October 31, 2015
The Rogersville Review Special Edition: Breast Cancer Awareness
Breast Cancer
AWARENESS Knowing and recognizing the signss — page 2
Tests to find and diagnose breast cancer — page 2 Cherokee, Volunteer raises more than $14,000 for Breast Cancer research
New American Cancer Society Breast Cancer screening guidelines — page 6
Did you know? — page 6
Vitamin D and breast cancer link — page 7
— page 3
Mammography guidelines continue to evolve — page 6
The Rogersville Review — A Special Edition — October 31, 2015
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The Rogersville Review Special Edition: Breast Cancer Awareness
A
October 31, 2015
Knowing and recognizing the signs of breast cancer may save your life
s with many types of cancer, breast cancer is most successfully treated when it is detected early. Over the previous quarter century, death rates for breast cancer have been on the decline, a positive development that Breastcancer.org, a nonprofit organization dedicated to providing reliable, complete and up-to-date information about breast cancer, suggests is a byproduct of the heightened awareness of breast cancer over the last 25 years and the increasing emphasis placed on breast cancer screening. Understanding the symptoms of breast cancer also can help women battle and defeat this potentially deadly disease. While the presence of any of the following symptoms does not necessarily mean breast cancer is present, the appearance of the following should be enough to inspire women and even men to visit their physicians for thorough examinations and screenings. • Changes in the feeling of the breast or nipple: A change in how the breast or nipple feels could be indicative of a larger problem. If the nipple is especially tender and this persists for an extended period of time, exercise caution and discuss this change with your physician. Similarly, if a lump or thickening develops on or near the breast or underarms, speak with your physician. • Changes in appearance of the breast: A lump or thickening in the breast may affect the appearance of the breast. Another visible symptom of breast cancer is a change in the skin texture or an enlargement of pores in the skin of the breast, which may appear similar to dimpling, not unlike an orange peel. Swelling or shrinking of the breast, especially when such symptoms appear on
with breast cancer have noticed a nipple turned slightly inward or inverted prior to their breast cancer diagnosis. Skin of the nipple, as well as that of the breast and areola, which is the dark circle of skin around the nipple, may also become red, scaly or swollen when breast cancer is present. • Clear or bloody discharge from the nipple: Women who are breastfeeding often notice a milky discharge from their nipple after breastfeeding. Such discharges are normal. However, when a woman who is not breastfeeding notices the presence of a clear or bloody discharge from her nipple, such a development should be brought to the attention of a physician. Any of the aforementioned signs and symptoms may be a sign of infection or the presence of a cyst, both of which are less severe than the presence of breast cancer. But the success rates of treating cancers that are detected early is such that any potential symptom of breast cancer warrants an immediate discussion with a physician. Even women who are a picture of health can develop breast cancer, highlighting the importance women must place on recognizing and detecting the symptoms of this often curable disease. just one breast, may also indicate breast cancer. In addition, some women with breast cancer notice a sudden asymmetry with their breasts despite their breasts previously being symmetrical, and such a development should immediately be brought to the attention of a physician. • Changes in the appearance of the nipple: A nipple that appears different also may be a sign of breast cancer. Some women
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Tests to find and diagnose breast cancer Self-examination is often the first step toward discovering the presence of breast cancer. The importance of self-examinations is immeasurable, and many women are taught from a very young age to conduct such inspections to protect themselves from breast cancer. Breast cancer that is detected early is very treatable, but the longer a person with breast cancer goes undiagnosed the less effective and the more difficult that treatment becomes. But even women who don’t find anything during self-examinations may want to ask their physicians to conduct the following tests designed to find and diagnose breast cancer. • Biopsy: A biopsy, which is the removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer, may be conducted to determine if breast cancer is present. When a lump in the breast is found, doctors may remove a small piece of the lump to perform a biopsy. There are four types of biopsies. An excisional biopsy is the removal of an entire lump of tissue, while an incisional biopsy removes just part of a lump or a sample of tissue. A core biopsy removes tissue using a
wide needle, whereas a fine-needle aspiration, or FNA, biopsy uses a thin needle to remove the tissue. • Blood chemistry studies: A blood chemistry study checks a blood sample to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual amount of a substance, whether that amount is higher or lower than normal, may be indicative of disease in the organ or tissue that makes it. • Clinical breast exam: A clinical breast exam, or CBE, is an examination of the breast that is conducted by a doctor or another health professional. The person conducting the examination will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. • Magnetic resonance imaging test: Commonly referred to as an MRI or a nuclear magnetic resonance imaging, or NMRI, this procedure employs a magnet, radio waves and a computer to produce a series of detailed pictures of areas inside the body. • Mammogram: A mammogram is an x-ray of the breast that can be used to check for breast cancer in women who have no signs or symptoms of the disease. Mammograms also may be used to check for breast cancer after a lump or other sign or symptom of the disease has been found. According to the National Cancer Institute, a mammogram performed on a pregnant woman may appear negative even if cancer is present. The NCI also notes that mammograms miss roughly 20 percent of breast cancers that are present at the time of screening. • Physical exam: Women should get a routine physical examination of their bodies once a year. Physicians conducting such exams will check for general signs of health while also checking for signs of disease, including breast cancer. Breast cancer symptoms may include swelling and lumps on the breast or under the arms. During a routine physical, a doctor also will request the patient provide a history of her health habits and past illnesses, and women with a family history of breast cancer should make note of that history when discussing their own medical histories. • Ultrasound exam: During an ultrasound exam, high-energy sound waves are bounced off internal tissues or organs to make echoes, which form a picture of body tissues called a sonogram.
October 31, 2015
The Rogersville Review Special Edition: Breast Cancer Awareness
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Cherokee, Volunteer raises more than $14,000 for Breast Cancer research BY WADE LITTLETON SPORTS EDITOR ROGERSVILLE –– The Cherokee Chiefs and Volunteer Falcons went Pink on October 10 at Big Red Valley for the American Cancer Society’s Making Strides Against Breast Cancer. Thanks to the efforts of the Chiefs and Falcons, $14,033.17 was raised for cancer research. “The Hawkins County Throwing Breast Cancer for a Loss event was an inspirational example of passion in action,” said Holly Booker of the American Cancer Society. “I was thrilled to see how both communities responded and how every player, parent, volunteer and sponsor took positive steps to help finish the fight against breast cancer.” The 2015 Pink Out game was made possible in part by the generous community sponsors, whom together donated more than $12,000. The American Cancer Society appreciates the efforts of the students and community supporters. The following companies also generously donated to the fight against cancer: • Simply Tee-Rific • Wellmont Hawkins County Memorial Hospital • Farm Bureau Insurance–Steve Hayworth (Rogersville) • Farm Bureau Insurance–Sam Griffith (Mount Carmel) • Christian-Sells Funeral Home • Appalachian Credit Union • @work Personnel Service • Food City • Volunteer Collision • B&E Collision • Civis Bank
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Eastman Credit Union Servpro of Kingsport Mountain Pride Restoration Davidson Farms First Lady Day Spa Rural Health Services Consortium Honda Kingsport Dewayne’s Body Shop Millenium Auto Singleton Collision Pro Kleen Construction Johnson-Arrowwood Funeral Home of Church Hill • Scott Farmer’s Repair Shop • Hawkins Farmers Co-Op • Creekside Market • Smith Auto Parts • Signature HealthCARE of Rogersville • Monroe’s Body Shop • Mark Stapleton Law Office. In addition, more than 50 other businesses and individuals also sponsored jerseys for both teams. This list may be found at www.facebook. com/hawkinscountysuperbowl. Coordinating sponsors of Pink Out Night are Farm Bureau Insurance Agency managers Steve Hayworth of the Rogersville office and Sam Griffith of the Mount Carmel office. They received great community support and help from their fellow agents and office staff. This is the fourth year Farm Bureau Insurance of Tennessee has been the statewide partner of Making Strides Against Breast Cancer. “Strides,” as it is commonly known, is ACS’ signature event to raise awareness and funds to fight breast cancer. The event unites the entire community to honor breast cancer survivors, educate people about how to reduce their breast cancer risk or find the disease early and raise funds to end breast cancer.
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While significant progress in the fight against the disease has been made, more needs to be done. Breast cancer remains the most common cancer among women in the U.S. other than skin cancer, and is the second leading cause of cancer death after lung cancer. The chance of a woman developing invasive breast cancer at some time in her life is about one in eight. This year, approximately 232,670 women will be diagnosed with breast cancer and more than 40,000 will die from the disease in the U.S. With one in every two newly diagnosed women turning to the American Cancer Society for help and support, Making Strides Against Breast Cancer funds are used to make a difference by: • Helping people take steps to reduce their
risk of breast cancer or find it early when it is most treatable; • Investing in groundbreaking cancer research to find, prevent, treat, and cure the disease; • Providing free information and services to help people facing breast cancer when and where they need it including transportation, lodging, wigs, support programs, financial assistance, and more; • Ensuring access to mammograms for women who need them. Additional details about Making Strides Against Breast Cancer and how you can get involved can be found at makingstrideswalk.org. For free breast cancer information and resources visit the American Cancer Society’s website at cancer.org or call (800)227-2345 anytime.
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Farm Bureau Agents Sam Griffith of the Mount Carmel office and Steve Hayworth of the Rogersville office, talk to Hawkins County Director of Schools Steve Starnes before the start of Saturday night’s Hawkins County Super Bowl/Pink Out game between Volunteer and Cherokee at Big Red Valley. More than $14,000 was raised for the American Cancer Society’s Making Strides Against Breast Cancer program. — photo by Wade Littleton
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The Rogersville Review Special Edition: Breast Cancer Awareness
October 31, 2015
BREAST CANCER RECONSTRUCTION By Greg Pastrick — October 1, 2015, Dr. Pastrick’s Blog
Dr. Gregory H. Pastrick, M.D. Certified by the American Board of Plastic Surgery
Many plastic surgeons like myself are intimately involved the treatment of breast cancer patients in that we perform breast reconstruction to try to restore normalcy to the female form after mastectomy, or the removal of the breast. There are many ways to reconstruct a breast after mastectomy but the two main ways are by transferring tissue from one are of the body to the breast area (known as a “flap”) or by using implants. The tissue transfer method most commonly utilizes the skin, fatty tissue, and muscle from the lower abdomen (TRAM flap) or the tissue from the back area (latissimus dorsi flap). These methods work well in the right candidate but these are fairly extensive operations. More commonly plastic surgeons use the tissue expander/implant method which provides very good results with less extensive surgery and a quicker recovery. In this reconstruction an initial expander device is implanted under the chest muscle and slowly inflated with saline over several office visits. Once the desired final volume is achieved, the expander is removed and replaced with a permanent implant. These days the most frequently preferred implants are silicone because there have been great advances in silicone implants recently that allow us to achieve fairly realistic results. One drawback to the tissue expander/implant surgery is the length of time it takes to get to the final result. Occassionally, a breast can be reconstructed with an implant in one stage without having to have a tissue expander. This most commonly occurs when a woman has had a previous submuscular breast augmentation (which, by the way, is the technique I use in my breast augmentation patients) so that the chest muscle has already been expanded with the prior implant. In my experience, these reconstructions actually have the best results in that the recovery is the easiest and quickest and the aesthetic outcome is outstanding. As you can see there are many options for breast reconstruction, and I encourage anyone facing the diagnosis of breast cancer to consult with a board certified plastic surgeon early in the journey to help guide you in healing and restoring your body.
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The Plastic Surgery Center of East Tennessee, the office of Dr. Gregory Pastrick, is Northeast Tennessee’s premier cosmetic facility. With 15 years of cosmetic surgery experience and proven ability, Dr. Pastrick can provide you with guidance and treatment options to help you achieve the look you desire at any age or to maintain youthfulness throughout the aging process. Your decision to have plastic surgery is very personal, and we are sensitive to your need for discretion. We pride ourselves in maintaining absolute confidentiality in a caring and comfortable environment in our state-ofthe-art surgical facility.
October 31, 2015
The Rogersville Review Special Edition: Breast Cancer Awareness
PREVENTION • TREATMENT • HOPE SUITE #2
Behavioral Health Nancy Crider, LPC SUITE #3
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The Rogersville Review Special Edition: Breast Cancer Awareness
October 31, 2015
Mammography guidelines continue to evolve
M
ammograms are used to screen for breast cancer and overall breast health. In a relatively recent departure from conventional wisdom that once advised women to get annual mammograms beginning at age 40, new recommendations say mammograms are not necessary before age 50, and that earlier screening benefits are limited and may even do more harm than good. The new guidelines come courtesy of the United States Preventive Services Task Force, which is a group of independent health experts convened by the Department of Health and Human Services. The USPSTF reviewed and commissioned research to develop computer-simulated models comparing the expected outcomes under different screening scenarios. The USPSTF is the most influential group to provide preventive care guidelines for doctors, and this is the first time the group has spoken up about breast cancer screening since 2002. The reasons for the change were based on the strong emotional stress breast cancer screenings can create and the rates of false positives that may require follow-up testing.
Younger women’s breasts are naturally more dense, and dense tissue can make it more difficult to read mammograms and identify problems. For this reason, perceived abnormalities on the mammogram may require follow-up mammograms or biopsies to rule out cancer. According to Harvard Medical School, almost half of women under age 50 who have mammograms are called back for repeat films or biopsies because their test results look suspicious. This can subject women to undue stress, further exposure to radiation and more invasive biopsies, not to mention the added expenses of further testing. The USPSTF revised recommendations state that: • Routine screening of average-risk women should begin at age 50, instead of age 40. • Routine screening should end at age 74. • Women should get screening mammograms every two years instead of every year. • Breast self-exams have little value, based on findings from several large studies.
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New American Cancer Society Breast Cancer Screening Guidelines On October 20, 2015 the made these new guidelines for breast cancer screening. American Cancer Society breast cancer screening guidelines are developed to save lives by finding breast cancer early, when treatment is more likely to be successful. The Society regularly reviews the science and updates screening recommendations when new evidence suggests that a change may be needed. The latest guideline applies to women at average risk for breast cancer. Among other recommendations, it says all women should begin having yearly mammograms by age 45, and can change to having mammograms every other year beginning at age 55. Source: http://www.cancer.org/cancer/news/ specialcoverage/american-cancer-society-breastcancer-screening-guidelines
Did you know?
When a person is diagnosed with breast cancer, tests are then conducted to study the cancer cells. According to the National Cancer Institute, such tests are used to determine how quickly the cancer may grow and the likelihood that the cancer will spread throughout the body. These tests also may help doctors determine a course of treatment and if a patient is likely to experience a recurrence of the cancer down the road. One such test is the estrogen and progesterone receptor test, which measures the amount of estrogen and progesterone receptors in cancer tissue. The cancer may grow more quickly in patients who have more of these receptors than normal. In addition to measuring the amount of these hormones in the cancer tissue, an estrogen and progesterone test can determine if a treatment aimed at blocking estrogen and progesterone may prevent the cancer from growing.
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But some health organizations disagree with the task force’s revised guidelines. For example, the Mayo Clinic supports screenings beginning at age 40 because doctors there believe mammograms can detect breast abnormalities early in women in their 40s. Others scoff at the notion that breast selfexams have little value, as many times it is a woman who first alerts her doctor to a lump or problem. Doctors are unable to distinguish dangerous breast cancers from those that are not life threatening, which is why many still recommend annual mammograms, despite the fact that mammogram screening has not decreased the number of deaths associated with advanced breast cancers. Ultimately, it is up to a woman and her doctor to chart the best course of preventative breast cancer treatment. Despite the recommendations from the task force, many insurance companies still cover annual mammograms beginning at age 40. Women who are at high risk for breast cancer are special cases, and such women should discuss earlier screening schedules with their doctors.
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Fruit and vegetables should be an important part of your daily diet. They are naturally good and contain vitamins and minerals that can help to keep you healthy. They can also help protect against some diseases.
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October 31, 2015
The Rogersville Review Special Edition: Breast Cancer Awareness
So Much MORE Than A Pharmacy Prescriptions: A Specialty Over 30 Years Experience The pharmacists you know and trust! Mike and Carol Rogan
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• Accept most all insurance plans • Immunizations (shingles, flu, pneumonia) • B-12 injections • Limited local delivery • Greeting cards and gift items • Free blood pressure and blood sugar screenings
Phone (865) 993-4074 • Fax (865) 993-4194 1034 Main Street • Bean Station, TN 37708 www.facebook.com/DownHomePharmacyTN
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Protect yourself. Early detection of breast cancer could save your life. Remember self examinations and mammograms. ERSVILLE R OG
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Vitamin D and breast cancer link
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ry as they may, the thousands upon thousands of medical researchers, scientists and doctors around the world have not yet figured out a way to eradicate cancer. Ongoing studies examining the disease as well as its risk factors may not have yielded a cure, but they certainly have helped shape a number of different methods of reducing risk and improving treatments. Breast cancer is a prolific disease affecting a quarter of a million women in the United States each year, annually claiming the lives of roughly 40,000 women. The Canadian Cancer Society says breast cancer accounted for 13.9 percent of the 36,100 female cancer deaths in 2013. Breast cancer remains the second most common cause of cancer deaths in women, and females are continually on the lookout for ways to reduce their risk of developing this potentially deadly disease. Vitamin D may help reduce breast cancer risk, and it may even help women already diagnosed in their fight against the d i s e a s e . According to a meta-analysis of five studies published in the March 2014 issue of Anticancer Research, patients diagnosed with breast cancer who had high vitamin D levels were twice as likely to survive when compared with those who had low levels of vitamin D. This analysis studied more than 4,500 breast cancer patients over a nine-year period. The study’s authors also found that a vitamin D level of 50 ng/ml is associated with a 50 percent lower risk for breast cancer. In addition, a study published in the American Journal of Preventative Medicine in 2007 found that a higher level of vitamin D is associated with a 50 percent lower risk of colorectal cancer. Vitamin D is most often credited with helping the body maintain its balance of
Vitamin D may help reduce breast cancer risk, and it may even help women already diagnosed in their fight against the disease.
calcium and phosphorous by controlling how much of these nutrients are absorbed from foods and added to bones. Although not fully understood, vitamin D also plays a role in other areas of the body, including the nervous system, muscles and immune system. Vitamin D also affects inflammation as well as cell growth and death, which may help prevent cancer growth. Women who are born with the BRCA1 gene mutation are at an increased risk for developing breast and ovarian cancers. BRCA1 genes are tumor suppressor genes that, when formed properly, work to prevent cells from growing into cancerous cells. When people have mutated or altered versions of these genes, cancer cells can grow unchecked. Vitamin D may play a role in turning off the pathway by which cancerous tumors grow. Vitamin D receptors are found on the surface of cells where they receive chemical signals. By attaching themselves to a receptor, says the Vitamin D Council, these chemical signals direct a cell to divide or die. Vitamin D receptors in breast tissue can cause cells to die or stop growing and may prevent cancer cells from spreading to other parts of the body. In turn, vitamin D may be protecting the breast against cancer. However, this is a complex area of study that is not fully understood. Right now it cannot be said with certainty that vitamin D can fully prevent cancer growth. Observational research has indicated that women with low levels of vitamin D have a greater risk for breast cancer, particularly women who are post-menopausal. Vitamin D3 is naturally produced in the body through exposure to ultraviolet sunlight and, like vitamin D2, can be absorbed from food. Vitamin D can be found in fish oils, liver, cheese, egg yolks and supplemented dairy products.
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The Rogersville Review Special Edition: Breast Cancer Awareness
October 31, 2015