A Woman’s Guide to Beating Breast Cancer – By Amy Spagnola

In Colorado, one in seven women are diagnosed with breast cancer each year. In honor of October as National Breast Cancer Awareness Month, Denver Life dedicates our September/October issue as […]

In Colorado, one in seven women are diagnosed with breast cancer each year. In honor of October as National Breast Cancer Awareness Month, Denver Life dedicates our September/October issue as a special women’s health focus and is proud to present A Woman’s Guide to Beating Breast Cancer. This 4th annual breast cancer awareness feature examines the latest findings in breast cancer screening technologies and treatments as well as inspiring stories from two local women about their personal journey through breast cancer diagnosis and survival. We’ve also compiled the most current breast cancer awareness information, national and local resources, support groups and local events to help you lead a healthy lifestyle, lower your risk and make informed choices about your health.

Editor’s Note: The information contained in this special editorial section has been researched by the Denver Life editorial team and is intended to increase awareness about breast cancer and encourage women to take charge of their health through informed decision making. The information contained in this section is not a substitute for regular checkups or the advice of a medical doctor. If you have any health concerns, please consult with your doctor.

The pink ribbon is the universal symbol for breast cancer survivors everywhere; it represents courage and passion in the battle against the disease. As the most common cancer among women, with the exception of skin cancer, there are many survivors spreading the word about strategies for survival and carrying on to live full, happy and active lives.

The statistics are a good reminder of the importance of early detection and healthy lifestyle choices. Breast cancer is the second biggest cancer killer of women after lung cancer. The chance of a woman having invasive breast cancer during her lifetime is a little less than one in eight. The chances of dying from the disease are 1 in 35. There are approximately 230,480 new cases of invasive breast cancer diagnosed every year. Around 57,650 new cases of carcinoma in situ (a non-invasive and the earliest form of cancer) are diagnosed per year. There are almost 40,000 deaths annually from women’s breast cancer. There are more than 2.5 million breast cancer survivors in the United States.

Katie’s Story

Local breast cancer survivor, Katie Robeda was diagnosed on June 10th, 2008 with invasive ductal carcinoma, stage II. “I had absolutely no symptoms whatsoever. I actually felt the lump myself on June 1st, 2008 while I was taking a shower. I was not even ‘doing an exam,’ I was just washing up after a day at the pool. I slid my hand across my right breast and my fingertips felt a foreign lump on the upper side of my breast. I had always been diligent about self breast exams so when I felt this foreign body, I knew something was wrong. I had an instant gut reaction that it wasn’t going to be good. I think I knew because I know my body so well and knew this wasn’t right,” says Robeda.

Robeda had no family history of breast cancer. She elected to have a bilateral mastectomy. Her tumor was estrogen and progesterone positive and HER 2 NEU positive, and her cancer was found to be a very aggressive kind. After having a test performed (Oncotype DX), which was done with the tissue from her mastectomy, it was determined that she would have a high risk of recurrence. “Initially, I was going to have four rounds of chemotherapy but with the results of this test, I had six rounds of chemo,” she says. “In addition to six rounds of chemotherapy, I had one year of Herceptin. I also am on adjuvant therapy, which suppresses my hormones. I have been taking a daily pill and get an injection every three months. I am in menopause currently and experience hot flashes, joint pain, migraines and fatigue.”

Robeda says that her emotions right after diagnosis could best be described as shock. “I think I just went into ‘survival mode.’ I had so many medical appointments, learning about my diagnosis and trying to absorb what my life was going to look like—surgery, losing my breasts, losing my hair, being sick from chemo, trying to maintain employment, worrying about the stress my illness was causing my family and friends, medical bills. I had several complications during treatment. I had two blood clots in my arm, I got a staph infection and was on daily IV antibiotics, I had my right ovary removed three months after I finished chemo (not related to cancer thank goodness) and had to have a revision on my right breast after the initial implant surgery. There were many days I thought, ‘I can’t do this.’ I felt alone and isolated and didn’t know anyone my age that was going through this.”

Then, Robeda turned to the Internet for support. She became involved with an organization called First Descents, which provides outdoor adventure camps to young adults ages 18-39. A very physically fit individual prior to her diagnosis, Robeda says one of the hardest challenges for her was losing her physical capabilities. “I fatigued so easily, had and continue to have, tremendous discomfort in my chest. I had to recognize my body had limits and was not able to push myself as I had since I was a little girl. This was emotionally draining and depressing for me. I did participate in an art therapy group during chemo and still paint as a way of emotional release,” she says. This courageous survivor is currently three years out from diagnosis and expresses that the “reality” that she had gone through cancer hits her harder now then it did in the beginning. She will be on adjuvant therapy (hormone suppression) for three more years, and says that she won’t say she’s in remission until she hits that five-year mark.

“I have been so fortunate to have such a strong support system of family, friends and co-workers and have always had a positive attitude. There are days that I get frustrated and think, ‘why me’ but all in all, I have always maintained such positivity and tried to see all the blessings that have come from such an ugly disease.”

Amid her positive attitude, Robeda’s daily life has changed significantly. She explains that she is constantly aware of her breasts. She elected to have reconstructive surgery but says the implants are extremely uncomfortable and prevent her from being able to lie on her stomach. The daily physical sensations she feels (tightness and pressure in her chest, as well as strange sensations like burning or “pulling” in her breasts), are a constant reminder that she has been through breast cancer, and she worries about recurrence. “When I am not feeling well or have strange pain, I often worry that something is wrong. Being diagnosed at 34 years old, I worry about ever being able to have children, dating, my social life. There is also a very positive side to all of this as well. I am much more tolerant, I don’t let little things bother me as much as I used to and I don’t take things for granted. I try to enjoy each and every day to the fullest.”

Robeda’s advice to other women is to know your body. “Because I was so familiar with my breasts from doing self-breast exams, I knew when I felt that lump I needed to take action. You have to be your own advocate. If you go to your doctor and you are not comfortable with what he or she says, it is your right and responsibility to get another opinion. Take control of your health.”

 

Susan’s Story

Susan Dunn discovered a bloody discharge from her right breast nipple area in late February 2011. She contacted her patient navigator from women’s wellness immediately and was directed to the Lutheran Medical’s Breast Care Center in Wheat Ridge. Dunn was told that she would need surgery after they found suspicious materials during an ultrasound and her initial surgery was done in March. That material was diagnosed as active cancer.

Unfortunately, Dunn’s family is no stranger to cancer. Her mother and her two sisters all had lung cancer, and one of their daughters was found to have breast cancer. Dunn explains that her treatment plan was to do the surgery on her breast to eliminate the ducts in her breast, which eliminated the possibility of another intraductal papilloma arising in the future. The surrounding area, which showed some early small cancerous material, was also removed. A month later, another surgery was performed to take out additional materials, to ensure that all areas with early indications were removed. Her sentinel node was taken out as well to check for cancer progress. It was clear.

After a month recovery time, it was planned that Dunn would have radiation treatments. There were 33 sessions planned, one each day Monday through Friday, until finished. Of those sessions, 28 of them consisted of a broader radiation field and the remaining five sessions were more intense focusing specifically on her surgical area.

“My emotions were initially all over the map. However, I knew I had to get on with getting the excellent medical help and getting through each step to put it behind me,” says Dunn. “There were many tears, some anger of ‘why me?’ a lot of staring into space hoping to wake up from the fog and be without any cancer attached to me. I am not sure I know the words to describe the feelings I felt.”

While she is now without the cancer that had been found, Dunn will soon begin her anti-hormone medication to help prevent any recurrence. “I see life differently and I truly want to help others see their cancer or any disease as something they can fight. There are things to do and plenty of help to be had for those who will open themselves to it. The fight is to be another day. The word cancer doesn’t mean you are done. It can mean it will make you feel more alive than ever before,” she says.

When asked what advice she has to offer other women, Dunn emphasizes the value and importance of mammograms as an available tool to answer the question of “What is it?” or “Why do I hurt there?” She says, “The point is do not put off finding out. Mammograms didn’t show my cancer clear enough so they did ultrasounds and saw it perfectly. So, if you have a question about the pain or whatever is making questions in your mind, it’s okay to be persistent and get an ultrasound done. If only to settle your own mind. Be vigilant. It starts with the individual, it starts with you. Ignoring something because you prefer to live in denial of what might be is a sure way of hurting yourself. It might let the cancer grow and become really difficult. So, why wait? Use the resources available and settle the answer for yourself.”

A big thank you to Katie Robeda and Susan Dunn for sharing their personal stories as well as Kelly Nelson, Owner of Citrus Public Relations representing Komen Denver.

Knowledge Can Help Save Your Life

Except for skin cancers, breast cancer is the most commonly diagnosed cancer for women. However, if breast cancer can be diagnosed early, the probability of surviving the disease increases dramatically. Early detection saves lives! The following are breast cancer awareness recommendations provided by Susan G. Komen For the Cure:

Know your risk

  • Talk to your family to learn about your family health history
  • Talk to your doctor about your personal risk of breast cancer

Get screened

  • Ask your doctor which screening tests are right for you if you are at higher risk
  • Have a mammogram every year starting at age 40 if you are at average risk
  • Have a clinical breast exam at least every 3 years starting at 20, and every year starting at 40

Know what is normal for you and see your health care provider right away if you notice breast changes:

  • Lump, hard knot or thickening
  • Swelling, warmth, redness or darkening
  • Change in the size or shape of the breast
  • Dimpling or puckering of the skin
  • Itchy, scaly sore or rash on the nipple
  • Pulling in of your nipple or other parts of the breast
  • Nipple discharge that starts suddenly
  • New pain in one spot that doesn’t go away

Make healthy lifestyle choices

  • Maintain a healthy weight
  • Add exercise into your routine
  • Limit alcohol intake
  • Limit postmenopausal hormone use
  • Breastfeed if you can

Breast Cancer Risk Factors

Being a Woman: Although men can be diagnosed with breast cancer, men’s breast cells are inactive and most men have extremely low levels of estrogen.

Age: With advancing age, risk goes up. Two out of three invasive breast cancers are found in women age 55 and older

Family History: Women with close relatives who have been diagnosed are at greater risk. If you’ve had one first-degree female relative (sister, mother, daughter) diagnosed with breast cancer, your risk is doubled.

Genetics: Approximately 5 to 10 percent of breast cancers are thought to be hereditary.

Personal History of Breast Cancer: If you’ve been diagnosed with breast cancer, you’re three to four times more likely to develop a new cancer in the other breast or a different part of the same breast. This risk is different from the risk of the original cancer coming back (called risk of recurrence).

Radiation to Chest or Face Before Age 30: Persons with radiation treatments to the chest to treat another cancer (not breast cancer), such as Hodgkin’s disease or non-Hodgkin’s lymphoma, have a higher-than-average risk of breast cancer. If you’ve had radiation to the face as an adolescent to treat acne, you’re at higher risk of developing breast cancer later in life.

Breast Changes: If you’ve been diagnosed with certain benign (not cancer) breast conditions, you may have a higher risk of breast cancer.

Race/Ethnicity: White women are slightly more likely to develop breast cancer than African American, Hispanic and Asian women. But African American women are more likely to develop more aggressive, more advanced-stage breast cancer that is diagnosed at a young age.

Being Overweight: Overweight and obese women have a higher risk of being diagnosed with breast
cancer compared to women who maintain a healthy weight, especially after menopause. Being overweight also can increase the risk of the breast cancer recurrence in women who have already had
the disease.

Pregnancy History: Women who haven’t had a full-term pregnancy or have their first child after age 30 have a higher risk of breast cancer compared to women who gave birth before age 30.

Breastfeeding History: Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than one year.

Menstrual History: Women who started menstruating (having periods) younger than age 12 have a higher risk of breast cancer later in life. The same is true for women who go through menopause when they’re older than 55.

Using HRT: Current or recent past users of HRT have a higher risk of being diagnosed with breast cancer. Since 2002 when research linked HRT and risk, the number of women taking HRT has dropped dramatically.

Drinking Alcohol: Research consistently shows that drinking alcoholic beverages (beer, wine and other types of liquor) increases a woman’s risk of hormone-receptor positive breast cancer.

Dense Breasts: Research has shown that dense breasts can be six times more likely to develop cancer and can make it harder for mammograms to detect breast cancer.

Smoking: Smoking causes a number of diseases and is linked to a higher risk of breast cancer in younger, premenopausal women. Research also has shown that there may be a link between very heavy second-hand smoke exposure and breast cancer risk in postmenopausal women.

Emerging Risk Factors (these factors are still being studied):

  • Lack of Vitamin D
  • Exposure to chemicals in water, sunscreen, plastics, grilled foods, lawn and pesticide treatments, cosmetics
  • Eating unhealthy food
  • Nighttime light exposure

Information provided by Susan G. Komen For the Cure

BREAST CANCER AWARENESS EVENTS

October 2, 2011
Komen Denver Race for the Cure
Pepsi Center
The Denver event is one of the largest Race for the Cures in the world! komendenver.org

November 12, 2011
A Pink Tie Affair™
Sheraton Hotel Denver
Denver Life is proud to be the magazine sponsor of this annual black-tie event featuring an elegant evening of cocktails, silent and live auctions, dinner, entertainment, dancing and exciting casino games! 303.367.1367 komendenver.org

March 2012
Colorado Romp to Stomp
Frisco Nordic Center, CO
Strap on your snowshoes for this fun, family-friendly snowshoe event (benefiting Denver Metropolitan Affiliate of Susan G. Komen for the Cure) that is truly in a class of its own! With the majestic Rockies raising high above, thousands of people decked out in pink will participate in a 3K or 5K Snowshoe Walk or a 3K Snowshoe Race. A festive atmosphere complete with live entertainment and FREE breakfast, this event is not to be missed! tubbsromptostomp.com

June 2012
Avon Walk for Breast Cancer
The Avon Walk Rocky Mountains is held in Summit County. Walkers and crew alike
indulge in gorgeous views of the surrounding Rockies. In addition, they can sneak
a peek at lakes, vistas and peaks of Summit County. The trails and paths link the
historic ski towns of Keystone and Breckenridge.
avonwalk.org/rocky-mountains

August 2012
Tri for the Cure
Since 2004, the annual Tri for the Cure has grown to be the largest sprint-distance triathlon in the United States. Its growth is a direct result of Colorado’s recreational enthusiasm, the strength of its beneficiary (Denver Metropolitan Affiliate of Susan G. Komen for the Cure), and a format, which is meant to include women of all ages, athletic abilities and fitness levels. The course includes a half-mile swim, 11.4-mile bike ride and 3.1-mile run. triforthecure-denver.com

New Treatments
New Technologies
New Hope

Estrogen Drug
Breast cancer specialist at Boston Massachusetts General Hospital, Dr. Paul Goss said, “We proved that exemestane (Aromasin) reduced the risk of invasive breast cancer by 65 percent.” Goss presented his research at the annual conference of the American Society of Clinical Oncology. The study has been published in the New England Journal of Medicine.
*information courtesy of CNN

Not Removing Lymph Nodes
Women who meet certain criteria—about 20 percent of patients, or 40,000 women a year in the United States—taking out cancerous nodes has no advantage. It does not change the treatment plan, improve survival or make the cancer less likely to reoccur.
*information courtesy of New York Times

Focused Microwave Thermotherapy
The technique, which was approved by the U.S. Food and Drug Administration, uses a modified version of the microwave technology behind the “Star Wars” defense system. Researchers tested the
therapy on tumors that were an inch to an inch-and-a-half in size. These large tumors usually required mastectomies. When researchers used the heating therapy, within two hours of patients
receiving chemotherapy, the tumor was more susceptible to the chemotherapy and shrunk rapidly. The percentage of patients needing mastectomies was reduced from 75 percent to 7 percent.
*information courtesy of the FDA

More MRI Screening
Magnetic Resonance Imaging (MRI) scans of women who were diagnosed with cancer in one breast detected more than 90 percent of cancers in the other breast that were missed by mammography and clinical breast exam at initial diagnosis.
*information courtesy of Harvard Health and Science Daily