Breast Cancer Awareness
Mammogram Screenings spotted breast cancer and lung cancer
Say What!? Commonly used terminology defined
PLUS!
+ Self Exam Tips + Is It A Risk Factor? Detection + Early Plan App
My Turn
Lisa Slepica of Crosby always knew breast cancer would be part of her story
A BRAINERD DISPATCH, ECHO JOURNAL PUBLICATION. OCTOBER, 2015.
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Breast Cancer Awareness • October 2015
Contents Breast Cancer Awareness ‘15 Features
Articles
09 Two Cancers, One Test Terminology...........................4
By Essentia Health
Common breast health and cancer terms.
Early detection saved Ramona Beach’s life when mammogram screenings detected not only breast cancer, but lung cancer as well.
Self Exam ...............................6 Steps and tips to help you recognize abnormalities.
12 My Turn By Sarah Nelson-Katzenberger Lisa Slepica is part of a three generation, eight woman breast cancer bloodline yet tested negative for the BRCA1 and BRCA 2 genes. She hopes to one day find the connection between them.
20 Breast Cancer Champion By Lisa Henry Besides being a three-time breast cancer battle winner, Kim Rhett has been a major advocate in raising awareness and funds for research.
On the cover: Lisa Slepica, Clinical Nurse Educator at Cuyuna Regional Medical Center. Photo by Steve Kohls
To our readers, We are so very honored and thankful to our featured survivors who
Early Detection Plan .............7 Yep! There’s an app for that!
Risk Factor? .........................16
Does breast density, size or implants affect breast cancer risk?
were willing to share their very personal and compelling stories with us in an effort to raise awareness about breast cancer. This publication would not be possible without the support of our loyal advertisers. Please note these companies: Accra Care Home Health
Breast Cancer in the News ..........................18 The latest news briefs
Care, Auto Import, Brainerd BN Credit Union, Brainerd Medical Supply, Cuyuna Regional Medical Center, Essentia Health, Good Neighbor, Hytec Construction, Lakewood Health System, Mills Motor, Susan G. Komen, Tanner Motors, Tanner Nissan and Thrivent Financial.
Many thanks!
Publication Staff Brainerd Dispatch Publisher: TIM BOGENSCHUTZ Echo Journal Publisher: PETE MOHS Advertising Director: PHIL SEIBEL Advertising Manager: SUSIE ALTERS Marketing Coordinator: LEO MILLER Copy Editor: DELYNN HOWARD Content and Art Director: LISA HENRY
Breast Cancer Awareness is an annual publication of the Brainerd Dispatch and Echo Journal. Questions or comments, please email: Leo.Miller@BrainerdDispatch.com Breast Cancer Awareness • October 2015
3
EDUCATION
Terminology
Breast health terms are important in prevention and detection as well as understanding a breast cancer diagnosis. Educate yourself on some of the vocabulary you may hear at an exam. Detection/Prevention Terms Accessory breast tissue – Uncommon condition where additional breast tissue is found in the underarm area. Women with this condition often require special mammographic examination. Atypical hyperplasia – A benign condition in which breast tissue has certain abnormal characteristics. This condition increases the risk of breast cancer.
Asymptomatic – Without noticeable symptoms of disease. Many cancers can develop and grow without producing symptoms, especially in the early stages.
Breast density – Breast tissue that has many glands (lobules) close together. Dense breasts may make masses difficult to detect by physical examination or mammography.
Benign – Not cancerous, not malignant. The most prevalent types of breast problems are fibroadenoma and fibrocystic disease.
Cancer-related check-up – Routine exam for cancer without obvious signs or symptoms of cancer. The goal is to find it early when chances for a cure are greatest.
Phyllodes tumors – tumors that may be found in the glandular and stroma (connective) tissues of the breast. Phyllodes tumors are usually benign and rarely cancerous. Also spelled phylloides. Premalignant – Abnormal changes in cells that may, but do not always, become cancer.
Healthy Breast Diagram
milk ducts
lobules
(milk producing glands)
fatty tissue
Did You Know?
Dead fat cells can be confused with breast cancer? Fat necrosis – The death of fat cells, usually following injury can cause a breast lump, pulling of the skin, or skin changes that can be confused with breast cancer.
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Breast Cancer Awareness • October 2015
Do you have these genes? BRCA1 (Breast Cancer Gene 1) BRCA2 (Breast Cancer Gene 2) Having these place a woman at greater risk of developing breast cancer and/or ovarian cancer if the gene is damaged (mutated), compared with women who do not have this mutation. A genetic test is available. Any women considering the test should consult with a genetic counselor for further discussion.
80%
Invasive ductal carcinoma
is the most common type of breast cancer, accounting for about 80 percent of breast malignancies.
Diagnosis Terms Inflammatory breast cancer – (IBC): Rare and very aggressive type that causes lymph vessels in the skin around the breast to become blocked. Breasts appear swollen, red and inflammed. Invasive lobular carcinoma – Arises in the milk-producing glands (lobules) then breaks through to involve the adjacent fatty tissue. Also called infiltrating lobular carcinoma. Invasive ductal carcinoma (IDC) – starts in the milk ducts then breaks through to invade fatty tissue of the
95%
Tubular carcinoma
There is a 95 percent survival rate for tubular carcinoma.
SOURCE: Breast Cancer Glossary of Medical Terms: https://www.facs.org/quality-programs/napbc/patient-resources/glossary#sthash. ccfCGAsX.dpuf
breast. Invasive ductal carcinoma is the most common type of breast cancer. In situ: Cancer that has not spread to nearby tissue also called “noninvasive cancer.” Medullary carcinoma – Less common form of breast cancer. It gets its name because the tumor color is close to that of brain tissue (medulla). The cancer cells are large and form a barrier between healthy tissue and tumors making it quite visible in mammograms.
Metastatic breast cancer – Cancer cells have spread past the breast and axillary lymph nodes to distant regions of the body (such as bone, liver, lung, or brain). Also called Stage IV or advanced cancer. Mucinous carcinoma (Colloid) Rare condition where cancer cells within the breast produce mucus, forming a jelly-like tumor. Tumors may feel like bumpy water balloons, but some are too small to detect with the fingers.
Nodal status – If breast cancer has spread (node-positive) or hasn’t spread (node-negative) to lymph nodes in the armpit (axillary nodes). The number and site of positive axillary nodes can help predict the risk of cancer recurrence. Tubular carcinoma This is a common cancer for women ages 50 and older. When viewed under the microscope, tubular carcinoma cells have a distinctive tubular structure. There is a 95 percent survival rate for tubular carcinoma.
Breast Cancer Awareness • October 2015
5
EDUCATION
Self-Exam
Doctors
Every Month!
urge women to conduct monthly self-exams to familiarize them-
selves with the look and feel of their breasts, which enables them to more readily recognize any abnormalities that may indicate illness. There are a number of ways to conduct a breast self-exam, and women are urged to find the method they feel is most comfortable for them.
IN THE MIRROR
LYING DOWN
Note size and shape of both breasts. Look for differences between breasts. Pay attention to how they change during menstruation. Many women find their breasts are not exactly the same size or shape.
NBCF advises conducting an examination in bed. The breast tissue will naturally distribute over your chest wall and ribs when you are lying down.
Positions: • Arms at sides • Arms over head • Arms on hips Abnormalities to look for in each position: • Unusual dimpling or puckering • Taut or thick skin • Inverted nipples • Swelling, redness
IN THE SHOWER Examine breasts in the shower. It’s a convenient place to conduct an exam. The National Breast Cancer Foundation (NBCF) suggests NBCF says you should use the pads of your fingers and move around your entire breast in a circular pattern, moving from the outside to the center, checking the entire breast and armpit area. Source: Metro Features.
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Breast Cancer Awareness • October 2015
• Place a pillow under your shoulder and your arm behind your head. • Using your opposite hand, move the pads of your fingers around your breast gently in small circular motions covering the entire breast area and armpit. • Squeeze the nipple and check for discharge or lumps. • Repeat process on the other side.
Find something?
Don’t panic. Make an appointment with your doctor. Any lumps or abnormalities should be examined more throughly which may include a mammogram or ultrasound.
Did you know? Three quarters of breast
cancer patients have no family history and were not considered high risk.
Early Detection Plan Yep! There’s an app for that! Breast cancer is most successfully treated when it is detected early. Death rates for breast cancer have been on the decline, a trend that many professionals agree is due to early detection with increased screenings as well as the overall heightened awareness.
FREE APP
For mobile, you can download the EDP app on iTunes or Google Play. For a desktop version that works the same, go to their website and login.
When breast cancer is detected early, in the localized stage, the five year relative survival rate is 100 Percent! -American Cancer Society
Do you have a plan? As with just about everything, there is an app that.The Early Detection Plan (EDP) offered by The National Breast Cancer Foundation offers a digital element to help you stay on track with exams and to be proactive about your breast health. Registration is easy by entering your name, password, birth date and answering a cou-
ple health questions. Based on your answers, EDP generates a suggested timeline for actions including self exams, clinical exams and mammogram screenings. The notifications feature makes it convenient to set exam reminders through text, email or both. You can also track exam dates and add notes about each. For example
breast appearance, feel and at a clinical exam as well as a any changes you may have mammogram screening. They encountered in a self exam or have also listed healthy habits what you discussed with your that can help reduce your risk doctor at a clinical exam. for breast cancer. For more inYou can get yourself edu- formation visit their website: cated by clicking on the help- www.EarlyDetectionPlan.org ful links provided. You’ll find things like signs and symptoms to look for, helpful pictures and instructions on how to perform self exams and what to expect Breast Cancer Awareness • October 2015
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early detection changes
run
healthy weight aerobic
friends
symptoms
annual mammogram organic
family
goals
exercise
yoga
dance move active lifestyle
warning signs whole grain
inspire
prevention
walk
limit alcohol digital women vegetables energy
healthy habits
men
Recommendations swim hike changes sleep
garden self-awareness
facts
October is National Breast Cancer Awareness Month It’s a perfect time for you to schedule your mammogram and to work on living a healthy lifestyle. Mammograms are part of a lifelong breast care routine you should begin yearly when you turn 40. Remember: early detection saves lives. To reduce your risk of developing breast cancer and other cancers as well, the Essentia Health Breast Program recommends you: n n n n
Watch your weight Exercise regularly Limit alcohol Eat a healthy diet
Beginning at age 20, all women should begin monthly breast self-exams and should have a clinical breast exam every three years and then annually at age 40. Some individuals have a higher risk of developing breast cancer. The ideal screening routine for these women is best determined individually with a physician.
EssentiaHealth.org
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Breast Cancer Awareness • October 2015
annual exam
self-exam
fruit
Call Essentia Health at 218.828.7646 to schedule your appointment today. If you are underinsured or uninsured, call us to discuss Minnesota state programs that will cover the cost of your mammogram.
SURVIVOR
Two Cancers, One Test PHOTOS BY ESSENTIA HEALTH
Early detection saved her life BY CONNIE WIRTA ESSENTIA HEALTH
Early
detection
has
helped
Ramona Beach survive not one, but two cancers. Like most people diagnosed with lung cancer, the tumor in Ramona’s left lung was discovered when she had an X-ray for another condition. Her annual mammogram last fall found breast cancer. “Ramona is a great example of what early detection can do in patients with cancer,” says Dr. Aby Z. Philip, a Dr. Aby Z. Philip
hematologist and oncolo-
gist at the Essentia Health Cancer Center at St. Joseph’s Medical Center in Brainerd. “Her annual mammogram found a very early breast cancer. A low-dose CT scan could have done the same for her lung
Ramona Beach
cancer.
Breast Cancer Awareness • October 2015
9
“
“I appreciate each and every day that I’m alive...I take whatever comes my way, and I stay positive.” - Ramona Beach
“
Ramona Beach and Melissa “Missy” Laposky
“Missy was always there to take notes, explain the big words...I was too emotional to listen. She really, really helped.” - Ramona Beach
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Breast Cancer Awareness • October 2015
Until recently, there was no screening test for lung cancer. Low-dose CT scans are now being offered for people ages 55-77 who are long-time smokers and therefore at high risk for developing lung cancer. In December 2011, Beach had a lingering cold and went to see her primary care physician, Dr. Sara Lokstad, to see if she had pneumonia. “I had a bad head cold that went into my chest and I found I was getting short of breath,” Beach recalled. A chest X-ray found a 3-inch tumor in her left lung. Further tests revealed she had small-cell lung cancer. This type of cancer is very aggressive and almost always caused by smoking, explained Dr. Philip. Beach’s cancer was discovered before it had spread and that early detection helped save her life, he said. Most lung cancers are found in later stages, which make them difficult to cure. That’s because people don’t have symptoms in the early stages. “When I first found out, I just cried and cried,” Beach recalled. She was comforted by a call from Melissa “Missy” Laposky, a registered nurse who works as a patient navigator at the Essentia Health Cancer Center. “I’d just found out, and Missy called to say if you need to talk, or need more information, just call her or come see her,” Beach said. “It was just the way she worded things. Missy made me feel like I had a little hope.” Laposky answered Beach’s questions and explained each step in the treatment plan. She also helped set up and coordinate appointments for treatments, tests and office visits. The coordination saved time and precious energy for Beach. Laposky also accompanied her to appointments. “Missy was always there to take notes, explain the big words,” Beach recalled. “I was too emotional to listen. She really, really helped.” Beach had twice daily radiation treatments and chemotherapy at the same time. Treatment took its toll. Beach remembered telling family and friends she wanted to change her birthday because she didn’t feel like celebrating that March 17. But the treatments worked and she praised Dr.
Walter Roberts, her radiation oncologist, and the staff in both radiology and chemotherapy. “Dr. Roberts was so good and it went just like he said it would,” she said. “If he said it would last six weeks, it lasted six weeks,” added Beach. After killing the tumor, Beach had whole brain radiation as a preventive measure. She’d smoked for 40 years but was able to quit. Last fall, Beach’s annual mammogram discovered a tiny tumor – just 2 millimeters – in her right breast. She was diagnosed last Oct. 3 with Stage I A breast cancer. She had a lumpectomy and six weeks of targeted radiation treatments. She didn’t need chemotherapy. “I thought, ‘I’ve got to go through all that again?’ But my breast cancer was detected early, and it was nothing compared to my lung cancer,” Beach stated.
Schedule a mammogram (218) 828-7646
Is cost a concern?
The Minnesota SAGE program can pay for an annual physical and mammogram. To learn whether you are eligible call (218) 454-5935 Dr. Philip says there is no link between Beach’s lung cancer and her breast cancer. Support from family and friends helped Beach through both her recoveries. “You need to stay strong, even when it’s hard, and believe in a higher power,” she advises other survivors. “I appreciate each and every day that I’m alive,” Beach said and added, “I take whatever comes my way, and I stay positive.” The Essentia Health Breast Program has developed breast cancer screening guidelines that consider clinical data on both the risks and benefits of such screening. For women who are at average risk, an annual mammography is recommended for ages 40-75. Older women should discuss continued screening with their primary care provider. Some women have a higher risk of developing breast cancer. For example, people with first-degree relatives, such as a mother, sister or daughter who have had breast cancer, or those with a personal history of chest radiotherapy, may be at a higher risk. The ideal screening method and schedule for these women is best determined with their healthcare provider. The ideal screening method and schedule for these women is best determined with their healthcare provider. n Breast Cancer Awareness • October 2015
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She always knew breast cancer would be part of her story. Lisa Slepica, Clinical Nurse Educator at Cuyuna Regional Medical Center facilitates a group of breast cancer survivors and shares her own survival story.
C o n n e c tio n Searching for a
BY SARAH NELSON KATZENBERGER
PHOTO BY STEVE KOHLS
FEATURE WRITER
In
2004, Lisa Slepica received some surprising, but welcomed news. At the age of 45, Slepica
found out she was pregnant. “I had a son about to graduate from school and a baby on the way,” Slepica said.
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Breast Cancer Awareness • October 2015
“
“It wasn’t ever really a matter of if, but when.” - Slepica said of her breast cancer diagnosis
With a history of breast cancer in her family, Slepica said regular mammograms had been routine for her since her early 20s, but because of her pregnancy and the doctor’s confidence in previous normal mammograms, Slepica opted to forgo the one she was scheduled to receive that year. “I had had them faithfully over the years,” she said. After her youngest son was born, Slepica said she nursed for a year creating a threeyear gap between her mammograms. When she went in for her scheduled mammogram, she received the news she anticipated she would hear at some time in her life — she had breast cancer. Slepica said she was diagnosed with fibro4.5x5.25 You can Always Count - Back of Nurse_Layout 1 9/7/15 4:09 PM 1 cystic breasts asPage a young woman and was
used to finding lumps that seemed harmless, but she knew this time was different. “It was very obvious,” she said. The week her older son graduated from high school, Slepica had surgery to remove a malignant tumor. For Slepica, breast cancer was not a distant fear like it is for many women. With six women in her family diagnosed before her, Slepica said she knew it was likely going to be part of her story also. “It wasn’t ever really a matter of if, but when,” she said. In 1939, Slepica’s maternal grandmother died of breast cancer at the age of 39. “Of course back then they didn’t know a lot — it was just very sad,” she said. “My mom was only 4 years old so she doesn’t really remem-
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Breast Cancer Awareness • October 2015
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I just started to cry...I just thought, ‘no, not my sister.’ I just hoped it would skip her.” - Lisa Slepica
Lisa Slepica (left), her mother Sunny Johnson and sister Ann Kisch at the 2015 Komen Race for the Cure. Photo submitted by Lisa Slepica.
ber her at all, but she does remember there was always this conversation about her having breast cancer.” Later a great-aunt was diagnosed, then her mom, her aunt and two cousins. Slepica said her cousin Ann was 27 and a new mom with a nursing baby when she was diagnosed. “She went to have a biopsy done and woke up with a mastectomy,” she said. Within a month, Slepica’s aunt, Ann’s mother, was also diagnosed. The two are 35-year survivors. Slepica’s mother, Sunny was diagnosed at the age of 52. Last spring, Slepica got the phone call she hoped would never come. It was her younger sister, Ann. She too was diagnosed with breast cancer. “I just started to cry. It was her turn, she said. I just thought, ‘no, not my sister,’” Slepica recalled. “I just hoped it would skip her.” Ann’s diagnosis was caught early with excellent prognosis, but it still made her the eighth woman in three generations of her family to receive a breast cancer diagnosis. “There’s just so many,” Slepica said.
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Breast Cancer Awareness • October 2015
“There has to be something that connects us.” Slepica’s own diagnosis came not only with a mastectomy and the standard chemotherapy and radiation treatment, but also genetic testing. Slepica said her doctor was 80 percent sure she would be a genetic carrier of the BRCA1/2 gene mutation that tends to increase the risk of breast cancer, but genetic testing showed she was not a carrier. When Slepica’s sister, Ann, was diagnosed earlier this year, her doctor opted to wait to do treatment until genetic testing was completed, to see if that would make a difference in the results. “Still there was nothing,” she said. “Nothing abnormal.” While the mystery remains as to what has caused eight women in one family to be diagnosed with breast cancer without the gene mutation, Slepica remains hopeful that someday they may find an answer. “There are people doing great research and still trying to find these markers that connect us,” she said. Of the eight diagnosed in Slepica’s family, five are still living and are participating in a study conducted by the Univer-
sity of Washington to determine connecting markers between the survivors. “They may never find anything, but if they did, how wonderful would that be that we could be a part of something so positive,” she said. “It feels kind of good to think that I may be a part of that.” Most of the women in Slepica’s family were in their 50s when they were diagnosed with the exception of her cousin Ann, and her grandmother. Slepica said it is uncertain if the tumors diagnosed in her family members functioned the same. Slepica’s tumor was diagnosed as triple negative, meaning it didn’t feed off of estrogen, progesterone or HER2 hormones and would be unresponsive to inhibitor medication. “There’s lots of different kinds. We have no idea about my grandmother’s tumor and my mom and aunt were diagnosed before they let people know that information — they just didn’t share that information,” she said. Her sister Ann’s diagnosis, while caught early and treatable was found to have invasive cells that could have been catastrophic. “People often ask, ‘why are you being so aggressive, ‘but with our family history
PINK FROSTING a sweet night out benefiting area breast cancer patients
Slepica embraces Christine Roy, RN, BSN, CRN Oncology Care Coordinator at Cuyuna Regional Medical Center. Photo by Steve Kohls.
— you have to be,” she said. Ann underwent a full double mastectomy. “She was very grateful she made that decision,” Slepica said. “It was the right decision for her.” Slepica said solid support is key for flourishing survivors. “We all want to be healthy survivors, we all want to thrive,” she said. “Our paths all look different — it can feel lonely.” Slepica facilitates a support group at Cuyuna Regional Medical Center (CRMC) in Crosby for women who have survived or are newly diagnosed with cancer. Slepica is a clinical nurse educator at CRMC. The group has about a dozen members, the majority of whom have or have survived breast cancer. Her group is made up of women of all ages. When patients are given a new cancer diagnosis they are immediately connected with Oncology Care Coordinator, Christine Roy who connects them with the group and helps them navigate their treatment, recovery and support. Slepica joined the group as a member 11 years ago and now facilitates along side Roy. Slepica said some in the group have undergone radiation and chemotherapy; others have had surgery or reconstructive surgery. “We all have different stories and that’s what makes it fun and encouraging,” she said. “As new people come they find there’s usually somebody who has been down a similar path. It’s just good to know you’re never alone.” n
Tuesday, October 27th
5:00 - 7:00 p.m. Heartwood Senior Living Community, Crosby • Silent and live auctions featuring accessories and products • Appetizers, decadent pink desserts, wine and refreshments • $5 per person at the door • No RSVP needed
Wear pink and show your support for breast cancer awareness! Please call 218-545-4455 or email jholmvig@cuyunamed.org for more information.
Breast Cancer Awareness • October 2015
15
PREVENTION
Risk
Factor?
Breast cancer risk is influenced by many things, including heredity, age and gender. Breast density is another factor that may affect cancer risk and the ability to detect breast cancer in its earliest stages, say some experts.
Q.
What do dense breasts mean for cancer risk?
According to the report, “Mammographic density and the risk and detection of breast cancer,” published by The New England Journal of Medicine, as well as data from the National Cancer Institute, women with high breast density are four to five times more likely to get breast cancer. Only age and BRCA1 and BRCA2 mutations increase risk more. However, at this time, health care providers do not routinely use a woman’s breast density to assess her breast cancer risk, according to Susan G. Komen for the Cure. Density does not refer to the size or shape of the breast, and it may not be apparent by just looking at the breasts. Usually women do not learn they have dense breasts until their first mammograms. Dense breasts have more glandular and fibrous tissue. Density may be hereditary, meaning mothers and daughters can share similar breast characteristics. Dense breasts cannot easily be seen through on a mammogram, which can make detecting lumps and other abnormalities more difficult. This can lead to missed cancers or cancers that are discovered at later stages. Women with dense breasts may require additional screening methods, such as a breast ultra-
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Breast Cancer Awareness • October 2015
Density does not refer to the size or shape of the breast.
sound or an MRI, in addition to yearly mammogram screenings. Education about breast density is gaining traction in some areas, thanks to informed women and advocacy groups like AreYouDense.org. Some states in the United States are part of “inform” lists, in which radiologists include information about breast density on mammogram reports so women and doctors can make decisions about extra testing. Even if a woman does not live in a state where density is shared, she can request the information from the radiologist or doctor. Dense breasts show up with more pockets of white on mammograms than gray fatty tissue in less dense breasts. Cancer also appears white, and, therefore, tumors can be hidden.
Q.
Does breast size affect my cancer risk?
Short answer: Probably not There is not a large enough body of evidence to link large breast size to an increased risk of breast cancer. It’s true that larger breasts have more breast cells susceptible to mutation, but many surmise that genetics and lifestyle factors are more likely than breast size to elevate a woman’s breast cancer risk.
Q.
What about breast implants? According to a study published in the Journal of the American
AA
A
B
Medical Association, although breast implants may decrease accuracy of mammograms, they do not raise a person’s risk of developing breast cancer. In fact, newly developed implants may deter the growth of cancerous cells in breast reconstruction patients. Researchers at Brown University developed a new kind of implant that has a microscopically bumpy surface, which can impede the growth of blood vessels that typically feed cancerous tumors. n
C
D
DD F
G
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17
Breast Cancer In The News PROVIDED BY LANNY FRIEDMANN Susan G. Komen Operations Director
Detecting Cells with the Potential to Spread According to Medical Xpress, researchers have shown that using a biochemical approach combined with magnetic resonance imaging (MRI) can detect the earliest signs of breast cancer recurrence and fast-growing tumors. Their approach uses a protein tagged with a tiny magnet that binds to micromestastases, breakaway tumor cells with the potential to develop into dangerous secondary breast cancer tumors elsewhere in the body. The technique allows for the very early detection of metastatic spread, which would allow adaptation of treatment more quickly and potentially better outcomes.
Study: Hormone Replacement Therapy (HRT) Clinical Oncology reports on a new analysis of two Women’s Health Initiative (WHI) clinical trials that investigated the post-intervention phase to get a deeper look at the aftereffects of hormone replacement therapy (HRT) on coronary heart disease and invasive breast cancer. Ongoing analysis of data from WHI reveals that even years after treatment has ended, postmenopausal women who took estrogen and progestin continue to have a greater chance of developing breast cancer.
Blood Test Relapse Predictions
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According to U.S. News & World Report, an experimental blood test may one day detect the return of early-stage breast cancer months before it is revealed by CT or MRI scans. The blood test can detect DNA shed by tumors into the bloodstream before the cancer cells invade other organs. The research found that 12 out of 15 patients’ relapses were identified by the blood test about eight months before conventional imaging detected breast cancer. However, more research is needed. n
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Breast Cancer Awareness • October 2015
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SURVIVOR
Breast Cancer Champion Three time breast cancer survivor
PHOTOS SUBMITTED BY KIM RHETT
BY LISA HENRY GUEST WRITER
Kim
and Tom Rhett moved to
the Brainerd lakes area with their three young children Brian, Matthew and Kara in 1992. Her husband had just retired from the Navy and she was looking forward to her new position with Bremer bank. Being new to the area, Rhett sought out a family physician. During her first appointment she went through a routine family history questionnaire with her doctor. After learning both Kim’s grandmothers had been diagnosed with breast cancer, he urged her to have a baseline mammogram screening. “At that time I wasn’t very vigilant about self breast exams,” Rhett admitted.
Kim Rhett
Kim Rhett, pictured with husband, Tom, has battled breast cancer three times and won. She’s also been a champion for raising money for cancer research and was selected as Komen Race for the Cure Honorary Survivor Chair in 2013. Breast Cancer Awareness • October 2015
19
SUPPORT TEAM
Rhett attributes most of her support to her husband Tom. The tremendous support from her family, co-workers and friends has made it possible for her to keep fighting and healing.
Kim and Tom Rhett at the 2014 Komen Race for the Cure in the Twin Cities.
“I could not have endured all of these years without my husband‘s care, it was a difficult task.” HER ADVICE TO NEW PATIENTS
Rhett makes phone calls and visits newly diagnosed patients as a way of showing support. She urges patients to ask for help and use the many resources available.
MISS HAIR
“I lost my hair three times! I was voted ‘Miss Hair’ in high school so I always loved my long hair. I didn’t think it would bother me, but when you have clumps coming out, it is a shock,” Rhett admitted. Her sister Kathy, a hair stylist cut it short and used clippers on another occasion along with Rhett’s husband when the hair was almost gone. “I remember looking up and she was crying,” Rhett said of her sister. Rhett wore wigs out of the house and picked out hand made hats that were donated to the oncology unit. Radiation on her head in 2012 has since left her hair very thin.
FAITH
“I have always had my faith,” Rhett said. “Although it has been tested, I am still here. I feel it all around me. I thank God and my surgeons every day.”
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Breast Cancer Awareness • October 2015
“
‘You’re only 33 years old, it’s probably not cancerous’ everyone told me.’” - Kim Rhett
Round One
The mammogram revealed a tumor. An ultrasound and needle biopsy followed. “‘You’re only 33 years old, it’s probably not cancerous’ everyone told me,” Rhett remembered. But it was.“Then they said, ‘Don’t worry, it probably hasn’t spread to your lymph nodes yet,’” Rhett added. But it had. “It’s devastating to say the least, but what do you do? I had to keep my chin up,” she said. Rhett opted for a lumpectomy. Soon after surgery a bone scan showed a large mass on her hip. She went back into surgery and received a pin and rod in her femer and celebrated the news that the hip tumor was benign (not cancerous). Radiation in addition to six rounds of chemotherapy were ordered for the breast cancer however. “I kept all of my checkups,” Rhett noted. “I made it to the 10-year mark. That’s when they tell you, if it hasn’t come back by then, it probably won’t. I was ‘home free!’” she exclaimed.
Round Two
But that wasn’t the case. In 2005 she had a recurreance in the same breast. This time she underwent a mastectomy. More chemotherapy and radiation followed. “I thought it was the right choice at the time,” Rhett says of not choosing a double mastectomy to remove both breasts. “As a woman you have breasts and taking them both away just seemed so final,” she added. Instead, Rhett opted to keep one and use a prosthetic breast for the other that can be placed in a special bra with a pocket. “Looking back I would have had a double mastectomy right away, I always feel a bit lopsided,” admitted Rhett. Finding the right neckline for shirts and looking for specialty swimsuits to hold her prosthesis has been a challenge. “It’s not something you can just go in and try on. You have to special order them,” she said of the swimsuits. “Some of them don’t hold the prosthesis in place very well and it feels like it’s just floating there and could fall out. In fact, once it did!” she laughed. “Well, I can laugh about it now, but at the time it wasn’t very funny,” she noted.
Kim Rhett (left), and Pam Loeffelebein or “Breast friends,” as they call themselves, hold up their years of survival signs during the 2014 Komen Race for the Cure in the Twin Cities. Loeffelebein received her diagnosis in 2007. Rhett confided, “It’s [cancer] not something you want to share with anyone, but it is nice to have someone who understands exactly what you’re going through.”
Rhett and her family have been involved in raising funds for cancer research for over 12 years. In 1995 they formed their team “Kim’s Cancer Crusaders” and participated in Relay for Life until 2005 when Rhett and her co-workers at Bremer bank formed a new team to support Komen Race for the Cure. They affectionately named their team “Fight for the Girls” which has been the top fundraising team five of the last six years. Rhett marveled, “It’s amazing to see all those survivors all at once. It makes me feel like there is hope. It’s not hopeless.” The team used a variety of fundraising ideas over the years including jeans day at work, potlucks, rootbeer float sales, homemade egg roll sales and selling flowers out of Rhett’s garden. The most successful campaign was
“I have always had my faith, although it has been tested, I am still here.” - Kim Rhett
Round Three
Life continued for Rhett and her family until the fall of 2011 when she reported a general ill feeling. “I couldn’t figure out what it was, but I knew something wasn’t right,“ she said. For three months it steadily got worse adding strange headaches and pain. Driving home one night she didn’t know where she was. That was the scare that sent her back to the doctor. After an MRI appointment she went back to work. Within a couple hours she endured horrified news that the breast cancer had moved into her brain. The tumor was the size of a softball with a smaller one at the base of her head. “You think they got it all, you think it’s gone and it just spreads,” Rhett said. People asked her if it meant she had brain cancer, but Rhett explained that it was still considered breast cancer, just in a
her personalized handwritten letters to family and friends asking for their support and a donation to her team. Last year however, Kim didn’t want to send the letters. “I felt like I was asking too much of my friends and family. Year after year constantly asking for money,” Rhett explained. But as past letter recipients found empty mail boxes they started coming to her asking if she was still taking donations. “They came to me!” she exclaimed. Rhett’s tireless efforts were highlighted when she was selected as Honorary Survivor Chair in the 2013 Komen Race for the Cure. Today Rhett continues her efforts with her team “Fight for the Girls,” participates as a survivor in the Relay for Life and continues to support the American Cancer Society.
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new location. While waiting for surgery Rhett remembered becoming so impaired by the tumors that she could barely walk or speak and couldn’t write her own name. As soon as surgery was over however those functions were completely restored. The next step was radiation. “Natural feelings of thinking I was going to die were calmed by my faith. But I will tell you, that I had my coffin picked out (a pink one) and the music selected for my funeral,” Rhett shared. Today Rhett is in remission. She has a spot in her lung and one in her sternum that her doctor continues to monitor. “I have always had my faith, although it has been tested, I am still here,” she said. Rhett retired on Feb. 28 after 23 years of service. She said she treasures each day as she works in her garden and travels as much as she is able to. She was happy to share her story and finished with saying “I have always been open about my treatments and sharing my thoughts about it. Don’t be afraid to ask; I love to share my story.” n
Join the fight for the Komen Vision: A World Without Breast Cancer! Save the Date! Saturday, June 25, 2016 17th Annual Komen Brainerd Lakes Race for the Cure® 5K Walk – 5K Run – 1 Mile Walk
watch for details at www.komenbrainerdlakes.org
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Breast Cancer Awareness • October 2015
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