Accessories Designer Rafe Totengco Bring Us Something Different

Story by Kristine Ortiz

 

When asked what his 10- year-old self would tell him today, Rafe Totengco jokes, “Why didn’t you get started sooner?” Even as a young child, the Filipino American accessories designer — who has been designing for his coveted namesake brand Rafe New York for the last 16 years, and serves as the creative director of handbags at The Jones Group, which handles more than two dozen labels including Rachel Roy, B Brian Atwood, Stuart Weitzman, Givenchy Jewelry and Nine West —always knew that fashion was in the cards for him.

A self-described “creative,” Totengco remembers growing up in the Philippines and making alterations to his school uniforms and Sunday church clothes on a seemingly weekly basis. “Since the fifth grade, I was already designing. The tailor and I had a very good relationship,” he says with a laugh. It was his realization that simple aesthetic changes to something as basic as trousers could bring him “instant gratification,” that laid the foundation for his future in the fashion industry.

After starting his own fashion business in Manila, Totengco made his way to New York to pursue his love for design, a move that his family supported. It was his time in the Big Apple that allowed Totengco to explore and to hone in on how he wanted to make his mark on the industry.

“I felt that the only way for me to be independent and be my own designer was to start an accessories company,” he says. “I didn’t have to go through the drama of producing so many sizes per style and all of that. You can essentially do a capsule collection of 10 pieces and be in business. So it was a great way for me to still be in fashion and express a different side of my creativity.”

But it wasn’t until Totengco saw one of his pieces in a fashion magazine that he felt his place was affirmed in an often-brutal industry. “I was like, ‘OK, here we go! It’s gonna be a whirlwind, it’s gonna be great, it’s gonna be fun!’”

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And what a whirlwind it’s been. Since his start in 1997, in addition to his namesake label, he has designed a collaboration collection with retail giant Target, has been recognized by prestigious organizations like the Council of Fashion Designers of America (CFDA) and Gen Art, and received the Pamana ng Pilipino Presidential Award from the Philippine government for bringing honor and recognition to his home country through his work.

The praise that he has garnered seems inevitable given his ability to draw inspiration from an “amalgam of different things.” For the fall season, he takes cues from graphic marbled floors in Venice (“[Everyone] was taking pictures of the frescoes, and I’m the only one taking pictures of the floor,” he laughs), a vintage photo of Eartha Kitt and Barbra Streisand featuring a leopard clutch, and the Art Deco aesthetic of The Great Gatsby. His pieces range from the structural Maryanne minaudiere, which he describes as one of his “iconic” designs, to practical zip clutches and totes, some of which are inspired by his time growing up in the Philippines.

Totengco is always prepared for visual inspiration, using both old-school and new-school technologies. He says that he always carries around his sketchbook, which he considers a type of “therapy” and a “second crutch” — it gives him a space to get all of his ideas out. But he also relies on his iPhone; an avid Instagram user, Totengco calls the popular phone application his “visual library,” a public space that enables people, both peers and customers, to get a glimpse into his world. Full of photos from his collections and various travels around the world, his feed lets people see where he draws his inspiration from. For Totengco, this allows him to nurture a close connection with his customers.

In a market flooded with big names and designer “It” bags, this intimate relationship is “something that’s really special” to Totengco, who’s more than pleased to have his small niche in the industry. “There’s a woman out there who wants something different [and] who wants to take the road less travelled,” he says. “There’s something authentic about what I do, [and] to me, that’s something I’m really proud of.”

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ON RAFE’S RADAR:

  • Go-to comfort food: Filipino food of course. Fortunately in New York I can run over to Jeepney, a restaurant in the East Village, to satisfy my craving.
  • On repeat on my iPod: “Blurred Lines” by Robin Thicke.
  • Pet peeve: Ill-fitting clothes — on anybody.
  • Talent I’d like to have: I would love to be able to play the piano.
  • What I love about being Asian: There’s an automatic kinship when you meet a fellow Asian, this unspoken understanding that you “get” each other.

 

This story was originally published in our Fall 2013 issue. Get your copy here.

APEX 20th Anniversary Gala: Good Food, Good Entertainment, Good People

On Saturday, September 28th, APEX (Asian Professional Exchange) celebrated their 20th anniversary with an awards gala in Los Angeles.

APEX is a non-profit organization in Southern California which aims to highlight Asian Americans through community service, fellowship, charitable fundraisers, cultural events, professional networking and educational seminars. APEX provides a platform to shape the future Asian American community and corporate leaders.

Has this organization been successful? You bet. Since it was founded in 1993, the organization has become one of the largest Asian American organizations in the U.S. and has raised thousands of dollars to support community-based organizations such as Asian Pacific American Legal Center, Asian Pacific Women’s Center, East West Players, Korean American Coalition, Service Network for Asian Pacific Youth, and many more.

In honor of their 20th anniversary, APEX decided to give it their all for their awards ceremony. We were lucky enough to attend the exclusive gala.

 

EMCEE’S: 
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AWARD RECIPIENTS:

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Deputy Chief Terry Hara - APEX Excellence in Community Service Award
PCA- APEX Excellence in Corporate Leadership Award
Phil Yu- APEX Excellence in Arts and Entertainment Award
Joyce Nakashima, Vice President of Programs for APEX- APEX President’s Award

 

PERFORMERS:
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In addition to amazing award recipients, hosts and performers, APEX delighted its guests with a silent auction, a handful of giveaways, a 4-course dinner courtesy of Starry Kitchen and, of course, an afterparty. Check out some of our photos below:

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Flashback Friday: The Truth About “Bromances”

Story by Paul Nakayama 

I recently returned from a trip to Vancouver where my writing partner and I celebrated New Year’s Eve. To quote our generation, it was epic. Now, judging from the photo (below), you might assume that we went there as lovers, or perhaps even newlyweds. But, no, dear readers, it is, in fact, a “bromance” of the highest caliber. For those of you who’ve never heard of a bromance, it’s defined as a very close, or homosocial, friendship between two straight men. You’ve all seen examples of a bromance through television shows like Scrubs and Friends or movies like I Love You, Man. There are even real world examples like Ben Affleck and Matt Damon or George Clooney and Brad Pitt. It’s a strong bond formed from common interests and long periods of time spent together. Hearing this, my editor was unsatisfied, or rather, still suspicious, and she demanded a better explanation. I took a look at the photo again, and I thought maybe it is in my best interest to provide a few insights into this new definition of brotherhood.

The concept of guy-love is lost on those who have never experienced it (so, men from older generations or women). It’s not weird or strange anymore to see men display their affections for their buds physically. I’ve seen grown, bearded men shove aside a fist bump request and instead firmly place their chest against another man’s chest. It’s strange and perhaps unnerving to them to see men platonically bond while throwing in the occasional hugs, butt-slaps and friendly wrestling. Whatever happened to the good ol’ days of stoic machismo, they wonder? Well, these days it’s cooler to be cool with man-love.

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I remember one time in high school I spent the night at my best friend’s house once. His dad, an old- fashioned type, raised an eyebrow when we went into the hot tub to relax. When it was time to turn in, his dad seemed nervous about something, as if the fate of his son’s future rested on the events of this particular evening. He kept hanging around the room, which was a drag because we wanted to close the door and talk about girls. Finally, after long periods of pacing and internal debating, he looked at us and pointed at the bed. He stuttered, “You know, I don’t think the bed is big enough to hold both of you.”

What do you do when your dad, like many others, mistakes guy-love for gay love? It’s not like we were planning to share the bed, but we did what anyone would do when faced with an awkward opportunity to teach someone about tolerance. We went with it and antagonized the poor man. Arms around each other and a big grin on our faces, we said, “We’ll make it work.”

I thought some more on why bromances are so common these days. When did it all start? I wondered if it was somehow a natural progression from the emergence of the metrosexual man. I thought that the heavy use of high-end conditioner and facial moisturizer made our hearts as soft as our hair and skin. In all seriousness, though, single men these days are simply less concerned with the notion of being identified as gay than their fathers and grandfathers. If anything, I’ve seen bromances take pride in their ability to ride the razor’s edge of platonic and sexual. Take me, for instance. Whenever I get drunk, I tend to lift my brothers into the air a la Patrick Swayze and Jennifer Grey in Dirty Dancing. I’m not trying to cop a feel (usually); there’s just no better way to show a brother you love him than by doing a ballet lift together.

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Bromances aren’t just an American thing. I’ve witnessed and experienced it on many of my travels, like Anthony Bourdain, but instead of food, I sampled male bonding. In Brazil, I befriended a group of the tallest, largest men I’ve ever met, and when I had trouble wading through the packed crowds, one of them actually lifted me up above the people and placed me in front of the bathroom. I said to him, “Obrigado, my gentle giant. Obrigado.” (True story.) In Hong Kong, I spent several nights drinking with guys that simply liked me because I could hold my liquor. Imagine that — bonding with strangers over such a superficial reason, and yet we were inseparable for days. In Singapore, I saw a club full of guys perform a synchronized interpretative dance to Madonna’s “Like a Prayer.” Actually, wait, that might’ve been a gay club; it was kind of confusing. Finally, in Korea, I saw men holding hands and kissing each other’s faces. Well, I wasn’t ready for the master class bromance, but you know, I just wanted to give you another example.

While most women comment that it’s “cute” to see men bond so closely, I’ve also had plenty of girls poke fun (with a hint of “what-the-eff” in their voices) at my bromances. When that happens, my buddies and I shrug it off because we know that it’s just jealousy. Now before I get angry letters from you (which I wouldn’t mind actually since it’s at least some evidence that someone is reading this), I’ll explain the source of the jealousy. It’s not uncommon for men these days to be more emotionally available to their man-mates than their actual girlfriends. There’s less emotional risk and you still get the satisfaction of catharsis. There’s no regard for what comes in the future; there’s only the enjoyment of the now. In other words, men can enjoy the intimacy of a long-lasting relationship without the dreaded “so-where-are-we-headed” talk. You combine that level of hassle-free friendship with man-dates that involve common interests in video games, sports, music and entertainment, and it’s not ironic that even the most commitment-phobic guys have at some point in their lives said to another guy: “Dude, if you were a girl, I’d marry you.”

Now, with the context I’ve given, does the above photo of me leaping into another man’s arms make more sense? Still weird, you say? Yes, there was alcohol involved at the time this was taken, but that’s not an excuse. There’s no need to make excuses for something as beautiful as the friendship of two men. If anything, I will fight like a Black Friday shopper to defend my right to be cradled in the arms of my best friends. It’s a great thing that the taboos of the past are being cast off to create a world where men are OK with showing feelings, affection and love. Why not have a world where men can accept and hug instead of front and fight? I think it’s awesome. Well, except for those really aggressive huggers that linger. That’s just awkward.

This story was originally published in our Spring 2012 issue. Get your copy here

5 Lessons Learned From Online Dating

Story by O.D.D. (Online Dating Diary) Girl

When Audrey unleashed its new look last fall, it was also the beginning of this column. Around the office (and to some of my close friends), I became known as O.D.D. Girl. What I didn’t disclose one year ago was that I had had my heart broken and was wavering on the idea of going online to find love. Nonetheless, it didn’t take too much convincing for my editor to get me to chronicle my adventures as an Asian American woman trying online dating for the first time.

Of course, it wasn’t easy. For the first time in my life, I was forced to look at myself and come to terms with what I really wanted in a partner. I’ve had my share of short-lived flings and semi-relationships, but I’ve never been in a long-term exclusive relationship. But after months of exchanging online messages and even going on dates, I realized it was time for me to think about getting serious with someone — and to be more serious about myself as well.

Over this past year, I managed to convince some of my peers and friends to try online dating for the first time, too. As I was coaching some of them, I gleaned some lessons from my experience. In no particular order, here they are.

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1. Don’t let the creeps get to you.
I know that online dating sites have horrible reputations for the kind of men on them. They’re slimy, they’re looking for hookups, they have weird fetishes — I won’t go on and on, but I’m sure you all know what I’m trying to get at. Just remember, they’re there. They will always be there. But the site is not 100 percent full of horrible men. For example, if some guy is projecting his Asian fetish onto you, you can (1) reply back with a sassy remark (with dignity, of course) to let him know he’s a racist prick, and (2) block him. Don’t allow one bad egg to ruin your entire experience, just like you shouldn’t allow the douchebag you met at the bar to define the rest of your love life either.

2. Dating does not get any easier as time goes on.
Whenever I tell my editor about my dates (from both online and offline), she always looks over to another married person and says, “I’m so glad I’m not dating in this age.” I’m realizing that as I get older, I’m running into guys with a lot of baggage because they’ve also had hard dating experiences, just like me. It’s not like my early 20s when we all pretty much had clean slates. So accept it — you’re not always going to meet perfect guys with perfect backgrounds, but it doesn’t mean that they’re not nice people or haven’t learned from their dating past.

3. Don’t be afraid to tell your Asian parents you met someone on an online dating site.
Not too long ago, my mother asked me if I was a lesbian. I suppose she had every right to, since I hadn’t brought anyone home to meet her. I then told her that I was talking to someone online — and she didn’t try to disown me. Perhaps it helped that one of my older aunts married a guy she met online recently. Either way, don’t be ashamed to let your parents know how you met the guy — it’ll help open them up if they haven’t already.

4. Don’t just go for the guys who look good on paper.
I was really surprised to see how many Asian guys were on these online dating sites — and how many of them looked really good on their profiles. There were so many guys who were tall, handsome, working professionals (with an income of six figures!), did just about every activity in the book, were well traveled, and were quite charming in their messages. Does that make them Prince Charming in real life? Of course not! My point is, take a chance on the guys who may not seem so perfect on paper because I’ve learned that some guys were intentional in not creating the perfect profile — they wanted to see if they could attract the right kind of girl. I actually did that once, and I found a pretty good guy in real life.

5. Be absolutely honest with the guys you date (and yourself, too).
Don’t ever tell a guy the opposite of what you’re looking for because you want to go along with what he wants. It won’t do you any good. Instead, communicate well and let him know what you’re looking for from the get-go — it will save you trouble and time. Trust me.

So how have my dating adventures fared to date, given the first anniversary of this column? I don’t want to give away too much now, because I feel like I’ve gotten into something that’s just starting. However, I’ll leave you with this: I think I’ve found one guy who’s got a hold on me.

Until next time.

 

This story was originally published in our Fall 2013 issue. Get your copy here

The Next Big Thing: Pom Klementieff in Spike Lee’s “Oldboy” Remake

Story by Ethel Navales 

Although American audiences may not recognize her yet, 27-year-old actress Pom Klementieff has already made quite a name for herself in France. Born in Canada to a Korean mother and French-Russian father, Klementieff lived in various locations, including Africa, before settling in France where her career took off. The actress has notable works under her name, but her supporting role in Spike Lee’s much-anticipated remake of the 2003 Korean cult film by Chan-wook Park, Oldboy, arguably takes the cake.

In Oldboy, Klementieff plays a woman named Haeng-Bok, and if you ask the actress if she’s anything like her, she will only respond, “My character and I have the same shoe size, 6.” Indeed, a quick Google search only confirms that the character remains an enigmatic figure. “The only thing I can tell you is that [Haeng-Bok] is never very far from the villain, and she is a mysterious character,” says Klementieff. One thing she does reveal is the martial arts training she endured to play the role. She trained for hours a day and proudly points out, “I loved it; I was kicking so much that I lost a toenail at the end of shooting.” In fact, she was given the nickname “The Pominator,” something that made her laugh so hard that she put it on her license plate.

But it wasn’t just martial arts that made this role a challenge; Klementieff had to delve into some personal demons during filming. “For the last scene I had to shoot, I had to do something strangely connected to my brother’s death in real life,” she says cryptically. “It was stressing me out during rehearsals, but I thought it would be fine. When we finally shot this scene, I burst into tears and yelled. Sometimes you can’t control your body — it just lets go, and it was very cathartic. The scene became an homage to him.”

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Despite the emotional and physical difficulties, or perhaps because of it, Klementieff says she’s decided to pursue her acting career in America. “The roles I’m auditioning for here in the U.S. are 20 times more interesting than those I had back in France! Asians are less represented in movies in France. It’s changing little by little, but here in L.A., there is a big Asian community.”

Get ready to see more of Klementieff. She just wrapped the independent film The Hackers with Cyril Morin, where she sported purple hair for “a love story between two computer hackers who get caught up in manipulation.” And once Oldboy hits theaters on November 27, we just may have a new starlet on our hands. As for the various actors and directors that she would like to work for in the future, Klementieff excitedly lists Martin Scorsese, Chan-wook Park, Christopher Nolan and many more. She jokes, “It makes me laugh each time I’m asked [who I would like to work with]. It paralyzes me, like when I’m asked ‘What do you want for Christmas?’”

This story was originally published in our Fall 2013 issue. Get your copy here

PREMIERING TONIGHT: Ming-Na Wen on “Marvel’s Agents of S.H.I.E.L.D.”

Story by Teena Apeles. 

Actress Ming-Na Wen has been fortunate to have played many strong female characters during her career: Dr. Chen in ER, Camile Wray in SGU Stargate Universe and, of course, the beloved Mulan. So you can bet that it would take a pretty amazing character to get this pro as giddy as a teenager. Enter Melinda May.

“When this opportunity came up, my skin was just tingling with excitement,” says Wen of her role in the highly anticipated series Marvel’s Agents of S.H.I.E.L.D., premiering on ABC this fall. “I wanted to have a show that I could enjoy doing, working with people who I love, and that my kids can watch. And so I think I hit the jackpot here.”

What’s not to like about Agent Melinda May? She has a reputation for being an expert pilot and skilled fighter as a member of the international organization S.H.I.E.L.D., which protects “the ordinary from the extraordinary.” And as May, Wen flexes her muscles often … on bad guys. “We were working on some fight sequences this past week, and I am so into it right now; it makes me feel really powerful,” she says. “I am going to be in the best shape of my life because of this show.” Extra plus, she’s taking direction from Joss Whedon, the show’s creator, which, in her own words, had her “screaming for joy” because she is a huge fan.

A self-described “geek girl,” Wen says she’s been drawn to the sci-fi world as an escape since she was a kid. Growing up as the only Asian girl in a very white suburban neighborhood, she says she liked anything that was “other-worldly.” She admits, “I used to pray that E.T. or some extraterrestrial being would take me away, to some other world, and get me out of some of the environments that I was in, always feeling like the outsider.”

As she got older, Wen became interested in Dungeons & Dragons through her science fiction class and, later, drama club, “where I found people who accepted me for who I was and understood me, and we had a lot in common. And that became my world.”

Star Wars, Star Trek and Aliens were among the movies she loved because in such worlds, says Wen, “there are outsiders and yet they have these amazing superpowers. And even though they don’t fit in, they become the heroes.”

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While Agent May doesn’t have superpowers, she is still part of an elite force that works within the government to facilitate and help out the superheroes. But as far as Wen’s daughter and son, ages 12 and 7, respectively, are concerned, she looks pretty super on screen. “After seeing the pilot, my son said, ‘Wow, I didn’t know you could fight like that!’ It is just so nice to be able to share with them why mommy disappears so much,” she says. “They get excited to think I can fly a plane and fight.”

Of course, they’re not the only fans thrilled with her role. After the summer release of the Melinda May trailer to promote the show, Wen was the talk of the Web — so much so that her Twitter following grew.

“I just love the fans so much, and when this was starting to trickle out, I started this fan group related to the show that I could talk to and party with,” she says of what she calls the M.O.B., short for “Most Optimum Badass.” As for how she came up with the name, Wen says, “Everyone kept calling me a badass. I think everyone wants to feel like a badass, so alright, I am going to form a group of badasses.”

So are her kids allowed to call her a “badass” at home? Wen laughs. “Well, it could be a donkey. …”

 

This story was originally published in our Fall 2013 issue. Get your copy here

 

Is Facebook Causing Depression?

Story by Anna M. Park.

You come home from work. It was a fair to middling day. Your boss didn’t yell at you, you didn’t totally cheat on your diet, and Andrew still hasn’t called. You sit down with a glass of wine, open your laptop, and start scrolling through Facebook. Brian finally tried a cronut. Jessica’s baby is growing some hair. Wow, Kris is looking really good. Tran got into that grad school? Sylvia took another vacation? Grace is engaged?!

You slam shut the laptop. Now you’re depressed.

Join the club. According to a 2013 study conducted by two German universities, one in three people felt worse and more dissatisfied with their lives after visiting Facebook. Users felt envy, loneliness and isolation, with the most common cause of Facebook frustration stemming from others’ vacation photos. The second most common cause of envy was social interaction — feeling a “lack of attention” from having fewer birthday greetings, comments and “likes” compared to friends.

And it wasn’t just college students. The study found people in their mid-30s were most likely to envy family happiness, while women were more likely to envy physical attractiveness. After all, what is Facebook but an online brag book for all to see? A 20-something colleague recently summed it up when asked why she posted so much food porn on Facebook: “To make people jealous.”

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These findings aren’t new. Scientists coined the term “Facebook depression” after a 2011 study found that teens could be negatively affected by using the social networking site too much. Another study published in the journal Cyberpsychology, Behavior and Social Networking, by sociologists Hui-Tzu Grace Chou and Nicholas Edge, concluded that “those spending more time on Facebook each week agreed more that others were happier and had better lives.” Students who used Facebook longer also agreed less with the statement “Life is fair.” Moreover, the more Facebook “friends” a person had whom they did not know personally, the more they believed that others had better lives. And in Chou’s most recent study, she found that those with more Facebook friends cared less about their work performance, and those who frequently updated their Facebook profile liked their current job less and were more likely to think about changing jobs.

Granted, feeling unhappy is not the same thing as depression, but it could be said that Facebook may not be the best thing for an already susceptible population. After all, Asians are arguably the most wired people in the world, and we also bear the ignoble distinction of having the highest rates of depression. According to a 2011 report by the National Alliance on Mental Illness, Asian American teenage girls have the highest rate of depressive symptoms of any racial, ethnic or gender group. In fact, Asian American girls and women aged 15 to 24 die from suicide at a higher rate than any other racial or ethnic group, and suicide is the fifth leading cause of death among Asian Americans overall (only ninth for white Americans). It’s not just young women either; Asian American women over 65 have the highest suicide rate in that demographic. And while some studies find depressive symptoms in 35 percent of Chinese immigrants, among Southeast Asians, 71 percent meet the criteria for major affective disorders such as depression.

So should we get offline altogether? Many have, or at least minimize their usage; the researchers behind the German study concluded that “users frequently perceive Facebook as a stressful environment, which may, in the long run, endanger platform sustainability.” But you don’t have to be entirely anti-social; just do it face-to-face. In her study, Chou also found that those who spent less time on Facebook and more time socializing with friends in real life were less likely to report that they were unhappy. So get out there and really like something.

This story was originally published in our Fall 2013 issue. Get your copy here

Exclusive Video Premiere: Sonia Rao’s “Little Blue Room”

In our Fall 2013 issue, we featured former The Voice contestant, singer-songwriter Sonia Rao, whose sophomore album, Los Angeles Part 1, dropped last week. Now we’ve got the exclusive video premiere of the emotionally charged single “Little Blue Room.”

“I wrote ‘Little Blue Room’ about time and love,” says Rao. “It was in writing this song that I figured out that it was time to end a relationship, a tough process, but I love songwriting for that reason. If I’m ever unclear about which step to take, I’ll start writing a song and by the end of it, I’m usually pretty certain about what I truly want. The video is a bit surprising, but I’m hoping that people will see the metaphor in it.”

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Watch as the soulful L.A.-based Rao tells the story of a woman coping with the end of a relationship — with an unexpected twist! Without further ado, the exclusive premiere of “Little Blue Room,” shot, directed and produced by Ron Utin Lalkin and Maddie Staszak.

Like what you hear? Pick up “Little Blue Room” and other tracks by Sonia Rao on iTunes — and while you’re at it, get our Fall 2013 issue here!

The Truth About Mammograms: To X-Ray or Not To X-Ray?

Story by Anna M. Park. 

When the U.S. Preventive Services Task Force announced that women should not be getting mammograms until they reach 50, it ignited controversy within the medical community. For years, doctors have insisted on mammograms starting at 40, and the American Cancer Society and Susan G. Komen Foundation still recommend an annual mammogram starting at the age of 40, citing early detection key to saving lives. Just do a quick search and you’ll find stories of all sorts of young women in their 40s whose lives were saved from early detection. Nonetheless, most major health organizations have concluded that the modest survival benefits of mammography in women ages 40 to 49 outweigh the risks of false positives and further unnecessary procedures. So what’s a woman to do? Dr. Maggie DiNome, chief of General Surgery at Saint John’s Hospital in Santa Monica, Calif., who specializes in breast cancer surgery, answers our questions.

Q. My OB/gyn insists I get annual mammograms starting at 40, even though I have no family history. But the new U.S. Preventive Services Task Force recommends mammograms starting at 50, and then every two years. What do I do?

Dr. Maggie DiNome: You would need to weigh the data to know what is right for you. The U.S. Task Force came out with their consensus statement based on their recommendations of what is most efficient for screening, meaning what has the biggest bang for the buck for the population as a whole. According to their review of the existing data, starting mammograms at age 40 only results in one life out of 1,000 being saved. That might not seem like much, but if you were that one patient, it means the world.

So what is the trade-off for starting mammograms at age 40? Well, the argument is that it leads to more false positives, which leads to more unnecessary biopsies and imaging. It may also be finding stages of “cancer” (i.e. DCIS, or ductal carcinoma in situ) that truly do not need treatment, although currently we treat everyone diagnosed with DCIS because we don’t yet know who can safely avoid treatment. As a breast surgeon, I see more than one might expect of breast cancers diagnosed by routine mammograms in women in their 40s, so it’s hard for me to say “stop.” I wouldn’t necessarily argue that biennial mammograms is a bad thing though, and maybe a compromise would be biennial mammograms beginning at age 40. In Europe, it is this way.

My recommendation to you would be to start mammograms at age 40, and plan to get them every year or every other year.

 

Q. Even if a woman holds off on regular mammograms until she’s 50, should she get a baseline mammogram in her 40s?

Dr. DiNome: That’s a difficult question to answer because, if you are starting your screening at age 50, that means you agree with the U.S. Task Force data that it is not efficient to begin screening at age 40. So a baseline at that age would not make sense. There is no doubt that starting annual screening at age 40 reduces death from breast cancer, but the argument is that it is too low of a number to be considered significant. The probability of dying from breast cancer after age 40 is 3 percent. If you screen biennially between ages 50-74, you can reduce that to 2.5 percent. If you start screening annually at age 40, then you reduce it to 2.4 percent, which hardly seems significant when you talk about numbers. It’s just difficult when you equate it with a life because in my mind any life is worth saving.

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Q. I got a mammogram and was told I have dense breasts, which I believe most Asian women have. Should we insist on an ultrasound?

Dr. DiNome: Almost every premenopausal female will have dense breasts because it’s a reflection of the hormonal stimulation on our breast tissue. After menopause, there is significantly less (unless they’re on hormone replacement therapy) and the breast tissue becomes more replaced by fat. The downsides of mammograms are that they are notoriously less sensitive in a woman with dense breasts, and that’s why we don’t recommend beginning screening in a woman under age 40. The ability of the mammogram to show anything helpful in that scenario is so low it’s not worth doing. For women over 40 who have dense breasts, a mammogram should still be performed because it is the only imaging modality that will pick up calcifications reliably, and this can be one of the earliest signs of breast cancer. A screening ultrasound does have some value as an adjunctive screening test to a mammogram, but not in place of. I do think it is worthwhile for women with dense breasts to advocate for a screening ultrasound, but it is not yet a test that is covered by insurance for routine screening.

Q. The risk of breast cancer for Asian American women seems to be rising (compared to women in Asia) — is there anything in particular we should be doing to protect ourselves?

Dr. DiNome: I think this has a lot to do with adopting a western diet. Population studies have demonstrated that if you followed immigrants from Asia to America, that over two generations the risk of cancer increases significantly. Right now, the risk of breast cancer in Asia is five times less than the risk in America. My recommendation would be to adopt a more whole food, plant-based diet and to minimize the amount of animal protein, which we eat way too much of in the U.S. My husband and I went vegan a few years ago for the health effects. I have a strong family history of cancer (not the least of which is my father who died from colon cancer at age 39) and I now have 3 1⁄2-year-old twin girls. Because my husband and I had kids later in life, we feel it’s our responsibility to do whatever we can to ensure that we will be around for them as long as possible. So we did a lot of research and we both independently concluded (my husband before me, mind you) that a vegan diet has the most evidence-based data for a cancer protective diet.


Dr. Maggie DiNome is the current chief of General Surgery at Saint John’s Hospital in Santa Monica, Calif. She is a board certified general surgeon, who focuses her clinical expertise on cancer surgery and advanced laparoscopic techniques. As a fellow of the Society for Surgical Oncology and a member of the American Society of Breast Surgeons, Dr. DiNome is particularly dedicated to caring for patients with breast and colorectal cancer. 

 

This story was originally published in our Fall 2013 issue. Get your copy here

Hello Kitty Jet Makes First Flight to the U.S.

Story by Taylor Weik.

 

They may have launched a Cartoon Network-themed line of trains back in July, but now Taiwan isn’t the only country who gets to experience cartoon travel firsthand. Taiwan’s EVA Air, known for its popular line of Hello Kitty jets, flew its Boeing 777-300ER Hello Kitty Hand-in-Hand Jet from Taipei to Los Angeles on September 18.

This will be EVA Air’s first long-range flight route and an expansion of the five shorter-range jets that, from its conception in 2005 up until now, had only flown from Taiwan to Japan, Korea, Hong Kong, China and Guam.

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Piloted by EVA Chairman and airline Captain K.W. Chang, who conceived the idea for a Hello Kitty-themed flight line “to make flying fun,” the Hello Kitty Hand-in-Hand jet flew from the Taoyuan International Airport to LAX to celebrate the new jet service with fans and guests. Among those present for the celebration were Sanrio Executive Vice President and Chief Operating Officer Kunihiko Tsuji, Japanese pop star Yoshiki and Head Hello Kitty Designer Yuko Yamaguchi, not to mention the nine cartoon members of the Sanrio Family.

Guests checked in at the Flight Path Museum at LAX, which was decorated with blown-up, pink boarding passes and various pictures of Hello Kitty flying in an airplane, before being escorted outside to a spacious tent where they could glimpse the jet landing on the strip. While waiting for the jet’s arrival, guests were invited to sip on champagne and munch on Hello Kitty-themed treats like red velvet iced cupcakes and browse the displays of all the in-flight items available. Hello Kitty playing cards, pillows and hand creams are just a few of the many items passengers can purchase in the jet’s sky shop. Hello Kitty artists from Tokyo were on hand to draw pictures of Sanrio characters and adorn fingernails with special Hello Kitty nail art, and Sanrio characters Cinnamoroll and Bad Badtz-Maru mingled and took pictures with fans.

 

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The arrival of the Hand-in-Hand jet revealed a colorful paint job, with 19 Sanrio characters splashed across the length of the aircraft holding hands. EVA explained that the union of the critters was designed to “bridge cultural barriers and invite new friendships from around the world.” The airline also pointed out that “this is the first time Sanrio has featured characters with the familiar Hello Kitty that are not typically depicted among her family and friends.”

 

A performance by a troupe of Hello Kitty dancers, the introduction of nine Sanrio characters and the recognition of Chang, Tsuji and the jet’s other pilots were given before the jet’s doors opened to reveal its first passengers –– Hello Kitty and Dear Daniel themselves –– and to invite guests on board to take a full tour of the cabin.

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The 312-seat is split into three cabins: Royal Laurel, Elite and Economy Classes, all of which offer passengers the opportunity to use more than 100 in-flight service items and select meals from its seasonal menus. EVA confirmed the Hand-in-Hand jet will be used on three of 17 weekly flights from LAX to TPE, with flight schedules listed on its website.

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