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Breast Cancer Awareness Month, Oct. 1-31
Positive attitude Beyond Pink Team support helps breast cancer patient HOLLY HUDSON holly.hudson@wcfcourier.com
In the last few years, Kristi Eastman, 46, of Waterloo, has faced enough challenges for a lifetime. Yet she still finds the time and strength to help others. The married mother of three was diagnosed with breast cancer in May 2011. After undergoing a double mastectomy in June of that year, six months of chemotherapy and six weeks of radiation, Eastman felt like she was making progress. “I was doing great,” she said. In fact, she helped host a fundraiser for the Beyond Pink Team, a local nonprofit organization that provides breast cancer prevention, education, support and advocacy for comprehensive, quality care in the Cedar Valley and surrounding communities.
“We knocked it out of the park,” she said. Then, in October 2013, she was diagnosed with multiple tumors on the left side of her brain. “I wasn’t feeling right,” she said. “It was a stressful time in my life ... and I was still undergoing breast reconstruction. So, I went in one day.” Eastman, who was seeing an oncologist in Iowa City, underwent some basic tests and the tumors were found. “I had brain radiation and came through that good,” she said. “But in April 2014, another tumor was found. I was walking with a dear friend — it was my daughter’s graduation party in two weeks — and I had a seizure. “I’ve had lots of seizures since then,” she said. “I can predict them a little bit now. I’ve been having them much more frequently the
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Kristi Eastman continues to battle cancer with the support of her family, from left, Charlie, 17; Kristi; husband Todd; Lauren, 19; and Will, 13. last three months. Sometimes it’s once a week, sometimes it’s a few a week, and sometimes I can go three weeks without having one.” She had another surgery in February of this year. Tumors were removed, but additional tumors were found in her lymph nodes. She once again started
chemotherapy in June, but didn’t respond well to the treatment. Even with her ongoing medical issues — she travels to Iowa City once a month — and not being able to drive, Eastman works a number of part-time jobs and keeps a positive attitude. “I have a huge support system of
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family and friends,” she said. And the Beyond Pink Team contacted her in June. “They were reaching out to see if there was anything they could do for me,” Eastman said. “I am very fortunate my family can eat,
See EASTMAN, page H2
319.272.7080 WheatonIowa.org/3D
Covenant Clinic | Covenant Medical Center | Mercy Hospital | Sartori Memorial Hospital
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• The Courier
COURIER FILE PHOTOS
Cheryl Ewoldt, right, helps Rilee Holland with her race number before last year’s Pink Ribbon Run on Saturday in downtown Cedar Falls.
Pink Ribbon Run is Saturday in downtown Cedar Falls
Photos by TIFFANY RUSHING / Courier Staff Photographer
Touch of Courage support group members of the Beyond Pink Team Mary Jo Juel, left, and Pat Buls, right, are shown with heart-shaped pillows they made for those battling cancer.
Group cushions breast cancer diagnosis, surgery with support, Hearts of Hope pillows MELODY PARKER melody.parker@wcfcourier.com
When the diagnosis — “breast cancer” — comes, it hits like a ton of bricks. You’re left staggering from the weight, the emotions, the fear. “You’re the one dealing with it. You know you’re going down this road essentially alone,” says Pat Buls, a 15-year breast cancer survivor. “You have to make the choices. You have to make the recovery. No one else can do that for you, and when you come to terms with that, that’s when you really start to heal.” But you aren’t really alone. Family, friends and medical professionals can help you make the journey. There is help along the way. There’s also the Beyond Pink Team’s Touch of Courage Breast Cancer Support Group. For 25 years, the support group has provided valuable support to women and their spouses — and men with breast cancer — offering a shoulder to lean on and an ear to listen. “We give a lot of encouragement, information, support and provide advocacy to people with breast cancer. It’s open to anyone with cancer, but we focus mainly on breast cancer survivors,” explains Buls. The retired nurse/instructor
EASTMAN
Jump subhead goes 2 decks no more From page H1 my employers adapt to my schedule. I told them ‘I think I’m good right now.’ They said they would call in a few weeks and touch base with me.” B u t l a te r, wh e n h e r daughter lost her health insurance, Beyond Pink wrote a grant to cover the cost, something the family could not absorb.
Heart shaped pillows made made by Touch of Courage support group members. leads the group. The group meets the first Monday of each month. Meetings begin at 1:30 p.m. in meeting room 1 at the Kimball Ridge building, 2101 Kimball Ave. There are no membership fees or promises of regular attendance. Those who attend are not obligated to speak or share their experiences. The informal gathering includes discussion of issues and experiences related to breast cancer. “We go from 1 to 1 ½ hours, whatever the situation calls for. Folks discuss what’s going on in their treatment and recovery. The biggest
“I know how important it is to have health insurance,” Eastman said. “Without it we would be able to eat, but would not have had the quality of care needed to get through this lengthy process and would have had to go to some type of state or federal assistance. There’s nothing wrong with that, but it takes a hit to the pride. “Nobody wants to ask for help,” she said. “It’s difficult. But it was a huge relief.” Eastman said there are days when it is all she can
thing that comes out of the group, beyond the information and support, is if someone is having a problem with a medication, for example, she can talk it over with the group and do some problem-solving,” Buls says. This spring, members began making Hearts of Hope pillows to give to surgery centers for women to use for comfort after a mastectomy. So far, they’ve made about 60 pillows and distributed them throughout the Cedar Valley, including Allen Hospital, Covenant Medical Center and Breast Care Center, all in Waterloo; Sartori Memorial Hospital in Cedar Falls; and Waverly Health Center. The soft pillows are about 10 inches long and designed to provide comfort under the arm where post-surgical tubes drain excess body fluid. “The pillow helps relieve the pulling and discomfort from the tubes because the area is very sore,” Buls says. The pillow also can be used over the mastectomy incision to provide cushioning from car seat belts and other pressure. “They’re pink and nicely done, and each has a little note of encouragement from the support group with our phone number. They know they can call us,” Buls adds.
do to get out of bed. “You put your head up, put your shoulders back and face the day,” she said. “I have a tight group of friends and family family (husband Todd and children Lauren, 19; Charlie, 17 and Will, 13) that has been there for me. I love to give back to those people who don’t have such a tight group.” Eastman urged people to reach out to others who need help. “If someone is struggling, just do it for them,” she said. “Give them a gift card … for gas or groceries.
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Those little things go a long way.” Eastman said she tries to make the most of every day. “You don’t always feel the best, but you just kind of get through it,” she said. “I try not to put stuff off. You’re not sure how you’re gonna feel the next day.” “I hear every day about someone else getting breast cancer right here,” she said. “With Beyond Pink, … the money they raise stays right here in the Cedar Valley. “Once I get through the next year, I plan to have another fundraiser.”
The ninth annual Pink Ribbon Run is Saturday in downtown Cedar Falls. The event starts at 8 a.m., with runners gathering outside the Cedar Falls Community Center. Following the race, there will be Panera Pink Ribbon bagels, awards and door prizes. Cedar Falls Community Main street organizes the annual run. Along with being able to run or walk the route, there will be special recognition for breast cancer survivors before the race begins and during the program afterward. Registration is $35 and can be done on race day, by visiting www.beyondpinkteam. org and filling out an entry form, or by calling Community Main Street at 277-0213. More than 700 people participate in the last year’s Pink Ribbon Run, resulting in $29,000 raised for the Beyond Pink TEAM. The Pink Ribbon Run committee has contributed more than $172,000 to the Beyond Pink TEAM since the race began nine years ago. In 2014, Beyond Pink awarded 71 grants totaling more than $51,000. This year’s run is presented by Oakridge Realtors and the University of Iowa Community Credit Union. Their sponsorship covers all expenses for the event, so all race registrations will go toward Beyond Pink grants. Community Auto is the survivor sponsor, covering the registration fee for any breast cancer survivor participating in the run. Award sponsor is Mudd Advertising, Inc.; cheer sponsors are VGM Group Inc., Terry L. Butz Creative Agency, Nagle Signs and
Panera Bakery Café; water stop sponsors are Scheels and Trio Salon; and Friend sponsors are John Deery Motors, Sartori Memorial Hospital, Clark and Associates, Jennifer’s on Main and the Breast Care Center. Race Director Stephanie Bardal says, “Our sponsorship committee worked hard, and it paid off, literally. This race continues to be blessed by generous local business owners who are willing to step up and give back to those in the community that are facing a breast cancer diagnosis. It’s very moving to see such wonderful support.” Funds from the Pink Ribbon Run are placed in the Beyond Pink Fund at the Northeast Iowa Community Foundation. Grants are given to women or men facing a breast cancer diagnosis in Black Hawk County and surrounding counties and need financial assistance for groceries, gas money, utility expenses, medical costs, etc. The Pink Ribbon Fund began awarding grants in 2008. Additional events: Delivering Fashion, Ladies After-Hours Event, 7 to 9 p.m. next Sunday, Scheels, 402 Viking Plaza Drive, Cedar Falls. This event features the season’s latest fashion trends, plus scarf tying, fashion accessories, refreshments,, hors d’ oeuvres and more. A portion of the proceeds will be donated to the Beyond Pink TEAM. Participants can register to win one of five $100 Scheels gift cards. The event is free but space is limited. For reservations, call 277-3033.
Cancer survivor Stacy Kuker spray paints the word “Conquer” on a banner carried by survivors to the starting line of the 2014 Pink Ribbon Run.
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SUPP RT
THE FIGHT
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What you need to know about getting a mammogram 1. What is a mammogram?
A mammogram is an x-ray of the breast that’s used to find breast changes. X-rays were first used to examine breast tissue nearly a century ago. Today, the x-ray machines used for mammograms produce lower energy x-rays and expose the breast to much less radiation compared with those in the past.
2. Find a center that specializes in mammograms.
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Participants in the 2014 Splash of Color 5K run/walk
The Food and Drug Administration certifies mammogram facilities that meet high professional standards of quality and safety. Ask to see the FDA certificate if one isn’t posted near the receptionist’s desk. And when you find a facility you like, stick with it. Having all your mammograms at the same facility will make it easier for doctors to com- mammogram. These products can appare images from one year to the next. If pear as white spots on the x-ray. you’ve had mammograms done at a different facility, have those images sent to 5. What to expect your new facility. The entire procedure takes about 20 minutes. The breast is compressed be3. When to schedule tween two plastic plates for a few secIt’s best to schedule your mammogram onds while an x-ray is taken. It is repoabout a week after your menstrual pe- sitioned and compressed again to take riod. Your breasts won’t be as tender or another view. This is then done on the swollen, which means less discomfort other breast. Flattening the breast can be during the x-ray. uncomfortable, but it is needed to provide a clearer view.
4. What to wear
Wear a two-piece outfit because you 6. Getting the results will need to remove your top and bra. You should get your results within 30 Do not apply deodorant, antiperspi- days. If you don’t, call to ask about them. rant, powder, lotion or ointment on or If doctors find something suspicious, around your chest on the day of your you’ll likely be contacted within a week
Splash of Color support group sponsors 5K walk/run Oct. 10 SHUTTERSTOCK PHOTO
to take new pictures or get other tests. But that doesn’t mean you have cancer. A suspicious finding may be just dense breast tissue or a cyst. Other times, the image isn’t clear and needs to be retaken. If this is your first mammogram, your doctor may want to look at an area more closely simply because there is no previous mammogram for comparison.
7. What you pay
Medicare and almost all private insurance plans now cover yearly mammograms, with no co-pay or other outof-pocket costs. Medicaid also covers mammograms. For information about free or low-cost programs in your area, call the American Cancer Society at 1-800-227-2345.
The fifth annual Splash of Color 5K Walk/Run will take place Oct. 10 from 7:30 a.m. to 4 p.m. at Waterloo East High School. The walk begins at 8:30 p.m. Registration is $20 for adults; $10 for students. Among other activities taking place are youth games, basketball games, a raffle, jump rope, inflatables, face painting, a $5 combo meal, dance contest, nail painting, a jewelry sale and much more. Splash of Color is a breast cancer support group that assists survivors of color with necessary resources,
education and support. The group meets the second Thursday of February, May, August and November. Meetings take place from 5 to 7 p.m. at the Waterloo Public Library. For more information, contact Cathy Ketton at (319) 493-8857. S p o n s o rs a re b e i n g sought. A tax deductible donation of $100 or more, and includes the sponsor’s name on the event’s T-shirt. Checks can be made payable to Beyond Pink Team-Splash of Color, and mailed before Friday to 541 Sherman Ave., Waterloo IA, 50703.
BarB KaYser, sue HetH, & Mariann Berg “Cancer started the fight, but you finished it. You are our heroes” - From Eric, Barb M., and Amy
Diane CHanDler
Cancer started the fight but you finished it! You strength and courage inspires us daily! You’re a survivor and an amazing mother, daughter, sister, and wife! Love, Your Family
Jaqie Yarrington
Early detection has given us 11 more years of memories with many more to come. My mom is always there for me. I don’t know what I would do without her! Love, Stefani
Carol Miller
Survivor of ovarian cancer and two breast cancers. Fought all 3 and am grateful for every day God gives me.
Joan aMMerMan
In loving memory of our mother, grandmother, and great-grandmother.
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Metastatic survivor battles back to health, urges self-advocacy JOHN MOLSEED john.molseed@wcfcourier.com
CEDAR FALLS — Kellie Leasure had no history of breast cancer in her family and showed no particular risk markers for the disease. Nonetheless, before moving to Iowa, Leasure kept a regular schedule of mammograms and MRI exams. When she moved to Iowa, she was told testing beyond regular mammograms wasn’t necessary. So when fatigue, back pain, pain in her ribs sent her to the doctor and her recent mammogram hadn’t shown anything irregular, doctors blamed it on stress and being an older mother (she had given birth at age 42). Six months before being diagnosed with metastatic breast cancer, Leasure noticed a swollen lymph node but was told to postpone her regular mammogram because she was nursing. So Leasure endured the pain and fatigue and tried various prescriptions for pain and depression. “I was always so exhausted,” Leasure said. “Looking back now, it’s obvious something was very, very wrong.” It was only when her father, suffering from colon cancer, urged her to get second, third, even fourth opinions if necessary, that she sought help. Leasure had metastatic breast cancer — meaning the cancer had spread beyond her breasts and throughout her body. “It was there for years,” she said. Her story is unnerving, but
Kellie Leasure, a breast cancer survivor. it’s also too common, she said. Often, women who get regular mammograms believe they are doing everything necessary to catch and treat breast cancer early. Many times mammograms catch early-stage cancers and give women an early start to fighting the disease. With the increase of frequency of mammograms came a higher survival rate for people with breast cancer. However, like in Leasure’s case, mammograms don’t always detect the most lethal forms of breast cancer — like triple negative — at its treatable phase. With such cases tumors can progress quickly, often cropping up between mammograms. Even
PHOTOS by COURTNEY COLLINS/Courier Staff Photographer
catching them “early,” can be too late because they have already spread to other parts of the body. So, despite the rise of regular mammogram screenings, there has been no decrease in incidences of metastatic cancer among women. Leasure underwent chemotherapy, radiation therapy and a double mastectomy and has battled her way back to health. She is training to run a half marathon race in October. Now, at age 45, she has found faith and joy in the life she has ahead of her. “I am living my best life right now,” she said. But her life has changed forever. “Scan, treat, repeat,” she
said. “That’s my life right now; my favorite word in the world right now is ‘stable.’” While some metastatic survivors can live for decades, the median life span is 26 months. Leasure’s experience evokes some women’s worst fears. Which is why she says few metastatic survivors — metavivors — are the “elephant in a pink room.” However, Leasure said the lesson from her story doesn’t have to be one of fear. “My hope is women demand MRIs,” she said. “You just have to advocate for yourself.” Leasure said women need to trust their own bodies and make sure doctors thoroughly note their symptoms
Kellie Leasure screamed with excitement as she started the Pink Ribbon Run last fall in downtown Cedar Falls. and observations. For her, the medical record was vague and wouldn’t have pointed clearly to cancer despite her symptoms. “No one took control of it,” she said. “It was just easier to write a prescription and write it off to my life circumstances.” Today, her life circumstances are positive. She says her experience helped
her find faith and strength. Her “team” of family, friends, community and church helped her, but ultimately, she knew it was up to her. “When you’re up against something so colossal... you have to reach and find something within yourself,” she said. “I made a pact with myself not to let my circumstances be my defeater.”
Fact vs. fiction: 5 myths about breast cancer Pink Ribbon Inc., separates separate fact from fiction about breast cancer causes. Myth 1: Underwire bras and antiperspirants Reality: It’s not true that wearing a bra, especially underwire bras, traps toxins by limiting lymph and blood flow in your breasts, increasing risk. There’s also no proof for the claims that antiperspirants and deodorants cause cancer by keeping the body from sweating out the cancer-causing substances that build up in the breasts, or because they contain harmful chemicals that are absorbed through the skin. Myth 2: Breast implants Reality: You aren’t at any greater risk with silicone or saline breast implants, according to recent analysis. The problem is, standard mammograms don’t always work as well on these women, so additional X-rays may be needed to examine breast tissue. Myth 3: Having a risk
factor for breast cancer means you’ll develop the disease. Reality: No risk factor either alone or in combination with others means you’ll definitely get breast cancer. There are various factors that may increase your risk of developing the disease. Some of these appear to increase your risk only slightly. They include smoking, drinking (more than five alcoholic drinks per week year after year), getting your first menstrual period before age 12, continuing to have periods after age 55, and not having your first full-term pregnancy until after age 30. If you have a number of these, the increase in risk can start to be more meaningful. That said, even an inherited genetic abnormality in your family doesn’t necessarily mean you’re going to get breast cancer. Abnormalities in the socalled breast cancer genes BRCA1 and BRCA2 are very strong risk indicators. But 20 to 60 percent
Classic & Contemporary
of women with these in- male breast cancer is most BRCA2 abnormality. So if who’s had breast cancer, herited abnormalities will closely associated with a there’s a man in the family be sure to tell your doctor. not develop breast cancer. Myth 4: If there is no breast cancer in your family, then you’re not at risk for the disease. Reality: Every woman is at risk for breast cancer. So are some men! For any individual woman, an inherited abnormality is the strongest risk factor, but only about 10 percent of all cases of breast cancer are due to inherited abnormalities. About 85 percent of women who develop the disease don’t have a family history. That’s why it’s important for all women to get screened regularly. Myth 5: Breast cancer is passed only from your mother, not your father. Reality: We now know that breast cancer genes can be inherited from your dad’s side of the family. So ask relatives about cases on both sides and in both men and women. About 2,000 cases of male breast cancer are diagnosed in the US each year. In fact,
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Advocate courts candidates, works New imaging helps to raise breast cancer awareness detect cancer in ANDREW WIND andrew.wind@wcfcourier.com
CEDAR FALLS — In the presidential candidate season, Iowa is an ideal place for Christine Carpenter’s advocacy work on behalf of breast cancer research. “I’m going to see all of the presidential candidates to see if they will endorse the Breast Cancer Deadline 2020,” said the Cedar Falls woman and breast cancer survivor. The “deadline” is an initiative of the National Breast Cancer Coalition, whose board she is a member of. Carpenter is also part of the local Beyond Pink TEAM. “They’ve set a deadline to know how to end breast cancer by 2020,” she said of the coalition, which works with researchers to meet that goal. “We’re just trying to add some urgency to the conversation.” She noted that endorsing the initiative means learning more about the blueprint and sharing it with others. In the past, Carpenter added, the United States both put a man on the moon and created a vaccine for polio within 10 years. “So, why can’t we find a vaccine for breast cancer in less than 10 years?” Creating a preventive vaccine is a focus of the coalition’s Artemis Project. The project brings together experts from broad ranging disciplines to address questions and develop strategic plans. It has also funded seed grants for researchers
MATTHEW PUTNEY / Courier Photo Editor
Christine Carpenter, right, a breast cancer research advocate tries to persuade Republican presidential candidate, Louisiana Gov. Bobby Jindal, left, at a campaign event at Beck’s on the Hill Thursday, Sept. 3, 2015, in Cedar Falls. working on the effort. According to the American Cancer Society, 294,480 women and men in the U.S. and 1.6 million women worldwide will be diagnosed with breast cancer this year. An estimated 40,730 women and 440 men will die of breast cancer this year in the U.S. In 2012, 522,000 women died of the disease around the world. And, Carpenter noted, the risk is higher for Iowans than the nation as a whole. “Women in Iowa have a 1 in 7 chance of getting breast cancer, and in the United State it’s a 1 in 8 chance,” she said. Breast cancer diagnoses typically rise every year, although mortality has dropped incrementally, she noted. With the search for a vaccine, “we’re looking for a dramatic drop in deaths,” said Carpenter. “Way too many people die of breast
cancer.” She was diagnosed with the disease in 1993 and three years later got involved with the coalition’s Project LEAD, which stands for Leadership, Education, Advocacy and Development. Soon she was named an Iowa field coordinator for the young organization, which was formed in 1991. At that point, she also joined the Beyond Pink TEAM, which is part of the Cedar Valley Cancer Committee. The group is focused on action, education and advocacy related to breast cancer research. The group is sponsoring a Cedar Valley conference on breast cancer called “Igniting the Cancer Conversation” that will be held April 7, 2016 from 5 to 8 p.m. at the PIPAC Center in Cedar Falls. The conference costs $20 and is open to the public. Among the attendees she is expecting are policy makers, cancer
survivors, caregivers and anybody whose life has been touched by the disease. While the focus is on breast cancer, Carpenter said the topics will be applicable to those interested in any type of cancer. The main speakers will be Dr. Keith Knutson, a breast cancer researcher in immunology at the Mayo Clinic, and George Weiner, a lymphoma researcher and the director of the Holden Comprehensive Cancer Center at the University of Iowa. “What we’re going to do is have them come speak about their cutting-edge research,” said Carpenter. “To me, it’s this huge coup that we got these big-name researchers to come to the Cedar Valley to talk about their research.” The event will be moderated by Pat Haugen, vice president of the National Breast Cancer Coalition, who will talk about the efforts of the Artemis Project. The conference will also include shorter presentations by a policy maker and an epidemiologist. “At our tables, people will talk about, ‘OK, what can we do to move this forward?’” said Carpenter. “We need to have more collaboration and actual problem solving.” The conference is intended to increase understanding about breast cancer research as well as boost engagement of and gather input from the Cedar Valley community on the issue. “Grassroots effort really does make a difference,” said Carpenter.
5 things that may reduce breast cancer risks STACY SIMON American Cancer Society
While you can’t change some breast cancer risk factors — family history and aging, for example—there are some risk factors that you can control. And while there is no sure way to prevent breast cancer, there are things you can do that may lower your risk. Here are 5 ways to help protect your breast health. 1. Watch your weight. Being overweight or obese increases breast cancer risk. This is especially true after menopause and for women who gain weight as adults. After menopause, most of your estrogen comes from fat tissue. Having more fat tissue can increase your chance of getting breast cancer by raising estrogen levels. Also, women who are overweight tend to have higher levels of insulin, another hormone. Higher insulin levels have also been linked to some cancers,
including breast cancer. If you’re already at a healthy weight, stay there. If you’re carrying extra pounds, try to lose some. There’s some evidence that losing weight may lower breast cancer risk. Losing even a small amount of weight — for example, half a pound a week — can also have other health benefits and is a good place to start. 2. Exercise regularly. Many studies have found that exercise is a breasthealthy habit. The difference in risk between the most active and the least active women is typically around 25 percent. In one study from the Women’s Health Initiative, as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman’s risk by 18 percent. Walking 10 hours a week reduced the risk a little more. 3. Limit time spent sitting. Evidence is growing that sitting time, no matter how much exercise you get when you aren’t sitting,
increases the likelihood of developing cancer, especially for women. In an American Cancer Society study, women who spent 6 hours or more a day sitting outside of work had a 10 percent greater risk for invasive breast cancer compared with women who sat less than 3 hours a day, and an increased risk for other cancer types as well. 4. Limit alcohol. Research has shown that women who have 2 to 5 alcoholic drinks daily have a higher risk of breast cancer than women who drink only 1 drink a day or not at all. Studies have found evidence that links even lower levels of drinking alcohol to an increase in breast cancer risk. As little as 3 to 6 glasses of wine a week has been shown to slightly increase breast cancer risk. It’s not clear how or why alcohol increases the risk, or which women are most likely to be affected. But limiting alcohol is especially
important for women who have other risk factors for breast cancer, such as breast cancer in their families. 5. Avoid or limit hormone replacement therapy. Hormone replacement therapy (HRT) was used more often in the past to help control night sweats, hot flashes, and other troublesome symptoms of menopause. But researchers now know that postmenopausal women who take a combination of estrogen and progestin may be more likely to develop breast cancer. Breast cancer risk appears to return to normal within 5 years after stopping the combination of hormones. Talk with your doctor about all the options to control your menopause symptoms, and the risks and benefits of each. If you do decide to try HRT, it is best to use it at the lowest dose that works for you and for as short a time as possible.
dense breast tissue Tribune News Service
ROCHESTER, Minn. – For women with dense breast tissue, supplementing standard mammography with a new imaging technique called molecular breast imaging can lower the cost of diagnosis of breast cancers, according to a Mayo Clinic study published in the American Journal of Roentgenology. Researchers at the Mayo Clinic Center for Individualized Medicine found that adding MBI to mammography of women with dense breast tissue increased the costs of diagnosis 3.2 times, compared to costs of mammography alone, and nearly quadrupled the rate of cancer detection. Because the supplemental test found more cancer, screening with a combination of mammography and MBI saved $8,254 per cancer detected. While mammography is still the standard tool for widespread breast cancer screening, it is now known to perform less effectively in women with dense breast tissue. Both tumors and normal dense breast tissue can appear white on a mammogram, making tumors hard to detect. Nearly half of all women over age 40 have mammograms classified as “dense,” according to Carrie Hruska, a medical physicist in the Mayo Clinic Department of Radiology and the study’s lead author. Supplemental screening techniques like MBI address a significant need for better cancer detection methods for this patient population. In an MBI examination, a radioactive tracer readily absorbed by cancerous breast cells is injected into the body. A small, semiconductor-based gamma camera then scans the breast, lighting up any areas where the tracer is concentrated. The screening combination of MBI and mammography can detect more cancers than mammography alone at acceptable radiation doses for screening, as the research group reported in a study published in AJR in February. But concerns persist about the costeffectiveness of MBI. Though the test finds more cancer in dense breast tissue, additional screening could also generate more false-positive results and lead to biopsies that do not result in
a cancer diagnosis, ultimately increasing costs unnecessarily. Hruska and her colleagues used the same data from the February study to compare the cost-effectiveness of screening 1,585 women with dense breast tissue with mammography alone and the combination of mammography and MBI. The comparison resulted in these findings: — Cos t p e r pa t i e n t screened increased from $176 to $571 for the combination of tests. Mammography alone detected cancer in five of these patients. With the combination, physicians detected cancer in the first five women and an additional 14 patients, nearly a fourfold improvement. — The cost per cancer detected was $55,851 for mammography alone and $47,597 for the combination of mammography and MBI, a savings of $8,254 per cancer detected. The risk of receiving an unnecessary biopsy because of a false-positive result increased from 0.9 percent with mammography alone to 3 percent with the addition of the MBI examination. However, this 2.1 percentage point increase in the benign biopsy rate is lower than the 6-point increase observed in outside studies using screening ultrasound or screening MRI, two alternative supplemental techniques. — The positive predictive value (PPV) of MBI, or the likelihood that a biopsy generated by MBI would result in a cancerdiagnosis, was 30 percent. In contrast, biopsies generated by screening ultrasound and MRI have PPVs of 6 percent and 20 percent, respectively. “Cost saving per cancer detected with supplemental screening MBI is compelling evidence for future coverage of screening MBI of women with dense breasts,” the authors write. The study did not consider any costs beyond the point of cancerdetection; however, the authors speculate that earlier detection with MBI may reduce the costs of treatment of advancedcancer further. When dense breast tissue is the only criterion for supplemental imaging like MBI, insurance coverage varies from state to state and among insurance providers. Source: Mayo Clinic News Network
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