2015 Breast Cancer Awareness Section

• Post-treatment Program Helps Cancer Survivors put Lives Back Together • History of Mammogram Technology • Life After Breast Cancer

Tuesday, October 13, 2015

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NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

5 Health Screenings Women Shouldn’t Miss A nutritious diet and daily exercise can promote long-term health, but preventative care also plays a key role in keeping adults healthy as they age.

Routine health screenings can head off potential problems, preventing illnesses and possibly limiting the duration of sickness.

Women may have longer life expectancies than their male counterparts, but that does not mean they can afford to overlook preventative care. The following are five health screenings women should include as part of their healthy routines.

1. Pap tests and pelvic exams: Beginning at age 21 (or earlier if they are sexually active), every woman should get regular Pap smears and pelvic exams to test for any abnormalities in their reproductive systems. Pap smears may be suggested every two to three years depending on a woman’s age. A routine visit with a gynecologist is recommended annually to discuss any changes or worrisome symptoms.

2. Mammograms and breast exams: In addition to conducting self examinations, women should get clinical manual breast exams. Women age 40 and older should get a manual breast exam each year and an annual or bi-annual mammogram.

3. Cholesterol checks: The ideal level of total cholesterol is below 200 mg/DL. Individuals with a higher level of cholesterol may be at a greater risk for

heart disease. Cholesterol screenings can alert doctors to potential trouble and help them develop plans for their patients to lower cholesterol levels. Doctors may suggest dietary changes and advise women to adopt more active lifestyles. Some doctors may even prescribe medication if cholesterol levels are especially high.

4. Skin examination and cancer screening: Women should examine their skin every month for new moles or changes in existing spots or moles to detect early signs of skin cancer. Be sure to check all areas of the body, as skin cancer can appear just about everywhere. Some doctors perform skin cancer screenings as part of routine physical exams, or women can visit a dermatologist.

5. Bone density screening: Those with a risk for osteoporosis, such as women with fractured bones or slender frames, should be screened earlier and more regularly than women without such histories or body types. Doctors generally recommend that women receive annual bone density screenings beginning at age 65. Healthy bones will show a T-score, or the measurement to determine bone density, of -1 or higher.

These suggested screenings and tests are based on general medical guidance.

Women should work with their doctors to develop wellness schedules that promote their long-term health.

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Breast cancer can affect both men and women and is one of the most common forms of cancer. Thanks to increased awareness and screenings, many cases of breast cancer are diagnosed early and treated successfully. BreastCancer.org says that invasive ductal carcinoma, or IDC, is the most common form of breast cancer, accounting for about 80 percent of all breast cancers. The American Cancer Society although IDC can affect women of any age, it is most 1410 North 13thsaysSt.that, • 379-2322 common among women age 55 or older. The good news is that this type of cancer is highly curable, provided it has not spread outside of the ducts to other breast tissue. Survival rates for any breast cancers diagnosed in the early stages are excellent.

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NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

“You feel every little ache and pain, and you think it’s cancer.

Once you have it, it’s never gone. It’s always in your body.”

JAKE WRAGGE/DAILY NEWS

BARBARA LOVERCHECK, a math teacher at Humphrey Junior-Senior High School, is one of the many Norfolk and area residents who have benefited from a post-cancer recovery program made available by Faith Regional Health Services in Norfolk.

‘A TIME TO HEAL’ Post-treatment program helps cancer survivors put lives back together

By KATHRYN HARRIS

kharris@norfolkdailynews.com

HUMPHREY — Barbara Lovercheck knows it’s pointless to worry about every little ache and pain.

But sometimes those thoughts just pop in. It comes with the territory of surviving cancer.

“You feel every little ache and pain, and you think it’s cancer,” the breast cancer survivor from Humphrey said.

“Once you have it, it’s never gone. It’s always in your body.”

Lovercheck is one of many cancer patients who have benefited from a class to help survivors work through those fears.

“A Time to Heal” is a 12-week program offered twice a year at Faith Regional Health Services in Norfolk specifically designed to help men and women regain physical, emotional, intellectual, psychological and spiritual health after undergoing treatment for cancer.

The program was developed in Omaha to address the needs of breast cancer survivors. It was adopted in Norfolk after Nita Totten, a two-time breast cancer survivor, began inquiring about post-treatment care.

“Something was missing from my treatment plan ... I just didn’t feel complete,” Totten said of her feelings after receiving a clean bill of health. “I came in here a whole person, and I’m not leaving a whole person. I want to feel better, but I didn’t feel better.”

Totten said survivors often feel like they need to push their feelings down to be strong for those around them.

“When you do that, you cannot heal.

You haven’t dealt with the issues. You haven’t dealt with how you feel about the way you look, about what you’ve lost and the changes that have gone on in your life,” Totten said.

Totten was put in touch with Sheri Sheriff, the outpatient therapy manager at Faith Regional, who had been

developing a cancer rehabilitation and wellness program since 2009. The hospital was preparing to launch the program in early 2011 when Totten approached.

Sheriff said the hospital’s plan addressed the physical problems that arose from cancer, but Totten was looking for something more.

“There’s caregiver issues. There’s spiritual issues. There’s fear beyond craziness in terms of, ‘Is this thing going to come back and will I have to go through this again?’ ” Sheriff said.

The women soon learned a program called “A Time To Heal” was being developed in Omaha by a doctor of nursing who also was a breast cancer survivor.

“She got done with treatments and had the same feelings, which is so common among cancer survivors,” said Totten, who has since become the administrator of Faith Regional’s Hope Fund.

The course covers a variety of topics throughout its 12-week run, including exercise, nutrition, spirituality and mental attitude. A caregiver or friend is welcome to attend as well.

Sheriff said research on the program’s benefits will soon be published by the program’s creators in Omaha.

The feedback she and Totten have received from program participants shows a vast improvement in the survivor’s quality of life.

The program is open to all cancer survivors, regardless of their type of cancer, where they’ve received their treatment or how long they’ve been cancer free. There is no cost, but space is restricted to 20 per season.

“Survivorship is a relatively new phase of the cancer continuum, but it is a very distinct and important phase,” Sheriff said. “People are living from cancer, and we need to give them the best quality of life possible.”

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NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

The Differences Between Chemotherapy and Radiation Cancer can take on many forms and spread throughout the body, infiltrating healthy cells and causing an uncontrolled division of abnormal cells that often turn into tumors.

Various cancer-treatment options are available to treat men and women diagnosed with this potentially deadly disease, but the ones most familiar to many people are radiation and

chemotherapy.

Working with their doctors, patients can explore their treatment options to determine which therapies may be most effective.

Chemotherapy

Chemotherapy is a cancer treatment in which a patient is administered drugs that are designed to kill cancer cells.

These drugs work by attacking the

components that allow cells to divide, grow and spread. Many chemotherapy drugs are given intravenously, in cycles, over a couple of weeks, but some chemotherapy medications may be taken orally. Chemotherapy primarily targets cells that divide rapidly, like cancer cells.

But because other healthy cells also divide rapidly, such as cells in the hair and digestive tract, patients may experience side effects in these areas when undergoing chemotherapy treatment, according to the Southeast Radiation Oncology Group.

Radiation

Radiation surrounds us in various forms. Many people are familiar with ultraviolet radiation from the sun, and radiation can be present in certain minerals and substances as well. The high-energy particles and waves contained in radiation can be used in cancer therapy, according to the American Cancer Society. Radiation therapy can be delivered in various forms. External radiation uses a machine that precisely

directs high-energy rays from outside of the body into a tumor and nearby tissue.

Internal radiation relies on a radioactive implant placed inside the body near the tumor. Systemic radiation is the delivery of radioactive materials to a patient orally or through an injection.

Hormone therapy

Doctors may suggest hormone therapy to treat breast cancer. The American Cancer Society says estrogen promotes the growth of cancers that are hormone receptor-positive (roughly 67 percent of breast cancers are). Hormone therapy will lower estrogen levels or prevent estrogen from acting on breast cancer cells.

However, it will not work on tumors that are hormone receptor-negative.

Doctors use a combination of therapies to treat breast cancer and other forms of cancer. Learn more about various cancer therapies at The National Institutes of Health’s MedLine Plus website www.nlm.nih.gov/medlineplus/ druginformation.html or speak with an oncologist.

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Public perception that breast cancer is only identified by lumps detected through self-examination or routine mammography may prevent thousands of women from receiving an early diagnosis and the care they need. Although lumps are the most common symptom associated with the disease, women should recognize that breast cancer can produce additional symptoms.

Susan G. Komen for the Cure, one of the premier organizations for breast cancer research, advocacy and treatment, advises that the warning signs for breast cancer are not the same for all women (or men).

Various changes in the breast and body can occur, including the following conditions.

• Breast-size changes: Many left and right breasts are not completely symmetrical, and women familiar with their bodies know that one breast is often slightly larger than the other. However, breast-size changes that occur out of the blue may be indicative of a medical problem.

• Skin rash or redness: Women who are breastfeeding can experience a rash on the breasts from an infection of breast tissue. But those who are not breastfeeding should be evaluated by a doctor if redness, irritation or rash appears.

• Nipple changes: Nipple discharge that starts suddenly and is not associated with breastfeeding can be indicative of cancer. Other changes to the nipples, such

as pulling in of the nipple (inversion) or itchy, scaling skin on the nipple, should be brought to the attention of a doctor.

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

• Lumps elsewhere: Cancerous tumors may not only be felt in the breasts. Breast cancer can spread to the lymph nodes around the breasts, and lumps may be felt under the arms.

• Unexplained pain: The Mayo Clinic advises that less than 10 percent of people diagnosed with breast cancer report pain as a symptom. But unexplained pain in an area of the breast should not be ignored.

Breast pain that does not go away and seems to involve one area of the breast should be checked.

• Fatigue: General cancer symptoms can include unusual fatigue and unexplained weight loss. These symptoms should not be left unchecked.

One of the best things women and men can do is to familiarize themselves with their bodies so they will be more capable of pinpointing any irregularities that may develop. Individuals can routinely look at their breasts and inspect for subtle changes. But remember that hormonal breast changes occur during the menstrual cycle, so it’s best to be familiar with how breasts look and feel both during and after menstruation.

NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

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What do Dense Breasts Mean for Cancer Risk?

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.

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 ultrasound 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.

In addition to more in-depth screenings, women with dense breasts can lower cancer risk by following these guidelines: • Maintain a healthy weight.

• Eat nutritious food.

• Exercise regularly.

• Never smoke or quit immediately.

• Limit alcohol consumption.

• Ask for digital mammography.

Women can consider breast density with other risk factors in the fight against breast cancer.

Preparing for Your Mammography Visit Annual mammograms are widely recommended for women beginning at age 40. Some estimates suggest that more than 48 million mammography screenings are performed in the United States every year.

Whether it is a woman’s first mammography or her twentieth, preparing for the appointment can ease anxiety and make the experience go more smoothly. The following are some guidelines to consider when preparing for a mammography visit.

• Choose a reputable and certified facility. Select a radiology center that is certified by the FDA, which means it meets current standards and is safe. Many women also prefer to select a facility that is covered by their health insurance. Plans usually allow for one mammogram screening per year.

• Time your visit. Schedule the mammogram to take place one week after your menstrual period if you have not reached menopause. Breasts are less likely

Did You Know?

Many abnormalities found on a mammogram are not necessarily cancer, but rather are benign conditions like calcium deposits or dense areas in the breast. If the radiologist or a doctor notes areas of concern on a mammogram, The Mayo Clinic says further testing may be needed. This can include additional mammograms known as compression or magnification views, as well as ultrasound imaging. If further imaging is not effective, a biopsy, wherein a sample of breast tissue is taken, will be sent to a laboratory for testing. In some instances an MRI may be taken when mammography or ultrasound results are negative and it is still not clear what’s causing a breast change or abnormality.

to be tender at this time. Also, schedule your visit for a time when you are not likely to feel rushed or stressed. Early in the day works best for many.

• Dress for the occasion. Two-piece ensembles enable you to only remove your shirt and bra for the examination. A blouse that opens in the front may be optimal. Some facilities require you to wear a paper gown for the exam.

• Watch your grooming practices.

You’ll be advised to abstain from wearing powder, perfume, deodorant, ointment, and lotions on the chest or around the area. These substances may look like an abnormalities on the mammogram image, potentially resulting in false positive diagnoses.

• Take an OTC pain medication.

Mammograms are not necessarily painful, but they can put pressure on the breasts,

which creates discomfort. Breasts are compressed between a plastic plate and the imaging machine. This spreads out the tissue and helps create a clearer picture. If your breasts are tender, medications like acetaminophen or ibuprofen taken an hour before the appointment may ease discomfort.

• Expect a short visit. Mammogram appointments typically last around 30 minutes. The technician will mark any moles or birthmarks around the breasts so they can be ignored on the imaging. You’ll be asked to hold your breath as the images are taken. If the images are acceptable, you are free to go. But new images may be needed in some instances.

Mammograms are now a routine part of women’s preventative health care. The procedure is simple and appointments are quick and relatively painless.

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NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

Proper Steps to Conducting a Breast Self-exam Women recognize the importance of living a healthy lifestyle, which includes conducting self-exams to detect for breast cancer. Breast self-exams are vital to discovering abnormalities, including lumps or tenderness, in the breasts.

Self-examination increases the chances of early detection of breast cancer. John Hopkins Medical Center states that 40 percent of diagnosed breast cancers are detected by women who feel a lump.

Doctors urge women to conduct monthly self-exams to familiarize themselves 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.

The National Breast Cancer Foundation, Inc., offers these tips for conducting a breast examination at home. * Examine breasts in the shower. A breast examination can take place in the shower while you are washing. The shower is a convenient place to conduct an exam since you already have removed your clothes. 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. Check both breasts each month for any lumps, thickening or hardened knots.

If you find a lump, visit your physician for an evaluation. * Conduct an examination in bed.

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exactly the same shape or size, but unusual dimpling or taut or thick skin may be indicative of a problem.

Should any lumps or abnormalities be discovered during an examination, a woman should not panic but schedule an appointment with her doctor for a more thorough examination, which may include a mammogram or ultrasound to map out images of the breast that may be hidden to the naked eye.

Breast self-examinations are an essential element of a healthy lifestyle for women. Early detection of breast cancer vastly improves survival rates, and selfexamination is often the most effective way to detect breast cancer early on.

Cancer Therapy and Coping with Hair Loss A breast cancer diagnosis can catch a person off-guard and drum up all types of feelings. Many people diagnosed with cancer become anxious about treatment and any potential side effects it may produce.

Hair loss is one side effect widely associated with cancer treatment, though not all cancer patients will lose their hair.

For example, Breastcancer.org notes that patients undergoing radiation therapy for breast cancer will not lose the hair on their heads because radiation is a localized treatment. Hair loss in the area of treatment, such as under the arms or on the breast itself, may occur. But hair loss on other areas of the body is more likely to occur as a result of chemotherapy treatment, as chemotherapy affects the entire body. Chemotherapy targets rapidly dividing cells. Hair follicles are some of the fastest-growing cells in the body and chemotherapy targets fast-growing cancer cells.

Various studies show that many women fear losing their hair more than losing a breast, as breast loss can be concealed more easily than hair loss. However, there are ways to cope with hair loss, particularly through the use of wigs and head coverings.

• Ask your doctor to write a prescription for a wig, which may be covered by your health insurance. If you are

covered, that can help to offset the cost of the wig.

• Start shopping for a wig early on — even before hair loss occurs. As you get further along into treatment, you may feel fatigued and not up to shopping for wigs.

• Choose a color that is similar to your natural hair color. This will help the wig look more natural.

• If possible, purchase more than one wig so you have a backup or another style choice.

• Visit a wig store at least once for a proper fitting so you will know what to look for. Wigs come in different cap sizes. Once you know your size, you can consider shopping for wigs online.

• Human hair wigs are more expensive, but they can be more durable than synthetic wigs and offer more styling choices.

However, synthetic wigs can usually be worn out of the box and require less daily styling.

• Head wraps and hats are an alternative when you need a break from wearing a wig. Choose a variety of options so you can coordinate with your clothing.

Losing hair due to cancer treatment is seldom easy. Being prepared for the transition by having a quality wig and comfortable head wraps at the ready can make dealing with hair loss easier.

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over your chest wall and ribs when you are lying down. NBCF advises you to place a pillow under your right shoulder and your right arm behind your head.

Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit. Squeeze the nipple and check for discharge or lumps. Then repeat the process on the left breast. * Conduct a visual examination.

Standing in front of the mirror, you can look at your breasts with your hands at your side and over your head. Look for any differences between breasts. Many women find that their breasts are not

NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

Life After Breast Cancer The moment a person receives a breast cancer diagnosis, his or her life changes immeasurably. The roller coaster of emotions begins, and suddenly this person is thrust into a schedule of doctor’s appointments, treatments and visits from friends and family.

The World Cancer Research Fund International says breast cancer is the second most common cancer in women and men and is the most frequently diagnosed cancer among women in 140 of 184 countries worldwide. Despite that prevalence, the five-year relative survival rate for women diagnosed with localized breast cancer (cancer that has not spread to the lymph nodes or outside the breast) is 98.5 percent, says the American Cancer Society. Survival odds increase as more is learned about breast cancer and more people take preventative measures, including routine screenings. Today, there are nearly three million breast cancer survivors living in the United States.

Breast cancer treatments may last anywhere from six months to a year.

Adjusting after treatment may not come so easily at first. But adjustments are easier with time, and many cancer survivors continue to live life to the fullest in much the same way they did prior to their diagnosis.

When treatment ends, patients often still have fears about the cancer, wondering if all of the cancerous cells have been destroyed and worrying about recurrence.

But focusing on the present and all of the things you now can do with health on your side is a great way to put your fears behind you.

Many cancer survivors must still visit their doctors after treatments end. Doctors still want to monitor patients closely, so be sure to go to all follow-up appointments and discuss any symptoms or feelings you may be having. Side effects may continue long after radiation or chemotherapy has ended. Your doctor may have suggestions for coping with certain side effects or will be able to prescribe medications to offset these effects.

It’s not uncommon to feel differently after cancer treatment, as your body has been through quite a lot. Many women still experience fatigue, and sleep or normal rest doesn’t seem to make it abate.

Realize this is normal, and how long it will last differs from person to person. It can take months or years for you to experience your “new normal.” Things do not happen overnight. While your hair may grow back quickly, it may take some time for you to feel like yourself again. Exercise routines or other lifestyle changes may help you overcome fatigue or make it more manageable.

Speaking with others who have survived breast cancer can help. Join a support group or reach out to others through social media. Getting a first-hand account of what can be expected the first year after treatment can assuage anxiety.

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NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

Oral Contraceptives and Breast Cancer Risk Oral contraceptives have prevented pregnancies for decades. But some women take contraceptives to help regulate menstrual period symptoms and to treat other issues, including acne.

Many women wonder if taking birth control pills affects their risk of developing breast cancer.

A number of studies indicate that taking oral contraceptives appears to slightly increase the risk of developing cancer among younger women, according to the National Cancer Institute.

However, discontinuing oral contraceptive use for 10 years or more returns risk levels to normal. The Mayo Clinic notes that it is difficult to weigh the effect of birth control pills on breast cancer risk. Although some studies have shown a link between the two, more recent studies do not show an increased risk for breast cancer while taking birth control bills.

The variety of oral contraceptives available perhaps plays a role in why studies into the potential link between contraceptives and breast cancer risk may be flawed. Birth control pills may combine various levels of two female sex hormones, called estrogen and progesterone, and this combination works by preventing the release of eggs from the ovaries, changing the lining of the uterus to make it inhospitable for a fertilized egg, as well as changing the mucus at the cervix to prevent sperm

from entering. A triphasic pill, in which the dose of hormones is changed in three stages over the course of the woman’s monthly cycle, seems to be the biggest culprit in raising breast cancer risk.

Women who started menstruating at an early age and subsequently began taking oral contraceptives in their teenage years also are at a slightly higher risk.

Experts believe that birth control pills could affect cancer risk because the estrogen and progesterone have been known to influence the development of some cancers. It is believed the more estrogen a woman is exposed to during her lifetime, the greater her risk for breast cancer. It is not known if this is only the case with naturally occurring estrogen, man-made synthetic versions used in oral contraceptives or both.

Women can weigh the pros and cons of taking birth control pills with their gynecologists. Some believe that taking oral contraceptives could decrease risk of other types of cancers, including ovarian and endometrial cancer. Women who take birth control pills to control severe premenstrual syndrome, known as premenstrual dysphoric disorder, may find that the benefits outweigh the slightly elevated risk of breast cancer.

There is no cut-and-dry answer as to whether or not oral contraceptives put women in danger of developing breast cancer.

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Wearing a Bra After a Mastectomy When treating breast cancer, doctors may explore various options based on a patient’s symptoms and how far the cancer has advanced. In addition to radiation, chemotherapy and removal of the tumor (lumpectomy), mastectomy may be part of the treatment plan.

Personal and medical reasons have increased the number of mastectomies being performed. According to Harvard Medical School, mastectomy has been effective in curing or at least retarding early-stage breast cancer. And today, surgeons can reconstruct breasts quite well through plastic surgery. However, whether women choose reconstructive surgery or not, they may need a little help getting used to their new bodies and feeling comfortable in bras and clothing.

• Find a good fit. A large percentage of women may not be wearing the right bra size even before mastectomy surgery. After surgery, it is essential to find the right fit. A good mastectomy bra fitter can help a person find the right size bra for her body and a shape that feels the most comfortable. Certified mastectomy fitters may be found by doing a little research and may even be covered by insurance.

• Discover your style. Depending on scarring or where tissue was removed, some women may need particular bra styles, such as a camisole or a fuller-coverage bra. Once correct measurements are taken, shoppers should try a variety of different bra styles until they determine which ones feel the best in terms of support and coverage.

• Consider a breast form or prosthesis. Women who have not had

reconstructive surgery can wear an artificial breast form after mastectomy.

This device helps balance the body and can offer a better bra fit on the side of the body where the breast has been removed. These prostheses come in different materials and can be customdesigned to provide a similar feel to natural breast tissue. Some forms adhere directly to the body, while others will fit into the pockets of mastectomy bras. Women can be fitted for a prosthesis around four to eight weeks after surgery.

• Change bras and prostheses regularly. Many women do not know that bras have a shelf life. The average bra should be replaced every three months to a year. Prostheses should be replaced every one to two years, says the American Society of Clinical Oncology.

It can take some time for a woman to be comfortable with her new body after mastectomy surgery. Getting the proper fit for a bra can help improve confidence and help women feel better in their clothing.

NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

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Men Not Immune to Breast Cancer

Though it’s significantly less common in men than women, breast cancer is not exclusive to women. That may surprise many men, who may not realize that they have breast tissue that can be susceptible to breast cancer just like their female counterparts.

The likelihood of a man developing breast cancer remains quite slim, as the American Cancer Society noted that they expected roughly 2,200 new cases of invasive breast cancer diagnoses in men in 2013. But the relative rarity of male breast cancer cases does not mean it’s something men should take lightly, as a breast cancer diagnosis can be just as deadly for men as it can for women. Though male breast cancer prevention can be difficult because of the uncertainty surrounding the cause of the disease, men who understand the risk factors are in a better position to handle a diagnosis than those who don’t. * Age: Age plays a role in many cancer diagnoses, and male breast cancer is no exception. According to the ACS, the average age a male is diagnosed with breast

cancer is 68, and a man’s risk increases as he ages. * Alcohol and liver disease: Heavy alcohol consumption increases a man’s risk for breast cancer, and this can be connected to liver disease, which is another risk factor for male breast cancer.

Heavy alcohol consumption can make men more likely to develop liver disease, including cirrhosis. Men with severe liver disease tend to have high estrogen levels because the liver finds it more difficult to control hormonal activity. Higher estrogen levels have been linked to breast cancer risk for men and women alike. * Family history: Just like age, family history can increase a man’s risk for various cancers, including breast cancer.

The ACS notes that roughly 20 percent of men with breast cancer have close male and female blood relatives who also have or have had the disease. * Inherited gene mutations: Gene mutations greatly increase a woman’s risk of developing breast cancer, and they can be risky for men as well. Men with a

mutation in the BRCA2 gene have a lifetime risk of breast cancer of about 6 percent. A mutated BRCA1 gene also can increase a man’s risk of breast cancer but not as significantly as a mutated BRCA2 gene. Mutations in these genes are most often found in families with significant histories of breast and/or ovarian cancer.

But even men with no such family history can have the gene mutations associated with breast cancer. Mutations in the CHEK2 and PTEN genes can also increase a man’s risk for breast cancer. * Klinefelter syndrome: A congenital condition affecting roughly one in 1,000 men, Klinefelter syndrome occurs when a man’s chromosome count is abnormal. A typical male body has cells with a single X chromosome and a single Y chromosome, but men with Klinefelter syndrome have cells with a Y chromosome and at least two and as many as four X chromosomes. Men with Klinefelter syndrome are often infertile, and, when compared to other men, they have more female hormones than male hormones. Though Klinefelter

syndrome is so rare that it’s hard to study, some studies have found that men with this condition are more likely to develop breast cancer than other men. * Obesity: Recent studies have begun to show that women who are obese have a greater risk of developing breast cancer, and researchers feel obesity poses a similar threat to men. That’s because fat cells in the body convert male hormones into female hormones, which means obese men will have higher estrogen levels than men who are not obese. * Radiation exposure: Men who have undergone radiation treatment in their chest area have a higher risk of developing breast cancer than those who have not.

Lymphoma treatments may require radiation treatment to the chest, so men who have been diagnosed with lymphoma might be at a heightened risk of breast cancer.

While the overwhelming majority of breast cancer patients are female, men should know they aren’t immune to this potentially deadly disease.

Educating Young Women About Breast Cancer At the age of 12 to 15, many young women are experiencing the body and life changes that accompany adolescence. It can be difficult to imagine that breasts that are just beginning to develop may contain cancer. But such is the reality for some girls.

The majority of women who receive a breast cancer diagnosis are over the age of 40.

Experts at Monroe Carell Jr. Hospital at Vanderbilt University note that only 5 percent of breast cancer cases are found in women under the age of 40. However, the hospital recently treated a 14-year-old girl who found a lump and learned she had a rare form of breast cancer called a phyllodes tumor. In 2009, a 13-year-old from Little Rock, Ark. found a quarter-sized lump in her right breast, while a 19-year-old student at the College of New Jersey was diagnosed with cancerous cells and underwent a bilateral mastectomy.

Though such cases are rare, it encourages teenage and adolescent girls to familiarize themselves with the disease and be mindful of their breast health.

Some organizations have increased breast cancer messages for young girls, and it is not uncommon to find young women participating in runs and fundraisers for breast cancer research. Some organizations even conduct breast cancer workshops to educate young women about breast health.

Dorothy Paterson of Texas, a former Girl Scout leader who was diagnosed with breast cancer herself, began conducting workshops for Girl Scouts in 2007. The idea isn’t to scare girls into believing they have the disease, but rather to increase their awareness of changes in their bodies that may or may not be normal.

Some parents worry that educating children about breast cancer may cause them to worry unnecessarily, especially considering a young girl’s risk of developing breast cancer is so minimal. However, others see the importance in schooling girls early on about a disease that is so common. Advocates of teaching young girls about breast cancer often note that any effort to help save lives and promote health is worthwhile.

Just as with older women, adolescents and teens should realize that eating healthy foods, exercising, avoiding alcohol and

tobacco, and maintaining annual physical exams with a doctor are key ways to reduce the risk for cancer.

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NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

What Causes Benign Breast Lumps?

Johns Hopkins Medical Center says that 40 percent of breast cancer diagnoses result from self-examinations in which individuals find lumps in their breasts. Selfexaminations are important for early diagnosis of breast cancer, but not every lump felt is cancerous. Though no lump found in the breast tissue should be ignored, women and even men must remain calm upon discovering a lump, as it could very well prove benign.

Several different types of benign lumps can form in the breast. Women may find that their breasts regularly feel a bit lumpy.

This is due to the milk ducts, lobules and lymph nodes that are found in and around the fatty tissue of the breast. In addition, benign lumps may form as the result of fluid-filled cysts, clumps of fat, excess skin, or even ingrown hairs that block a hair follicle. Benign lumps generally require no treatment if they are not causing pain or any other problems in the body. Infection and hormonal changes during menstruation can contribute to benign lumps in the breast, as can a host of other conditions.

Fibroadenoma: A fibroadenoma is a common lump found in the breast that is not cancerous. These are typically smooth, rubbery lumps that move easily in breast tissues. These types of lumps commonly occur in teenagers and also in women under the age of 30. The cause of fibroadenomas is unknown, but they are thought to be linked to reproductive hormones. They may increase in size during pregnancy and tend to shrink after menopause.

Cysts: Cysts are fluid-filled sacs that

form under the skin. If they are painful, cysts can be drained of fluid. Oftentimes a doctor will take a fluid sample from the cyst to rule out cancer.

Fibrosis: This is a firmness in the connective tissues of the breast. Lumps may form where breasts are especially firm.

Benign tumors: Benign tumors can grow where breast cells have grown abnormally or rapidly. Unlike cysts, tumors are solid. A biopsy is the only way to determine if a tumor is benign or cancerous.

Fat necrosis: Scar tissue that feels like a lump may develop when a breast heals after injury.

Mastitis: This is an infection that most often occurs when a woman is breastfeeding. The breasts can feel painful and warm. Abscesses also may form.

Antibiotics can usually clear up the infection.

Intraductal papillomas: Papillomas can form inside the breast as tiny, wart-like growths. When they occur around the ducts in the nipple, they can cause the nipple to discharge blood. These fibrous tissues can be removed and are not cancerous.

Duct ectasia: When a milk duct beneath the nipple dilates, the walls of the duct thicken and the duct fills with fluid. Then the duct can become blocked and clogged, causing unusual nipple discharge.

Many of these conditions mimic the symptoms of breast cancer. But very often lumps found in the breast are benign. If a lump is found, don’t panic and contact your physician.

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Foods That Help Fight Cancer The foods we eat contribute directly to our overall health. From toddlers just getting used to solid foods to adults planning their diets, the foods we eat heavily influence how healthy or unhealthy we become.

Some foods can even reduce our risk for certain diseases, including cancer.

According to the American Institute for Cancer Research, numerous studies have demonstrated that individual minerals, vitamins and phytochemicals have certain anticancer properties that can protect men, women and children from this potentially deadly disease. The following are a handful of foods the AICR says can fight cancer and help men and women improve their overall health. * Apples: Apples are a great source of vitamin C, with one apple providing at least 10 percent of the recommended daily amount of this valuable vitamin. Apples also are a great source of fiber, which can help men and women maintain a healthy weight. That’s important, as excess body fat increases a person’s risk for seven different types of cancer. A major portion of apples’ dietary fiber is pectin, a polysaccharide that bacteria in the stomach uses to produce compounds that protect colon cells. * Cherries: Cherries are another great source of fiber and vitamin C, and sweet and tart cherries also contain potassium.

Cherries get their dark color from anthocyanins, which are antioxidants that protect cells from damage. Studies have shown that anthocyanins inhibit the growth of cancer cells and even stimulate their self-destruction while having no negative effects on healthy cells.

Anthocyanins also have been shown to reduce signs of inflammation in adults who consumed two to three servings of cherries or cherry juice per day.

* Grapefruit: One-half of a mediumsized pink, red or white grapefruit provides at least 50 percent of an adults’ daily recommended intake of vitamin C. Though research into the potential anticancer properties of grapefruit with regard to humans is ongoing, studies of animals and cells have shown that grapefruit powder as well as limonin and naringenin, two phytochemicals found in grapefruit, decrease the growth and increase the self-destruction of breast, colon, lung, mouth, skin, and stomach cancers. * Walnuts: Nuts are often cited when discussing foods with anticancer properties, but the AICR notes that walnuts, in particular, are the most heavily researched. Despite that research, the AICR remains hesitant to draw any conclusions with regard to walnuts and their potential link to lowering cancer risk.

However, several studies of mice found that consuming walnuts decreased the growth of breast and colon tumors among mice who ate walnuts as opposed to those who did not, while other studies in mice indicated that walnuts reduced the growth of prostate cancer. Studies into the impact of the Mediterranean diet, which includes walnuts, have shown that such a diet can help people lose fat and lower their blood pressure and triglycerides. But the AICR still notes the need for more research into walnuts before they can be considered foods that fight cancer.

Many factors, such as family history, that increase our risk for developing cancer are beyond our control. But the foods we choose to eat can play a significant role in reducing our risk of developing various cancers. More information about the link between diet and cancer is available at www.aicr.org.

NORFOLK DAILY NEWS, TUESDAY, OCTOBER 13, 2015

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History of Mammogram Technology Mammography remains one of the most popular and well-known diagnostic tools for breast cancer. It is estimated that 48 million mammograms are performed each year in the United States and many others are conducted all around the world under the recommended guidance of doctors and cancer experts.

Mammography can be traced back more than 100 years to 1913, when German surgeon Albert Salomon attempted to visualize cancer of the breast through radiography. By the 1930s, the concept of mammography was gaining traction in the United States.

Stafford L. Warren, an American physician and radiologist, began his own work on m a m m o g r a p h y, developing techniques of producing stereoscopic images of the breast with X-rays. He also championed the importance of comparing both breast images side-by-side.

Raul Leborgne, a radiologist from Uruguay, conducted his own work on mammography and, in 1949, introduced the compression technique, which remains in use today. By compressing the breast, it is possible to get better imaging through the breast and use a lower dose of radiation. Also, compression helps spread

the structures of the breast apart to make it easier to see the individual internal components. Compression helps to pull the breast away from the chest wall and also to immobilize the breast for imaging.

Advancements in mammogram technology continued to improve through the 1950s and 1960s. Texas radiologist Robert Egan introduced a new technique with a fine-grain intensifying screen and improved film to produce clearer images. In 1969, the first modern-day film mammogram was invented and put into widespread use.

The mammogram process was finetuned in 1972 when a high-definition intensifying screen produced sharper images and new film offered rapid processing and shorter exposure to radiation.

By 1976, the American Cancer Society began r e c o m m e n d i n g mammography as a screening tool.

Through the years, mammography became a great help to women looking to arm themselves against breast cancer.

Thanks to improvements in early detection Call 402.887.6269 to schedule your appointment today! and treatment, breast cancer deaths are down from their peak and survival rates continue to climb.

Celebrities Who Have had Breast Cancer Breast cancer remains one of the most common forms of cancer among women, surpassed only by skin cancers. Anyone, even men, can get breast cancer, but gender, age and hereditary factors do put some at greater risk than others.

Many famous women have bravely battled breast cancer. The following are just a few of the famous women who made their battles with breast cancer public.

• Christina Applegate: Applegate underwent a double mastectomy after being diagnosed with early stage breast cancer in 2008. She continues to be a source of inspiration for other breast cancer patients and survivors.

• Sheryl Crow: Even before her own diagnosis in 2006, Crow was raising money and awareness for cancer. Crow had radiation therapy and minimally invasive surgery and has since been cancerfree.

• Cynthia Nixon: Popular television actress Nixon originally kept her cancer diagnosis private. But she shared her story two years after diagnosis and is now a breast cancer awareness advocate.

• Giuliana Rancic: Talk-show host Rancic

had a double mastectomy in 2012. She shared her story to help other women and provide inspirational hope.

• Judy Blume: The famed young adult author was diagnosed with breast cancer in 2012, 17 years after being diagnosed with cervical cancer.

• Olivia Newton-John: The actress and singer discovered breast cancer in 1992 and took a hiatus for surgery and chemotherapy. She has since been an advocate for breast cancer awareness so other women can see the importance of early detection.

• Dame Maggie Smith: Renowned British Actress Smith was diagnosed with breast cancer in 2007 while filming her sixth appearance as Professor McGonagall in the “Harry Potter” series. She continued to work on the movie while undergoing chemotherapy and radiation.

• Wanda Sykes: Comedienne Sykes revealed that she had a double mastectomy in 2011 after doctors found evidence of early-stage breast cancer in her left breast.

• Robin Roberts: The “Good Morning America” anchor was diagnosed with early-stage breast cancer in 2007.

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Rethinking Breast Cancer Treatment: One Woman’s Story (BPT) - In the United States, one in five new breast cancer cases is stage 0 disease, but for Amy Thigpen, a mother of three who works in an oncology clinic, breast cancer is not a statistic; it is personal. After all, her mother is a breast cancer survivor, and later, she too faced-off with a similar diagnosis.

After Amy’s mother was diagnosed with early-stage invasive breast cancer, Amy was determined to be proactive about her breast health. She had a feeling something was not right and requested a mammogram from her doctors at the age of 34, even though clinical practice guidelines do not recommend screening before the age of 50. The mammogram found a small tumor that was confined to the milk ducts; fortunately, it had not spread to the surrounding tissue. At that point, Amy faced her diagnosis - stage 0 breast cancer, known as ductal carcinoma in situ, or DCIS.

An oncology nurse in the hematology oncology department at Physicians East in Greenville, North Carolina, Amy worked alongside a breast cancer specialist and had seen many patients battle the disease and struggle with the many decisions that had to be made - including whether or not to pursue post-surgery treatment. After caring for so many cancer patients over the years, Amy now was speaking with her doctors about a difficult decision of her own, as it was not clear whether her cancer would come back and if she needed radiation therapy.

Amy was familiar with genomic testing and a tool doctors sometimes used to guide treatment decisions. Her mother had received the Oncotype DX test for her invasive breast cancer and used the test results to help inform her decision of whether she needed chemotherapy.

Inspired by her mother’s experience, Amy talked to her doctor about genomic testing,

5 Ways to Support a Friend Diagnosed with Cancer (BPT) - Learning a good friend or family member has been diagnosed with cancer can be shocking news. You want to do anything you can to help and support her, but it’s difficult to know what to say and do.

Cancer patients with strong emotional support tend to have a more positive outlook and adjust better to the changes cancer treatment brings to their lives, according to cancer.org. You have the opportunity to be a part of that emotional support group and help bring about a better quality of life for your friend or family member.

With the emphasis on breast cancer awareness during October, it’s a great time to think about how you can serve women with any kind of cancer. Here are some ideas for what you can do right now: Give the gift of a clean home. One of the most beneficial things you can do to help are everyday tasks that get forgotten like grocery shopping or cleaning the house. Sometimes it’s the unexpected that makes the biggest impact. Cleaning for a Reason is an organization that partners with professional residential maid services to provide free house cleanings to women battling cancer. With more than 1,200 local maid services in all 50 states, this

organization helps women focus their energy on fighting cancer. “Breast Cancer Awareness Month is a special time for our organization,” says Cleaning for a Reason founder Debbie Sardone.

Make plans. Spend time with your friend just like you did before cancer came into her life. Short, regular visits are always better than long, infrequent ones and always be sure to call ahead before your visit. Be flexible and understanding if your friend suddenly isn’t feeling up to a visit.

Encourage other family members.

People tend to focus solely on the cancer patient which puts their caregivers and family members on the back burner. These caregivers are under a lot of stress trying to cover both their existing roles and the new responsibilities of caring for someone who is sick. Offer to babysit the kids for a night or drive them to their after school activities. Don’t forget to take time to ask how the rest of the family is doing.

Be careful with gifts of food. While cooking a meal or bringing over baked goods may seem like a good idea, your friend may have diet restrictions during her treatment. Cancer patients often have symptoms of nausea and vomiting, so always ask before you bring over a dish to share.

Maintain your support. Cancer patients need steady support throughout the entire process. It’s easy to be there during the initial diagnosis, but it’s the people who stick around that truly make a difference. Make an agreement with your friend group, church group or other organization to take turns offering support.

Even if your friend turns down help, ask again every week or two, so it’s clear you are always willing to be there for her.

Learn more about supporting a friend with cancer by visiting cleaningforareason.org.

and since the Oncotype DX test was now available and validated to provide the 10year risk of an invasive or a DCIS local recurrence in DCIS patients, they decided to move forward. The Oncotype DX DCIS Score result has been shown to change treatment recommendations in 30 percent of patients and doctors rank it as the most important factor in treatment planning for DCIS patients.

When Thigpen received her Oncotype DX test results, her DCIS Score result was zero. “I was so excited, I carried the results to my doctor and knew we had our answer.

I wouldn’t have radiation. The test probably saved me from having to go through six weeks of radiation that my body really did not need, as well as the side effects that it can cause.”

“When a woman is diagnosed with DCIS, my goal as a physician is to accurately assess her individual risk for cancer returning so we can define and personalize an appropriate treatment plan with greater confidence,” said Michael Alvarado, M.D., breast cancer surgeon, the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center. Reflecting on a UCSF-led

study of the clinical utility of the Oncotype DX test for DCIS, Dr. Alvarado added that that test was “an objective biomarker that provides independent information beyond what has been available to physicians before, which can be seen as the biggest advancement in the management of DCIS in more than a decade.”

To encourage other women to pursue personalized treatment, Amy decided to share her story on www.MyBreastCancerTreatment.org, a patient education resource providing information around breast cancer and the benefits of genomic testing. The tools, resources and eligibility quiz offered on this website enable patients and their loved ones to empower themselves with information about their specific cancer and work with their doctor to confidently select a treatment plan that can guide personalized treatment decisions based on their individual tumor.

“You have to be your own advocate and push for what you truly feel in your heart is right, because when the day is over, you have to be 100 percent comfortable with your treatment plan.”

Front row, left to right: Kevin Armbruster, Bobbi Risor, Scott Bonsall, Travis Reich, Chad Wurdeman, John Reding. Back row, left to right: Ross McKenzie, Lance Conroy

City Of Norfolk Fire Division Support Breast Cancer Awareness

By Diane Becker Special to the Daily News

Three years ago, members of the City of Norfolk Fire Division decided to wear pink t-shirts when they were on duty for the month of October to show their support for breast cancer awareness. They have since made it a tradition each October to wear pink on their emergency calls.

“We’ve had people say they appreciate us recognizing the need for treatment and also the support we are giving for people

fighting this disease. Almost everyone knows of a relative or friend that has been affected by breast cancer. Wearing the pink shirts is a way we can make a connection to the people we serve,” said Captain John Reding.

Breast Cancer Awareness Month is an annual international health campaign organized by major breast cancer charities to increase awareness and to raise funds for research. The color pink is used to increase awareness and also to remind women to be “breast cancer aware” for early detection.