Sharing with Friends - Autumn 2014

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A newsletter for breast cancer survivors


<ul><li><p>SharingAutumn 2014 A NEWSLETTER FOR BREAST CANCER SURVIVORS</p><p>with Friends</p><p>It has been five years since I had the pleasure of writing an article for Sharing &amp; Caring. At that time the United States Preventive Services Task Force (USPSTF) had come out with their new mammography screening guidelines which created a furor across the country and were eventually rescinded by Congress. At the present time the Task Force is in the process of redoing their analysis of breast screening guidelines. Despite irrefutable scientific evidence which shows major life-saving benefits for women who have annual mammograms starting at the age of forty, I am worried that the guidelines will be altered and the USPSTF will recommend less frequent screening. There will be more to come about this later.On a much brighter note, we have seen major advances in personalized breast cancer diagnosis and treatment over the past five years. Our surgical techniques for breast cancer surgery have continued to evolve. Our ability to offer genetic counseling and therapy treatments for women who are predisposed to the development of breast cancer has vastly improved. New molecular markers for breast cancer which are detected by our pathologists have enabled them to identify patients who do not need as aggressive therapy as others might. Our radiation oncologists are using more precise therapies to treat both focal and more advanced tumors. Our medical oncologists also have newer drugs which are better at destroying tumor cells, as well as leaving normal healthy tissues intact.From a diagnostic perspective, there has been much excitement among women and also in the media about a new technology called digital breast tomosynthesis (also known </p><p>as 3D mammography). This new device is a different type of mammogram (unfortunately, the breasts still need to be compressed). What happens is that the x-ray tube, which is stationary for a normal 2D mammogram, rotates through a series of different angles and images are taken at each angle. The amount of time to take these pictures is slightly longer than for a standard mammogram therefore it is important that the patient does not move. A computer built into the device analyses all the images. It reconstructs the information and displays it on monitors for the radiologist to interpret. The images are thin slices of the breast tissue which go from one end of the breast to the other side (imagine slicing a loaf of bread and then looking at each individual slice).The major advantages of looking at these thin slices of breast are twofold. First, we can improve our ability to find small breast cancers. Sometimes, it is hard to see through dense breast tissue since it can sit in front of and behind a small tumor. A normal 2D digital mammogram cannot see the cancer because it is hidden by this adjacent dense tissue. The 3D thin slices separate the small cancer from the surrounding tissue and allow us to find it. (imagine a small grape in the loaf of bread- taking one picture of the whole loaf wouldnt allow you to see the grape but individual pictures of each slice would let you find it).Large studies across the world have shown that the increased cancer detection rate ranges from 15-40%.The second main advantage of tomosynthesis is that it allows us to see normal breast tissue in these thin slices. Sometimes normal tissue can arrange itself so it mimics the appearance </p><p> Murray Rebner, MD, FACR Director, Section of Breast Imaging </p><p>Beaumont Health System, Royal Oak Campus Professor of Diagnostic Radiology, </p><p>Oakland University William Beaumont School of Medicine</p><p>with Friends does it differ from regular mammography?</p><p> Our Expert explains: Getting your BEST mammogram. </p><p> Calendar of Events</p><p>In This Issue:</p><p>Beaumont Cancer CenterMailing Address: </p><p>3577 W. Thirteen MileRoyal Oak, MI 48073-6710</p><p>248-551-8585email: sharingandcaring@ </p><p></p><p>You can make a difference</p><p>Sharing &amp; Caring is a non-profit </p><p>organization devoted to the education and support of </p><p>breast cancer survivors. Donations support </p><p>programs for others who follow in the same </p><p>footsteps and can be made by a check payable </p><p>to Sharing &amp; Caring at the above address.</p><p>On the Horizon - Tomosynthesis - aka 3D Mammography</p></li><li><p>Farewell..As summer comes to a close, so </p><p>does my time at Sharing &amp; Caring. I am heading to a new, full-time </p><p>position at Beaumont. This was a very difficult decision for me since </p><p>I truly enjoy working at S&amp;C and being with all of you.</p><p>I would like to thank you all for welcoming me into your lives and </p><p>allowing me to be a part of your journey. I have been blessed to have spent time with so many of you. You </p><p>have all touched me more than you know.As I leave, I would like to ask you to continue to support S&amp;C. Every donation helps, no matter how small! S&amp;C </p><p>programs are about YOU, your cancer journey and SURVIVORSHIP! Without YOU this program would not </p><p>be possible.I wish you all good health, and happiness.</p><p>Hugs, Lorelei</p><p> Greetings from Lorelei</p><p>Tomosynthesis - aka 3D Mammography ...continued from page 1of a cancer. The thin slices taken through the area proves that all the tissue is normal and there is no cancer at this location. This means that fewer women are recalled for extra images to determine if the tissue is normal or if an abnormality really exists at this location. Many studies have shown that the decrease in the recall rate ranges from 30-40% for the screening population. This means that many women will be called normal and will not have to come back for additional imaging. This will decrease their anxiety as well as save them time and money.It should be noted that 3D mammography is not a panacea for breast cancer. There are still going to be cancers which do not show up either on 2D or 3D mammography. This is where tailored imaging for the individual patient, depending on her risk for breast cancer, becomes important. Many medical organizations such as the American College of Radiology, the Society of Breast Imaging and the National Comprehensive Cancer Network have specific recommendations for imaging based on risk. We encourage patients to discuss their risks (and possible supplemental screening with other devices in addition to mammography) with their health care providers.</p><p>Digital breast tomosynthesis appears promising at this time. However, additional research studies are still needed to determine for which type of patients it would have the greatest benefit. For example, perhaps regular 2D mammograms would be sufficient for a woman who has mostly fatty tissue. Also, we need to know if 3D mammography finds certain types of cancers which are potentially more aggressive than those detected with 2D images. This data has important treatment implications. Our team at Beaumont plans to participate in these important studies.As I write this column there is only one FDA-approved 3D vendor in the USA- Hologic. However others including General Electric and Siemens have applied for FDA approval and likely will be approved in the near future. We at Beaumont were the only facility in the country to provide GE with the clinical images which they needed for their application. We believe in this technology and we hope to have it available for some, if not all of our screening patients, in the first quarter of 2015</p><p>2</p><p>Dont forget that you can find us on Facebook! We are </p><p>Sharing &amp; Caring at Beaumont. </p><p>You will find lots more information there, including reminders of our programs and </p><p>events, great healthy recipes and tips, updated news about breast cancer and more. </p><p>Be certain to Like the page so that our posts will show in your Facebook feed. Feel free to </p><p>post your thoughts and comments as well! We love hearing from you.</p></li><li><p>Sharyn Schymick, R.T. (M) Radiology Supervisor, Diagnostic Radiology, Royal Oak </p><p> Ask the Expert </p><p> How often should I get a mammogram?Beaumont follows the American College of Radiology and the America Cancer Society recommendations for screening mammograms. Average women, who have not been diagnosed as high risk for breast cancer, should have a mammogram annually after the age of forty. High risk patients should talk to their physician to determine if they would benefit from getting a screening exam earlier and whether they would be a candidate for screening with MRI.</p><p> When is the best time to schedule my mammogram?The best time to schedule your mammogram is about ten days before you start your period if you are still menstruating. Your breasts are the least tender at this time and it will help you to tolerate the compression. Some women can tolerate compression better than others. If you seem to have trouble with compression during the exam possibly refrain from caffeine before and let the technologist know that you are very sensitive. They will work with you to get the best exam and they will try to minimize your discomfort.</p><p> If something suspicious is found during a mammogram, what happens next?If you are called back for something suspicious on your mammogram dont panic. One out of every ten women are called back for a diagnostic work-up. Your breasts change as you grow older and any slight change may cause the Radiologist to have you return for additional imaging. Make an appointment for your call back. Most of the time it will be a slight normal change in your breast tissue that warranted the call back and you will either be able to return to normal screening exams or undergo several short-term six month follow-up studies. If at the time of your call back exam you do have to have a biopsy, be aware that seventy-five percent of the time it is a negative finding. If it does turn out to be a positive finding usually it is a small, highly treatable tumor. This is why we screen for breast cancer to find early, localized tumors which have an excellent prognosis.</p><p> How accurate is mammography?With the new digital technology, mammograms find more breast cancer. They are about eighty-five percent accurate in diagnosing breast cancer. However, some breast cancers do not appear on a mammogram. Your health-care provider should evaluate any abnormality you or he/she feel when examining your breasts.</p><p> Ive been told I have dense breasts. What does that mean?Breast density is a measure used to describe the proportion of different tissues that make up a womans breasts. Breast density compares the volume of dense fibrous connective tissue seen on a mammogram to fat. High breast density means there is a greater amount of fibrous connective tissue compared to fat. Low breast density has a greater amount of fat and less connective tissue. For women with high breast density, digital mammograms can offer benefits over film screen because of its ability to penetrate dense breast tissue.</p><p> What is new on the horizon for Mammography?Tomosynthesis is the newest technology in screening for breast cancer. It has shown to have fewer call-backs for ultimately negative results. It reduces the stress among patients who ultimately are shown to have nothing wrong, while being more accurate at finding early stage invasive cancers. Beaumont plans to have this available in the first quarter of next year.</p><p>3</p><p>Man</p><p>y th</p><p>anks</p><p> to </p><p>Dr. </p><p>Rebn</p><p>er </p><p> an</p><p>d Sh</p><p>aryn</p><p> Sch</p><p>ymic</p><p>k!</p><p>Dont forget to schedule YOUR mammogram! </p></li><li><p>With some of the most advanced treatments available for cancer, more patients are living through, and beyond, a cancer diagnosis every day. At Beaumont, our Cancer Survivorship Program partners with you to develop a plan to help maximize health and healing of mind, body and spirit.</p><p>The Cancer Survivorship Program has four distinct components:</p><p> Long term follow up and Cancer Survivorship Clinics: The long-term effects of cancer and cancer treatment can be challenging. To meet these unique needs, Beaumont offers a multidisciplinary approach for survivors of breast and other cancers. These clinics offer a comprehensive, multidisciplinary visit, which is designed to focus on any issues you may be experiencing related to treatment, and guidance with living a healthy life after treatment. Clinicians will work with your physicians in a partnership to provide long term care. You will be provided with educational materials relevant to diagnosis, treatment, and potential late effects of therapy. </p><p>For information or to make an appointment, please call: Cancer Survivorship Clinic: 888-924-9460, option 6</p><p> Psychosocial support: Emotional support and resources, connection to licensed social workers, cancer resource centers, classes, support groups, integrative medicine and spiritual support.</p><p> Exercise and wellness: Licensed physical and occupational therapists are available to provide you with a personal evaluation, supervised exercise program, individual wellness, or physical and occupational therapy, with a focus on improving movement and balance, promoting fitness and supporting a healthy lifestyle.</p><p> Nutrition: Licensed dietitians will help you develop beneficial nutritional practices that are designed specifically for your needs. Following a one-on-one consultation, youll receive a nutritional assessment that includes an evaluation of your daily intake, weight, diet, nutritional needs and challenges. Classes within the community are also available: Nutrition During Cancer Treatment and Nutrition for Cancer Prevention and Survivorship.</p><p>For more information about any components of the Cancer Survivorship Program, contact one of our Cancer Resource Centers: 248-551-1339 (Royal Oak) or 248-964-3430 (Troy) or visit us online:</p><p>Featuring the Cancer Survivorship Clinic Canc</p><p>er Survivorship Program: </p><p>A Word from Nayana Dekhne, MD, Director, Comprehensive Breast Care Centers</p><p>It is with mixed feelings that I say farewell to Lorelei. A feeling of sadness to see her go, yet happiness to see her expanding her career opportunities within the Beaumont Health System. Sharing and Caring continues to be an integral part of the breast...</p></li></ul>