Breast Health

A Mediaplanet Guide to Breast Cancer Prevention & Treatment

Breast Health

Olivia Newton-John Read why the pop culture icon is funding plant-based cancer therapies

Discover the truth behind this littleknown form of breast cancer Learn why Amy Robach says she doesn’t regret a thing

DECEMBER 2020 | FUTUREOFPERSONALHEALTH.COM

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One Patient With Metastatic Breast Cancer Shares Her Story Athenex Oncology spoke with patient Susan Swanson about living with metastatic breast cancer (MBC). Life was busy and moving along for Swanson, her husband of 30 years, and their three kids before she got the diagnosis — stage 4 MBC. Has your diagnosis affected you emotionally?

I’ve had times of emotional and physical isolation. I haven’t met anybody with MBC who hasn’t experienced that. But I try to live in the moment and appreciate the joy in each day.

How have you approached your treatment for MBC? I spend a lot of time looking at clinical trials, researching treatment options, talking to different doctors, and trying to be as knowledgeable as I can.

What do you do to help yourself from feeling isolated or down?

I walk. With friends, with my dog, by myself. I’ll walk with anybody. Walking is a great way to just be — to not always be thinking.

Have you found any online support or resources to be helpful?

Yes! Through FacingMBCTogether.com, I’ve connected to a community of people who also have MBC. It is life-changing to interact with people who can relate to what I’m going through. Remember that no matter how you feel, you don’t have to feel alone.

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Why Experts Are Worried About the Future of Cancer Research Cancer research is vital to improved treatments and patient outcomes, but experts at the American Cancer Society and elsewhere warn that the pandemic has put research funding at serious risk.

Shannon Vick of Berkeley Heights, New Jersey was pregnant with her second child when she learned she had breast cancer, the first of her two diagnoses. About five years later, after the cancer had metastasized to her pelvic bone, she was “terrified,” but there were more and better treatment options available to her.

“These treatments, as my doctor put it, work until they don’t work,” said Vick, who now has four children.

“So, when or if my protocol stops working, I want another one to be in place that’s just as good or better.

I can’t afford cancer research to slow down even for a second.”

Vick attributes her surviving and thriving to cancer research. Without research, the drugs that she is currently on wouldn’t be available, she said, nor would new treatments be on the horizon.

Experts fear the pandemic has put the future of cancer research at risk

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because research takes decades to come to life. Today’s cancer breakthroughs began perhaps 10-20 years ago with a novel idea from a single investigator. Incremental discoveries push research forward over a period of years or decades, and breakthroughs occur only after years of foundational work. But much of that work has been put on hold, or faced being halted, because of a lack of funding.

“This is a once-in-a-generation crisis,” said Dr. William Cance, chief medical and scientific officer of the American Cancer Society (ACS).

“If researchers cannot get funding many will shift their careers in another direction — potentially losing the next big cancer-related breakthrough.”

It’s crucial to keep the pipeline of cancer research full, Cance explained, not only to discover new and better treatments and potential cures, but also to continue work to advance health equity. For example, Black women have a death rate that’s almost 40 percent higher than white women. The ACS is funding research to determine why this is happening and to correct it.

“Cancer is a disease that affects everyone, but it is a disease that does not affect everyone equally,” said Cance. “We cannot let lack of funding stand in the way of everyone being able to prevent and fight this disease equally.”

According to the American Cancer Society Cancer Facts & Figures, in 2020 an estimated 279,100 women and men in the United States will be diagnosed with breast cancer and 42,690 will die from the disease. “[Lack of funding] could affect a generation of new scientists,” said Dr. Darren Roblyer of Boston University’s School of Engineering, who is developing a wearable probe to monitor breast tumors during therapy. “If we lost funding for the lab, that means that we can’t make the findings that we might otherwise have that could help cancer patients.

And more than that, it means that some Ph.D. students, or post-docs that were being trained in this area might have to switch to other fields or go out of research altogether.” n Theresa Freeman, Director of Communications, American Cancer Society

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The Olivia Newton-John Foundation Is Funding Research of Plant-Based Cancer Treatments Olivia Newton-John says that her experience with plant-based cancer therapies inspired her to establish the ONJ Foundation.

therapies by her husband, John Easterling, a medicinal plant specialist. “I’ve learnt from him that there are over 100,000 species of plants in the Amazon forest alone and they’ve only studied three percent of those for their therapeutic value,” New- L E D AY ton-John said. “Just imagine the possibilities out there.” in Western medicine. “Right The ONJ Foundation now, doctors probably don’t focuses its mission on explorfeel confident recommending these possibilities and ing plant-based therapies helps fund research into because there isn’t the sciplant-based cancer treatence to back it up,” Newments. “A lot of people out ton-John said. “That’s what there are believing these we want to provide with the things can work but they havONJ Foundation.” en’t had the funds to research Newton-John first got them properly,” Newton-John involved with wellness said. “That’s what made me research when she estabwant to form this foundation lished the Olivia Newand fund the research.” ton-John Center in MelPart of the resistance bourne, Australia in 2005. towards plant-based medi“The relationship with cines, Newton-John said, is the ONJ Center has been simply a lack of knowledge P H OT

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livia Newton-John is a three-time breast cancer survivor, having undergone surgery, chemotherapy, and radiation treatments over the course of 28 years. A combination of plant-based medicines with these mainstay treatments, however, is what inspired her to establish the Olivia Newton-John Foundation (ONJ), which helps fund new cancer research.

“I always wondered as I was going through my treatments, wouldn’t it be wonderful if there were kinder therapies for cancer,” the star of “Grease” and “Xanadu” said. “Things that helped build the body’s immune system instead of poisoning it and breaking it down before you built it back up again.”

Newton-John was first introduced to plant-based

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amazing,” she said. “That was a very novel idea to have a wellness center in a public hospital. I had to fight for that. In the beginning people didn’t really know what to think of it or take it seriously but it’s really had great benefit for the patients.”

When she was a patient at the wellness center two years ago, the actor experienced the benefits firsthand. “I was in the center with a fractured sacrum from a metastasis,” Newton-John said. “The wellness programs would come to me in my room and I had great benefit from it.”

The new organization is beginning its fundraising efforts by auctioning memorabilia, photos, and other items that Newton-John has donated, hosted by Julien’s Auctions on November 30th.

“We’re trying to create a community. We’re just a baby,

we just were born. Now we’re trying to put together a little kindergarten of people to share their stories,” Newton-John said. “Then we’ll start interviewing different researchers and scientists, the ones who are doing the studies, who we think will have the most benefit around the world.”

In addition to her personal experience, Newton-John said she was inspired in this mission after losing a close friend to cancer — her friend Kelly Preston in July of this year. “I think it just reinforced my need to do this,” she said.

“It saddened me incredibly but also gave me the strength to keep going with what I’m doing, because I don’t want this to keep happening to any more of my friends, or anybody,” Newton-John said. “I feel that my life’s purpose is to see a world beyond cancer and to see an end to it.” n Ross Elliott

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Spreading the Word About Triple Negative Breast Cancer Not so long ago, there wasn’t much publicly available information about this unique type of breast cancer. Luckily, thanks to advances in healthcare and the work of advocates, patient outcomes for triple negative breast cancer are looking better than ever.

hen my friend Nancy Block-Zenna was diagnosed with triple negative breast cancer (TNBC) in 2005, her family and friends struggled to find credible information about the disease. At the time, little was known about TNBC and support services for the thousands of families faced with this diagnosis was scarce. Most people were completely unaware that not all breast cancers were the same, and that certain subtypes of the disease were far more difficult to treat. Today, things are different. There is a much better understanding of TNBC, improved treatment options, and tremendous support for the TNBC community.

Understanding triple negative breast cancer The various types of breast cancer are generally diagnosed based on the presence or absence of three “receptors” known to fuel most breast cancer tumors: estrogen, progesterone, and HER2.

A diagnosis of TNBC means that the tumor in question does not exhibit any of these three receptors. Since most advances in the fight against breast cancer involve receptor-targeting therapies, those with triple negative tumors are at a disadvantage.

That said, chemotherapy can be highly effective in early stage TNBC, and significant progress has been made over the past decade in the metastatic setting as well.

PARP inhibitors, immunotherapy, and antibody-drug conjugates have changed the treatment landscape, and researchers are actively

investigating potential new therapies. Ongoing clinical trials are looking into reducing the risk of recurrence, particularly for those patients who have not had a complete response to their initial treatment.

“It’s exciting to see the FDA approvals that have come in over the last few years which have led to dramatic changes in how we treat metastatic TNBC,” said Dr. Rita Nanda, associate professor of medicine and director of breast oncology at the University of Chicago.

Being a self advocate While treatment of TNBC has advanced over the years, it’s as important as ever to take an active role in your healthcare decisions. This begins with being proactive and checking your breasts regularly. When something doesn’t feel right, seek out

medical help as soon as possible. And in the event of a TNBC diagnosis, know your options. Being comfortable with your medical team and confident in their knowledge of treating TNBC is crucial.

While the pandemic has created many challenges in the healthcare world, increased use of telemedicine has also provided new opportunities to access experts.

Second opinions are now easy to obtain. For patients who live in rural areas or for those with transportation issues, virtual medical appointments are a game changer.

Now, no matter where you are being treated, you can have your data reviewed by TNBC experts in a leading academic center. There are also many educational resources available online through the Triple Negative Breast Cancer Foundation (www.tnbcfoundation.org) and other advo-

cacy groups. These resources, from taped teleconferences to printed resources, can help educate you about your diagnosis and make you feel more confident about your treatment choices.

Connecting with family and peers during COVID-19 Another positive consequence of the pandemic is the widespread use of Zoom, which allows people to access a virtual community. The Triple Negative Breast Cancer Foundation offers virtual monthly meetups through Zoom, where TNBC thrivers from all over the United States and even abroad join to share information and to support one another. Many long-term TNBC thrivers participate, offering guidance and hope to newly diagnosed members. n Hayley Dinerman, Co-Founder and Executive Director, Triple Negative Breast Cancer Foundation MEDIAPLANET

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IMPORTANT SAFETY INFORMATION TRODELVY can cause serious side effects, including: • Low white blood cell count (neutropenia). Low white blood cell counts are common with TRODELVY and can sometimes be severe and lead to infections that can be life-threatening. Your healthcare provider should check your blood cell counts during treatment with TRODELVY. If your white blood cell count is too low, your healthcare provider may need to lower your dose of TRODELVY, give you a medicine to help prevent low blood cell count with future doses of TRODELVY, or in some cases may stop TRODELVY. Your healthcare provider may need to give you antibiotic medicines if you develop fever while your white blood cell count is low. Call your healthcare provider right away if you develop any of the following signs of infection during treatment with TRODELVY: fever, chills, cough, shortness of breath, or burning or pain when you urinate.

• Severe diarrhea. Diarrhea is common with TRODELVY and can also be severe. Your healthcare provider should monitor you for diarrhea and give you medicine as needed to help control your diarrhea. If you lose too much body fluids (dehydration), your healthcare provider may need to give you fluids and electrolytes to replace body salts. If diarrhea happens later in your treatment, your healthcare provider may check you to see if the diarrhea may be caused by an infection. Your healthcare provider may decrease your dose or stop TRODELVY if your diarrhea is severe and cannot be controlled with anti-diarrheal medicines.

- Call your healthcare provider right away the first time that you get diarrhea during treatment with TRODELVY; if you have black or bloody stools; if you have symptoms of losing too much body fluid (dehydration) and body salts, such as lightheadedness, dizziness, or faintness; if you are unable to take fluids by mouth due to nausea or vomiting; or if you are not able to get your diarrhea under control within 24 hours.

Do not receive TRODELVY if you have had a severe allergic reaction to TRODELVY. Ask your healthcare provider if you are not sure. TRODELVY can cause severe and life-threatening allergic reactions during infusion (infusion-related reactions). Tell your healthcare provider or nurse right away if you get any of the following symptoms of an allergic reaction during an infusion of TRODELVY or within 24 hours after you receive a dose of TRODELVY: swelling of your face, lips, tongue, or throat; hives; skin rash or flushing of your skin; difficulty breathing or wheezing; lightheadedness, dizziness, feeling faint, or pass out; chills or shaking chills (rigors); or fever.

Nausea and vomiting. Nausea and vomiting are common with TRODELVY and can sometimes be severe. Before each dose of TRODELVY, you will receive medicines to help prevent nausea and vomiting. You should be given

medicines to take home with you, along with instructions about how to take them to help prevent and treat any nausea and vomiting after you receive TRODELVY. Call your healthcare provider right away if you have nausea or vomiting that is not controlled with the medicines prescribed for you. Your healthcare provider may decide to decrease your dose or stop TRODELVY if your nausea and vomiting is severe and cannot be controlled with antinausea medicines.

Before receiving TRODELVY, tell your healthcare provider about all of your medical conditions, including if you: • have been told that you carry a gene for uridine diphosphate-glucuronosyl transferase A1 (UGT1A1)*28.

People who carry this gene have an increased risk of getting side effects with TRODELVY, especially low white blood cell counts.

• have liver problems.

• are pregnant or plan to become pregnant. TRODELVY can harm your unborn baby. Your healthcare provider should check to see if you are pregnant before you start receiving TRODELVY. TRODELVY may cause fertility problems in females, which could affect your ability to have a baby. Talk to your healthcare provider if fertility is a concern for you.

–Females who can become pregnant should use effective birth control during treatment and for 6 months after your last dose of TRODELVY. Talk to your healthcare provider about birth control choices that may be right for you during this time.

–Males with a female partner who can become pregnant should use effective birth control during treatment and for 3 months after your last dose of TRODELVY. –Tell your healthcare provider right away if you or your partner become pregnant during treatment with TRODELVY. • are breastfeeding or plan to breastfeed. It is not known if TRODELVY passes into your breastmilk and can harm your baby. Do not breastfeed during treatment and for 1 month after your last dose of TRODELVY. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Certain medicines may affect the way TRODELVY works.

The most common side effects of TRODELVY include nausea, low white blood cells (neutropenia), diarrhea, tiredness, decreased red blood cell count, vomiting, hair loss, constipation, rash, decreased appetite, stomach-area (abdomen) pain and respiratory infections.

These are not all of the possible side effects of TRODELVY. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

HER2=human epithelial growth factor receptor 2; HR=hormone receptor. ©2020 Immunomedics, Inc

All Rights Reserved. Sep 2020

2020-US-TROT-00034

For patients with metastatic triple-negative breast cancer (mTNBC) who have received at least two therapies for metastatic disease

I’M TAKING ON mTNBC Not an actual patient.

Ask your doctor about TRODELVY

What is TRODELVY? TRODELVY™ (sacituzumab govitecan-hziy) is a prescription medicine used to treat adults with a certain type of breast cancer known as triple-negative (HR and HER2 negative) that has spread to other parts of the body (metastatic) and who received at least two therapies for metastatic disease.

TRODELVY is approved based on medical studies that measured how many patients responded and how long they responded. Continued approval may depend on benefit demonstrated in additional medical studies.

It is not known if TRODELVY is safe and effective in people with moderate to severe liver problems or in children.

Please see Brief Summary of full Prescribing Information on following pages.

VISIT TRODELVY.COM TODAY TO LEARN MORE

Patient Information TRODELVY™ (troh-DELL-vee) (sacituzumab govitecan-hziy) injection What is the most important information I should know about TRODELVY? TRODELVY can cause serious side effects, including: • Low white blood cell count (neutropenia). Low white blood cell counts are common with TRODELVY and can sometimes be severe and lead to infections that can be life-threatening. Your healthcare provider should check your blood cell counts during treatment with TRODELVY. If your white blood cell count is too low, your healthcare provider may need to lower your dose of TRODELVY, give you a medicine to help prevent low blood cell count with future doses of TRODELVY, or in some cases may stop TRODELVY. Your healthcare provider may need to give you antibiotic medicines if you develop fever while your white blood cell count is low. Call your healthcare provider right away if you develop any of the following signs of infection during treatment with TRODELVY: - fever - shortness of breath - chills - burning or pain when you urinate - cough • Severe diarrhea. Diarrhea is common with TRODELVY and can also be severe. Your healthcare provider should monitor you for diarrhea and give you medicine as needed to help control your diarrhea. If you lose too much body fluids (dehydration) your healthcare provider may need to give you fluids and electrolytes to replace body salts. If diarrhea happens later in your treatment, your healthcare provider may check you to see if the diarrhea may be caused by an infection. Your healthcare provider may decrease your dose or stop TRODELVY if your diarrhea is severe and cannot be controlled with anti-diarrheal medicines.

Call your healthcare provider right away: - the first time that you get diarrhea during treatment with TRODELVY - if you have black or bloody stools - if you have symptoms of losing too much body fluid (dehydration) and body salts, such as lightheadedness, dizziness or faintness - if you are unable to take fluids by mouth due to nausea or vomiting - if you are not able to get your diarrhea under control within 24 hours What is TRODELVY? TRODELVY is a prescription medicine used to treat adults with breast cancer that is: • estrogen and progesterone hormone receptor (HR) negative, and human epidermal growth factor receptor 2 (HER2)-negative (also called triple-negative breast cancer), and • that has spread to other parts of the body metastatic, and • who previously received at least two therapies for metastatic disease It is not known if TRODELVY is safe and effective in people with moderate or severe liver problems.

It is not known if TRODELVY is safe and effective in children.

Do not receive TRODELVY if you have had a severe allergic reaction to TRODELVY. Ask your healthcare provider if you are not sure.

Before receiving TRODELVY, tell your healthcare provider about all of your medical conditions, including if you: • have been told that you carry a gene for uridine diphosphate-glucuronosyl transferase A1 (UGT1A1)*28. People who carry this gene have an increased risk of getting side effects with TRODELVY, especially low white blood cell counts. See “What is the most important information I should know about TRODELVY?” • have liver problems.

• are pregnant or plan to become pregnant. TRODELVY can harm your unborn baby. Your healthcare provider should check to see if you are pregnant before you start receiving TRODELVY. - Females who can become pregnant should use effective birth control during treatment and for 6 months after your last dose of TRODELVY. Talk to your healthcare provider about birth control choices that may be right for you during this time.

- Males with a female partner who can become pregnant should use effective birth control during treatment and for 3 months after your last dose of TRODELVY. - Tell your healthcare provider right away if you or your partner become pregnant during treatment with TRODELVY. • are breastfeeding or plan to breastfeed. It is not known if TRODELVY passes into your breastmilk and can harm your baby.

Do not breastfeed during treatment and for 1 month after your last dose of TRODELVY. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Certain medicines may affect the way TRODELVY works.

How will I receive TRODELVY? • Your healthcare provider will give you TRODELVY into your vein through an intravenous (IV) line.

• TRODELVY is given 1 time each week, on Day 1 and on Day 8 of a 21-day treatment cycle.

• You will receive the first dose of TRODELVY over 3 hours. If you tolerate the first dose well, future doses may be given over 1 to 2 hours.

• Before each dose of TRODELVY, you will receive medicines to help prevent infusion reactions, and nausea and vomiting.

• You will be monitored for side effects during and for at least 30 minutes after you receive each infusion of TRODELVY. • Your healthcare provider may slow down or temporarily stop your infusion of TRODELVY if you have an infusion-related reaction, or permanently stop TRODELVY if you have a life-threatening infusion-related reaction.

• Your healthcare provider will decide how long you will continue to receive TRODELVY. What are the possible side effects of TRODELVY? TRODELVY can cause serious side effects, including: • See “What is the most important information I should know about TRODELVY?” • Severe and life-threatening allergic reactions. TRODELVY can cause severe and life-threatening allergic reactions during infusion (infusion-related reactions). Tell your healthcare provider or nurse right away if you get any of the following symptoms of an allergic reaction during an infusion of TRODELVY or within 24 hours after you receive a dose of TRODELVY: - swelling of your face, lips, tongue, or throat - difficulty breathing or wheezing - hives - lightheadedness, dizziness, feeling faint or pass out - skin rash or flushing of your skin - chills or shaking chills (rigors) - fever • Nausea and vomiting. Nausea and vomiting are common with TRODELVY and can sometimes be severe. Before each dose of TRODELVY, you will receive medicines to help prevent nausea and vomiting. You should be given medicines to take home with you, along with instructions about how to take them to help prevent and treat any nausea and vomiting after you receive TRODELVY. Call your healthcare provider right away if you have nausea or vomiting that is not controlled with the medicines prescribed for you. Your healthcare provider may decide to decrease your dose or stop TRODELVY if your nausea and vomiting is severe and cannot be controlled with anti-nausea medicines.

The most common side effects of TRODELVY include: • tiredness • rash. See “Severe and life-threatening allergic reactions” above.

• decreased red blood cell count • decreased appetite • hair loss • stomach-area (abdomen) pain • constipation TRODELVY may cause fertility problems in females, which could affect your ability to have a baby. Talk to your healthcare provider if fertility is a concern for you.

These are not all of the possible side effects of TRODELVY. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

General information about the safe and effective use of TRODELVY. Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. You can ask your pharmacist or healthcare provider for information about TRODELVY that is written for health professionals.

What are the ingredients in TRODELVY? Active ingredient: sacituzumab govitecan-hziy Inactive ingredients: 2-(N-morpholino) ethane sulfonic acid (MES), polysorbate 80 and trehalose dihydrate Manufactured by: Immunomedics, Inc., 300 The American Road, Morris Plains, NJ 07950, USA U.S. License No. 1737 For more information about TRODELVY, go to www.TRODELVY.com or call 1-888-983-4668.

The Patient Information has been approved by the U.S. Food and Drug Administration.

©2020 Immunomedics, Inc All Rights Reserved. Sep 2020 2020-US-TROT-00088

Issued: April 2020

The Internet’s “Cancer Fashionista” On Life as a TNBC Thriver

What was your first reaction when hearing the words, ”triple negative” when you got your diagnosis?

My immediate reaction was, “triple negative sounds triple bad!” Upon my diagnosis, I immediately scheduled a consultation with my breast oncologist.

Fortunately, I already had a long-standing relationship with a genetic breast oncologist because I’m a BRCA1 gene carrier and was closely monitored for several years prior to my diagnosis.

I attribute my positive outcome to a couple of things. First and foremost, I found tnbc.org! Their website and organization is not only information, but also incredibly community-oriented and supportive. I found current information, but also a special group of women who were going through the same thing that I was going through.

Secondly — taking my mother’s great advice to get tested for the BRCA gene, since we’ve had so much breast cancer in our family, was a key factor to my survivorship. If I wasn’t so closely monitored, I don’t know that my breast cancer would have been detected so early in the game. I was diagnosed with stage 1 triple negative breast cancer with no lymph node involvement. My treatment included a bilateral mastectomy and aggressive chemotherapy.

I recall my oncologist explaining to me that although triple negative breast 12

cancer sounds pretty bad, it’s also very responsive to chemotherapy, and the likelihood of a recurrence decreases significantly once you’ve hit the five-year mark. I’m so grateful to say that I am now at my seven-year mark!

What were some of the day-today challenges that you faced while living with TNBC that oftentimes go undiscussed?

One of the most difficult challenges that I faced during my TNBC treatment was my depression and anxiety. Facing a cancer diagnosis head-on is difficult enough, but the one thing that I didn’t expect was the psychological effect that the chemotherapy drugs can have on you. I would love this conversation to be opened up and discussed more regularly.

What are three things that a breast cancer survivor needs to transition back to work, and what should their colleagues be mindful of?

1. Flexibility and patience; if possible, speak to your employer and colleagues and let them know you’ll need some time to transition back in. Your memory may be foggy, and you may experience fatigue during the day. It’s best to let your team know to be patient with you as you transition back in to your full-time-role.

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PHOTO: JEN ROZENBAUM

Melissa Berry put her fashion and beauty background to good use during her journey with triple negative breast cancer (TNBC), by creating the Cancer Fashionista, an online resource for essential style tips for patients with cancer. In an exclusive Q&A, she’s answering questions about her own experience with TNBC, from diagnosis to thriving seven years on.

2. Be patient with yourself. Healing takes time, and your healing isn’t just physical, it’s also emotional. You may not be able to complete tasks as quickly as you did before. Your attention span may be compromised. Try to make your task lists very realistic and achievable, this way you’ll feel productive as well as positive about returning to the workplace.

3. Having an active social life makes you feel better and happier. You may not feel like going out for late dinners or drinks with your co-workers, so instead don’t hesitate to suggest lunch or even a coffee before the workday begins.

Tell us a little bit more about Cancer Fashionista. What does that entail? Any other fun projects on the horizon?

My background is fashion and beauty PR. Throughout my breast cancer journey, I struggled to look and feel my best during such a difficult chapter of my life. I began scouring the internet for beauty tips and tricks to help manage the appearance-related side effects of my experience, as well as for niche products that would help me with recovery from treatment. I began to keep track of the best advice and items that I found, then created the CancerFashionista.com blog to share my rec-

ommendations with other women facing similar diagnoses.

Cancer Fashionista quickly grew in popularity with its readers and followers on social media, and I’m proud to say that I’ve become a trusted voice in the breast cancer community, as well as in the triple negative breast cancer community. In 2016, I received the Triple Negative Breast Cancer Foundation’s Courage Award which was a truly incredible honor.

Today, I sit proudly on the Board of Trustees for the Triple Negative Breast Cancer Foundation. I hold breast cancer workshops, moderate panel discussions, advocate for triple negative breast cancer, and help women look and feel their best throughout their breast cancer journeys and beyond.

My fashion and beauty background combined with my TNBC experience has afforded me the unique ability to research and report on fashion, beauty, and lifestyle resources and trends that the breast cancer community can truly benefit from.

I’m currently working on some exciting projects with several different publications, nonprofit organizations, and like-minded brands. I can’t wait to share more with you as these initiatives solidify!

You spoke of a longstanding relationship with your breast oncologist. Why is it important to have a close relationship with your medical support team?

I was fortunate enough to have a really wonderful breast oncologist who was there for me every step of the way. After my diagnosis, our relationship evolved from very serious and critical to a more lighthearted one. As the years went on without recurrence, my appointments were stretched out and I saw him less and less. I actually began to miss him!

There’s something really comforting about being closely monitored. It feels safe, a layer of protection. As time goes on and you see your oncologist less and less, it feels as though the cord has been cut. During my last chemotherapy treatment, I remember him telling me, “Survivorship is the hardest part.” I had no idea what he meant until now. n

Helping Breast Cancer Patients Cope With Hair Loss Longtime stylist and cancer survivor Sydney Berry believes personal wellbeing plays a key role in the healing process.

hen women undergo radiation and chemotherapy, it can be an extremely difficult time. In addition to battling a frightening disease, they experience side effects that typically include hair loss.

Sydney Berry, owner of the Seattle-area distributorship Salon Services & Supplies, Inc., wants to make that transition as easy as possible.

“Our outward appearance to our world is very important, specifically when you’re going through treatment, as it supports continuity of your ‘who you are,’ while undergoing medical aspects that change the visual for yourself and how you project yourself in your interactions with others,” said Berry, who understands the pain of losing all your hair — including eyelashes and eyebrows.

“One of the first places women go when they’re in chemo is to the hairdresser. A stylist can transform their vision of who they are and can also listen and console.”

Looks do matter Berry explained that as a woman endures surgeries and treatments, it’s essential for her to hold on to the sanctity of self-image.

“When you step out of the shower, you’ve suddenly lost the perception of who you are. It can be scary.

That’s why the outward appearance is important, to let

you know you’re going to be okay,” she said. “It’s a fact that 8-12 percent of cancer patients will forgo chemotherapy due to loss of hair.”

COVID complications The global pandemic has made a difficult situation even more challenging for cancer patients. Some may even consider skipping a trip to the physician’s office, which Berry calls a huge mistake.

“I have to see a doctor every three weeks to monitor my progress. The medical community takes every precaution necessary to keep you safe. The biggest priority is adherence to the medical protocol that’s established to monitor the success, or not, so they can assess the next option.”

Berry shared her personal experience as an example.

“As a cancer ‘thriver’ of 31 years, with the last six years with metastasized bone cancer treatments, we’ve altered the treatment seven times, with various results,” she explained. “The one I am on now is the best, as it’s lowering my cancer markers. The doctors wouldn’t be able to address [your cancer] if you’re inconsistent with your treatment protocol, if you weren’t adhering to the specifications required.”

Finding solutions Fortunately, there are options for patients worried about losing their locks. HairtoStay, for example, is a foundation that makes cooling caps — which can help

reduce hair loss during chemotherapy — affordable for patients facing financial hardship.

“In addition, ‘Look Good, Feel Better’ is taught by volunteers within the beauty industry and in association with Professional Beauty Association, which I currently chair and have been involved with for decades,” Berry said. “They host workshops to assist in teaching beauty techniques to people, with lessons in skin and nail care, cosmetics, wigs, and stylists to help find some normalcy in their lives.”

Giving back “As a company, we consistently work with foundations we believe are making a difference in the world,” said Berry.

“We work with WingsofKaren.org and Valleygirlsandguys.org in raising money for hospital wings to doctors researching cures for cancer, with a vaccine with immunotherapy for your body to work in its own defense.”

Berry added, “We align with many more foundations, as salons are so connected to the world in understanding and supporting clients, plus generous in their giving to be the resource for their clients. Our industry is one of beauty and well-being, and we’re here to be their resource with avenues to support.” n This has been paid for by Salon Services.

Cindy Riley

MEDIAPLANET

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Understanding the Role of Pathology In Breast Cancer Diagnosis & Care The laboratory plays a central role in breast cancer diagnosis and care, and pathology and medical laboratory scientists are critical to patient health.

Waiting for test results is never an easy time. You feel like your health is hanging in the balance, and the next words out of your doctor’s mouth could change the course of your life forever.

As technology and treatments have advanced over the past decade, a breast cancer diagnosis isn’t what it used to be. We know so much more now about the different stages and types of breast cancer than we did even 10 years ago.

You may not be familiar with the pathology department — not many patients are. Or you may know it only as the place your vials of blood or swabs are sent for testing. This is true, and it’s where we run the tests to help figure out if there is an issue with your health. For breast cancer patients, the laboratory is also where tubes of your blood samples are sent to check for biomarkers.

Clinical laboratory scientists analyze substances in blood that can signal cancer, your propensity for developing cancer, or the progression of disease. And when a sample of tumor is sent to the laboratory, the pathologist examines tumor cells under the microscope, sometimes using special staining techniques to determine exactly what type and stage of cancer you have. This is done by analyzing thin slices of tumors under a microscope. These test results help your pathologist determine your diagnosis, and ultimately your course of treatment.

It’s important to remember that these tests are all moving parts of a diagnosis and are performed by men and women with incredibly refined skill sets. The laboratory is responsible for approximately 70 percent of the decisions made during the course of a patient’s care. The men and women in the laboratory, and the work they do, are critical to patient health. We are a part of your care team, and while there is no one-sizefits-all scenario when it comes to breast cancer, the laboratory is another vital resource for you in responding to your diagnosis.

While the laboratory has always played a central role in care, the recent evolution toward patientcentric care across healthcare has encouraged pathology teams to take a more visible role with patients. We can be invaluable partners for patients with cancer, and we encourage patients to involve us — to ask questions to better understand what test results mean for life going forward and diagnosis.

We are stronger when we work together, and pathology and medical laboratory scientists are here as a partner in your health, every step of the way.

Kimberly W. Sanford, M.D., MASCP, MT(ASCP), President, American Society for Clinical Pathology

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Breast Cancer Rehabilitation & Survivorship Care Helps Patients Get Back to Normal Survivorship care for breast cancer patients starts with screening for physical, emotional, and nutritional needs, ensuring the design and implementation of an accurate aftercare program.

Breast cancer is devastating for the 1 in 8 women diagnosed. Fatigue, reduced mobility and function, pain, and lymphedema have major impacts on patients’ lives.

But rehabilitation — including physical therapy, exercise, emotional support, and nutritional counseling — has been shown to improve and even prevent these issues.

Every person navigating breast cancer should receive individualized survivorship education, screening, and management of these issues that allow them to feel better faster and get back to their usual activities more quickly.

Massage therapy has been shown to reduce pain and fatigue and increase wellness and quality of life. The role of physical activity and exercise is essential, since multiple researchers have found that fitness decreases the risk for lymphedema and recurrence of breast cancer.

Nutrition is also a vital part of fitness. During and after radiation and chemotherapy, a patient has many unique

nutritional needs. Nutritional counseling and education are integral to the survivorship journey. Additionally, any person going through cancer has new fears, so emotional counseling and group support are also important.

Nutrition is also a vital part of fitness. During and after radiation and chemotherapy, a patient has many unique nutritional needs.

Outcomes from patients able to receive survivorship care has demonstrated significant results. There is improvement in motion, function, strength, and lymphedema. Patients report that they know how to eat healthier and they know how to start their respective fitness programs. Their sense of self and their role within their family and within society are drastically improved.

COVID-19 has shifted how survivorship care can be delivered. Many survivors have suppressed immune systems, and it would be a risk for them to come to a clinic.

Therefore, there are now virtual services available. Similar outcomes are attained via telerehabilitation.

Not all patients or even physicians know about the importance of survivorship care. Patients need to advocate for themselves and ask for such critical care. It may be that this care is not available in their geographical area.

The nonprofit organization TurningPoint Breast Cancer Rehabilitation offers specialized rehabilitation services with in-person and virtual programs to support individuals with breast cancer near and far. TurningPoint uses a prospective surveillance model for breast cancer rehabilitation developed in conjunction with the American Cancer Society.

It has a strong emphasis on early detection and management of issues along with patient education about treatment side effects that ideally begins at diagnosis or early in postoperative care. n Jill Binkley, Founder & Program Director & Dr. Marilyn Pink, Executive Director, TurningPoint Breast Cancer Rehabilitation

It’s Time to Reschedule Breast Cancer Screenings Elective procedures, including mammograms, were put on hold during the early days of the pandemic, but it’s time to get these important breast cancer screenings back on the schedule.

hen hospitals were quickly filling with patients infected with the new coronavirus back in the spring, many elective medical procedures were put on hold because staff and resources were diverted to treating COVID19 patients. Included in these cancelations were screening tests such as mammogram appointments for early detection of breast cancer.

We know that cancer will not stop during the pandemic.

An estimated 280,000 people in the United States will have their lives change dramatically after they receive a breast cancer diagnosis in 2020. Among those diagnosed, African American women will have the highest death rate of all racial and ethnic groups, as they are 42 percent more likely to die of breast cancer than white women.

Reducing risk There are some things that can help lower your chances of getting breast cancer, including maintaining a healthy weight, regular exercise, and decreasing alcohol consumption. Other risk factors cannot be avoided, like the natural aging process or inherited genetic mutations that significantly increase your risk of getting breast cancer.

Getting screened Finding cancer early is important because it improves the odds of survival and can reduce side effects from more invasive treatments.

Even though the pandemic is not over, hospitals and medical facilities are offering elective procedures again, including cancer screenings. All healthcare facilities have put rigorous protocols in place to protect patients and employees.

From temperature checks at entrances, to stringent disinfecting practices, mask and social distancing rules, and regular testing for staff, healthcare providers are

doing everything possible to keep the spread of COVID-19 at bay.

Various organizations have different recommendations on when to start getting mammograms, but a good rule of thumb for average-risk women is to start getting mammograms when they are 40 years old. Talk to your doctor to find out what is best for you.

For people with inherited genetic mutations linked to breast cancer, the likelihood of getting breast cancer increases by 50 to 80 percent.

In those situations, the age at which to start screening — as well as the type of screening — is more individualized than recommendations for the general population. There are standardized blood tests that can determine if you have some of these genetic mutations.

Patients who test positive for the mutations can then discuss with their doctors and determine if they want to take specific preventive measures to lower the likelihood of developing cancer.

Advancements in research We’ve known for several years that breast cancer is not a single disease. Researchers have discovered biological differences in the types of breast cancers that carry a risk of spreading to other parts of the body. Although major improvements in this field have been made recently, there remains much work to be done and finding new treatments is as important as ever. A big goal currently is to identify the right therapy for each person to minimize side effects and improve the odds of survival.

Recognizing this need for better therapies, Stand Up To Cancer® (SU2C) has assembled some of the world’s preeminent doctors, researchers, engineers, and mathematicians into breast cancer dream teams. For more than 10 years, SU2C has dedicated over $54 million to breast cancer research, including ongoing studies focusing on three major subtypes of breast cancer: estrogen-positive, HER2 positive, and triple negative.

The goal is to find new ways

to outsmart cancer cells that become resistant to current drugs, prevent the cancer from spreading to other organs, and find ways to harness the body’s immune system to recognize and destroy cancer cells.

With a commitment to accelerating research and clinical trials that lead to new therapies and ultimately save lives, SU2C-supported research has contributed to the development of two treatments for breast cancer approved by the FDA in the last decade.

Time to reschedule While research and treatment options continue to advance, the most important factors in beating breast cancer include a healthier lifestyle along with early detection.

The five-year survival rate for breast cancer is 99 percent if it is caught before it spreads outside of the breast. So please check with your doctor and do not delay your mammogram.

Cancer screenings can, and do, save lives. n Dr. Edith A. Perez, M.D., Committee Chair, Stand Up To Cancer Health Equity MEDIAPLANET

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Amy Robach Doesn’t Regret Going Through Breast Cancer in Public When she got a mammogram in the middle of Times Square in front of millions of people, the morning show host had no idea that it would be the beginning of a public battle with cancer.

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s cohost of GMA3, Amy Robach has a whole new platform to talk about women’s health, to spread awareness about breast cancer, and to provide support and community to women dealing with the same issues she did.

But this is not Robach’s first rodeo when it comes to candid discussions about women’s health on the airwaves. In fact, it was during a live televised mammogram that the broadcast journalist was first alerted to her own breast cancer. A follow up doctor’s appointment confirmed the diagnosis.

Robach lived her cancer journey from diagnosis to remission all in the public eye. In many ways she went her own way when it came to breast cancer, including choosing to get a double mastectomy against the advice of her oncologist and choosing to continue at work throughout her treatment. At the same time, she said, realizing she wasn’t alone at all gave 16

Now, Robach says she can’t imagher the support she needed through ine having done it any other way. “I even the toughest times. wasn’t even prepared for the unbe“When I decided to have the mamlievable support I got from women mogram in a mammoth van in the all over this country,” she said. “They middle of Times Square in front of sent me gift boxes and about 5 million people, care packages and letI thought I was just ters and emails and doing a public service. texts, and I didn’t realRobin Roberts, my dear They don’t ize how important that friend and colleague, want to be was to feel supported, convinced me to do it, thought of to not feel alone, to feel and it was all for other as weak or that love coming.” women, right?” vulnerable, and Still, Robach admits When she got the so they keep it it wasn’t easy to be so breast cancer diagnoto themselves vulnerable or to go on sis a few weeks later, and they’re TV every day when Robach said she didn’t silent, strong she felt at her absolute hesitate before decidwarriors. worst. “But it did give ing to go public. “To me purpose.” not share it would have Robach also underjust felt wrong in every stood firsthand the way, because the goal value of seeing another public figure was to save lives and to change lives go through the same experience. and to help women realize the tools Robach got support from Roberts, for that are there for them and available one, and she said she was encouraged to them.”

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in her decision to go through with a double mastectomy by seeing actor Angelina Jolie get the same surgery.

“I was less fearful of the idea of it, knowing that she did it and still looked elegant and beautiful, because it is a very devastating surgery,” Robach said. “I mean, you’re having a double amputation, basically, and it’s a lot of pain and multiple surgeries. It’s a lot to take on and you live with the scars and you never look the same.”

Robach says she also understands other women living with the same cancer who don’t reach out for support or to share their story. “They don’t want to be pitied. They don’t want to be thought of as weak or vulnerable, and so they keep it to themselves and they’re silent, strong warriors,” she said. “But I always say you’re missing out on letting people love you and that love that you receive — it’s not pity. It’s love and it’s nothing else other than that.” n Lynne Daggett MEDIAPLANET

Our lives have changed so much this past year From the way we work How our kids go to school How we buy groceries But what hasn’t changed is our need for annual breast exams Breast cancer doesn’t pause during a pandemic

Don’t delay. Get yourself a mammogram.

Proudly supporting breast cancer awareness and research for over 25 years

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Understanding Options When It Comes to Breast Reconstruction

PHOTO: COURTESY OF AMERICAN SOCIETY OF PLASTIC SURGEONS

A double mastectomy can be a devastating procedure, both physically and mentally, but breast reconstruction surgery can offer breast cancer patients a renewed sense of self.

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reast cancer is the second-most common type of cancer among women in the United States, but only 23 percent of those facing the disease understand all of 18

their treatment options — including their eligibility and legal right to coverage for breast reconstruction following a mastectomy.

Choosing to undergo breast reconstruction is extremely personal.

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Following surgical removal of the entirety of their breast tissue, some patients decide against further surgery, but many choose to undergo breast reconstruction as a means of restoring breast shape, appearance, and symmetry.

Breast reconstruction typically involves multiple procedures performed in stages, and it can begin at the time of mastectomy or at a later date. The two primary plastic surgery techniques for reconstructing a breast are implant-based reconstruction and flap reconstruction, which uses the patient’s tissue from another part of the body, such as the back or lower abdomen, to restore form.

There are several factors to consider when opting for breast reconstruction, such as cancer treatments, health status, type of mastectomy and body type. To that end, it’s important to learn about the techniques available, identify the pros and cons of each procedure, and discuss your options with a board-certified plastic surgeon.

A breast cancer diagnosis is life-changing, and the side effects of treatment can take a toll. It’s not uncommon to experience a loss of sensation and numbness in the breast and chest post-mastectomy.

Although a reconstructed breast will not have the same sensation as a natural breast, recent technological advancements in breast reconstruc-

tion, such as nerve reconstruction and nipple-sparing mastectomies, aim to preserve and improve sensation. Resensation, a surgical method of nerve repair performed during a flap reconstruction surgery, can restore feeling to the breast area by using allograft nerve tissue to reconnect the severed nerves in the chest to the reconstructed tissue. This innovative technique can help women feel more like themselves and boost their self-confidence and body image.

Breast reconstruction can improve a patient’s quality of life and provide emotional and physical healing during her breast cancer journey. For some, the procedure is a final step in treatment and offers a sense of closure. Although breast reconstruction may not be the right choice for everyone, everyone deserves to know their options so they can make an informed decision about their health.

If you are considering breast reconstruction, the American Society of Plastic Surgeons offers a wealth of online resources, including a listing of board-certified plastic surgeons across the nation who can guide you through the process, recommend an individualized treatment plan and help determine the best reconstruction option for you. n Kendra Y. Mims-Applewhite, Associate Editor, American Society of Plastic Surgeons

Is There Evidence to Support Genetic Testing for All Patients With Breast Cancer?

Genetic testing for breast cancer can help prevent cancers and improve patient outcomes, but there isn’t enough evidence to support hereditary tests for all patients.

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dentification of inherited cancer risk empowers individuals and their families to prevent cancers or detect them early. Furthermore, incorporating genetic testing results into patients’ care plans has the potential to guide treatment and improve outcomes. But testing alone will not improve outcomes.

Implementation of appropriate care following testing is required and data are needed to generate evidence that informs clinical practice.

Of all cancers that develop in women in the United States, breast cancer has the highest incidence, regardless of race or ethnicity. Approximately 5-10 percent of breast cancers are estimated to result from hereditary causes, the majority of which are attributed to pathogenic or likely pathogenic (P/LP) variants in the BRCA1 and BRCA2 (BRCA1/2) genes, although variants in other genes such as PALB2, TP53, PTEN, CDH1, CHEK2, and ATM also contribute.

As progress in precision medicine continues, it is important that patients receive accurate information to ensure the implementation of risk-reducing strat-

egies and evidence-based cancer genomics best practices. The purpose of this new ACMG document is to outline the rationale for ongoing support of existing evidence-based guidelines built on a risk stratification approach while data related to broader testing strategies continues to emerge.

“Medical geneticists play an important role in facilitating the best care and practices of patients with cancer or a predisposition to develop cancer,” said American Col-

Medical geneticists play an important role in facilitating the best care and practices of patients with cancer or a predisposition to develop cancer.

lege of Medical Genetics and Genomics (ACMG) president Anthony R. Gregg, M.D., MBA, FACOG, FACMG. ACMG addressed the question of whether genetic testing should be offered to all patients with breast cancer in a recent statement: “Points to Consider: Is There Evidence to Support BRCA1/2 and Other Inherited Breast Cancer Genetic Testing for All Breast Cancer Patients? A Statement of the American College of Medical Genetics and Genomics.”

“This Points to Consider document acknowledges the complexity of professional organization guidelines in the cancer space. Medical geneticists are uniquely qualified to analyze the literature that informs professional organizations and their guidelines. Implementation of cancer genetic testing guidelines is best when carried out with input and in many cases under the direction of a medical geneticist with cancer expertise,” Gregg said.

When it comes to testing breast cancer patients for genetic predispositions, ACMG advises clinicians to consider patients’ unique medical and family histories, the limited evidence available, genetic testing best practices, and how best to discuss implications of testing with patients.

The document concludes that there is insufficient evidence to recommend genetic testing for all breast cancer patients but outlines the importance of supporting existing guidelines for genetic tests. n Susan Klugman, M.D., FACMG, VP Clinical Genetics , American College of Medical Genetics and Genomics MEDIAPLANET

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