exam is at the end of your menses, or about 5-7 days after the 1st day of your cycle.
    • This is when breasts are least lumpy.
    • If you have irregular menses, pick 1 day a month and stick to it.  
  • Mammograms are sufficient screening in most women.
    • We recommend yearly screening along with breast exams in the office starting at the AGE OF 40. 
  • MRIs may be helpful in some cases of women who are at a high risk of breast cancer.
    • Known BRCA mutations carriers
    • 1st degree relatives of known BRCA mutation carriers
    • A lifetime risk of breast cancer greater than 20-25% based on prediction models that INCLUDE family history 
  • Never assume your mammogram was normal: You should always hear back from the radiologist about your results. If you do not, call our office and we will help you.  
  • Remember: In approximately 90% of women with an abnormal mammogram, breast cancer is NOT found.
    • However an abnormal mammogram will require further imaging or testing 
  • When should you stop?
    • Everyone has a different opinion.
    • However we recommend screening AT LEAST until age 75.
    • Beyond this, the decision to continue or stop can only be made after consulting with your physician and assessing your individual risk.


If you have any questions about any of the issues, please call and schedule an appointment so that you can discuss them further with one of our physicians. We look forward to seeing you.

 POF - Premature Ovarian FailurePOF
Premature Ovarian Failure (POF), also referred to as primary ovarian insufficiency or premature menopause, is the loss of the function of the ovaries before age 40. On average, the ovaries supply a woman with eggs until age 51, the average age of natural menopause.
POF is not the same as menopause. The dysfunction of the ovaries, loss of eggs or removal of the ovaries at a young age is not a natural occurrence. POF can occur as early as teenage years but varies widely. If a girl never begins menstruation, it is considered primary ovarian failure.
Infertility is often the result of this condition yet there are additional health implications. Due to the insufficiency of estrogen, women may experience decreased bone density or osteoporosis.  There is also an increased risk of auto-immune disorders.
The abnormally low levels of estrogen and high levels of FSH, follicle stimulating hormone, do not allow the body to produce fertile eggs.
Often, the cause of POF is unknown. For some, a few causes may include:
  • Genetic, chromosomal or auto-immune disorders
  • Enzyme or metabolic defects
  • Smoking
  • Chemotherapy or radiation therapy
  • Surgical removal of the ovaries or multiple ovarian surgeries
  • Viral infection
There are also several autoimmune diseases associated with POF:
  • Thyroid dysfunction
  • Polyglandular failure
  • Hypoparathyroidism
  • Rhematoid Arthritis
  • Diabetes
  • Anemia
  • Adrenal insufficiency
  • Vitiligo
  • Lupus
Some symptoms of POF can include missed periods, hot flashes, night sweats, sleep disruption, mood swings, vaginal dryness, energy loss, dry eyes, painful sex, bladder control problems and low sex drive.
Approximately 6-8% of women will become pregnant after this diagnosis due to spontaneous ovulation.
Treatment can help. It is important to work with your gynecologist to begin hormone replacement therapy that is appropriate for you. You also want to be tested to ensure you are treating any other associated conditions, if applicable.

Healthy Living: Run for RobRun4Rob

The Rubino OB/GYN Group is a major sponsor of the 9th Annual Rob's Memorial Run on October 26th, 2013. As an active runner, Dr. Rubino understands the health benefits of cardiovascular exercise and is proud to support such a great cause.

Robert P. Giaimo, the son of Annette Giamimo - front desk staff for the practice, passed away in a car accident just prior to his 21st birthday. Robert was a graduate of West Essex High School's class of 2002 and was attending Ramapo College. Robert was a young man with a zeal for life and devoted himself to his friends and passions.


The Robert P. Giaimo Memorial Fund is designed to split funds raised in two ways. The first is in the form of scholarships for West Essex Regional High School and Ramapo College students. The scholarships are designed to acknowledge students that possess the ideals that Rob lived his life by. They are not given necessarily to the student with the best grades, but rather one that gives all of themselves to their loves. Rob practically lived in the Berrie Theater at Ramapo College, so a scholarship is also given to a deserving student studying in the field of technical theater arts.


The second way is in the form of donations that will benefit the children in the swim programs that Robert taught in. Each year, the fund hosts a swim clinic in the Township of Fairfield to teach swimming and water safety classes free of charge. It also contributes to community organizations each year, for example the West Essex First Aid Squad and the Red Cross (especially in times of disaster for example Haiti).


In the past 7 years, more than 25 scholarships have been awarded to students from West Essex Regional High School and Ramapo College. The Giaimo Fund has also conducted swim clinics in the township of Fairfield which have taught more than 400 children swimming skills and water safety.


Training for a 5k is a great way to get active and have a goal in site. Running is a fantastic aerobic and cardiovascular activity to keep your heart and body healthy. Grab some friends and family members and join the race while getting some great exercise and supporting a great cause!


If you have any further questions regarding the fund or its events, please visit or

Meet the Staffmeetthestaff

Yolanda recently joined The Rubino OB/GYN Group as a Medical Technician.
Yolanda, has many years of experience in medical offices. She spent the last seven years in family practice where she managed Community Family Health in Haskell, NJ. 
The medical field is very close to Yolanda's heart. Her son, Stephen, is a doctor of internal medicine, working at New York Methodist Hospital. Her daughter, Jenn, works for a medical insurance auditing firm in Bedminster.  Her and her husband are very proud of them and feel additionally connected through the field of medicine.
Yolanda is very excited to join The Rubino OB/GYN Group. She says "It is truly a pleasure to work along side of people who honestly care and take pride in what they do."

Yolanda enjoys spending time with her family and friends, celebrating every accomplishment and milestone.  They are a very close family and love to spend time together.  She is looking forward to the holidays, especially Christmas, which is their favorite time of the year.

Please join us in welcoming Yolanda to the practice.
New Video for The Rubino OB/GYN Group cordblood

We recently completed a new video for the practice that provides an LOGO overview of our services, doctors and philosophy. The video can be viewed on the home page of our website:


We hope you enjoy seeing the practice on a more personal level and welcome your feedback! Simply reply to this newsletter.


Office Announcements announcements
Flu Shots Now Available for Pregnant Patients
Please call the office today to schedule your vaccination. The flu shot can be administered in all three trimesters.
vitaMedMD Vitamins
The Rubino OB/GYN Group is now offering vitaMedMD™ in all 4 office locations. VitaMedMD offers patients high quality physician recommended products at an affordable price. Available products include Women's Multivitamin, Prenatal Plus, Prenatal One, Menopause Relief and Iron 150.

Emmi Video Tutorials
Emmi is a free, online video tutorial that makes complex medical information simple and easy to understand. Emmi provides clear and concise step-by-step information on common health topics and procedures right on our website. Click here to find out more.


Save Time with Online Appointments, Consultations &Personal Health Records
To schedule online appointments, consultations or view your personal health records at your convenience, just visit the home page of You can also call 973-736-1100 now to schedule an appointment at any of our four locations. 

"Important Announcements" on Our Website
You can find important new developments and time-sensitive announcements (such as office closings) right on the upper right hand portion of our home page.


Enterprising Patients

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please e-mail us at


Products Available on Our Website

For more information visit the products page on our website.