Power of Pink 2021

Power of Pink Breast Cancer Awareness and Treatment

INSIDE: Early Screenings ‘Worth the 15 Minutes’, Page 2 How to Make an Impact with your Purchases, Page 4 Low-Cost or Free Testing Available, Page 4 Why Black Women Die from Cancer at a Higher Rate, Page 5 Cancer During COVID… One Woman’s Journey, Page 7

October 2021 INSIDENOVA.COM | OCTOBER 2021 | SURVIVING BREAST CANCER | POWER OF PINK

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‘Worth the 15 Minutes’

Local Hospital Team Member Finds Peace of Mind with Early Cancer Screenings Being only 36 years old with no family history of breast cancer, mammograms weren’t top of mind for April Hanlin of Manassas.

But living with multiple sclerosis – an autoimmune disease that attacks the protective coverings of the nerves – and starting a new treatment that increased her risk for breast cancer, she decided to take control of her health and talk to her provider about early screening.

Her team may not have found cancer but undergoing 2D and 3D mammograms put Hanlin in the driver’s seat for her future health.

MAMMOGRAMS DETECT MORE THAN CANCER A mammogram is a non-invasive, low-dose X-ray that detects malignancies in breast tissue. It can identify early signs of breast cancer and other breast abnormalities, months or even years before a self-exam.

There are two types of mammograms. 2D mammograms produce two images: one from the side and one from above. In 3D mammograms, the X-ray machine moves in an arc over the breast. This movement captures multiple images from different angles to give radiologists a clearer view of the breast tissue.

The American Cancer Society recommends women who are at average risk for breast cancer start screening through annual mammograms around age 40. Risk factors such as family history or, as in Hanlin’s case, certain medications could be reasons to consider early screening.

If there is a strong family history of breast cancer, screenings should start 10 years before the age that the family member was diagnosed. For example, if a mother was diagnosed at 35, the daughter should Mammography technologist Misty Carroll and April Hanlin. start screening at 25.

CARE CLOSE TO HOME As a member of the local health system’s communications team since December 2019 and a patient in the outpatient infusion center even longer, Hanlin knew how to navigate the halls at Prince William Medical Center. But that didn’t make her any more confident about going in for her baseline mammogram.

“I was really nervous,” Hanlin said.

However, she quickly became more relaxed when she met her mammography technologist, Misty Carroll.

“She was super friendly,” Hanlin added. “We talked about our families and decorating for the holidays. She knew how to get my mind off everything that was happening.”

Carroll has been a mammography technologist at Prince William Medical Center for four years. She thrives on interacting with patients and being able to care for them at their most vulnerable state.

“When April came in for her baseline, she didn’t really know what to expect,” Carroll recalled. “But she’s so strong and stayed positive the entire time.”

Carroll tries to treat every patient like her own family. She walks each patient through what to expect ahead of their mammogram and explains what she is doing every step of the way.

After receiving the results of her baseline mammogram, Hanlin was called back for further imaging of two abnormal findings. One ended up being normal, and one warranted a breast ultrasound for

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“The additional testing gave me the peace of mind I needed. We have to be our own advocates when it comes to our health.”

— APRIL HANLIN additional imaging.

Before the end of the appointment, the radiologist had the results of the 3D mammogram and ultrasound and provided Hanlin with a presumed diagnosis for the roughly dime-sized mass and options for the next steps. With the support of her breast imaging team, she chose to undergo a biopsy.

Within one month of her baseline mammogram, Hanlin had pathology results – and answers.

As the radiologist suspected, she had a fibroadenoma, a very common non-cancerous tumor found in women in their 20s and 30s.

“The additional testing gave me the peace of mind I needed,” Hanlin said. “We have to be our own

POWER OF PINK | SURVIVING BREAST CANCER | OCTOBER 2021 | INSIDENOVA.COM

MARISSA PILCHER|UVA HEALTH

advocates when it comes to our health.”

Hanlin knew seeking care close to home would mean not having to travel far for procedures, but she was pleased to experience first-hand the exceptional women’s care that she helps to promote at Prince William Medical Center.

MAMMOGRAMS SAVE LIVES Like all cancer screenings, mammograms make a difference in diagnosis, prognosis and treatment of breast cancer. According to the National Cancer Institute, mammograms have helped improve the breast cancer survival rate to nearly 90% of patients.

“Early detection is key, and imaging like mammograms make this possible,” Carroll said.

A baseline or annual mammogram takes on average just 10 to 15 minutes to complete and diagnostic imaging, including 3D imaging, averages 30 minutes.

“It’s worth the 15 minutes,” Carroll said. “We’ve probably waited longer in the Starbucks drivethrough.”

Today, Hanlin says she’s feeling great after her mostly uneventful first breast cancer screening. Her six-month follow-up scan came back normal with no further tests required, and she’s excited about only needing to get screened once a year for the foreseeable future.

“Visiting Misty is now something to look forward to every July,” she said.

For more information on women’s health services at Prince William Medical Center and Haymarket Medical Center, visit UVAHealth.com/PW-women.

We put women’s health front and center in our community.

Comprehensive care for women across Prince William County. We know that care close to home is important for busy women in all stages of life. That’s why we provide robust women’s healthcare services right in the Gainesville, Haymarket, Manassas and Warrenton communities. We provide access to generalists and specialists in women’s conditions, ranging from bone strength and pelvic floor health to premature menopause and other advanced specialty areas. Our expert providers have access to leadingedge technology, such as minimally invasive robotic procedures, to meet your changing needs. For more information about local care for women of every age, visit UVAHealth.com/PW-women.

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How to Make an Impact During National Health District Provides LowCost or Free Mammograms Breast Cancer Awareness Month October is National Breast Cancer Awareness Month, an annual opportunity to spend your dollars on products and services that benefit breast cancer advocacy, research and patient care services.

However, experts say the clutter of pink products on store shelves and online can make savvy shopping a challenge.

“Determining if a given product sold during October actually benefits a breast cancer charity is not always easy,” said Sarah Rosales, vice president of corporate partnerships at Susan G. Komen, the world’s leading breast cancer organization.

One way to ensure that your purchases are making the impact you think they will is by shopping with Komen’s Annual Live Pink program.

This year, Komen has partnered with more than 25 companies, and the lineup of products and services available includes everything from specially designed clothing and skin care products to bagels and bikes. By shopping with the brands in the Live Pink portfolio during October, you can help fund research and care services that support people through their breast cancer diagnosis, treatment and beyond. Program details are transparent on the Live Pink site.

For other purchases you make this National Breast Cancer Awareness Month that make charitable claims, Susan G. Komen recommends

MORE INFORMATION

» To learn more and to shop, visit komen.org/ livepink. asking the following questions: 1. What charity is the program supporting?

Do promotional materials about the product or service clearly and conspicuously state this information?

2. How will the benefitting charity use the donation? You should be made aware where your money is going and what charitable programs your purchase will support. Funds raised to benefit Komen, for example, go to support the organization’s advocacy for breast cancer patients, investments in research and a number of direct patient care services.

3. How is the program structured? What percentage or exact amount of the proceeds will go to the charity? Will the company be making a minimum or maximum donation to the charity?

Shop only with companies that offer transparency with regards to program details and how donations are structured.

By shopping savvy this October, you can support the fight against breast cancer and ensure your purchases are making the biggest impact possible.

– StatePoint

National Breast Cancer Awareness Month is about raising breast cancer awareness and reminding women to get their mammograms, especially if they have put it off due to the pandemic or other reasons.

The Centers for Disease Control and Prevention says mammograms are still the best way to detect breast cancer early when it is easier to treat. Early screening and early detection reduce death rates and dramatically increase survival.

According to the CDC: • Each year in the United States, about 42,000 women and 500 men die from this disease.

• Annually, some 255,000 cases are diagnosed in women and 2,300 diagnosed in men • Black women die from breast cancer at a higher rate than white women According to the American Cancer Society, there is a 99% five-year survival rate if diagnosed early, but the survival rate drops to 28% if the cancer has spread.

The Prince William Health District helps provide low-cost or free mammograms and cervical cancer screening services to women who qualify through the Every Woman’s Life program.

You may be eligible for this program if you meet these qualifications: • If you are a woman between 40 and 64 years old • You are symptomatic and a woman between 18 and 39 years old • You live primarily in the Prince William Health District • Your income is at or below 250% of the Federal Poverty Level • You have absolutely no insurance For more information on the Every Woman’s Life program, call (703) 792-7301 or (703) 792-6301.

Mary Washington Healthcare Breast Care Program The Breast Care Program at the Mary Washington Healthcare Regional Cancer Center ensures you receive a lifetime continuum of care. We provide everything, from routine exams for ongoing breast health to specialized services if diagnosed or considered at high risk for breast cancer.

From the moment you are diagnosed, you are a survivor.

We take a multidisciplinary, highly personalized team approach toward determining the best management plan for you, focusing on cure whenever possible. Our Breast Cancer Nurse Navigators are ready to provide information, guidance, and support throughout your cancer journey.

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Medical Director Kay Blanchard, MD, PhD, FACS

Jeffrey J. Pelton, MD, FACS

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Rachel Coggins, DO

Accreditation Our facility is fully accredited by the National Accreditation Program for Breast Centers through the American College of Surgeons.

NAPBC-accredited centers provide access to comprehensive care by a multidisciplinary team, information about ongoing clinical trials, and new treatment options.

Tiffany G. Simons, RN, MS, C-ANP

Natalie Gergler, PA-C

Learn more about us at

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POWER OF PINK | SURVIVING BREAST CANCER | OCTOBER 2021 | INSIDENOVA.COM

Ashley Sisson, RN Cancer Nurse Navigator

BreastCare.mwhc.com.

Why Black Women Are More at Risk of Dying From Breast Cancer Health equity means that everyone has a fair and just opportunity to be as healthy as possible.

Yet, according to a recently released report, Black women in the United States face a perfect storm of issues spanning across every aspect of the healthcare system and society at large that are causing them to die about 40% more often from breast cancer than white women. Indeed, in some metropolitan areas, the gap can be as high as 74% Why is this happening?

As the report, “Closing the Breast Cancer Gap: A Roadmap to Save Lives of Black Women in America,” by breast cancer leader Susan G. Komen highlights, despite advances in science and increased access to early detection nationally, Black women face the combined effects of racial, gender, ethnic and other forms of bias while navigating systems and institutional structures in which entrenched inequities remain the status quo.

This experience is felt by Black women nationwide, regardless of their income, education or insurance status.

For example, one Black healthcare professional who participated in a focus group for the report noted that her own experience is poor when she goes for treatment without her “white coat.”

“I was ignored until the doctor came into the room and started asking me very specific questions.

The way I answered made the doctor stop and ask my background. I asked, ‘Why does it matter?’ She said, ‘Do you work in the healthcare field?’ I said, ‘More or less.’...

She stopped, and she said, ‘Oh, so what's your title?’ I said, ‘It’s Dr.,’ and within 30 minutes I was upstairs in a room,” the professional said. “If I get treated this way, then what do other people go through? I really felt like I was just another Black face, until they understood that this Black face came with a level of influence and authority.”

These issues are exacerbated by the socioeconomic impacts of segregation, employment practices and racist policies like redlining that still divide many metropolitan areas today. For example, many Black women face difficulties finding high-quality cancer care located near them.

In the report, one Dallas-area

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Black women are 40% more likely to die from breast cancer than white women.

health care provider recounted how a 65-year-old woman walked about 10 miles in the July heat to get to her screening mammogram. By the time she got to the hospital she was dehydrated and had to go to the emergency room to get fluids before her screening. And those who rely on Medicaid or similar insurance are often turned away once they arrive or are forced to wait hours to see someone.

These transportation and insurance issues are just a few of the barriers tragically impacting Black women today. Whether it’s substandard care, the availability and affordability of diagnostics and follow-up care, unfair public policies, insurance practices and implicit bias and racism, the report authors stress that Black women are dying more than white women because our systems are failing them at every step in their breast cancer journey.

Leveraging the insights and solutions recommended in the report, Komen is launching a new initiative called Stand for H.E.R. – a Health Equity Revolution to take specific action in each of the 10 U.S. metropolitan areas where disparities are the greatest.

Made possible by funding from Robert Smith and the Fund II Foundation, this initiative will include several specific interventions to improve the quality of care and to overcome obstacles and bias, including connecting women to care through culturally competent patient navigators.

The hope is that by launching this initiative, other organizations and community stakeholders will join with Komen to address the long-ignored issues that continue to marginalize the Black community.

– StatePoint

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Sentara Northern Virginia Medical Center in Woodbridge.

PHILIPPE NOBILE PHOTOGRAPHY

Cancer During COVID… One Woman’s Journey It’s estimated that one in eight women will develop breast cancer in her lifetime.

For Adwoa Bonsu, it happened in 2009 when she was just 35 years old. Adwoa was diagnosed with Stage 2 Breast Cancer. After a removal of her right breast in April of 2009, Adwoa was on the mend and life returned to normal. So, when she felt a lump in her left breast in January 2020, she panicked.

“I was scared and worried. As time went on, the lump started getting bigger and bigger,” Adwoa said.

In May 2020, at the height of the COVID-19 pandemic, she decided to get answers.

“I decided to get a mammogram to find out if it was cancerous,” Adwoa said. “I was getting my hopes up because I thought I was cancer-free after 10 years.”

Through the Mother of Mercy Free Clinic, Adwoa was able to get a diagnostic order from a doctor for a mammography.

“I had a mammogram and then a biopsy. The lump was determined to be cancerous and aggressive. Right then and there, I became scared. I had no hope because I didn’t know how I was going to get treatment,” she remembers.

The Mother of Mercy Free Clinic referred Adwoa to Dr. Jeffrey Sinclair of the Sentara Surgery Specialists.

“Dr. Sinclair was really nice and talked me through details of my diagnosis and treatment,” she said. “What really registered with me about Dr. Sinclair was when he said, ‘We are going to take good care of you, so don’t worry.’”

During her first meeting with Dr. Sinclair, Adwoa met Heather Byrne, a nurse navigator. Heather introduced herself to Adwoa and asked to join the consultation.

“I don’t know what I would have done without her,” Adwoa said. “She’s been amazing and a Godsend.”

Sentara Northern Virginia Medical Center offers nurse navigators as a free service to help its patients.

Nurse navigators help patients “navigate” through the sometimes confusing process of a cancer diagnosis and the appointments, tests and procedures that follow. Nurse navigators, like Heather, are there

MORE INFORMATION

» Early detection is your best protection against breast cancer. Schedule your mammogram by calling (703) 523-1560 or make an appointment online at sentara. com/mammogram. » Learn how Sentara Healthcare can help you by calling the Sentara Cancer Network Resource Center at (703) 523-1599 or visit sentara.com/cancer.

Heather Byrne is a nurse navigator at Sentara Northern Virginia Medical Center. Nurse navigators help patients “navigate” through the sometimes confusing process of a cancer diagnosis and the appointments, tests and procedures that follow.

PROVIDED

for the patient every step of the way.

“The name ‘navigator’ says it best,” explains Heather, “Many people feel lost trying to figure out how to get the care they need and from whom and when and what they need to do next. When you get a diagnosis of cancer, it becomes even harder. My job is to help make it easier. So I navigate people through the maze of making appointments, understanding the scary words, anticipating the next steps, identifying needs and finding resources both during treatment and after.”

Adwoa says Heather’s help was invaluable.

“She helped me access all the available resources,” Adwoa added. “Without her, I don’t think I would have been able to go through all of my treatments.

She gave me hope. I always feel like I am her only case – which I know I’m not, but that’s how amazing

she is. I really appreciate her.”

Dr. Sinclair referred Adwoa to the chairman of the breast program leadership, oncologist Dr. Geoffrey Moorer, and the co-chairman of the Women’s Health Center, OB/GYN Dr. Richard Jenet.

The next few months was a whirlwind of doctors’ appointments and exams. Adwoa had CT scans, MRIs and repeated blood tests. Her comprehensive team of health providers created a specialized treatment plan that took her cancer and history in account.

On Oct. 22, 2020, Adwoa had her first chemotherapy in the Infusion Center at Sentara Northern Virginia Medical Center.

“Everyone at the infusion center was amazing.

They were patient, caring and went above and beyond to make sure I was always comfortable at every appointment. I’m grateful to them,” she remembers.

Chemo sessions continued into April 2021. As chemo ended, Adwoa was scheduled for surgery in mid-May. Dr. Sinclair removed Adwoa’s left breast, and plastic surgeon Dr. Azra Ashraf implanted expanders for eventual reconstruction, which will take place in the fall.

“Sentara Northern Virginia Medical Center is the best. Their care teams are all amazing,” Adwoa said. “I recommend all of my care team at Sentara because they are the best. They have given me the best of care I could ever ask for and the hope to live.”

It has been a long road, but Adwoa continues to move forward, “As of now, I’ll be on chemo pills for the next year. Eventually after a year, I’m hoping and praying to be cancer free.”

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SENTA R A C A NCER NE T WOR K

Don’t Wait To Get Your Mammogram The Sentara Cancer Network is dedicated to providing women with high-quality, personalized care for breast health. Women can trust that when they choose Sentara Comprehensive

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Masking Everyone Who Enters Our Facilities

Individualized Treatment & Advanced Technology

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Don’t wait to schedule your annual mammogram.

Limiting Visitors

Ongoing, Robust Cleaning for Infection Prevention Sentara is taking every precaution to keep you safe. Visit SafeAtSentara.com to learn more.

Our Sentara Comprehensive Breast Centers are safe and ready to care for you. To schedule an appointment, please visit Sentara.com/Mammogram.

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