2016 Breast Cancer Awareness by Billings Gazette

October 2016

Breast Cancer Awareness

By the Numbers

The American Cancer Society estimates that in 2016, there will be 246,660 new cases of invasive breast cancer in U.S. women. When looking at a number that large, it is important to consider it as more than just a statistic. GREEN SHOOT MEDIA

INSIDE Billings Clinic’s 3D Mammograms ................. 4 Lesser-Known Symptoms ........................... 6 Self-Exam Guidelines ................................. 6 American Breast Cancer Foundation ............. 7 Risk-Reduction Surgeries ............................ 7 Healthier Fats ............................................ 7 General Manager Dave Worstell Advertising Director Ryan Brosseau Advertising Manager Shelli Scott Special Sections Coordinator Spencyr Knatterud

Breast Cancer Awareness is a special advertising publication of The Billings Gazette. Access Breast Cancer Awareness at www.billingsgazette.com/specialsections

Breast Cancer Awareness

These “numbers” could be your close family members, friends or colleagues. Some of these diagnoses may be more serious than others, but one thing is constant: These patients need our support and love as they work through the difficult process of survivorship. Consider the following numbers compiled by Susan G. Komen and pledge to make a donation or become involved in the fight against breast cancer: ■ Breast cancer is the most common type of cancer developed during a pregnancy. About one in 3,000 pregnant women will be diagnosed with breast cancer each year. ■ A f r i c a n -A m e r i c a n women have the highest breast cancer mortality rate, while Asian-Americans have the lowest. ■ 30,700 new cases of breast cancer are expected in African-American women this year. ■ Breast cancer causes more deaths than any other type of cancer in women ages 20-59. ■ Cases of breast cancer in men has slightly increased in the past 30 years.

■ Mortality rates are highest in Washington, D.C., Louisiana and Mississippi. ■ From 1990-2013 mortality rates have decreased by 37 percent. ■ Most breast cancer diagnoses and deaths occur in women over age 50. ■ Diagnoses in younger women usually have a mutated BRCA1 or BRCA2 gene that has mutated.

Did you know? According to data published by the researchbased healthcare company Roche, for reasons that are not entirely understood, breast cancer is more common in the left breast than the right. The left breast is 5 to 10 percent more likely to develop cancer than the right breast. The left side of the body is also 10 percent more vulnerable to the skin cancer melanoma than the right side of the body.

The Billings Gazette is proud to support the fight against breast cancer.

THINK PINK! WHaT Is BreasT CaNCer?

Breast cancer is a group of diseases that affects breast tissue. Both women and men can get breast cancer, though it is much more common in women. Other than skin cancer, breast cancer is the most common cancer among women in the United States. Some women are at higher risk for breast cancer than others because of their personal or family medical history or because of certain changes in their genes.

MaMMograM sCreeNINgs

Getting mammograms regularly can lower the risk of dying from breast cancer.The United States Preventive Services Task Force recommends that average-risk women who are 50 to 74 years old should have a screening mammogram every two years. Average-risk women who are 40 to 49 years old should talk to their doctor about when to start and how often to get a screening mammogram. Mammograms are covered by most health insurance programs.You can get a screening mammogram without any out-of-pocket costs. If you are worried about the cost or don’t have health insurance, CDC offers free or low-cost mammograms and education about breast cancer. Courtesy of cdc.gov

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Breast Cancer Awareness

Tomosynthesis: Next-generation breast imaging BILLINGS CLINIC ‌ ne in eight women will develop breast O cancer in their lifetime. Besides skin cancer, breast cancer is the most commonly diagnosed cancer among American women. Susan G. Komen foundation estimates in 2016 there will be nearly 250,000 new cases of invasive breast cancer, and that’s not even counting recurring cases among survivors. Though it’s important to always be aware of your breast health, October is Breast Cancer Awareness Month offering the perfect opportunity to brush up on everything you need to know about prevention and detection.

Over 40? Get a mammogram. Better yet, get a 3D mammogram.‌ Mammograms can typically detect lumps even before they can be felt, making it a key part of breast health. “Women might hear some inconsistencies in recommendations for yearly mammograms,” said Dr. Tara Bowman, Billings Clinic breast radiologist, “Billings Clinic abides by the American College of Radiology’s recommendations, which encourage all women of average risk to begin yearly mammograms at age 40.” Early detection is the key to higher survival rates, better prognosis, and lower treatment costs. At Billings Clinic, the Reger Family Center for Breast Health offers comprehensive tools for breast cancer detection, including state-of-the-art “next generation” full field digital mammography. Tomosynthesis, also known as 3D mammography, allows doctors to get a better picture of exactly what’s going on—leading to the detection of up to 41% more invasive cancers versus traditional mammograms, according to the Journal of the American Medical Association. “3D mammography gives me a more detailed image with which to base my decisions as a breast radiologist,” said Dr. Bowman. “3D mammography allows me to view the breast in one millimeter slices, which gets rid of the tissue overlap that can obscure findings on 2D mammograms. That means finding more cancer and at the same time reducing false positives.” With 3D mammograms, studies show a 15-30% reduction in the unnecessary additional imaging following screening exams. Most insurances will also include tomosynthesis under yearly screening allowances, but patients are always encouraged to check with their insurances prior to an appointment. In addition to mammography, the Center for Breast Health houses breast ultrasound,

Breast Cancer Awareness

“3D mammography gives me a more detailed image with which to base my decisions as a breast radiologist. 3D mammography allows me to view the breast in one millimeter slices, which gets rid of the tissue overlap that can obscure findings on 2D mammograms. That means finding more cancer and at the same time reducing false positives.” — Dr. Tara Bowman, Billings Clinic breast radiologist stereotactic breast biopsy and bone densitometry (DEXA scan) all together in one location for a comprehensive assessment. The Reger Family Center for Breast Health features a spa-like atmosphere, private changing rooms with doors, direct entry to the mammography suite, warm spa robes, specialty coffee, comfortable lobby seating, and a private breast boutique with a certified fitter for bras and prosthetics for post-surgery needs.

Between mammograms: Know your body‌ It’s important for you to be familiar with your own breasts. Get to know your breast shape while in the shower, in front of a mirror, or lying down. Check around your entire breast area as well as around the armpits, making note of any lumps or hardened areas you find, or any discharge. According to the Johns Hopkins Medical

Center, 40 percent of diagnosed breast cancers are detected by women finding a lump through self-awareness. But if you do find a lump, don’t panic — the National Breast Cancer Foundation says that 8 out of 10 lumps are noncancerous. For more information on the Billings Clinic Reger Family Center for Breast Health and the Billings Clinic Cancer Center, visit the Center for Breast Health or call 406-238-2501.

Your breasts are threedimensional. Shouldn’t your mammogram be?

For an appointment, call 238-2501 or 1-800-332-7156.

Why is Tomosynthesis (3D) better? • 3D mammography detects up to 41% more invasive breast cancers. This means one simple thing: early detection. • 3D mammography allows doctors to see masses and distortions associated with cancers significantly more clearly than conventional 2D mammography. • In addition, with 3D mammograms, studies show a 15-30% reduction in the unnecessary additional imaging following screening exams. • Not all insurance policies cover 3D. Please check with your insurance company for coverage.

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Breast Cancer Awareness

Lesser-Known Symptoms of Breast Cancer METRO SERVICES

‌ long family history of cancer may A put you at a greater risk of contracting the disease. Usually, when cancer is hereditary, a family passes down mutated genes. These genes can become out of control and are likely to cause cancer. Public perception that breast cancer is only identified by lumps detected through self-examination or routine mammography may prevent thousands of women from receiving an early diagnosis and the care they need. Although lumps are the most common symptom associated with the disease, women should recognize that breast cancer can produce additional symptoms. Susan G. Komen for the Cure, one of the premier organizations for breast cancer research, advocacy and treatment, advises that the warning signs for breast cancer are not the same for all women (or men). Various changes in the breast and body can occur, including the following conditions.

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Breast-size Changes‌

Many left and right breasts are not completely symmetrical, and women familiar with their bodies know that one spread to the lymph nodes around the breast is often slightly larger than the breasts, and lumps may be felt under other. However, breast-size changes that the arms. occur out of the blue may be indicative of Unexplained Pain‌ a medical problem. The Mayo Clinic advises that less than Skin Rash or Redness‌ 10 percent of people diagnosed with Women who are breastfeeding can breast cancer report pain as a sympexperience a rash on the breasts from an tom. But unexplained pain in an area of infection of breast tissue. But those who the breast should not be ignored. Breast are not breastfeeding should be evaluated pain that does not go away and seems by a doctor if redness, irritation or rash to involve one area of the breast should appears. be checked.

Nipple Changes‌

Nipple discharge that starts suddenly and is not associated with breastfeeding can be indicative of cancer. Other changes to the nipples, such as pulling in of the nipple (inversion) or itchy, scaling skin on the nipple, should be brought to the attention of a doctor.

Changes to the Skin‌

Dimpling of the skin, peeling, flaking, or scaling skin can be a cause for concern as well.

Lumps Elsewhere‌

Cancerous tumors may not only be felt in the breasts. Breast cancer can

Breast Cancer Awareness

Breast Self-Exam Guidelines

Fatigue‌

General cancer symptoms can include unusual fatigue and unexplained weight loss. These symptoms should not be left unchecked. One of the best things women and men can do is to familiarize themselves with their bodies so they will be more capable of pinpointing any irregularities that may develop. Individuals can routinely look at their breasts and inspect for subtle changes. But remember that hormonal breast changes occur during the menstrual cycle, so it’s best to be familiar with how breasts look and feel both during and after menstruation.

I‌ n addition to scheduling clinical screenings and mammograms, women should routinely examine and massage their breasts to detect any abnormalities. These breast self-exams can be an important part of early breast cancer detection. Although many women are aware that they should become familiar with their bodies, many are unsure about just how frequently they should conduct breast examinations. Experts at Johns Hopkins Medical center advise adult women of all ages to perform selfexaminations at least once a month. That’s because 40 percent of diagnosed breast cancers are first detected by women who feel a lump. Establishing a regular breast self-exam schedule is very important. Begin by looking at the breasts in a mirror. Note the size and appearance of the breasts, and pay attention to any changes that are normal parts of hormonal changes associated with menstruation. Breasts should be evenly shaped without distortion or swelling. Changes that should cause concern include dimpling, puckering or bulging of the skin. Inverted nipples or nipples that have changed position, as well as any rash or redness, should be noted. In addition, the same examination should be done with arms raised over the head. The breasts should be

felt while both lying down and standing up. Use the right hand to manipulate the left breast and vice versa. Use a firm touch with the first few fingers of the hand. Cover the entire breast in circular motions. The pattern taken doesn’t matter so long as it covers the entire breast. All tissue, from the front to the back of the breast, should be felt. The same pattern and procedure should be conducted while standing up. Many women find this easiest to do while in the shower. It is important not to

panic if something is detected. Not every lump is breast cancer. And bumps may actually be normal parts of the breast, as certain areas can feel different than others. But bring any concerns to the attention of your doctor. Breast self-exams are a healthy habit to adopt. When used in conjunction with regular medical care and mammography, self-exams can be yet another tool in helping to detect breast abnormalities. Doctors and nurses will use similar breast examination techniques during routine examinations.

American Breast Cancer Foundation Many organizations are involved in fighting breast cancer. Each has its own unique goal, but overall, the focus is ultimately on ending the deadly disease.

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Breast cancer can strike anyone. Having to deal with a financial burden on top of the disease can cause stress that may affect your chances of recovery. Fortunately, advocates across the country have built prestigious organizations dedicated to lessening the emotional and financial blow of breast cancer. The American Breast Cancer Foundation centers its attention on providing financial assistance for screenings and testing for uninsured individuals. The ABCF offers several programs that benefit the fight against breast cancer. From financial assistance to emotional support and cancer education, it’s easy to see why the ABCF is such an influential force in the fight against breast cancer. by the GuideStar Exchange for its strides to implement a best practice model. When deciding on which organization deHistory of ABCF Formed in 1997, the ABCF uses more than serves your support—and money—it’s im65 percent of its donations to assist with portant to look for these types of credentials. medical fees and fund fundraisers. In 2014, Most breast cancer awareness organizations the ABCF was awarded a Gold Level Rating are legitimately committed to the cause, but

unfortunately there are dishonest groups out there, too. Do your homework and choose an organization with the history, testimonials and track record to make sure you’re putting your efforts and dollars in good hands.

ABCF Programs

Through its Breast Cancer Assistance Program, ABCF provides cancer screenings for individuals who would otherwise not be able to afford them. By providing 45,700 screenings, 1,300 recipients have been diagnosed with breast cancer. The group’s Community Partnership Program works with medical clinics to provide discounted breast cancer services, such as mammograms and ultrasounds. Like most charities, ABCF is donation driven. Through its website or 24/7 hotline, you can even donate your vehicle. They also accept cash donations, allowing you to make your donation in memory of those who lost their battle with breast cancer.

Risk-Reduction Surgeries A long family history of cancer may put you at a greater risk of contracting the disease. Usually, when cancer is hereditary, a family passes down mutated genes. These genes can become out of control and are likely to cause cancer. GREEN SHOOT MEDIA

If you do have a long-running history of cancer in your family, you should have regular check-ups with your doctor. Susan G. Komen reports that patients who discover their cancer during Stage I have a 90 percent survival rate. This statistic underscores the importance of staying on top of your health as you age. One of the keys to beating breast cancer is catching it before it is able to spread to your lymph nodes. If you are at high risk, there are many options to consider to remain cancer free. Riskreduction surgeries are becoming a common option for those who are at the highest risk level for breast cancer.

gery may cause anxiety concerning body image. Speak with your physician about the psychological side effects while you are Bilateral prophylactic mastectomy — the deciding to commit to this surgery. surgery to remove both breasts in order to reduce the risk of breast cancer — has been Other Options shown to drop the risk of cancer by 95 perIf you decide that preventative major surcent, according to Cancer.gov. gery is not the path you want to travel, there This surgery is usually meant for women are still ways to keep your risk down. with family histories showing the BRCA1 Frequent check-ups will let you and your or BRCA2 gene. According to the National health professional know exactly where you Cancer Institute, these two genes account stand. Talk with your physician or oncolofor 20 to 25 percent of hereditary breast gist about how frequently they recommend cancers. you be tested. Your doctor will be able to determine Chemo prevention is the use of drugs if you have these gene mutations with a to delay cancer’s development in highsimple blood test, and can then walk you risk patients. The Food and Drug Adthrough your options. ministration has approved several of these drugs and shows that they will Risk Involved As with all major surgeries, the removal reduce the risk of breast cancer in paof both breasts is one with many factors to tients at higher risk. Again, always consult with your physiconsider. Potential harms that may arise are similar to any major surgery, including cian to discuss the specifics of your health in relation to starting new drugs or treatmajor bleeding or infection. Experts also note that receiving this sur- ments.

Effectiveness of Risk-Reduction Surgery

An avocado, tuna and tomato salad is packed with healthy, unsaturated fat.

Healthier Fats

When it comes to breast cancer, researchers have not been able to pinpoint a certain behavior that causes the disease. However, many have determined that a diet containing healthy fats can have great benefits in reducing your risk.

Why Fat is Important

In the past, many studies concluded that it’s best to avoid fats when it comes to your diet. Did you know that there are certain fats that can promote your well-being? Your body counts on vitamins A, D, E and K to operate properly. The only way these vitamins are able to be absorbed is with the help of fats. Eating foods that boast “unsaturated fats” will allow your body to process the vitamins without the harmful risks of a diet high in “saturated fats.”

Incorporating Healthy Fats

While diet alone will likely not cause or cure cancer, it is a factor that needs to be on your healthcare radar. The Harvard School of Public Health has compiled the following tips on how to use fats to your advantage: Avoid packaged food that is labeled “0g of Trans Fat.” At least one meal a day should be packed with Omega-3, which can be found in salmon, walnuts and tuna. Lower your intake of saturated fat by eating chicken and fish instead of red meat and cheese. Read labels. Even if a food claims to be low fat, it may still include bad fats such as saturated and trans fats.

Breast Cancer Awareness