Breast Cancer

Breast Cancer: Risk Factors, Screenings, Symptoms & Therapy Live Chat

bc-cil-638What questions do you have about breast cancer?

Emory Glenn Family Breast Center at Winship Cancer Institute is dedicated to breast cancer prevention, detection and comprehensive treatment of breast health issues and breast cancer including aggressive forms of triple negative breast cancer.

Our breast cancer doctors and researchers are thought leaders in the field of breast cancer, and are uniquely positioned to have access to the latest information on cancer care.  The breast cancer program at Winship Cancer Institute of Emory University offers multidisciplinary teams including oncology surgeons, radiologists, medical oncologists, pathologists, and advanced practice nurses with expertise in only breast cancer.  There are a variety of treatment options for breast cancer; for some patients, a combination of treatment methods may be used.

Join physicians with Winship Cancer Institute of Emory University’s breast cancer team, on Tuesday, October 11th at 12pm EST for a live chat where they will answer your questions about breast cancer risk factors, screenings, symptoms and therapy. All are welcome to attend an online open-forum discussion about breast cancer. Sign up for this live chat here.

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New Mammography Guidelines

mammogramAlthough the American Cancer Society (ACS) confirms that mammography saves lives, the organization issued new breast cancer screening guidelines on Oct. 20 that recommend women at average risk for breast cancer start getting annual mammograms at age 45. The previous recommendation was to start at age 40, and I will continue to recommend that women get yearly screening mammograms starting at age 40.

Evidence shows that the most lives are saved when screening starts at age 40. Although breast cancer is a little less common in women aged 40 to 44, this group receives the same life-saving benefit from screening mammography that older women do. As a radiologist specializing in breast cancer detection and diagnosis, I see this first-hand. My colleagues in the American College of Radiology agree and are also continuing to recommend that yearly screenings begin at age 40.

The new ACS guidelines note that the “harms” associated with screening may outweigh the benefits in women age 40-44. It is vital that women compare the magnitude and implication of the harms versus benefits associated with screening mammography. The harms they identify are about getting false positive readings from mammograms that can result in women being called back in for more imaging or an ultrasound. About 10% of women are recalled for these additional tests and the vast majority are cleared at that point. About 1 – 2% of patients who are recalled receive a needle biopsy using local anesthetic.

The benefits include saving lives and finding cancers smaller and earlier so that less aggressive treatment is required. I believe most women will agree that the drawbacks pale in comparison to the benefits of screening, and will choose to proceed with yearly screening. In fact, the ACS declares that yearly screening is beneficial and something that the majority of women would want, as long as they are healthy and have a 10 year or longer life expectancy. It is vital that we preserve a woman’s access to this life-saving technology so that she may choose to screen.

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About Dr. Newell

Newell_MaryMary S. Newell, MD, began practicing with Emory Healthcare in 2001 where she is a board certified radiologist specializing in breast cancer imaging and diagnosis. Dr. Newell has interests in emerging imaging technologies, teaching, and healthcare policy.

Dr. Newell chairs the American Board of Radiology Maintenance of Certification (MOC) Breast Committee and the American College of Radiology Joint Practice Guidelines and Technical Standards and Appropriateness Committee on Criteria. She is Head of Curriculum Assessment for the Society of Breast Imaging and Special Consulting Editor for CME for the American Journal of Roentgenology. She also serves as the treasurer for the Georgia Radiologicial Society, is a councilor to the American college of radiology representing the state of Georgia, and serves on numerous committees institutionally and nationally.

Dr. Newell earned her medical degree from the University of Michigan Medical School. She then completed her residency in diagnostic radiology and fellowship in body imaging at the St. Francis Hospital in Illinois. Dr. Newell’s research focuses on discovery and evaluation of new imaging modalities for future use in breast cancer screening and detection.

Life After Breast Cancer

supportive-friendsBreast cancer is the most frequently diagnosed cancer in women according to the American Cancer Society. This year alone, more than 234,000 cases of invasive breast cancer will be diagnosed in the United States. Most women with breast cancer do quite well and have long lives after completing treatment. One of the hardest things for survivors is living with the worry that the cancer may come back. We recommend scheduling regular follow-up appointments with an oncologist and following the screening and/or prevention guidelines that your provider recommends. I also tell my patients to try, as best as they can, not to worry.

It is easy to see how breast surgery, radiation, and some of the side effects from systemic therapy (which, depending on treatment, can include hair loss, nausea, fatigue, weight gain, hot flashes, joint aches, or other unpleasant symptoms) can wreak havoc on a woman’s self esteem. In addition, many women are used to serving as a support system for their spouse, children, parents, or other loved ones; and to being responsible for important matters at work and at home. Learning to accept help and support rather than giving it can be very challenging. I always recommend honest conversations with family and loved ones, and involving a social worker, psychologist, or psychiatrist if patients are interested and willing to pursue this. Sometimes it can be helpful to talk with someone outside of one’s immediate network of family and friends to try to sort through some of the feelings surrounding the diagnosis and treatment of breast cancer. Support groups can also be helpful; hearing from others who are going through the same thing (perhaps at similar points in life and/or stages of the disease), can help normalize the experience.

Physical changes to the breast – scars from lumpectomy or mastectomy, getting used to the look and feel of reconstructed breasts (if this approach is chosen), and radiation-related changes – can make women less comfortable with their bodies and therefore less comfortable being intimate. These changes can also make them worry about whether a partner will still find them attractive. In addition, some of the systemic treatments used in breast cancer, such as chemotherapy or anti-estrogen therapy, can change hormone levels and decrease interest in intimacy. I always recommend sharing these concerns with your doctor or health care team. Talking with a social worker, psychologist, or even sex therapist can be helpful in dealing with some of the complicated feelings surrounding the look and feel of the breasts after treatment for breast cancer. There are also a number of options for managing symptoms like vaginal dryness, which can be a result of chemotherapy or anti-estrogen therapy and can make intimacy uncomfortable. Finally, open communication with significant others is critical, as they too may be struggling to find the best way to show affection in this new situation. I have actually seen many situations where the diagnosis of breast cancer actually brings couples closer together, as they navigate the path from diagnosis to treatment and finally to recovery together.

About Dr. Meisel

jane lowe meiselJane Lowe Meisel, MD, joined the Glenn Family Breast Center at Winship Cancer Institute as a practicing physician in January 2015. Prior to her arrival, she was Chief Fellow at Memorial Sloan Kettering Cancer Center in New York. Dr. Meisel is a medical oncologist with a special interest in women’s health and in cancers that affect women, including breast, cervical, endometrial, and ovarian cancers. Her goal is to provide exceptional, state-of-the-art individualized care to patients fighting these diseases and to conduct research that improves treatment options for these patients.

 

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Exercise, Diet and Breast Cancer
Take-Aways from Breast Cancer Chat with Heather Pinkerton, BSN
Advancements in Imaging for Early Breast Cancer Detection
Latest in Breast Cancer Research
Breast cancer care at Winship
Social services at Winship
Support groups at Winship

Exercise, Diet and Breast Cancer

trio-exercisingDiet and exercise can help women who have completed treatment for breast cancer to live longer and feel better. They may even help lower the chance of the cancer coming back (recurrence). The Women’s Intervention Nutrition Study (WINS) was a randomized study of a low fat diet in women who had completed treatment for early stage breast cancer. At five years, the women on the low fat diet lost weight about six pounds on average (the control group didn’t lose weight) and had a lower risk of the cancer coming back or getting a new breast cancer than the control group. After longer follow up, the risk of recurrence evened out between the two groups, but the women in the low fat diet group had better survival. Observational studies have also found that women who exercised more had lower risks of the cancer coming back. These kinds of studies have also found that women who gain weight after diagnosis have a higher risk of the cancer coming back. Diet and exercise are key to preventing weight gain.

Women who are obese have an increased risk of post-menopausal breast cancer compared with women who maintain a healthy weight, which means that those who maintain a healthy weight have a lower risk (of getting breast cancer after menopause) than those who do not. Studies have shown that moderate to vigorous exercise is linked to a lower risk of breast cancer. This may be in part due to effects on body composition, as well as hormone levels. Exercise can improve fatigue and other symptoms in women with breast cancer in active treatment, as well as maintain their physical function and prevent changes in body composition (like weight gain) that can result from treatment. Women in treatment may have to cut back on their exercise routine for a time (exercise at a lower intensity or for shorter periods) due to side effects of treatment, but it is helpful for them to try to stay active.

So how much exercise is enough? The American Cancer Society recommends that healthy adults engage in at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week. Moderate activities may include walking, dancing, leisurely bicycling, and yoga, while vigorous activities may include jogging or running, fast bicycling, circuit weight training, swimming, jumping rope, aerobic dance, and martial arts.

About Dr. Kramer:

jkramerJoan Kramer, MD, is an assistant professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Dr. Kramer graduated cum laude receiving her Medical Degree from Saint Louis University in Saint Louis, Missouri. She completed her postdoctoral training with a residency in internal medicine at Saint Louis University Hospital and a fellowship in hematology and medical oncology at University of Texas Health Science Center at San Antonio in San Antonio, Texas. Dr. Kramer served as Medical Editor for the American Cancer Society until May 2015. She is published in a number of peer-reviewed journals.

 

RELATED RESOURCES
Take-Aways from Breast Cancer Chat with Heather Pinkerton, BSN
Advancements in Imaging for Early Breast Cancer Detection
Latest in Breast Cancer Research
Breast cancer care at Winship
Social services at Winship
Support groups at Winship

What is High Dose Rate Brachytherapy?

One of the most technically advanced and convenient options for cancer treatment is called high dose rate brachytherapy (HDR). It is a precise type of radiation therapy that is commonly used to treat localized gynecologic, lung, breast and prostate cancers that have not spread to lymph nodes. As opposed to low dose rate (LDR) brachytherapy, where tiny radioactive “seeds” are permanently placed inside or near a tumor, HDR brachytherapy involves temporarily placing high intensity sources of radiation inside the body with a catheter, for example, and then removing them once treatment is complete.

With short treatment and recovery times, HDR brachytherapy can help patients get back to their lives with minimal disruption. At Winship Cancer Institute of Emory University, the therapy is usually performed on an outpatient basis and carried out in two short sessions over one to two weeks. This results in an extremely precise radiation dose and minimal toxicity to the patient. Patients considering HDR brachytherapy may wonder if they will be radioactive following treatment. The answer is no. The radiation flows like the light that shines from a flashlight; it is not present once the treatment session is completed and the device used to deliver the radiation is removed.

HDR brachytherapy is performed at Winship locations by knowledgeable radiation oncologists with special expertise and certification in brachytherapy. The Department of Radiation Oncology at Winship is the only program in Georgia with advanced credentialing recognized by the National Cancer Institute for both LDR and HDR brachytherapy administration and expert usage.

Watch the short video below to learn more about how HDR brachytherapy is used to treat prostate cancer.

Find a Doctor

HDR Brachytherapy is performed at Winship locations by the following physicians:

For more information regarding HDR brachytherapy treatment at Winship Cancer Institute, please visit Emory Radiation Oncology.

In addition to regular treatments, a voluntary research study is being conducted to help men with recurring prostate cancer by using advanced imaging technology called FACBC to guide radiotherapy and determine the best possible course of treatment. Read more>>

About Dr. Rossi

Peter Rossi, MDPeter Rossi, MD, is a board certified radiation oncologist and the Medical Director of Radiation Oncology at Winship at Emory St. Joseph’s Hospital. Dr. Rossi specializes in the treatment of prostate cancer, cervical cancer and ovarian cancer, and his expertise is in the use of external radiation therapy and brachytherapy for treating prostate and gynecologic tumors. Dr. Rossi is on the Quality Assurance Committee of the American Brachytherapy Society. He lectures, proctors and mentors physicians on the use of HDR brachytherapy for the treatment of prostate cancer at Winship and internationally.

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