Again the information I post here is neither related to any medical institution or direct person in the medical field. Having said that I will admit that I had occasion to talk to several specialists and reviewed the data in regards to the implant information that was recently disseminated. I found that the results were related to textured implants only and further studies are documenting that quite possibly it is an imflammatory response as once the implant has been removed the previous issues are resolved. Keep in mind that this was also a very small number of persons with unfavorable outcomes amongst thousands, and quite possibly millions of others with no issues. I only posted the FDA information so that you could make your own assumptions and formulations .
We are happy to have the following guest blog from the National Breast Cancer Coalition (NBCC) President, Fran Visco, talking about setting a deadline to end breast cancer in 2020. NBCC is one of our collaborators and has played a key role in the success of the Army of Women. Read this important piece from Fran and we hope you take a minute to learn more and get involved with the Breast Cancer Deadline 2020.
Special Message from Fran ViscoOn September 20, 2010, we called for a global strategy to end breast cancer by January 1, 2020. We launched Breast Cancer Deadline 2020®. When we announced this bold move, Susan Love said, “We can be the generation that stops breast cancer—and we must be the generation that stops breast cancer.” It’s time. With the power, commitment, passion, intelligence and courage of our advocates at NBCC, we will make this happen.
By calling for an end to breast cancer, we’re calling for an end of business as usual. Breast Cancer Deadline 2020® changes the conversation from raising awareness about the disease to one that asks, “What must we do differently to end breast cancer by January 1, 2020? How do we succeed?” It upends "business as usual" and brings back the sense of urgency needed to save lives.
Read the FDA report on breast implants and ALCL here.
Many women being treated for breast cancer consider breast implants after a mastectomy. Yesterday, the FDA issued a communication about a possible association between breast implants and a rare type of lymphoma, anaplastic large cell lymphoma (or ALCL).
Based on studies performed between January 1997-May 2010, the FDA identified women with breast implants have a very small but increased risk of developing ALCL in the scar capsule adjacent to the implant. The FDA website currently has clear information for women with implants. They recommend women with implants, but no symptoms, schedule routine follow-up appointments with their medical providers. Women who do not currently have breast implants but who are considering them should discuss the risks and benefits with their doctor.
BCA has long advocated that the FDA stop approving products for the marketplace before we fully understand their potential impact on human health. In this case, the studies that identified that women with breast implants have a small but increased risk of ALCL were conducted in post-approval monitoring – that is, after approved implants were surgically placed in women's breasts. BCA will continue to urge the FDA to put patients first and before corporate profits. We demand that health risks be fully explored before medical devices are approved, not after, when women’s lives are put at risk.
Kimberly Irish, J.D.
BCA Program Manager
Breast Cancer Action | 55 New Montgomery St. #323 | San Francisco, CA 94105
Toll-free at 877-2STOPBC (278-6722) | www.bcaction.org | www.thinkbeforeyoupink.org
The information in this blog came through www.bcaction.org and are not necessarily my views, information, or opinion. I have included it due to the fact it hit the news last night and felt you might like the site or more information.
MedPage Today) -- Our Year in Review series highlights the major medical news stories of 2010. New breast cancer screening recommendations was one of the compelling topics that made headlines during the year and here, again, is the original article, first published on Jan. 14, 2010. In a companion article, you'll find out what's happened since. The controversy over breast cancer screening centered largely on a handful of terms and concepts that were overlooked, ignored, misunderstood, or misinterpreted, according to the authors of a commentary on the issue.
Few observers dispute that the most contentious aspect of the U.S. Preventive Services Task Force recommendations related to the age when women should begin routine mammographic screening: 50 versus 40. The key term was "routine," which was overlooked or ignored, depending on the source, Steven H. Woolf, MD, of Virginia Commonwealth University in Richmond, wrote in one of four commentaries in the Jan. 13 issue of JAMA.
"The USPSTF did not recommend against women having mammograms," wrote Woolf, a member of or adviser to the task force from 1987 to 2007. "This pivotal misunderstanding resulted from poor wording of the recommendation."
Specifically, Woolf referred to the following statement: "The USPSTF recommends against routine [emphasis added] screening mammography in women aged 40 to 49 years."
The sentence was followed by an explanatory statement emphasizing that the decision to begin mammographic screening should be individualized and take into account "the patient's values regarding specific benefits and harms" (Ann Intern Med 2009; 51: 716-726).
"Inserting 'routine' in the first sentence and adding the explanatory second sentence was meant to convey a nuance that was lost on the public," Woolf wrote. "The panel did not oppose mammography, as widely misinterpreted, but recommended against automatic ('routine') imaging, without informing women about potential harms."
One's Harm Is Another's Benefit
Addressing the harm issue in a second commentary, Steven Woloshin, MD, and Lisa M. Schwartz, MD, of Dartmouth Medical School in Hanover, N.H., said that recognizing and understanding the trade-offs of breast cancer screening is a requisite for informed decision making. Most of the discussion about the harms of mammography has focused on false-positive results, which can lead to unnecessary biopsies and associated anxiety and morbidity.
"False-positive test results are not the most important harm of screening overdiagnosis is," wrote Woloshin and Schwartz. "Because it is not possible to know which women are overdiagnosed, all are treated with surgery, chemotherapy, radiation, or some combination. Overdiagnosed women are unnecessarily diagnosed, undergo treatment that can only cause harm, and must live with the ongoing fear of cancer recurrence."
Estimates of the frequency of overdiagnosis range from two to 10 for every cancer death avoided, they added.
Women have divergent views about the benefits and harms of screening. Many women ages 40 to 49 find breast cancer screening worthwhile despite the risk of false-positive results. Others will find the harms too great to accept.
"[That] is exactly the point," wrote Woloshin and Schwartz. "Each woman, with the help of her physician, needs to consider these harms and benefits and decide whether to undergo screening."
Seconding a view expressed by Woolf, Woloshin and Schwartz said balanced information is essential for clinical decision making. Noting that the goal of medicine is healthier, longer lives, they wrote "sometimes more testing helps to reach the goal, but other times less testing does. Suggestions to do less may be as much in an individual's interest as suggestions to do more."
Anne Murphy, MD, of Johns Hopkins, offered two perspectives on the screening controversy: one from a clinician and researcher and the other from a breast cancer survivor. She implored physicians to address both sides of the issue with their patients.
"Clinicians should specifically discuss the USPSTF recommendations, recognizing that this task force has considered a great deal of medical evidence, but also should discuss that advocacy organizations including the American Cancer Society, the Susan G. Komen for the Cure, and the Avon Foundation for Women still favor the recommendation of yearly mammography screening starting at age 40," Murphy wrote.
Breast Self-Exam Is Another Issue
Physicians also should be prepared to address women's questions and concerns regarding another controversial aspect of the USPSTF guideline: The recommendation against the value of teaching women breast self-examination.
"Data from large randomized studies have indicated that this type of formalized breast self-examination may result in more biopsies without reducing the risk of death," Murphy wrote. "This issue also was addressed in prior clinical practice guidelines and by advocacy organizations, and enthusiasm for teaching formalized breast self-exam has diminished.
"However, a practical issue is that many women present to clinicians and are ultimately diagnosed with breast cancer based on self-palpation of a mass."
In addressing the benefits of screening mammography, Wendie A. Berg, MD, PhD, also of Johns Hopkins, reviewed four major areas of controversy about the USPSTF recommendations: potential harms, raising the age for routine screening to 50, clinical breast examination, and screening after age 74, which the task force said has no supporting data.
With regard to breast self-examination, Berg said "resources might be better spent on ultrasound in women with dense breasts than on clinical breast examination." However, she emphasized that women should tell their physicians about any changes detected on self-examination.
Berg referred to "downsides" of mammography, which she said most women would not consider harmful. She cited a survey showing that almost two-thirds of women considered 500 or more false-positive results per life saved would be a reasonable trade-off.
Given that 75% of breast cancers are diagnosed in women with no obvious risk factors, the recommendation against routine screening before age 50 is "problematic," Berg said in her commentary. She noted progress toward development of other screening modalities to augment mammography for high-risk women. Breast ultrasound and breast MRI have shown promise in selected patients, but both modalities are associated with increased recall rates and more needle biopsies.
Once started, mammographic screening should continue "as long as a woman is in reasonably good health and would pursue treatment if cancer is identified," Berg wrote. In support of that view, she noted that women in their 80s have an average life expectancy of 8.6 years.
"Annual mammographic screening is appropriate starting at age 40 years, provided the woman is willing to accept the downsides of false positives, including being recalled for more imaging and the possibility of a needle biopsy for a finding that is not breast cancer," Berg concluded. "The overwhelming majority of women are willing to accept these downsides as part of the process of saving lives otherwise lost to breast cancer."
Echoing sentiments expressed in the commentaries, an editorial by JAMA editors Catherine D. Deangelis, MD, and Phil B. Fontanarosa, MD, urged physicians and patients to make decisions about screening mammography on the basis of "unbiased, rigorous, objective evaluation of the available evidence for recommendations about screening for breast cancer and other clinical interventions."
Citing frequent reporting inaccuracies in the news media and the "politicization of biological science," they also emphasized the need for independent review bodies, such as the USPSTF, to offer "objective appraisals, reports, and guidelines without concern about special interests, politics, or ideology or fear of repercussions for seeking the truth in providing evidence-based recommendations."
"In issuing the 2009 recommendation statement, the USPSTF has fulfilled its mandate to provide guidance and evidence that will help physicians and patients make informed, individualized decisions about screening for breast cancer" they wrote.
Primary source: Journal of the American Medical Association Source reference: DeAngelis CD, Fontanarosa PB "US Preventive Services Task Force and breast cancer screening" JAMA 2010; 303: 172-73.Additional source: Journal of the American Medical AssociationSource reference: Woolf SH "The 2009 breast cancer screening recommendations of the US Preventive Services Task Force" JAMA 2010; 303: 162-63.
I recently started networking a request from my list of contacts for prayer shawls for our patients here at the institute. The shawls are made with love and care and prayers for the person that receives the shawl and helps provide comfort, support and love during their treatment. I received one of these shawls during my treatment days from an unknown person and to this day, I keep my prayer shawl close. It actually is on the back of my chair at work and reminds me of how far I have come and of the loving support I received during and after my treatment. This is a special gift and to think someone made it special just for me, to help me through my difficult times, means the world to me. I have received donations from two area churches and I am honored to be able to pass these out to patients as they come to our institute for treatment. This is a comforting hug from people that care and the time and effort it took to make this shawl adds to the love that surrounds the shawl. I have also received lap robes and some scarves and hats as well and I will share those with those that can use this gift at this time. My request went out when I saw that my stock was depleted and I hope to again fill the need by your support. This is ongoing so, if now is not the time, maybe down the road you can help. I thank you for all of us that have had to deal with the trials and tribulations of the diagnosis of Cancer and know that this gift will provide great comfort and a gentle reminder that we are not alone.
Wow, can you believe it, it is snowing! Ha Ha, just to bring a smile to your face. Get yourself a nice glass of liquid libation -your choice, sit by the fire, read a book and enjoy the day. S
Healthy Alternatives for Your Home and Family Many products that are used in our homes everyday contain chemicals that can be harmful to our families, our pets and the environment. Additionally, the manufacturing and disposal of hazardous chemicals contributes to pollution, and often places serious health burdens on communities located near these facilities. There are steps that can be taken everyday to minimize our exposure to toxic substances. In the process, we can make sure our families, our communities, our food and water supply, and our environment will be protected.
Here’s a list of some of the products in everyday use and some ways to make safer choices:
CLEANING PRODUCTS Everyone likes a clean home, but many cleaning products contain toxic chemicals that can cause health problems. The EPA found that the air inside a home is typically 2 to 5 times more polluted than air located just outside it, largely because of the use of household cleaners and pesticides. You can make your own products, or purchase safer cleaning products.
Things You Can Do:
Site Gail Armanini
BellaOnline's Breast Cancer Editor
Local Recurrence of Breast Cancer
The thought of a breast cancer recurrence sits in the back of our minds day in and day out. With some effort, we can keep it in the background most of the time, and get on with our lives. But what happens when you notice something different? Maybe there's a lump that you're sure wasn't there before. Maybe something looks a little different around the scar. Maybe there's pain or tenderness all of a sudden. In this article, we'll look at some of the common symptoms of a local breast cancer recurrence and talk about what to do next.
Often you or your doctor will find a small abnormality near the site of your original cancer. Approximately 70% of cancers come back to the same area as the original cancer, so it's understandable to be alarmed.
If you've had a lumpectomy (with or without radiation) you might notice a new lump that gets bigger, or maybe a feeling that the breast tissue has become thicker. However, there is a very good chance that this lump is only scar tissue – either scar tissue that is filling the area where the breast tissue was removed, or scar tissue that has formed around one of the stitches your surgeon put in during your original surgery.
A local recurrence can occur after a mastectomy as well. The symptoms are similar to those of a lumpectomy patient. With a mastectomy patient, a recurrence most often occurs in the skin or fat areas where your breast used to be. Usually, you will notice a small lump or lumps, often near the scar.
Lumps and thickening are not the only symptoms of recurrence. Any change to the appearance of the breast skin or the scars from your first surgery (redness, a rash-like appearance, puckers in the skin – like an orange peel, or pain or tenderness) are reasons to see your doctor.
What will your doctor do if you have a new lump or other symptom? He or she may order a mammogram. If the mammogram shows suspicious results, your doctor may choose to order a sonogram, a PET scan or an MRI. If the results of these further tests are still suspicious, your doctor will most likely want to do a biopsy. These are all very similar procedures to what most women experience the first time they are diagnosed.
Needless to say, your anxiety level by this point is through the roof. I honestly don't know which is worse – the anxiety during the first breast cancer because you don't know what treatment is like, or the anxiety of a possible recurrence because you do. I think it's safe to say that feeling betrayed by your body, for a second time, might be the deal breaker. Try to remember though, that there's a good chance your symptoms are benign, and can easily be treated.
It is imperative to seek support if you feel overwhelmed. There are special support groups designed specifically for patients with breast cancer recurrence. They are usually lead by counselors specially trained to help you through the process. Additionally, no matter how good the images from a mammogram, sonogram, MRI, etc. may be, the only way to be absolutely certain that it's cancer or not is with a biopsy. If you've had these tests, and your doctor assures you everything's fine, but your intuition tells you differently – speak up! Voice your concerns and, if you want a biopsy, say so. It's your body and your life – you have every right to peace of mind.
Why does the first day of the week feel like hitting a brick wall running most days? It is and has been an extremely busy time and although I am not out doing programs I am doing alot of one on one and that is good. I often listen and am reminded that our walks through this disease are not that different. I hear the joy at having completed or the anticipation of completion of treatment, I hear the clatter that rummages through your head that brings up fears and concerns having gone through this once and wondering if it will happen again. I see the love and comfort that family and friends provide and I see the bravado that patients sometimes put on for family members and the determination to get through the next step. Whatever each one feels, it is normal! How can I say that? Well, since there is no step by step book on how to deal with this most effectively, I feel we are all doing our best to meet the challenges we face on a daily basis just as anyone does in life. Some days we are better at it than others and some days we just suck. Sometimes we need to reach out and get help. We have a friend that is losing his significant other to a valient battle with disease and through the pain that is there, there is faith and love. This is a time that family needs to bind together and let go of all the little things that never did matter, really. What is most important to you today? Getting to work, finishing a report, fixing lunch, finding time to exercise... what matters most to you? Listen to your heart and to your head and take care of yourself each and every day and rather than just MAKE IT THROUGH MONDAY, find what is important for you for this day ...and make it a great day! s
Spring is coming and with it new hopes and dreams. I like fresh new snow at the beginning of the season but already I am getting tired of it. I am working on putting a Spring retreat for breast cancer patients/ survivors with a day of learning and fun activities. I hope that with what I am presenting I am peaking your interest and that you will keep coming back to see what this will all be about. In the meantime, enjoy the moment and the day and know that tomorrow has bright promise- spring is coming. Making it a good day! S