Breast Cancer Update
By Paris Brewster / Photo by Tisha Delcambre
Breast Cancer. It is a diagnosis all too familiar to families across Acadiana. Each year folks we know are faced with diagnosis, decisions and life changes. Suddenly life becomes altered by prognosis, treatment and the effects thereof. Unfortunately, statistics show that five out of six parishes, Acadia, Iberia, Lafayette, St. Martin, and Vermilion, rank higher than the national average for breast cancer mortality. St. Landry Parish comes under the national average.
Awareness and education is the key to empowering women against the onset of breast cancer and their options, once diagnosed. Here are just a few facts that may be unknown to families in Acadiana.
Building A Game Plan With Awareness
“Becoming familiar with your own body helps to detect changes quickly enabling you to seek proper care in a timely fashion,” says Dr. Tyshaun M. James-Hart, breast surgeon with Women and Children’s Hospital in Lafayette.
There are many factors to consider when establishing a breast healthcare regimen. Early detection begins with self-awareness and education while increasing the chances of survival by 98 percent. Regular clinical and self-examinations should begin as early as age 19 and mammograms at the age 40 unless otherwise advised by your physician.
Becoming familiar with your breasts through self examinations is the first step towards preventative measures and may assist in early detection of cancer. An estimated 50 percent of all women have some level of breast density. Breast density is comprised of less fat and more connective tissue which appears white on a mammogram. This is a concern because cancer also appears white, therefore tumors are often hidden behind the dense tissue and a mammogram alone may not be reliable at detecting breast cancer during its earliest stages for those with higher levels of breast density.
Levels of density are determined by a radiologist and are classified into four categories. The result of your density can be determined on the mammogram results and should be discussed with your physician to decide if further screening may be required in addition to your mammogram. Those with a breast density of a category three or four require further screening such as a breast ultrasound or MRI, depending on the patient’s family history.
While not yet law in Louisiana, it is law in more than 15 states and the U.S. House of Representatives has legislation pending to mandate woman being informed of their breast density upon having a mammogram screening.
“Here at the Breast Center of Acadiana, we have decided to step forward and get the word out now, before the law passes,” says Linda Rose, administrator for Breast Center of Acadiana, “in order to educate them about their breast density and give them options.”
Breast density may mean another test that insurance may or may not pay for.
Family history is an important variable in the equation to prevent cancer. Immediate family members such as great-grand parents, grandparents, mother, aunts and siblings with a history of either ovarian or breast cancer automatically increases your chance of developing breast cancer. Therefore, become familiarized with your family health history and consult your doctor about gene testing. Breast cancer gene (BRCA1 and BRCA2) testing is often considered for high risk patients with a family history of BRCA1 and BRCA2 mutations.
For those who fall into a high risk category, hormone replacement can become very complicated due to the added risk.
“Vast majorities of breast cancers are driven by estrogen and progesterone hormones,” states James-Hart “If you are at an elevated risk and you feel as though you need hormone replacement therapies, do not do these two combined.”
Taking responsibility for the things we put in our bodies is of substantial importance in the effort to combat the onset of cancer. There are enough risk factors of developing cancer without personally contributing to the risk factors. Alcohol, tobacco, and a grocery list of other packaged items are said to increase toxins and acidity within the body. When our bodies are high in acidity and toxicity our chances of developing cancer increase.
Proper water intake, as well as eating healthier will reduce the chances of developing breast cancer considerably. Proper rest is also vital and helps to naturally restore and strengthen the body in order to meet the demands and pressures of life. Eliminating unnecessary stress and incorporating a regular exercise program will help to strengthen the body’s resistance against injury and disease.
Know The Facts About Breast Screening
“Women are sometimes concerned with the radiation received from a mammogram. The radiation received is equivalent to three months working out in the sun,” explains Rose. “We are always looking for equipment with lower doses of radiation.”
The risk of developing cancer is greater than the risk of too much radiation exposure. There are various screening methods available according to the specific need of each woman. Screening mammograms are performed for routine monitoring, however in the event that more images are required under specific circumstances, a diagnostic mammogram, MRI or ultrasound would then be prescribed.
One such circumstance would be those who have breast implants. Implants make it more difficult to see breast tissue on standard mammograms therefore requiring more advanced screenings such as an ultrasound, MRI or diagnostic mammogram.
Ultrasound technology offers a high resolution 3-D diagnostic option which gathers up to 350 images to assist in breast screening for women who are at high risk or those with dense breast tissue. Another 3-D diagnostic ultrasound option is the High Resolution Hand Held Breast Ultrasound which uses a hand held probe that is directly placed on the breast and is similar to the ultrasound used during pregnancy.
Breast reduction and reconstruction may slightly change the way breast screening is normally done, but routine breast screening is just as vital for those who fall into this category.
Although breast reduction decreases the chances of developing breast cancer, yearly screening is still encouraged for those who have had this surgery.
Only an estimated 95 percent of breast tissue can be removed during a mastectomy, thereby failing to eliminate all risk of developing the reoccurrence of cancer or the potential for developing cancer for those who have chosen a mastectomy as a preventative measure.
Ultrasounds and MRI’s are often scheduled as a part of the screening process.
“Although mammograms will no longer be needed after a mastectomy, because only an estimated 95 percent of breast tissue is removed the patient will still need annual clinical breast exams by their doctor,” according to James-Hart.
Routine breast screening is not normal for women who are pregnant or lactating due to a greater increase in breast density with nodular or rope-like characteristics. Mammograms are only performed on pregnant women who are at risk for breast cancer. Although studies have found that mammograms during pregnancy are fairly safe due to the low dosage of radiation needed for the mammogram and the isolated focus of the radiation itself, ultrasounds are considered safer for women who are pregnant and are often used before a mammogram to evaluate a palpable lump. For extra protection, a lead shield is placed on the belly to block any possible radiation scatter if a mammogram is the chosen option.
The safety of a breast MRI has yet to be determined and is considered during pregnancy only when a mammogram reveals a definite threat of cancer.
Women who are lactating are advised to empty all milk supply prior to having a mammogram, although there is no evidence that the milk will be impacted from the radiation.
Helpful Tips When Scheduling A Mammogram
• Schedule your mammogram for the week following your menstrual cycle when your breasts are less likely to be tender.
• Inform the doctor and technologist ahead of time in regards to any breast surgeries, implants or large moles as these may affect test results.
• Wear a two piece outfit so that you will only have to undress from waist up.
• Do not wear deodorant, lotions, oils, etc. for this may alter result.
• Inform your doctor if you think you might be pregnant.
Breast Reconstruction: More Natural Look
By using the body’s own tissue from a donor site, a more natural result can be obtained with breast reconstruction. Donor sites such as the abdomen, buttocks, back or thigh supply a tissue transfer by using one of two techniques.
The Pedicle Flap Technique involves tunneling muscle, fat and a skin flap from the donor site (abdomen or back) to the breast area while still attached to its blood supply.
Free Flap Technique is another option which involves detaching and lifting fat and/or muscle along with a skin flap and moving the flap to the breast area. The blood vessels of the flap are reattached to those under the arm or in the chest by microsurgery.
Both techniques entail a longer recovery period due to the healing process of both the donor site and the surgical site, but those who choose this type of reconstruction benefit from a more natural result and an additional bonus of a tummy tuck.
When considering breast reconstruction, one might consider whether sparing the nipple is an option. Choosing to remove the nipple can open the door to another cosmetic option in breast reconstruction. Nipple tattooing can offer patients a 3-D cosmetic result. Various shades of pigment are mixed by the surgeon in order to match and re-create the correct shade of the patient’s original areola by using preoperative photos or skin tone. As with all tattoos however, the pigment will fade in time and may need re-touching.
Innovative Breakthrough To Prevent Hair Loss During Chemotherapy
Being diagnosed with breast cancer is one of the most frightening times in a woman’s life. The initial shock and confusion can prove overwhelming. It is an extremely difficult process when choosing a surgeon and oncologist all the while researching treatment options. The added trauma of losing one’s hair during chemotherapy is now one that may soon be obsolete with Chemo Cold Caps.
Blood vessels normally carrying harmful drug agents to the hair follicles of cancer patients undergoing chemotherapy can now be constricted by cold agents applied to the scalp in the form of a specialized cap. A mild discomfort is experienced when the cold agent cap of approximately -30 degrees is applied to the scalp before treatment. After 10 minutes the scalp becomes numb and in most cases the discomfort subsides.
The caps are only applied to the scalp allowing the drug agents to freely work throughout the rest of the body to eradicate cancerous cells. The cap is worn throughout the chemotherapy treatment and is reported to give the best results after wearing the cap for eight hours.
Commonly reported side effects include headaches, temperature intolerance or uncomfortable sensations as a result of the temperature, also dizziness and claustrophobia have been reported.
Many factors determine the success of preventing hair loss through Chemo Cold Caps. The age of the patient and her hair characteristics are genetic factors to consider. However, the patient’s drug regimen, dosage, number of chemotherapy courses undergone and method of administration will also contribute to success or lack thereof.