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Pink October- Remember to get your mammogram

I decided to dye some of my hair pink as a reminder to all that this is Breast Cancer Awareness month. Schedule your annual mammogram if you haven’t already. Early detection is key to an easier and better outcome. My May 2012 a routine mammogram showed invasive lobular cancer. Luckily after lumpectomy surgery and radiation, I did not need chemo. May 2017 was my five year anniversary and my surgeon Dr. Dahlia Sataloff discharged me!

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Breast Cancer Radiation Less Scary Than Thought

Breast Cancer Radiation ‘Less Scary’ Than Thought

Majority of patients report more tolerable experience than they expected. I found this to be true in my case.

Monday, September 25, 2017

HealthDay news imageMONDAY, Sept. 25, 2017 (HealthDay News) — Radiation therapy for breast cancer is actually “less scary” than anticipated, nine out of 10 patients say after treatment.

A survey of 300-plus breast cancer patients also found that more than 80 percent said the side effects of radiation were better than expected.

“The word radiation itself sounds frightening and is associated with many negative news stories,” said lead researcher Dr. Narek Shaverdian, of the University of California, Los Angeles (UCLA).

But over the last 20 years, significant advances have been made, said Shaverdian, chief resident in radiation oncology at UCLA’s David Geffen School of Medicine.

“These changes allow us to spare critical organs, create an individual radiation plan for each patient, and also deliver radiation in more convenient schedules,” he explained.

Shaverdian and his team surveyed patients who had received radiation while treated at a UCLA breast cancer clinic between 2012 and 2016.

“The vast majority of patients agreed that if future patients knew the real truth about radiation therapy, they would be less scared about treatment,” he added.

Recent studies have shown better survival and quality of life in patients treated with breast-conserving surgery and radiation rather than breast removal (mastectomy), Shaverdian noted.

“Despite this, more and more patients are electing for mastectomy, and there is an underutilization of radiation therapy, even in patients treated with mastectomy where radiation has shown to result in superior survival,” he said.

What women may not realize is that the course of radiation in many cases has been cut from six weeks to barely three weeks, said Dr. Jed Pollack. He is chairman of radiation medicine at Lenox Hill Hospital in New York City.

Modern radiation therapy also results in less damage to the skin or other body organs, Pollack said.

“Those things added up make radiation a lot more convenient and a lot more tolerable” than it was in the past, Pollack explained.

In this study, researchers wanted to look at radiation therapy from the patient’s perspective, Shaverdian said.

“We hoped having tangible real-world data could help guide patients and providers in their decision-making,” he added.

Questionnaires were completed between 6 months and 5 years after radiation therapy. The women underwent either standard whole-breast radiation that did or did not include the lymph nodes, or short-course radiation after mastectomy, or partial breast radiation.

Nearly 50 percent of the patients said they’d heard horror stories of patients having serious radiation side effects.

And 94 percent said they had feared radiation. Their greatest concerns were damage to internal organs, skin burning and, for a small number, becoming radioactive, the survey found.

Only 3 percent, however, found the negative stories to be true, according to the researchers.

When patients compared their experience to their expectations, between 80 percent and 90 percent found their actual side effects were less than or as expected, Shaverdian said.

“We found most patients treated with radiation as part of breast conservation said that their radiation toxicities were less than expected regarding breast pain, work limitations, limitations on recreational activities, disruption on family and time felt ill,” he said.

In addition, the overwhelming majority of breast-conservation patients and mastectomy patients agreed with the statement, “After treatment, I now realize that radiation therapy is not as bad as they say it is.”

The study focused on 327 patients, average age 59. Eighty-two percent had had breast-conserving surgery.

The results were scheduled for presentation Monday at a meeting of the American Society for Radiation Oncology in San Diego. Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

SOURCES: Narek Shaverdian, M.D., chief resident, department of radiation oncology, University of California, Los Angeles; Jed Pollack, M.D., chairman, radiation medicine, Lenox Hill Hospital, New York City; Sept. 25, 2017, presentation, American Society for Radiation Oncology, San Diego

HealthDay

Stages of Breast Cancer

The stage of breast cancer provides key information about how invasive it is, and whether it has spread or is likely to spread to other areas of the body.

Stage zero breast cancer or stage 0 is noninvasive. That means it has not spread to other cells in the breast or to other organs. Some doctors refer to stage zero breast cancer as precancer.

In most cases, it is discovered by accident, such as after a biopsy or during a breast-imaging test to view another lump. Stage zero breast cancer does not usually cause lumps or other symptoms.

Article from Medical News Today

3 Key Lifestyle Factors Can Lower Breast Cancer Odds

3 Key Lifestyle Factors Can Lower Breast Cancer Odds

Tuesday, May 23, 2017

HealthDay news imageTUESDAY, May 23, 2017 (HealthDay News) — Things that keep you healthy overall, also appear to help lower a woman’s risk of breast cancer, a new review says.

The review found that exercising regularly, maintaining a healthy weight and limiting alcohol could all reduce breast cancer odds.

The report, from the American Institute for Cancer Research and the World Cancer Research Fund, is based on a review of over 100 studies.

On balance, researchers found, regular exercise was tied to small reductions in the risk of breast cancer.

On the other hand, the risk was elevated among women who drank regularly — even at a “moderate” one-drink-a-day level.

Meanwhile, women who were overweight throughout adulthood faced a heightened risk of breast cancer after menopause.

The bottom line is that women can take steps to cut their odds of developing the disease, according to Dr. Anne McTiernan, one of the report authors.

“I think of lifestyle choices as being like wearing a seatbelt. It’s not a guarantee you’ll avoid injury in a car accident, but it significantly reduces your risk,” said McTiernan, of the Fred Hutchinson Cancer Research Center, in Seattle.

In the United States, a woman has about a one-in-eight chance of developing breast cancer, on average, according to the American Cancer Society.

Some of the risk factors for the disease cannot be changed — such as older age and having a strong family history of breast cancer.

But lifestyle still makes a big difference, said Dr. Paula Klein, an oncologist with the Mount Sinai Health System, in New York City.

“We know that more than 50 percent of cancers are preventable with lifestyle choices,” said Klein, who wasn’t involved in the report.

So if a woman takes steps to curb her breast cancer risk, Klein said, she’ll also be lowering her odds of developing other cancers — including major diseases, such as type 2 diabetes and heart disease.

“And you don’t have to run a marathon, or be skinny like a model,” Klein pointed out.

The research review found that women who were moderately active throughout the day tended to have a lower risk of postmenopausal breast cancer — the most common kind.

Overall, women with the highest amounts of daily activity were 13 percent less likely to develop postmenopausal breast cancer, versus women with the lowest activity levels.

That included formal exercise, such as a 30-minute fast-paced walk. But it also included housework, gardening and other daily tasks that got women moving.

According to McTiernan, fitting in physical activity throughout the day is key. “That is, once you do your 30-minute walk, don’t spend the rest of the day on the couch,” she said.

When it came to breast cancer before menopause, only vigorous exercise was tied to a lower risk. The women who were most active had a 17 percent reduced risk of premenopausal breast cancer versus those who were least active.

For postmenopausal women who were the most active when it came to vigorous exercise, the risk of breast cancer dropped by 10 percent compared to the least active, the study showed.

Women who were overweight or obese faced a higher risk of breast cancer after menopause. For every 5-point increase in body mass index (BMI), the risk of breast cancer rose by 12 percent, McTiernan said.

BMI is a measure of weight in relation to height. As an example, McTiernan said, a woman who is 5 feet, 4 inches and weighs 140 pounds has a BMI of 24 (which is normal-weight).

If she gained 30 pounds, McTiernan said, her BMI would reach 29 — a 5-point increase.

“While 30 pounds might seem like a lot to gain,” she noted, “many women do gain that amount over the years.”

As for alcohol, the review found that even moderate drinking was tied to increased breast cancer risks: Drinking the equivalent of a small glass of wine each day boosted the odds of breast cancer by 5 percent to 9 percent.

Does that mean women need to give up that glass of wine with dinner?

Klein recommended looking at the big picture. “If you’re thin, you exercise and you don’t smoke, maybe that small additional risk from your glass of wine isn’t a big deal,” she said.

But the calculation might be different, Klein said, for a woman with risk factors, such as a strong family history of breast cancer.

The report included 119 studies that looked at the relationship between breast cancer risk and diet, exercise and body weight.

The review dug up only “limited” evidence that specific diet habits are related to breast cancer risk.

But a few studies have linked diets high in dairy, calcium and non-starchy vegetables to a lower risk, the report noted. Foods containing carotenoids — such as carrots, spinach and kale — have also been tied to a benefit.

SOURCES: Anne McTiernan, M.D., Ph.D., researcher, Fred Hutchinson Cancer Research Center, Seattle; Paula Klein, M.D., medical oncologist, Mount Sinai Health System, New York City; May 23, 2017, World Cancer Research Fund/American Institute for Cancer Research, Continuous Update Project

5 year mark!

Well, this May is my 5th year since having breast cancer in 2012! I was very happy when Dr. Dahlia Sataloff pronounced me cured and that it was not necessary to come see her on a regular basis. Of course, she said, I am always her patient if I do need her. So I drove home on cloud 9!!

Then I googled  “5 year mark – breast cancer” and got a gloomier story. There is no magic about 5 years.  it is statistically relevant but anyone can have recurring breast cancer at any time.

From breastcancer.org

“According to the National Cancer Institute, the five-year survival rate for non-metastatic breast cancer (breast cancer that has not spread beyond the breast) is 80%. Newspapers and television usually translate that to, “If you’ve survived for five years, you’re cancer-free.”

This is a bit misleading. It’s true that during the first five years, the risk of recurrence is highest. But breast cancer can recur even after five years. The important point to know is that the more time passes, the lower the risk of recurrence becomes.

The chance of surviving breast cancer depends on MANY different factors taken together. Lymph node involvement has a strong influence on prognosis. The more lymph nodes involved, the more serious the cancer. Some of the other factors that affect outcome are your general health, the size of the cancer, hormone receptor status, growth rate, tumor grade, and HER2/neu status. Learn more about all of these factors in the Your Diagnosis section.

Even with the best information, no one can predict the future. Each of us is unique, and how each woman’s body and mind handle breast cancer and treatment is truly a mystery. Many women have beat the odds, while other women “sure to do well” somehow didn’t. You just have to do the best you can, with the best team of doctors and nurses that you can assemble, together with your support network.

The good news is that more and more women are living longer than five years past breast cancer as a result of early detection, more effective breast cancer treatments, and better overall medical care.”

I am hoping for no re-occurrence, but who knows?? Meanwhile get your annual mammograms, because early detection does save lives!!

Breast Density: What it is and what it means to you

 
There are several steps that women can take to reduce their breast cancer risk. From following a healthy diet, having an active lifestyle, to limiting alcohol and using safe beauty products, there are a number of opportunities for women to take charge of their breast health.

But one significant risk factor that women can’t control? Breast density.

Breast density, a term that some women who have had mammograms may be familiar with, refers to the percentage of different tissues that make up a woman’s breasts—fat tissue, glandular tissue and connective tissue. While some women’s breasts are comprised primarily of fat tissue, nearly 40 percent of women have breasts with mostly glandular and connective tissue, a characteristic commonly referred to as dense breasts that can make breast cancer more difficult to detect.

“Dense breast tissue appears white on a mammogram, and so do tumors and other abnormalities, which makes it easier for tumors to hide. Although mammograms can still be effective for women with dense breasts, detecting calcifications for example, this camouflaging does make it more difficult to detect some cancers,” explains John Stassi, MD, radiologist with The Barbara Brodsky Comprehensive Breast Center at Bryn Mawr Hospital, part of Main Line Health.

Not only do dense breasts make breast cancer more difficult to detect, they also make it a more likely occurrence. Studies have linked breast density with a higher risk for breast cancer.

Previously, women were not made aware of their breast density but thanks to new regulations in nearly half of the states across the country, including the 2013 Pennsylvania Breast Density Notification Act, physicians are now required to alert women when a mammography exam shows dense breasts.

“For women, this news can be concerning. However, by telling our patients whether or not they have dense breasts and then educating women about how to manage that risk, we will hopefully be able to reduce the number of undetected or hidden cancers in our patients with dense breasts,” says Dr. Stassi.

Even if they learn they have dense breasts, Dr. Stassi encourages women to continue to schedule their annual mammogram. Some of the earliest signs of cancer, such as calcifications, are still easily detected even in dense tissue. The use of 3D mammography throughout Main Line Health has already improved breast cancer detection in our patients with dense breast tissue.” says Dr. Stassi. Learn more about 3D mammography at Main Line Health.

If you learn that you have dense breasts, talk with your primary physician or gynecologist, or a breast center nurse navigator about your lifetime breast cancer risk. A risk assessment will take into account your family history and many other factors and if it indicates that you are at a higher lifetime risk for breast cancer, they can help you determine what supplemental screenings are best for you. If additional testing is necessary, your physician may recommend breast MRI, or breast ultrasound, all of which have been shown to increase cancer detection in dense breasts.

“The earlier we can begin education and awareness, the better. We are making efforts to educate women and their physicians not only about the significance of having dense breasts, but how to manage the associated risk,” says Dr. Stassi.

More Evidence Tamoxifen, Other Meds Help Limit Breast Cancer Spread

6-year study finds follow-up therapy cuts survivors’ risk for cancer in the other breast

By Robert Preidt

Thursday, October 6, 2016

HealthDay news imageTHURSDAY, Oct. 6, 2016 (HealthDay News) — Treatment with tamoxifen or another class of drugs called aromatase inhibitors does cut breast cancer patients’ risk of developing cancer in their other breast, a new study finds.

Some breast cancers rely on estrogen to help them grow, and drugs like tamoxifen or the aromatase inhibitors (which include anastrozole) have long been prescribed to certain breast cancer survivors.

Tamoxifen blocks estrogen receptors in the breast cells to hamper cancer growth. Anastrozole stops estrogen production in fat tissue, which makes small amounts of the hormone.

According to background information in the new study, about 5 percent of breast cancer patients develop cancer in their other breast (contralateral breast cancer) within 10 years after their initial breast cancer diagnosis. Prior clinical trials had concluded that tamoxifen and aromatase inhibitors reduce this risk, but their impact on actual patient treatment was unclear.

The new study was led by Gretchen Gierach, of the U.S. National Institutes of Health, and involved almost 7,500 women diagnosed with invasive breast cancer between 1990 and 2008.

Most of the patients were white and their average age at diagnosis was nearly 61. Tamoxifen was used by 52 percent of the patients for an average of just over three years.

Aromatase inhibitors were used by nearly 26 percent of the patients. About half of this group took aromatase inhibitors with tamoxifen for a median of 2.2 years, and about half took aromatase inhibitors alone for a median of almost three years.

During just over six years of follow-up, 248 of the patients in the study were diagnosed with a cancer appearing in the previously unaffected breast.

However, the risk of this happening declined the longer patients took tamoxifen, Gierach’s team found. Compared to those who did not take the drug, current users had a 66 percent lower risk after four years of taking tamoxifen. Risk reductions were smaller but still significant at least five years after stopping tamoxifen therapy, the study authors noted in a news release.

Use of aromatase inhibitors without tamoxifen was also associated with reduced risk of cancer in the previously unaffected breast, the findings showed.

Overall, for every 100 patients who’d survived at least five years, using tamoxifen for at least four years was estimated to prevent three cases of tumors spreading to the previously unaffected breast over a decade, the researchers said. That finding was specific to women with what are known as estrogen receptor-positive tumors, where the cancer is sensitive to the hormone.

Gierach’s team believes the findings support recommendations that breast cancer survivors “complete the full course” of whichever medication (tamoxifen or aromatase inhibitor) they’ve been prescribed.

Two oncologists each called the new findings “reassuring.”

One is Dr. Stephanie Bernik, who is chief of surgical oncology at Lenox Hill Hospital in New York City. She believes that tamoxifen and aromatase inhibitors are potentially life-saving, so the new findings are welcome.

“Many women have side effects from the drugs and although these side effects are often minor, they need encouragement to continue using the drug,” Bernik explained. “With more evidence showing that in real-life settings tamoxifen and aromatase inhibitors help prevent recurrences, more women will continue to take the drug for longer periods of time.”

Dr. Nina D’Abreo directs the Breast Health Program at Winthrop-University Hospital in Mineola, N.Y. She believes the NIH trial confirms the benefits of the drugs as evidenced in prior studies, and may help dissuade some women from deciding to have the unaffected breast removed for preventive purposes.

D’Abreo said the study “also affirms that the duration of therapy matters, but even shorter use has benefits for the ‘real-world patient’ who cannot comply with the recommended five to 10 years.”

The findings were published online Oct. 6 in the journal JAMA Oncology.

SOURCES: Stephanie Bernik, M.D., chief, surgical oncology, Lenox Hill Hospital, New York City; Nina D’Abreo, M.D., medical director, Breast Health Program, and attending physician, department of oncology and hematology, Winthrop-University Hospital, Mineola, N.Y.; JAMA Oncology, news release, Oct. 6, 2016