Breast Cancer Awareness 2015

BREAST CANCER

Awareness SUNDAY, OCTOBER 4, 2015 SPECIAL ADVERTISING SECTION I

Identifying Breast Cancer Lesser-known symptoms of breast cancer

Life After Diagnosis Living after beating breast cancer

Talking Treatment The differences between chemotherapy and radiation

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Lesser-known symptoms of breast cancer

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ublic 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 t he Cure, one of the premier organizations for breast cancer research, advocacy and treatment, advises that the wa r n i ng sig ns for brea st 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, breastsize 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 cha nges : 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.

Lu mps elsewhere : Ca ncerous tumors may not only be felt in the breasts. Breast ca ncer ca n spread to t he ly mph nodes a rou nd t he breasts, and lumps may be felt under the arms.

Unex pla i ned pa i n : T he 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.

Fa t i g u e : G e n e r a l c a n cer symptoms can include unusual fatigue and unexplained weight loss. These symptoms should not be left unchecked.

One of t he best t h i ngs 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. Indiv idua ls 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.

MetroCreative Services Lumps in the breast are not the only potential indicators of breast cancer.

Preparing for your mammography visit 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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nnua l ma mmog r a m s a r e w idel y re c om mende d for women beg in n ing at age 40. Some estimates suggest that more than 48 million mammography screenings are performed in the United States every year.

W hether it is a woman’s first mammography or her twentieth, preparing for the appointment can ease anxi-

ety 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 t he ma mmog ra m to ta ke place one week after your menstrual period if you have not reached menopause.

Breasts are less likely to be tender at t his time. A lso, schedule your visit for a time when you are not likely to feel rushed or stressed. Early in See PREPARING, Page I-3

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Breast self-exam guidelines

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n addition to scheduling clinical screenings and mammograms, women should routinely examine and massage their breasts to detect any abnormalities. These breast self-exams can be an important part of early breast cancer detection.

Although many women are aware that they should become familiar with their bodies, many are unsure about just how frequently they should conduct breast examinations. Experts at Johns Hopkins Medical center advise adult women of all ages to perform self-examinations at least once a month. That’s because 40 percent of diagnosed breast cancers are first detected by women who feel a lump. Establishing a regular breast self-exam schedule is very important.

Begin by looking at the breasts in a mirror. Note the size and appearance of the breasts, and pay attention to any changes that are normal parts of hormonal changes associated with menstruation.

Breasts should be evenly shaped without distortion or swelling.

C ha nges t hat shou ld c au se concer n i nclude dimpling, puckering or bulging of the sk in. Inverted nipples or nipples t hat have changed position, as well as any rash or redness, should be noted. In addition, the same examination should be done with arms raised

PREPARING Continued from Page I-2

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

over the head.

The breasts should be felt while both lying down and standing up. Use the right hand to manipulate the left breast and vice versa. Use a firm touch with the first few fingers of the hand. Cover the entire breast in circular motions. The pattern taken doesn’t matter so long as it covers the entire breast. All tissue, from the front to the back of the breast, should be felt.

The sa me pattern a nd procedure should be conducted while standing up. Many women find this easiest to do while in the shower.

It is important not to panic if something is detected. Not every lump is breast cancer. And bumps may actually be normal parts of the breast, as certain areas can feel different than others. But bring any concerns to the attention of your doctor.

Breast self-exams are a healthy habit to adopt. When used in conjunction with regular medical care and mammography, selfexams can be yet another tool in helping to detect breast abnormalities. Doctors and nurses will use similar breast examination techniques during routine examinations.

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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.

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Did you know?

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 says that, although IDC can affect women of any age, it is most 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

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What do dense breasts mean for cancer risk?

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History of mammogram technology

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ammography 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.

Ma m mog r aphy c a n 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 mammography, developing techniques of producing stereoscopic images of the breast with X-rays. He a lso cha mpioned t he 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 dos e of r ad i at ion . A l s o,

compression helps spread the structures of the breast apart to ma ke 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 fineg ra in intensif y ing 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 fine-tuned 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 recommendi ng m a m mog r a phy a s a screening tool.

Through the years, mammography became a great help to women looking to a r m t hem s el ve s a g a i n st breast cancer. Thanks to improvements in early detection and treatment, breast c a ncer deat h s a re dow n from their peak and survival rates continue to climb.

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reast 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, “Ma mmog raphic densit y 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.

Densit y 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 mammog ra ms. 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 ma mmog ra m repor ts s o w omen a nd do c tor s

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 fatt y tissue in less dense breasts.

Cancer also appears white, and, therefore, tumors can be hidden.

In addition to more indepth screenings, women with dense breasts can lower cancer risk by following these guidelines: • Ma i nt a i n a he a lt hy weight.

• Eat nutritious food.

• Exercise regularly.

• Never smoke or quit immediately.

• Limit alcohol consumption.

• Ask for digital mammography.

Wo m e n c a n c o n s i d e r breast density with other risk factors in the fight against breast cancer.

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The differences between chemotherapy and radiation

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a ncer ca n ta ke on ma ny 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 highenergy 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 ther-

apies 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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Celebrities who have had breast cancer

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reast 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 cancer-free.

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.

See CELEBRITIES, Page I-6

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Life after breast cancer

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he 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 a nd v i s it s f r om f r iend s and family.

T he World Ca nc er 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 sur-

vivors 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 a nd 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.

Ma ny ca ncer su r v ivors 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 che-

motherapy has ended. Your doctor may have suggestions for coping with certain side effects or will be able to prescribe medications to offset these effects. Follow-up appointments should gradually decrease the longer you have been cancer-free.

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 rou-

tines 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.

CELEBRITIES

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: Reno w ne d Br it i s h A c t r e s s Smith was diagnosed with breast cancer in 2007 while filming her sixth appearance

as Professor McGonagall in the “Harr y 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 earlystage breast cancer in 2007.

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Judy Blume: The fa med young adult author was diagnosed with breast cancer in 2012, 17 years after being

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Wearing a bra after a masectomy

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Cancer therapy and coping with hair loss

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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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hen 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 custom-designed 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.

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D.M.X.I.

Digital Screening Mammograms Is proud to participate in the promotion of early detection and diagnosis of breast cancer for National Breast Cancer Awareness Month. We will be offering our patients digital screening mammograms at the special rate of $75.00 payable at the time of exam, throughout the month of October.

According to the American Cancer Society, it is recommended that woman age 40 and over have an annual mammogram, as current statistics reveal Breast Cancer will affect 1 in 8 women throughout their lifetime.

Please call 330-726-6010 to schedule an appointment at your earliest convenience.

Dr. Adam G. Crouch Inc. dba Diagnostic Medical X-Ray & Imaging 8390 Tod Avenue, Boardman, Ohio 44512

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