Breast Cancer Archives - SB Magazine

SB MAGAZINE CONGRATULATES MIKE JOHNSON – SPEAKER OF THE HOUSE

SB Magazine — Tue, 31 Oct 2023 18:41:32 +0000

As a member of the House of Representatives, Mike Johnson has demonstrated his commitment to public service through a series of key legislative accomplishments. Despite serving only six years in the House before being elected as the new Speaker, Johnson has played pivotal roles in several significant legislative endeavors. His most notable accomplishments include advocating for conservative values and policies, developing crucial economic and social legislation, and playing a key role in the 2020 election campaign. These achievements, among others, have contributed to Johnson’s growing reputation as an influential and effective lawmaker.

As a Republican, Johnson has been a vocal supporter of former President Donald Trump and was a key congressional ally during his tenure. Furthermore, Johnson’s election as Speaker of the House came after the ousting of Kevin McCarthy, reflecting the confidence his fellow Republicans placed in his leadership abilities.

As the newly elected Speaker of the House, Mike Johnson’s key responsibilities and duties include overseeing the legislative process, setting the House agenda, and serving as a key spokesperson for the Republican party. Additionally, Johnson is responsible for maintaining order within the House and ensuring all members adhere to parliamentary rules and procedures. With his relative inexperience in the House, Johnson will face a steep learning curve as he navigates these responsibilities and attempts to establish himself as an effective leader.

Throughout his political career, Johnson has championed several major initiatives and reforms, often driven by his strong evangelical Christian beliefs. As Speaker, he has continued to support policies such as restructuring federal education funding and promoting socially conservative policies that align with GOP priorities. In his new role, Johnson will likely continue to advance these initiatives, as well as seek out opportunities to enact additional conservative reforms in line with his party’s goals.

Mike Johnson faces numerous challenges and obstacles, both within his party and from the opposition. One of these challenges involves fostering relationships and building trust among the diverse factions within the Republican party, many of whom are still reeling from the ouster of former Speaker Kevin McCarthy. Johnson will also need to navigate the complexities of passing legislation in a highly polarized political environment, where bipartisan cooperation is often in short supply. To overcome these obstacles, Johnson will need to draw upon his skills as a negotiator and consensus-builder while simultaneously maintaining his commitment to core conservative principles.

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Breast Cancer Early Detection

SB Magazine — Thu, 19 Oct 2023 21:34:49 +0000

October is National Breast Cancer Awareness Month. Breast cancer is a serious health concern that affects millions of women worldwide and detecting breast cancer early is crucial to increasing the chances of successful treatment.

Breast cancer is the most common cancer among women, with the majority of cases originating from the inner lining of the milk ducts or lobules that supply the ducts with milk. Ductal cancers, the most common type of breast cancer, begin in the cells that line the ducts, while lobular cancers start in the cells that line the lobules. Non-invasive breast cancer cells are confined to the ducts and do not invade the surrounding fatty and connective tissues of the breast. The most common form of non-invasive breast cancer is ductal carcinoma in situ (DCIS), while lobular carcinoma in situ (LCIS) is less common and considered a marker for increased breast cancer risk.

Breast cancer is caused by the uncontrolled growth of cells in the breast tissue, which can be triggered by genetic and environmental factors. Symptoms vary depending on the type of breast cancer and the stage of the disease. However, some common symptoms include a lump or thickening in the breast, changes in the skin texture of the breast, and discharge from the nipple. It is important to note that breast cancer can also cause endocrine symptoms, such as fatigue, night sweats, hot flashes, and weight gain or loss.

Early detection of breast cancer is the best way to increase the chances of successful treatment. Generally, the initial symptom of breast cancer is a lump or mass that is found either by the patient or by a healthcare provider. Other signs that may be associated with breast cancer include dimpling of the skin, nipple retraction, changes in the shape or size of the breast, and breast pain.

Treatment for breast cancer is becoming more effective and individualized due to improvements in early detection and more targeted therapies. Hormonal therapy with tamoxifen is a standard treatment option for women with estrogen receptor-positive breast cancer, while aromatase inhibitors like letrozole can also be used. The US FDA has approved additional cancer treatments, such as ixabepilone and bevacizumab, for metastatic breast cancer.

Preventative measures can also be taken to reduce the risk of developing breast cancer, such as regular physical activity and maintaining a healthy diet. Phototherapy, such as photodynamic therapy, is one treatment option available for those who are already at an increased risk of developing breast cancer.

Breast cancer is a complex disease with several types and stages, making early detection and treatment critical for successful outcomes. Understanding the symptoms and characteristics of each type of breast cancer is important for facilitating early diagnosis and effective treatment.

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BREAST CANCER

SB Magazine — Fri, 29 Oct 2021 09:56:39 +0000

BREAST CANCER

SCREENING & TREATMENT

BY DR. SARAH THAYER

Breast cancer is the most diagnosed cancer among American women. Breast cancer will affect about 1 in 8, or 13%, of women in the United States. In 2021, it is estimated that 281,550 new cases of breast cancer will be diagnosed along with an additional 49,290 new cases of DCIS (non-invasive breast cancer). Breast cancer is the second leading cause of death in women with 43,600 breast cancer deaths estimated to occur in 2021. The good news is fatality rates have been steadily decreasing since 2007 and continue to decrease in women over 50. This decrease is believed to be the result of advancements in treatment and increased early detection through screening.

In the United States, the most frequent age of breast cancer diagnosis is 61 years of age. However, not everybody’s risk for breast cancer is the same. For example, African American women appear to get breast cancer at an earlier age (around 50) and have a higher rate of aggressive breast cancers. Among women 45 years of age or younger, breast cancer is more frequently identified in African American women than Caucasian women. Unfortunately, African American women are also more likely to die of breast cancer. The reason for this is unclear, but likely due to a combination of social, economic and genetic factors. Regardless of race, each woman should understand her personal risk for developing breast cancer. This depends on may factors, but can include your personal history, family history for cancer and lifestyle choices. One of the most powerful indicators for risk of breast cancer is your family’s history of breast and ovarian cancer. Approximately 15% of breast cancer cases are associated with an inherited gene that increases your risk of breast cancer.

Screening

The purpose of breast cancer screening is to decrease breast cancer mortality and morbidity through early detection. The cornerstone of breast cancer screening is breast mammography by 3-D tomosynthesis. Presently, some controversies exist among professional associations about when to start and how often to screen. For example, National Comprehensive Cancer Network (NCCN) recommends starting age at 40 with a screening interval of once per year. Other associations, such as the US Preventative ServicesTask Force (USPSTF) suggest a starting age of 50 with a screening interval of every two years. However, screening between the ages of 40 and 49 should be individualized based on your risks and values. Women of African American descent – given the early age onset of breast cancer – should consider starting at 40 and continue annually.

The question remains: whose screening guidelines should you use? Remember, breast cancer mortality is reduced with mammography. Mammographic screening is a tradeoff of risks and benefits, and not all women have the same risk. These screening recommendations are for women of average risk. However, it becomes hard to define “average risk,” as 85% of breast cancer cases is occurs in women with no family history of breast cancer.

Today there are many tools to assess your personal risk for breast cancer. Risk assessment models, such as the Tyrer-Cuzick Model, have been designed to calculate your lifetime risk for developing breast cancer. This model takes into consideration factors such as personal, reproductive, and family history of breast cancer to calculate your lifetime risk (LTR). Women above 20% LTR are considered high risk. Consult with your healthcare provider to choose the most appropriate screening strategy based on your personal risks and values around the age of 30-35.

Non-Modifiable

Age
Early menstruation (before age 12)
Menopause after age 55
Personal history of breast cancer or breast biopsy
Strong family history of breast cancer
Inherited genetic trait (BRCA 1 or 2; PALB2)
History of radiation to the breast/chest
Having dense breast tissue
Having taken the hormone diethylstilbestrol (DES) during pregnancy or being the daughter of a woman who took DES while pregnant
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Lifestyle-Related

Obesity
Not getting enough exercise
Drinking alcoholic beverages
Taking hormone replacement therapy
Older age at first birth (after 30) or having never given birth

Diagnosing Breast Cancer

Most breast cancers are identified by mammography and diagnosed by a core needle biopsy directed by either ultrasound or mammography. Receiving a breast cancer diagnosis can be overwhelming and filled with uncertainty. The good news is there are currently more than 3.8 million breast cancer survivors in the United States, according to the American Cancer Society. Additionally, early-stage breast cancer has a survival rate of 95%. Breast cancer treatments and outcomes have drastically changed in the last five years. This is mainly due to coordinated research efforts identifying that not all breast cancers behave the same and that treatments must be tailored to those risks. Treatments have now become very customized depending on patient characteristics such as age, personal risk, inherited risk, prior history of cancer, and prior treatments (such as radiation).

Diagnosis also includes tumor size and whether the lymph nodes have been affected. The most important factor to determine treatment recommendations is the tumor’s behavior and risk – is it a high-risk tumor or a low-risk tumor? Insights into the nature of breast cancer come from tumor pathologic features such as grade (abnormality of cells), the expression of estrogen and progesterone receptors, the expression of HER2 hormone receptors, and its proliferative activity (how cells are multiplying and spreading). Recent advances in genetic testing can more accurately predict tumors that have higher risk. Most importantly, treatments must also incorporate your personal values.

Breast Cancer Treatment

Breast cancer treatments are evolving. Breast cancer is no longer treated in isolation, but requires a network of breast-specific providers that work with one another to develop a comprehensive treatment plan. This plan should include recommendations for surgery, systemic therapies such as chemotherapy and/or hormonal therapy, and radiation approaches. An extensive family history should also be performed to determine if genetic testing for familial genes is appropriate.

Feist-Weiller Cancer Center in Shreveport focuses on a patient-centered multidisciplinary approach to breast cancer treatment planning. The treatment approach to breast cancer is to remove the tumor (through surgery) and make sure that it does not return (through chemotherapy and radiation therapy). If your tumor is considered high-risk or aggressive (HER2-expressing tumors or triple negative breast cancer) giving chemotherapy first is favored in order to assess your tumor’s response to the drugs. Some tumors will have a complete pathologic response while other patients will have residual tumor. These patients may be considered for further therapies after surgery depending on how much cancer remains. New targeted and immune-based therapies can be added to improve outcomes.

Like chemotherapy, surgical management of breast cancer has also evolved. Surgical options include breast-conserving therapy (BCT), which involves a lumpectomy with radiation versus mastectomy (unilateral or bilateral). In the majority of women, breast-conserving therapy is preferred for the management of early breast cancer as it has the same overall survival as mastectomy. Bigger surgery does not equate with better outcomes. So, how do you choose between lumpectomy and mastectomy? Although lumpectomy with radiation is preferred for the majority of women, there are some patients who are not candidates for breast-conserving therapies. This is due to the extent of the tumor (a small breast and a large tumor), multifocal disease (meaning multiple areas of the breast are involved), the patient having prior radiation, risk of a contralateral tumor (patient with inherited genes for breast cancer syndromes), screening considerations, and most importantly, patient preference.

Since there are more than 3.8 million breast cancer survivors, consideration for improved cosmetic outcomes become paramount to improve psychosocial well-being of a breast cancer survivor and to enhance quality of life and body image. Because of this, surgical techniques have been developed to improve cosmetic outcomes. For patients considering mastectomy, nipple skin-sparing mastectomies (NSSM) are now proven to be safe. This type of mastectomy is done through incisions that hide the scar, creating a natural skin envelope. For women who choose BCT, new oncoplastic approaches have now been developed. These combine the principles of breast cancer surgery and plastic reconstructive techniques with the goal of complete resection of the lesion for improved cosmetic outcomes in a single definitive procedure. One example is using a breast reduction technique to remove and reshape the breast. Remember – the decision on what type of surgery is needed is guided by data and personal choice; it should be a shared decision between patient and care team.

In Conclusion

Breast Cancer screening reduces breast cancer mortality and morbidity
Current recommendation for screening is for women of AVERAGE risk
When to start mammographic screening should be based on careful discussion with your health care provider to evaluate risks, benefits and choice
Breast Cancer Treatments are becoming very individualized
Surgical techniques have been developed to improve cosmetic outcome
New targeted therapies have improved survival outcomes
Once diagnosed patients should be referred to a multidisciplinary breast clinic for comprehensive evaluation and personalized treatment planning.

October is Breast Cancer Awareness Month. Sarah Thayer, MD, PhD, is the Director of Feist-Weiller Cancer Center.

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