Indy's In the pink 100213

AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR 1 S T WEDNESDAY, OCTOBER 2, 2013 • P1

A custom advertising publication of The Indianapolis Star ✱ Wednesday, Oct. 2, 2013

By Angela Parker For Custom Publications

Megan Rosbottomwas 33 years old and 29weeks pregnant with her second child whenshe felt a lump in her armpit. Because swollenmammary glands aren’t unusual duringpregnancy and typically subside after the birth,she and her doctor logically decided towaitand see.Rosbottom’s daughter, Fiona, was bornDec. 28,

2012. In the excitement that followed, she forgotabout the lump until mid-January, when she feltsomething on the side of her breast. Her husband,Lucas, confirmed that it felt abnormal. By the timeshe saw her doctor and had both amammogramand an ultrasound, anothermonth had passed.Test results confirmed a cancerous lump and asecond suspicious area, this one behind the nipple.“Theyweremore concernedwith that area than

the lump,” Rosbottom said. “But [Dr. Erin Zusan,breast surgical oncologist, Community Breast

Whateverit takes

Pregnancy and cancer: The connectionIs there a link between pregnancy and breast cancer?“Yes, there is,” said Stanley Givens, MD, medical director and radiation oncologist

with the Hendricks Regional Health Cancer Center. “When a woman is pregnant, thecycle of estrogen and progesterone is different than in the nonpregnant state. This maymake breast cancers behave much more aggressively and be somewhat less responsive

to therapy in a pregnant female than one who is not pregnant.”The risk ranges from 1-in-1,000 to 1-in-10,000 pregnant women

who develop breast cancer. According to Givens, either set of oddsis relatively small.“Cancer in a pregnant woman is uncommon, but in that

uncommon event, breast cancer is the most common to see,” hesaid. “The younger a woman is when she develops breast cancer,the greater the likelihood of a genetic link to that development.”Breast cancer in pregnant women typically is more aggressive

and more likely to be detected at a later stage, however. Onereason, Givens said, is that some warning signs can mimic normal

pregnancy changes. The breasts become fuller, more tender and lumpier, whichmakes it more difficult to identify abnormalities. Abundant estrogen also makesyounger women’s breast tissue more dense, which can reduce the effectiveness ofmammography.Some women don’t pursue a diagnosis for fear of harming the baby.“Treatment can be a challenge, balancing the needs of the mother with the

developing fetus,” Givens said. “It’s got to be difficult. They’ve just gone through thistremendous process and given life to their child and all the joy that comes with that, butthey’re immediately confronted with a very challenging health issue — all while tryingto take care of a brand-new baby.”✱

PINKBreast cancer awareness month: LIVING BEYOND THE DIAGNOSIS

Care South] wasn’t comfortable saying the lumpwas just a cyst. She wanted to biopsy it that day.”The procedure indicated cancer was present.

Based on the tumor’s size and the lymph nodesinvolved, Rosbottom’s diagnosis was Stage 3 cancer.“Then the treatment began rapid-fire,” she said.Within the next week she had anMRI,

an echocardiogram and surgery to place achemotherapy port. A PET scan revealed that thecancer was located in the right breast only but hadspread to the lymph nodes.“It was an aggressive cancer, and I was so young

that they wanted to hit it hard. Theywanted to doeverything they could to get rid of it,” Rosbottomsaid.She began chemotherapy onMarch 1, 2013,

and finished in June. In July she had a doublemastectomy. Of 20 lymph nodes removed, eightwere determined to be cancerous. Rosbottom alsotested positive for the BRCA1 gene, an indicator forbreast and ovarian cancer, so she had her ovaries

and fallopian tubes removed as well.Rosbottomwas scheduled to begin radiation

treatments last month. But before the firstappointment arrived, she discovered another lump.Another biopsy— and yet another cancer diagnosis— quickly followed. Her doctors don’t expect thenew tumor to require surgery— radiation therapyshould take care of it— but a PET scanwill helpmake sure. She’ll also have regular Herceptintherapy for the next year to prevent any recurrence.“It’s been awhirlwind at our house this whole

year,” Rosbottom said. “My stepmom andmymother-in-law have beenwonderful. One if notboth of them have stayedwith us since Valentine’sDay. I’ve just recently gone at it onmy own.“And Lucas, my husband, is fantastic. He’ll say,

‘We have two girls, so whatever (the doctors) tell usto do, we’re going to do.’ Any time I get down, heremindsme of that. I have those three to live for.I’m not ready to say goodbye, so we’re going to dowhatever it takes.”✱

Megan and LucasRosbottom with their

daughters, Fiona and Reese

By Angela Parker For Custom Publications

Fromzeroto10 to zero

INDY’Sin the

Babies and breast cancer

Every woman knows her bodywill changeduring pregnancy. But what if somethingchanges in a negative way? How can she

tell if her new normal is anything but normal?For these women, the joy of pregnancywasaccompanied by a dreaded disease: cancer.

Givens

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❯ See ZEROTO 10, on Page 2

On Feb. 3, 2013, Levi Rosenfeld came into the world abit earlier than expected. After being cared for at RileyHospital for Children at IUHealth, his family thought

the worst of their worries was over.But just as life settled down, Levi’s mother, 28-year-old

Brittanny Seybold, found a lump in her right breast. Herobstetrician, Ian Johnston, MD, sent her to the HendricksRegional HealthWomen’s Center for a biopsy and ultrasound.The next day, March 22, Johnston called with the news:

Seybold had breast cancer.“It was a shock because nobody inmy family has had breast

cancer, andwe don’t really have a strong history of cancer at all,”she said.She even tested negative for the BRCA gene, an indicator

of breast and ovarian cancers. Her doctor believes the cancerwas present before the pregnancy, and the surge of hormonesspurred rapid growth.

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P2 • WEDNESDAY, OCTOBER 2, 2013 1 S T AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR

By Shari Held For Custom Publications

Every womanwho has experiencedbreast cancer has a unique story totell. Among them all, the common

denominators are courage, resiliency and afierce determination to live life to the fullest.

Jill’s storyJill Golightly discovered a lump in her

breast in November2010, when she was inNewYork City to watchthe University of NotreDame play football atYankee Stadium. Shechalked it up as a benigncyst; cancer wasn’t on herradar. She had no familyhistory of the disease andhad seen her doctor for an

exam in June.“I didn’t let it ruinmy vacation,” she said.

“I wasn’t that concerned.”Golightly saw her doctor the following

Monday and scheduled an ultrasound forseveral weeks later, on her day off. After that

Every survivor has a storytest, her doctor ordered a biopsy for the nextday. At this point, she became concerned.The biopsy confirmed a diagnosis of

noninvasive ductal breast cancer. Golightlysubsequently tested positive for the BRCA1gene.Within a week, she began a four-month chemotherapy regimen, followed bya singlemastectomy, lymph-node removaland 32 radiation treatments, then preventive

mastectomyon the left side,reconstructionand ahysterectomy.“I did it all,”

Golightly said.Chemotherapy

was the “hardestpart,” she said,and she remains

thankful for family and friends who offeredsupport during that difficult time.“Now that I am involvedwith a lot

of survivors, I realize that althoughmy journeywas very difficult, I wentthrough it well,” she said. “I didn’t have thecomplicationsmanywomen get.”

Seybold immediately underwent tests to determine the disease’s progression, and shelearned it already had spread. In addition to the breast tumor, 10more growths were foundon her liver.“My first oncologist basically said there was not a whole lot he could do because it was

Stage 4,” she said. “I was like, ‘Oh, great. I have an 8 year old and a baby at home.’ It wasdevastating.”Seybold decided not to accept that prognosis. Shemet with Ruemu Birhiray, MD, an

oncologist with St. Vincent Health. And though the specialist acknowledged the difficultyof the situation, he also offered hope.“He said, ‘We’ll do everythingwe can. There’s no reason to plan a funeral,’” Seybold said.

Theywent to battle in April. After the second high-dosechemotherapy session, the breast tumor no longer waspalpable.“Dr. Birhiray was really excited,” she said. “Only about 30

percent of patients respond that quickly. Since it was reactingsowell inmy breast, he said there was no reason to believe itwasn’t reacting as well inmy liver.”After sixmore rounds of chemotherapy, Seybold had a CT

scan last July. That test showed breast tissue clear of cancer anda single 1-centimeter spot on the liver. Aweek later, that singlespot was not visible on anMRI.For her part, Seybold did everything possible to boost her

odds. She decided to keep a positive outlook, change her lifestyle and switch to a plant-based diet, which she says helped her tolerate rigorous chemotherapy.In early September, surgeons removed Seybold’s right breast and one lymph node,

which proved to be disease-free. Thought the left breast was unaffected by cancer, it will beremoved in about sixmonths.“It was a hard decision,” she said. “But to potentially savemy life and keepme here longer

formy kids, I have to do it.”✱

INDY’S IN THE PINK

This is a product of Custom Publications, a division of Star Media. This feature andothers can be found at indystar.com/custompubs.

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Golightly, now 38, has discovered areserve of strength she didn’t know shehad. She focuses on being a goodmom,attending school events and soccer gameswith her two daughters, ages 11 and 7. Shecontinues to work hard, taking time off onlywhen necessary.“Bothwork and keeping asmuch

normality for the girls as possible helpedmeget through it as well as I did,” she said.With cancer behind her, Golightly is

getting back to the activities she enjoys. InMay she participated in the 500 FestivalMini-Marathon and is training for a secondrace.“In someways it

feels like it was justyesterday,” she said. “Inother days, it feels likeit was eons ago.”

Julie’s storyIn February 2012,

Julie Hollis felt a lumpin her right breast.She didn’t have anyreason to believe it wasserious.“I was in great shape

andwonderful spirits,”she said. “I had neverfelt better inmy life.”Still, she went to see

her doctor the nextday. And twoweeksafter being diagnosedwith Stage 3 invasiveductal cancer, Hollishad amastectomy. Ina second surgery, performed inMarch, 20lymph nodes were removed— and threewere found to be cancerous. Her doctorreported that the cancer hadmetastasized.“The cancer was so extensive and

aggressive, my chance of recurrence was86 percent,” said Hollis, a 2013 KomenAmbassador who is helping to advocate forhealth andwellness in central Indiana. “Iwas young and healthy, so they needed tothrow everything atme.”But her body had other ideas. Hollis

Brittanny Seybold, her fiance, Stephen Rosenfeld, and their sons, Devlin and Levi

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❯ ZEROTO 10continued from Page 1

“It was a harddecision, but topotentially savemy life and keepme here longerfor my kids, Ihave to do it.”

struggled to get through eight rounds ofchemotherapy. A regimen of the Taxol drugmade her feel as though every bone in herbodywere breaking. She was weak anddizzy, suffered severemigraines and had nofeeling in her hands and feet.“I couldn’t function,” said Hollis, the

mother of two, ages 13 and 16. Thattreatment was suspended and replacedwith33 rounds of radiation, whichwere easy incomparison.Hollis, 39, wasn’t a good candidate for

hormone treatment to suppress her body’sestrogen production. After sevenmonths,

she was bedriddenand nonfunctional.She also developedlymphedema—swelling in the arms— andwrappedup threemonths ofphysical therapy lastJuly. Thismonth,she’ll undergoreconstructivesurgery.Despitemany

challenges, Hollis,owner of Julie’sFlowers of Geist,provided floralarrangements for 20weddings, with helpfrom friends andfamily. She even gotmarried in June.“I decided it was

time tomove onwith life and start

the next chapter,” she said. “My husband hasbeen phenomenal, never leavingmy sidethrough all this and taking care ofmy kidswhen I couldn’t.”Hollis has decided to forgo additional

treatments and rely instead on frequentcheckups.“It was just too toxic,” she said.And now that the side-effects of

treatment are gone, she worries less.“If you’re always worrying about what

will happen, you’re not actually living life,”Hollis said.✱

By Shari Held For Custom Publications

at a timeA step

KimDeMasie, 50, was diagnosedwith triple positive invasiveductal carcinoma in the left breast

in July 2011. Follow-up tests revealedtwo “satellite” areas on her right breast.Though a nurse at RiverviewHospital,

DeMasie was in noway prepared for whatlay ahead.Throughout her journeywith cancer,

she kept a journal on CaringBridge.org,a health-focused social networking site.Parts of her journal are excerpted below.

August 2011When I found out I had to have chemo ... I was heartbroken. Yesterday when I woke up my scalp

was sore. Then when I washed my hair, it started coming out in handfuls. It was a weird feelingjust watching it fall. But I have to think if the chemo is doing this on the outside to good cells,(hopefully) it’s doing worse on the inside to bad cells. So we drudge forward into the next phase ofthis crazy walk.

September 2011Even though it’s been two months, it still feels like some kind

of dream. I took our dog Zoe out the other day and saw myreflection in the patio door without my hat. I thought, ‘Who isthat bald girl?’

November 2011The last chemo was Friday, and I’m definitely feeling it. My

brain knows it’s over but my body hasn’t heard the news yet.Everything hurts. I feel like my body went through one of thoseold washing machines.

February 2012The past three surgeries weren’t good enough. I feel like I’ve been able to stay strong and just

‘go along’ with the plan, but I lost it and couldn’t stop crying. I want to have a mastectomyand be done with this. I just can’t put my family through another failed surgery. After muchconsideration I’ve decided to have a bilateral mastectomy.

After fourmonths of chemotherapy, in December 2011DeMasie had a partialmastectomy on her left breast and a biopsy of her right breast. In January her lymphnodes were surgically removed, alongwith additional tissue around the tumor site.When the tissuemargins weren’t cancer-free, she had a third surgery in February.Each time she was supported by her family, including her husband, Jeff.

DeMasie’s fourth surgery was completed inMarch.

April 2012It started to hit me what this cancer has cost me. I cried hard and loud

and just let it out. It felt good to finally just scream at cancer and howmuch hurt it causes people.

April 21, 2012I got the ALL CLEAR! Hooray! I told Jeff I felt like a cloud was lifted

when we finally got all of the cancer out and we can get on with life.Hopefully this is the last entry in this journal. Thank you for all of your well wishes.✱

Golightly

PHOTO:RIC

HMILLER

Hollis and her husband at their June wedding.

“Both workand keepingas muchnormalityas possiblehelped me getthrough it.”

DID YOU KNOW?❯ Scientific evidence does not support a link between wearing underwire bras and increased risk of breast cancer.

❯ More than 40,000 women will die from breast cancer in the United States this year. It will kill about 440 men.

❯ Breast cancer is the most frequently diagnosed cancer among U.S. women.

❯ In the United States, a woman is diagnosed with breast cancer every three minutes. And every 13 minutes, onewoman dies of the disease.

❯ The five-year survival rate for women with breast cancer that has not spread to lymph nodes or other sites increasedfrom 74 percent in 1982 to 98 percent in 2009.

❯ African Americans have the highest death rate from breast cancer of any racial/ethnic group in the United States.

❯ There are more than 2 million breast cancer survivors in the U.S. today.

—Komen Central Indiana

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As a Breast Imaging Center of Excellence,Hendricks Regional Health uses all-digital mammography,which provides electronic images of the breast thatcan be enhanced by computer technology. Usingcomputer-aided detection systems, mammogram imagesare analyzed for abnormalities that may indicate thepresence of cancer.

What to expect:1 You will remove clothing and deodorant, jewelryor other objects from the waist up, and will be givena gown to wear.

2 The technologist will discuss with you any lumpsor other breast changes you have noticed. Areas ofconcern are noted.

3 You will stand in front of the machine and thetechnologist will position your breasts, one at a time,on the x-ray plate.

4 A separate plate will be placed on top of the breastto compress it against the x-ray plate. Compression ofthe breast is required to ensure optimal images of thebreast tissue.

5 Two pictures will be taken of each breast.

Types of mammogramsThe American Cancer Society recommends that womenage 40 and older have a screening mammogram everyyear. Screening mammograms take about 15 minutes. Adoctor’s order is not required.

If you are experiencing breast pain, a lump or skinthickening, nipple discharge or a change in the size orshape of your breast, contact your doctor to be referredfor a diagnostic mammogram or other tests. A diagnosticmammogram takes about 30 minutes, with resultsavailable before the patient goes home.

Screening mammograms are done at our Danville andPlainfield campuses. Convenient early and eveninghours are available. Diagnostic mammography isperformed in Danville.

Don’t forget to get your mammogram.Go to hendricks.org/mammo or call (317) 745-3404.

mammo 101

IS-0000000246

By Julie Young For Custom Publications

The news canweaken a husband fasterandmore decisively than Kryptonitesubdues Superman. Though they

attend appointments, gather informationand vow to be strong for the women they

love, men say that breastcancermakes them feelless like a superheroandmore like a haplesssidekick.“Men, by their very

nature, are problemsolvers. They like tofix things, but there isnothing they can do to fixcancer. That realization

can be quite a blow,” said Lee Stephan, amental health professional for CommunityHealth Network.Stephan’s ownwife passed away from

breast cancer in 2010.

Staying strongDespite feeling helpless, men tend to act

quickly to protect the womenwhomeanthe world to them. They juggle personal andprofessional responsibilities, and they striveto create a normal home environment atthe verymoment their universe is shifting.Fortunately, men can find emotionalsupport in a number of outlets.WhenMike Petraits learned that his wife,

Donna, had breast cancer, he immediatelyreached out to the St. Vincent Center for

To support their wives,men become breast cancer heroes

Women’s Health helpline,(317) 338-4437. By calling thatnumber, he was able to gatherinformation that helped himstay strong and keep smilingwhen his wife needed himmost.The woman on the other end

of the phone describedmanyoptions and positive scenarios,and though the cancer wasserious, Petraits was ableto remain upbeat when thesituation got tougher.“Sometimes you hear

things you don’t want to hearand you get information you don’t wantto know about,” he said. “But you simplyhave to jump in and dowhatever it takes tohelp your wife climb out of this hole.Wecelebrated every victory.We cried whenwe needed to, andwe stayed in control ofa situation that seemed to have a life of itsown at times.”

Relying on othersRichDawsonwas 32when his wife,

Heather, was told that the lump in her breastwas cancerous.With two young children,he had to face the possibility of raising themalone.The couple did their best to keep home

life normal for the kids, but Dawson feltfears and doubts creep in during quietmoments.When that happened, he wouldturn to his family, friends and pastor to

Stephan


PHOTO:KOME

NCENTRALIND

IANA

express his frustrations and soothe his heart.“When something like this happens, it

is really transformative,” he said. “It setspriorities where they need to be, and yourealize that you have toman up and dowhatneeds to be done.”Whenmen have to face the worst-case

scenario, theymay need to connect withothers who’ve been through a similarsituation.When Stephan lost his wife, he discovered

a real shortage of local support groupsgeared towardmen. Though theymay notwant to admit they need help or support,men should have the opportunity to shareconcerns and ask questions.“I’m really committed to growing this

group and getting the word out to let menknow that whatever feelings they have, it’snormal— and above all, they are not alone,”he said.✱

When shehas breastcancerResources for male caregiversMen who endure breast cancer

alongside their wives may benefit frompeer support, but their needs often areoverlooked. A number of local facilitiesoffer information, hope and help asmen work through their questions andfrustrations.

Community Health Network men’ssupport groupCommunity Hospital North8040 Clearvista Pkwy., Suite 290First Tuesday of each month,6 - 7:30 p.m.(317) 621-4323

Franciscan St. Francis Health patientand caregiver supportIndianapolis and MooresvilleMondays, 6 - 8 p.m.(317) 257-1505

Hendricks Regional Health cancersupport group(317) 718-4360

St. Vincent Center forWomen’sHealth helpline(317) 338-4437Available 24 hours

St. Vincent Health’s Our FightAgainst Cancer program(317) 338-4968www.ourfightagainstcancer.com

Riverview Hospital Cancer Centersupport group395 Westfield Road, NoblesvilleFirst and third Tuesday of each month(317) 776-7179

“You simply haveto jump in and dowhateer it takes tohelp your wife.”

—Mike Petraits, whosewife Donna (right) is abreast cancer survivor and2013 Komen Ambassador

DID YOU KNOW?❯ In the U.S., more than 250,000 women under age 40 areliving with breast cancer. Many were in their 20s when itwas discovered.

❯ It’s OK for people with cancer or a history of cancer toget a flu shot, but those with cancer should not receivethe nasal spray vaccine. That’s because the virus in theshot is dead; the virus in the nasal spray is living.

❯ 90 percent to 95 percent of breast cancer occurs inwomen with no immediate family history.

❯ Radiation is measured in rads. A woman who has anannual mammogram for 50 years receives about 20 to40 rads. Breast cancer patients who are treated withradiation receive several thousand rads.

❯ It can take up to 10 years for a mass to grow largeenough to detect on your own.

❯ Some studies have found that larger breast size increasesrisk, while others have found no link.

❯ Cancer is 5 percent more likely to occur in the left breastthan in the right.

❯ Studies have found that for each alcoholic drinkconsumed per day, the relative risk of breast cancerincreases by about 7 percent. Women who had two tothree alcoholic drinks per day had a 20 percent higherrisk than nondrinkers.

❯ The three largest studies to date on caffeine and breastcancer found no link between drinking coffee or tea andthe risk of breast cancer.

❯ Many studies have found that women over 5’3” have aslightly higher risk for breast cancer. One reason might begrowth spurts caused by higher hormone levels.

❯ Research does not support a link between breast cancerand the use of deodorant or antiperspirants.

❯ Before menopause, being overweight appears to decreasea woman’s risk of breast cancer. After menopause, itincreases her risk by 30 percent to 60 percent.

—Komen Central Indiana

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2 c flour½ c sugar1 T baking powder1 c blueberries (fresh or frozen)1 egg

¼ c canola oil1 t vanilla extract½ c milk½ c pomegranate juice

Preheat oven to 425 degrees. Combine dry ingredients andblueberries in a bowl. Combine liquid ingredients in another bowl.Add the liquids to the dry ingredients and stir until just combined.Fill muffin cups 2/3 full and bake 12-15 minutes until golden brown.Optional streusel topping: Combine 2T brown sugar, 2T flourand 1T butter; sprinkle 1T on each muffin before baking. Yield: 12muffins, 135 calories/muffin (without the topping)

Ingredients

Directions

Blueberry Pomegranate Muffins

2 (6 ounce) packagesfresh raspberries2T sugar2 (6 ounce) cartons lemonmeringue light yogurt

1 ½ cups (4 ounces) frozen fatfree whipped topping, thawed3 cups (1 inch) cubedangel food cakeRaspberries for garnish (optional)

Combine raspberries and sugar in a medium bowl. Let stand 5minutes, stirring occasionally. Place yogurt in another bowl; gentlyfold in whipped topping until combined. Layer about 1/3 cup eachangel food cake, raspberry mixture, and yogurt mixture in eachof 4 tall glasses. Repeat procedure once. Garnish with additionalraspberries, if desired. Serve immediately, or chill until ready toserve. Yield: 4 servings

Ingredients

Directions

Raspberry Lemon Parfaits

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By Jen Bingham For Custom Publications

Are you at risk of being diagnosedwith breast cancer? To get a betteridea, take a look at your family

history and genetics, both of which are keyrisk factors.

Understand your risk“Most women don’t know their risk,” said

Debbie Saslow, PhD, director of breast andgynecologic cancer forthe American CancerSociety. “They eitherthink it’s greater than it isor smaller than it is.”Women tend to

overestimate their ownrisk when any familymember has had thedisease, she said.

“The closer someone is to you on yourfamily tree and the younger their age whendiagnosed, themore danger you’re in,”Saslow said. “On the one hand, everyone’s atrisk. On the other, somewomen are afraidthey’re at high risk when they’re not.”

Talk to your healthcare provider about yourfamily history, but don’tbe overly anxious if onerelative has had breastcancer.Rebekah Krukenberg,

MS, CGC, LGC, agenetic counselor with

Family history, genes and breast cancerCommunity Health Network, said cancercomes in three types: sporadic, familial andhereditary.“Sporadic cancer accounts for greater

than 60 percent of cancers and is basedon environmental or unknown factors. Infamilial cancer, a family looks like they havemore cancer than normal but don’t have agenetic component you can find,” she said.The third type, hereditary cancer, is

passed down through generations and canbe pinpointed genetically. Krukenberg saidit accounts for 7 percent to 10 percent ofdiagnosed cancers.

Working with a proGenetic testing for cancer is oneway

to determine your risk level. But Saslowemphasizes thatmany doctors aren’tequipped to recommend genetic testing forbreast cancer and aren’t able to interpretresults.“If you have a worrisome history, ask for

a referral to someonewho knows how totake the information and transfer it intoclinical recommendations,” she said. “Goto a genetic counselor or a doctor or nursetrained in cancer genetics. A trained procan take your cancer info and use a complexmodel that will help you decide whether tohave genetic testing.”Helping patients determine whether

to pursue testing is one task Krukenberghandles daily.“When patients come in to see whether


Saslow

they’re a candidate for testing, we talk abouttheir medical and family history,” she said.“We draw it out on a board so they can seeit on one page.We also talk to them aboutcancer and genetics and how they’re related,and give the details on genetic testing andwhat it can and can’t do.”

Genetic testing isn’t for everyone,Krukenberg said. Generally, it’srecommended only for individuals whosefamily history places them at high risk forbreast cancer. Even then, test results shouldbe takenwith a grain of salt.“Having negative results doesn’t mean

you’re never going to get breast cancer;you’re at the same risk as everyone else,”Saslow said. “And if you’re positive, it doesn’tmean youwill get cancer.”

If the risk is highWhat should you do if you have a genetic

factor that increases your risk?The common recommendations are to

increase the frequency of self-exams athome and to get annualmammogramsandMRIs, with the two imaging testsspaced sixmonths apart. Other courses ofaction include preventivemedication andprophylacticmastectomies, alongwithroutine well care, such as exercising, eatingwell, maintaining a healthy weight andavoiding tobacco smoke.“Increased screening does reduce risk

most of the time,” Krukenberg said, notingthat genetic counselors guide patientsthrough testing and help them understandtheir present and future options.When a strong familial risk is present,

she said, some patients are advised to seekincreased screenings and take preventivemeasures, even if they test negatively for agenetic factor.✱

You may havea higher risk ofbreast cancer if …❯A male relative has been diagnosedwith breast cancer.

❯A number of close blood relatives onone side of the family have had breastcancer.

❯Any relative has had cancer in bothbreasts.

❯ You have relatives with other glandularcancers, such as pancreatic.

❯A relative has had ovarian cancer atany age.

❯A relative was diagnosed with breastcancer at a young age.

❯Any relative has had cancer of thebreast and ovary.

❯ You have a personal history of ovariancancer.

Krukenberg

Imaging’s new offeringBreast cancer detection is making new strides as the latest development in imaging

is helping patients detect tumors earlier. Tomosynthesis,called 3D mammography by some, might detect earlierstages of breast cancer when used in conjunction withtraditional mammography.“Mammograms can detect tumors as small as three

to four millimeters in many cases,” said Jack Drew,MD, a radiologist who practices at Riverview Hospital.“Tomosynthesis doesn’t detect smaller tumors, but itincreases the sensitivity by taking multiple images ofthe breast from many angles, which can lead to betterdetection rates. It can also be less painful because it

requires less pressure on the breast when compared to a traditional mammogram.”Tomosynthesis was approved by the FDA in 2011, but has not yet been widely

adopted as physicians evaluate its effectiveness.✱

By HollyWheeler For Custom Publications

Breast cancer specialists emphasize regularmammograms and self-exams as twoimportant ways to detect and treat tumors early on, giving patients the best chanceof survival.

Conflicting consensusWhen and how often should a woman get amammogram? The American Cancer

Society recommends that females should begin getting an annualmammogram at age 40.The U.S. Preventive Services Task Force says women should have the test done at age 50and every other year after that. For eachwoman, the actual timing should depend on herphysician’s advice and her understanding of her own health.“The source of confusion is that there’s never been a perfect research study for

screening for breast cancer,” said Erika Rager, MD,MPH, a breastsurgeon for Franciscan St. Francis Health Indianapolis. “Some startedat 40, some started at 50, some did screenings every year, every two ormaybe two-and-a-half years.”The ACS recommendation takes into account the benefits of

mammograms, Rager said, but it doesn’t consider the risks.“That’s where the (American Academy of Family Physicians)

and the U.S. Preventive Services Task Force came out with theirrecommendations,” she said.With earlier mammograms, women aremore likely to get a false

positive. About 10 percent undergo additional testing, which can bestressful and costly and cause patients tomiss work unnecessarily. A small percentage ofthese women are advised to have a biopsy.“We argue about the details, and that’s fine, but we don’t want to lose sight of the forest

for the trees,” Rager said. “The bottom line is that womenwho have regular screenings forbreast cancer have a 15 percent to 20 percent lower risk of dying from breast cancer.”

Know your genesIn determining a woman’s risk for breast cancer, family history is big factor. Genetics

and certain other conditions can help an individual understand her risks and spur hertoward regular care and, when recommended, genetic testing.Genetic counselors are health professionals who help patients withmultiple risk factors

and educate them about genetic disorders. Based on test results, acounselor can describe the available options and recommend certaintreatments.“There are several things that we look for, such as younger ages of

onset, cases of cancer that fit known hereditary patterns, bilateralcancers – these are cancers affecting both organs. These red flagssuggest there could be a hereditary cancer condition,” saidMorganDally, MS, CGC, a genetic counselor with Franciscan St. Francis HealthIndianapolis. “Just one case in the family does not warrant geneticcounseling. It’s whenwe seemultiple cases for a physician to refer.”If a geneticmutation is present, Dally noted, the woman has an 87

percent chance of developing breast cancer.“For these womenwe suggest routine surveillance or preventive surgery,” she said.

“Increased surveillance canmean earlier mammograms, while preventive surgery couldbe amastectomy.”✱

Rager

Dally

Sooner is better

“Mammogramscan detecttumors as smallas three to fourmillimeters inmany cases.”

FACTS❯Tomosynthesis increases the sensitivity of screening for breast cancerto 76%. Mammography has on overall sensitivity of 66%

❯Tomosynthesis increases the specificity of screening for breast cancerto 89% from 81% from mammography.

❯Tomosynthesis decreases the recall rate for additional imaging by 43%.

Indy’sturningpink in

OctoberBy John Adams For Custom Publications

As summer turns to autumn,Midwesternersanticipate nature’s smooth transition fromevery shade of green to red, orange, brown

and brilliant gold.This October, Indianapolis is bucking the typical

color trend by turning bright pink instead. The shiftis a visible sign of the city’s support for NationalBreast Cancer AwarenessMonth, an annual effortto promote understanding of the disease.

Items from clothing and jewelry to food and drinks are turningpink to spread the word that breast cancer can be prevented andtreated through early detection.“There’s never toomuch pink,” said Dana Curish, executive

director of Susan G. Komen Central Indiana. “We’re still losingwomen to breast cancer, and all of these events going on are raisingmoney to help low-incomewomen access early screening anddetection services, in addition to funding research to help savefuture generations.”Just 60 percent of womenwho have health insurance today

choose to get an annualmammogram, Curish said. The ultimategoal thismonth is to createmass awareness through these and other local events:

Power of Pink bracelets ❯ Throughout OctoberBrighton Collectibles, located inside The Fashion Mall at Keystone, is offering uniquePower of Pink bracelets for $60. Each bracelet sold benefits Susan G. Komen CentralIndiana and the Indiana Women in Need Foundation. Visit the store soon to get your one-of-kind bracelet.

Break (pink) bread ❯ Throughout OctoberSince Panera Bread began offering Pink Ribbon Bagels 12 years ago, the eatery has helpedraise more than $2 million for breast cancer charities nationwide. Central Indiana locationsare offering this tasty favorite and donating proceeds to Susan G. Komen.

Premium pink ❯ Throughout OctoberWhen you’re in a shopping mood and up for a short road trip, head down I-65 toEdinburgh Premium Outlets. Donate $10 to Susan G. Komen and you’ll receive 25 percentoff the cost of your favorite item at a number of retailers. The mall is planning to kick theaction up a notch on October 26 and 27, serving up light eats and live music.

Pink pottery party ❯ Thursday, Oct. 10Stop in at the Ceramic Dreams studio at 1134 E. 54th St. from 5 to 8 p.m. You’ll receive a20 percent discount on all pottery you paint. Ceramic ribbons and lots of pink paint will beavailable for patrons. Wear your brightest pink painting clothes!

Cancer Sucks party ❯ Saturday, Oct. 19Sara’s Soldiers is a group of friends and family who’ve come together after the breast-cancer death of Sara Moyer Carpenter last September. Sara, just 30 years old at the time,left behind a husband and 18-month-old daughter. The team is hosting a Cancer Sucksparty from 7 to 10 p.m. at the Stonegate Meeting House on 6653 Westminster Drive inZionsville. Bring cash for the silent auction and you’ll help raise money for Susan G. KomenCentral Indiana while keeping Sara’s memory alive.

Celebration of Life ❯ Thursday, Oct. 17Riverview Hospital is sponsoring this special event to share cancer survivors’ stories,including their struggles and challenges. WTHR-Channel 13’s Julia Moffitt will hostthe event, held at the Mill Top Banquet and Conference Center, 802 Mulberry St. inNoblesville, from 6 to 8 p.m. Register at www.riverview.org.

Someone to lean on ❯Monthly throughout the yearHendricks Regional Health in Danville hosts a free support group for breast cancersurvivors, patients and family members. The group originated with women who beat thedisease and continues on today to encourage others through the journey. Meetings are thethird Thursday of each month from 6 to 7:30 p.m. Call (317) 250-3057 for details.

To learn more and join the effort to end breast cancer, visit www.komenindy.org. ✱

Curish

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FranciscanStFrancis.org/cancer

INDIANAPOLIS • MOORESVILLE • CARMEL

Inspiring Health

YOU AREQUIRKY, LOVING,

STRONG,FUNNY, SMART.

Erika Rager, M.D.Breast Cancer Specialist

And Breast Cancer Shouldn’tChange That. Your family andfriends treasure who you are.And so do we. At the FranciscanSt. Francis Health Breast Clinic,you’ll benefit from leading-edgetreatments and research. You cansee all of your specialists in onevisit, and in one location, withoutspending hours in waiting rooms ortraveling to appointments. Becausewe know you have a life to live.

To schedule an appointment, or for asecond opinion, call (317) 528-1420.

IS-0000000458

By Shauna Nosler For Custom Publications

There is a link between a woman’sdiet and her risk of breast cancer,but it’s not as direct as using

sunscreen to avoid melanoma. TheAmerican Institute of Cancer Research,which funds research and developsrecommendations, reports two main riskfactors: family history and age.GaelWasserman, RD, CD, an oncology

nutrition specialist for Community HealthNetwork, adds twomore.“Good nutrition and

maintaining a healthy weight playa role in breast cancer prevention,”she said.That’s good news, because

choosing the right foods andmaintaining an appropriate weightaremodifiable risk factors—oneswomen can control.

Calories, alcohol and soyA recentWomen’s Health

Initiative study of the linkbetween dietary fat andbreast cancer shows no definiteevidence that low-fat foods helpprevent the disease. But a diet highin calories often leads to obesity,which is clearly linked to breastcancer.The American Cancer Society

urges women to limit theirconsumption of alcohol, high-fatmeats and foods high in saturatedfats. Regarding alcoholic beverages,the ACS says women should limitthemselves to one daily drink, whichequates to 12 ounces of beer, 5 ounces ofwine or 1.5 ounces of spirits.The ACS also recommends that women

diagnosedwith breast cancer eat onlysmall amounts of soy products and avoidsupplements containing large amounts ofisoflavones, an estrogen-like plant chemicalthat could increase the risk of estrogen-responsive cancers.

Increase the green, bump up the DApotentially potent cancer-fighting

ingredient is vitaminD. Research alsopoints to the positive benefits of consumingcalcium-rich foods. The connectionbetween vitaminD and breast cancer is not

Food fight!yet clear, but a diet that includes foods andsupplements containing this vitamin areshown tomoderately decrease the risk inpremenopausal women.Antioxidants like vitamins C and E

are found in densely colored fruits andvegetables. Andwhile regular intake offruits and veggies isn’t known to preventbreast cancer, these fiber-rich foods are lowin calories, which can help youmaintain ahealthy weight and therefore help reduce therisk for cancer. The ACS urges adults to eatat least five servings of fruits and vegetables

every day.

11 for preventionTo further reduce the risk of

cancer, theACS recommendsthese 11 steps to better health.

❯Consume food and drinks inmoderate amounts so you canmaintain a healthyweight.

❯ Eat only small portions of high-calorie foods.

❯Choose vegetables,whole fruit and otherlow-calorie options overFrench fries, chips, icecreamand donuts.

❯ Limit your intake of sugar-sweetened beverages.

❯Reduce the amount ofprocessed and redmeat youeat.When you do eat redmeat,choose lean cuts in smallportions.

❯ Limit your intake of processedmeats,including bacon, sausage, lunchmeatand hot dogs.

❯Choose fish, poultry or beans over redmeat.

❯ Eat five ormore servings of vegetables andfruits daily.

❯Choosewhole grains instead of refined-grain products.

❯ Limit your carbohydrates by turningaway pastries, candy and sugary breakfastcereals.

❯Drink nomore than one alcoholic beveragea day if you’re awoman; two drinks formen.✱


Good nutrition can help women beat breast cancer Beauty and thebreast-cancerbeast

Innovations in surgeryCancer patients today have the advantage of highly advanced medical procedures and

treatments. Where the previous generous of women might have to undergo a deformingmastectomy, they now can choose from a variety of surgical options.“One of the things we always take into consideration is body image,” said Kandice

Ludwig, MD, a breast surgeon with IU Health. “Oncoplastic surgery is a cancer surgeryusing plastic surgery techniques. (The surgeries) are done in conjunction with a plasticsurgeon, and oftentimes the patient will get a breast reduction. That allows me as a cancersurgeon to remove what I need to remove, and then the plastic surgeon comes in torearrange the tissue and make the other side match.”Patients facing a mastectomy can work with a surgeon to determine the ideal treatment,

which could include reconstructive surgery, implants or prostheses.“A technique that’s gained popular attention is the subcutaneous mastectomy, or

‘nipple sparing’ mastectomy, as popularized by Angelina Jolie,” said Robert Goulet, MD,FACS, medical director of the Community Health Network breast program. “You do themastectomy through an incision, which is hidden underneath the fold of the breast, butsave the envelope of skin, including the nipple, and remove the breast tissue.”✱

By HollyWheeler For Custom Publications

Anyonewho’s been through cancertreatment knows that the diseaseaffects the whole person. For

women, breast cancer can have a profoundimpact on outward appearance.To support breast cancer patients

and survivors, themedical communityincreasingly offers new resources.Hair loss perhaps is themost noticeable

physical change a woman experiencesduring chemotherapy. AnnMaier, CMT, LC,educates patients and helps prepare them forthis and other changes. She also coordinatesDebbie’s Make You Smile Fund, part ofIU Simon Cancer Center’s CompleteLifeprogram, which provides support and carefor patients, families and caregivers.“I tell themwhat can happen— I feel like

I’m giving themmore bad news—but it’sbetter if they know ahead of time than havemore surprises,” Maier said. “Every patientreacts to treatment differently.”Because intense cancer treatments

canmake skin appear sallow,Maierrecommends womenwearmakeupwhenpossible. She also advises patients to cuttheir hair short before it begins to fall out.As to other beauty treatments, she urges

patients to steer clear ofmanicures andpedicures for the time being, as both canincrease the risk of infection. A better way

to accessorize is to choose fun, trendy orcolorful scarves and hats.“I try to get the body andmind towork

together,” she said. “On the days you feelgood, take the time to put on your wig andyourmakeup.When you do that, it makesyou feel good and your family, too.”Hospitals and treatment centers

increasingly are introducing productsand services to help patientsmanage thephysical changes of cancer. Doing so canimprove an individual’s self-image and stateofmind.“TheOasis is an appearance center, a

place where all of our patients can go andleave feeling better about themselves,” saidKimberlyWilliams, RT(R)(T), manager ofradiation oncology at Franciscan St. FrancisHealth Indianapolis. She alsomanages TheOasis store, which stocks wigs, turbans,scarves, breast prostheses, swimsuittops and lingerie, as well as skin creams,synthetic eyelashes and UV-protectiveclothing— all reasonably priced.“I once had a patient with breast cancer

whowore a different wig everyday,”Williams said. “One day she’d have shortblond hair, the next long red hair. I wantour prices to be affordable so a patient canhavemore than onewig, so they can have alittle fun. Themore fun you have with it, thebetter you feel.”✱

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NO PULLINGPUNCHES

AGAINST FIGHT THE IN

CANCER.

5K WALK EVENTSaturday, October 26, 2013

Celebration Plaza in White River State Park, Downtown IndianapolisRegistration starts at 7:30 a.m.; walk begins at 9:00 a.m.

To learn more or to sign up for the event, visit www.MakingStridesWalk.org/IndianapolisIN

Purchase a Making Strides donation “card of hope” atany Central Indiana Kroger in the month of October.

ON BEHALF OF OUR CUSTOMERS ANDASSOCIATES, WE ARE PROUD TO JOINTHE F IGHT AGA INST BREAST CANCERAND SUPPORT THE IMPORTANT WORKOF THE AMERICAN CANCER SOCIETY.

ON BEHALF OF OUR CUSTOMERS ANDASSOCIATES, WE ARE PROUD TO JOINTHE F IGHT AGA INST BREAST CANCERAND SUPPORT THE IMPORTANT WORKOF THE AMERICAN CANCER SOCIETY.

IS-0000000389

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