3D Mammograms,Tomosynthesis, and Dense Breasts

Reading this post about 3D Mammograms, Tomosynthesis, and Dense Breasts may save your life.

This new mammogram technology was only approved by the FDA in February, 2011.   http://www.diagnosticimaging.com/tomosynthesis/fda-approves-first-3-d-mammography-imaging-system

In one day, I heard from two women who had Tomosynthesis.   It probably saved their lives, and certainly gave them a much better chance of survival.  In their cases, they had to pay $50 and $40 more respectively in addition to insurance.  At my local hospital,Mercy St. Charles, Oregon, Ohio, they do not charge any additional, so check with your hospital.  So many women I hear from had lumps that were never discovered on a regular Mammogram.  By the time they were diagnosed, they were Stage 3 or Stage 4.  And over 40% of women who are diagnosed with breast cancer find their own lumps.  The cold, hard reality is that many , many women diagnosed with advanced breast cancer had nice little letters from their mammography center saying they were okay.

This story from Jane:

My breast cancer was found when I went for a routine mammogram and the woman at the front desk talked me into having a new test called Tomosynthesis.  Sometimes insurance doesn’t cover the additional costs, but my radiology center was offering it for $50.  The woman behind the desk reminded me that I would pay more for a pair of shoes, so I agreed to have it done.  Well guess what – nothing showed on the Mammogram, but there it was on the Tomosynthesis. That woman may have saved my life as my breast cancer was then caught early (Stage 1).

This story from Michelle from Iowa:

In the past, I got the regular mammograms, then Iowa Radiology changed to “digital mammography” several years ago.  The digital mammography always picked up things like calcifications, so every year for the past five years, I had to go back in for an unltrasound to check on something. 
This year, they introduced 3D mammography for the first time and I decided to do that and pay the extra $40.00 because I had learned that having dense breast tissue makes it very hard to see if there are any tumors in the breast.  Dense breast tissue appears white on the image.  Tumors also appear white so it can be very difficult to see a tumor. 
Even the 3D mammography did not show any tumors even though there were two tumors in the left breast (2cm and 1.8cm) very close to each other, but the Radiologist did see on the 3D mammogram a little “puckering” in one area. The doctor followed up on that, ordered an ultrasound and then a biopsy. That’s how they found the first 2cm tumor.  I later had an MRI (ordered by the surgeon prior to my lumpectomy)  which showed the 2nd tumor. 
Women with dense breast tissue should make sure their radiologist is looking closely for anything that might indicate a problem. 
I was diagnosed as Stage 2B (3 of 14 lymph nodes involved and tumor less than 5cm).

Since it is new technology, it can be difficult to find Tomosynthesis or 3D Mammography, however, more and more breast cancer centers are getting these new machines.  I would encourage you to find out where you can get this 3D Mammogram, ESPECIALLY IF YOU HAVE BEEN TOLD THAT YOU HAVE DENSE BREASTS OR DENSE BREAST TISSUE.  

On April 1, 2013, California became the fifth state passing a  law, which was bipartisan, that required patients to be told if they had Dense Breasts following Connecticut, Texas, Virginia, and New York.  Katie, one of my blog readers and a breast cancer patient, sent me this great information on Dense Breasts:

http://www.breastdensity.info/index.html

The only downside I can see to 3D Mammograms/Tomosynthesis is that according to USAToday, it has two times the radiation because it is like a CT Scan of the breasts.  http://www.usatoday.com/story/news/nation/2012/10/09/3d-mammogram-tomosynthesis/1615719/   There are pros and cons about this, but I will let you decide for yourself.   The stories of Jane and Michelle made me a believer.

Icing Hands and Feet During Paclitaxel, Taxol, and Docetaxel, Taxotere Chemotherapy

I receive a lot of inquiries about Taxol (Paclitaxel) and Taxotere (Docetaxel), and icing your hands and feet during Chemo infusions, so I wanted to provide  more information.     Taxane drugs (Taxol and Taxotere) can cause neuropathy which is numbness of hands/fingers and feet/toes and extreme discolorations of your nails or loss of nails.

My Chemo Nurse said fingers and toes have twice the circulation as other places in your body, so by icing them, it constricts the blood vessels and prevents the Chemo from infiltrating those areas. 

I would highly recommend you ask your Oncologist about thisMake sure you have their permission.  Your Oncologist may look at you questionably, but get them to say okay!  Mine gave me the go ahead.  In fact, it worked so well for me, they are now recommending it for others.  One more added bonus, you get so sleepy from the drugs pre-chemo.  The ice wakes you right up!

Mary, a friend of mine, is 10 years out from Taxol treatment.  Both of her feet are numb and this will never go away.  She suffers greatly because of this on a daily basis.  If you can prevent neuropathy, it is worth the sacrifices. On my first attempt at doing this in the Chemo room, a young gal next to me  was Stage 4 Breast Cancer had iced on several chemo regimes.  She attested to me that it worked for her, so that gave me encouragement I needed to continue.

Please check out my store www.hellocourage.com and cute chemo hats.  I learned what was needed in the bald phase of my life.  Click on a hat  below.  I look high and low and have the best chemo caps designed for comfort and style.

CH-h4calypsobirdofparadise1CH-h4flappergraysweatshirt1CH-h4activityblackwhitegreen4CH-h4flapperorangeblackwhite1



 

I am now 11 months since my last Taxol infusion.

1)  I have no neuropathy in either hand or any fingers.

2)  I had no nail discoloration or nail loss on either hand.

3)  My left foot had no nail discoloration or no neuropathy.

4)  My right foot has numbness on the upper tips of all 5 toes and I had one toenail discolored, but no nail loss.  I pulled my right foot out of the ice too often.

Here is what I did:

1)  I took two small dish pans to infusion purchased at a Dollar Store for $1.00 each.  Some people take frozen peas or baggies of ice.  The dish pans worked better for me.

2) Before the Chemo Nurse began the Taxol, I had her fill up the dish pans with ice.  I only used the ice during the Taxol infusion, not with the preliminary drugs.

3) I kept my socks on (brought an extra pair for after Chemo) and had the nurse give me a washcloth to put over the ice for my hands. (thin gloves would have worked as well)

4)  I soaked my hands and feet in the icy dish pans as long as I could tolerate it, then I would pull my hands and feet out of the ice for short breaks.   The nurse got me two towels to dry off when I was through.  I did it for the entire Taxol portion of the infusion.

With the annoyance the little bit of neuropathy causes me daily, I am so thankful I took the time to do this to prevent debilitating neuropathy.

I-SPY2 Clinical Trial for Newly Diagnosed Breast Cancer Patients

UPDATE:  12/15/13   some breaking good news about experimental drugs in ISPY2 trials.

http://www.cbsnews.com/news/new-drug-study-method-show-breast-cancer-promise/

If you have been newly diagnosed with breast cancer, you are overwhelmed.  Not only are you frightened for your life and health,  afraid for your family and loved ones, but you have to make many huge medical decisions in a relatively short period of time.  The time when I was newly diagnosed before my treatment plan was is in place was the worst time.  One thing to consider when newly diagnosed is to see if you qualify for a clinical trial, which is a rigorously controlled test of  new drug(s) or procedures.

Katie Brown from Bainbridge Island, Washington wrote and told me about the Clinical Trial she is participating in for her diagnosis of breast cancer.  The Clinical Trial is called                I-SPY2 and is currently recruiting patients from across the country in various locations (see below).

Terry Maas, an Oncology Research Nurse Coordinator at Swedish Cancer Institute in Seattle, Washington where Katie is receiving treatment, encourages women to look at these Clinical Trial websites to allow yourself time to absorb the information, educate yourself by identifying and understanding new terminology, while formulating questions you may have, so you can further discuss them with your Health Care Team.  Ms. Maas recommends reviewing www.ISPY2.org and http://clinicaltrials.gov/show/NCT01042379 to learn more about this I-SPY2 Clinical Trial.

ispy2-clinical-trial.jpg

I-SPY2 will help get investigational drugs to the market much more quickly.  Katie is undergoing standard chemotherapy treatment for her tumor, Taxol with Herceptin, then on to Adriamycin and Cytoxan with Herceptin.  In addition, a yet unnamed drug is being added.  The trial drug she is on is MK2206 which is in pill form and for her is taken as part of the Taxol protocol.   Katie’s tumor shrunk by one-third after only two chemo treatments!

This from the www.ISpy2.org website:

I-SPY 2 is a clinical trial for women with newly diagnosed locally advanced breast cancer

Today most women with breast cancer receive standard chemotherapy.  We know that some breast cancers respond well to standard chemotherapy but some do not.  The I-SPY 2 TRIAL (Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging And moLecular Analysis 2) is a clinical trial for women with newly diagnosed locally advanced breast cancer to test whether adding investigational drugs to standard chemotherapy is better than standard chemotherapy alone before having surgery.  The treatment phase of this trial will be testing multiple investigational drugs that are thought to target the biology of each participant’s tumor.  The trial will use the information from each participant who completes the study treatment to help decide treatment for future women who join the trial.  This will help the study researchers learn more quickly which investigational drugs will be most beneficial for women with certain tumor characteristics.  The I-SPY 2 TRIAL will test the idea of tailoring treatment by using molecular tests to help identify which patients should be treated with investigational drugs.  Results of this trial may help make investigational drugs available to more women in the future.

____________________

HERE ARE THE LOCATIONS WHICH ARE CURRENTLY RECRUITING FOR I-SPY2 PARTICIPANTS:

Please refer to this study by its ClinicalTrials.gov identifier: NCT01042379

Contacts
Contact: Meredith Buxton, MPhil, MPH 415-353-7357 meredith.buxton@ucsfmedctr.org
Contact: Donya Bagheri, MS, DABT 650-691-4400 ext 116 dbagheri@ccsainc.com

Locations
United States, Alabama
University of Alabama at Birmingham Recruiting
Birmingham, Alabama, United States, 35294
Contact: Valerie Caterinicchia, RN, BSN     205-934-5367     val7@uab.edu
Principal Investigator: Andres Forero, MD
United States, Arizona
Mayo Clinic – Scottsdale Active, not recruiting
Scottsdale, Arizona, United States, 85259
University of Arizona Recruiting
Tucson, Arizona, United States, 85724
Contact: Amy S Bauland     520-694-0859     abauland@azcc.arizona.edu
Principal Investigator: Rebecca Viscusi, MD
United States, California
University of California San Diego Recruiting
La Jolla, California, United States, 92093-0698
Contact: Cynthia Meyer     858-822-6575     cjmeyer@ucsd.edu
Contact     858-822-5354     CancerCTO@ucsd.edu
Principal Investigator: Anne Wallace, MD
University of Southern California Recruiting
Los Angeles, California, United States, 90033
Contact: Debu Tripathy, MD     323-865-3900     Tripathy@usc.edu
Contact: Kristy Watkins, RN     323-865-0452     Watkins_K@ccnt.usc.edu
Principal Investigator: Debasish Tripathy, MD
University of California San Francisco (UCSF) Recruiting
San Francisco, California, United States, 94115
Contact     877-827-3222
Principal Investigator: Amy Jo Chien, MD
United States, Colorado
University of Colorado Recruiting
Aurora, Colorado, United States, 80045
Contact: Tessa Mcspadden     720-848-0609     tessa.mcspadden@ucdenver.edu
Principal Investigator: Anthony Elias, MD
United States, District of Columbia
Georgetown University Medical Center Recruiting
Washington, District of Columbia, United States, 20007
Contact: Minetta Liu, MD     202-444-3677     Liumc@georgetown.edu
Principal Investigator: Claudine Isaacs, MD
United States, Georgia
Emory University Active, not recruiting
Atlanta, Georgia, United States, 30322
United States, Illinois
University of Chicago Recruiting
Chicago, Illinois, United States, 60453
Contact: Jean Gibson     773-834-2167     jgibson@medicine.bsd.uchicago.edu
Principal Investigator: Rita Nanda, MD
Loyola University Recruiting
Maywood, Illinois, United States, 60153
Contact: Kathy Czaplicki     708-327-3322     kczapli@lumc.edu
Contact: Agnes Natonton     708-327-2237     anatont@lumc.edu
Principal Investigator: Kathy Albain, MD
United States, Kansas
University of Kansas Active, not recruiting
Westwood, Kansas, United States, 66205
United States, Minnesota
University of Minnesota Recruiting
Minneapolis, Minnesota, United States, 55455
Contact: Charlotte Smith     612-625-9498     Smit4652@umn.edu
Principal Investigator: Doug Yee, MD
Mayo Clinic Recruiting
Rochester, Minnesota, United States, 55905
Contact     507-538-7623
Principal Investigator: Judy C Boughey, MD
United States, Oregon
Oregon Health & Science Institute (OHSU) Recruiting
Portland, Oregon, United States, 97239
Contact: Deirdre Nauman, BSN,CCRP     503-494-3078     naumand@ohsu.edu
Principal Investigator: Stephen Y Chui, MD
United States, Pennsylvania
University of Pennsylvania (U Penn) Recruiting
Philadelphia, Pennsylvania, United States, 19104
Contact: Luke Velders     215-615-6821     Luke.Velders@uphs.upenn.edu
Principal Investigator: Angela DeMichele, MD
United States, Texas
University of Texas, Southwestern Medical Center Recruiting
Dallas, Texas, United States, 75390-9155
Contact: Barabara Staves, BS     214-648-1988     barbara.staves@utsouthwestern.edu
Contact: Vanessa Tagoe, MA, CCRC     214-648-7020     Vanessa.Tagoe@utsouthwestern.edu
Principal Investigator: David Euhus, MD
University of Texas, M.D. Anderson Cancer Center Recruiting
Houston, Texas, United States, 77230-1439
Contact: Cara Dunlap, RN     713-745-8748     CLDunlap@mdanderson.org
Principal Investigator: Stacy Moulder, MD, MSCI
United States, Virginia
Inova Health System Recruiting
Falls Church, Virginia, United States, 22042
Contact: Alyssa Bruflodt     703-776-3565     Alyssa.Bruflodt@inova.org
Principal Investigator: Kirsten Edmiston, MD, FACS
United States, Washington
Swedish Cancer Institute Recruiting
Seattle, Washington, United States, 98104
Contact: Barry Boatman, RN     206-215-3086     CancerResearch@swedish.org
Principal Investigator: Hank Kaplan, MD
Principal Investigator: Erin Ellis, MD
University of Washington Recruiting
Seattle, Washington, United States, 98115
Principal Investigator: Larissa Korde, MD, MPH

Surviving Cancer–Adapting and Adjusting Equals New Hope

Perhaps you landed here because you are a Cancer Survivor and are having difficulties.   Or maybe a spouse, parent, or loved one had cancer, and you do not understand why they are having such a difficult time adjusting to life after cancer treatment.

Six months into being an “official” Cancer Survivor, I made this realization:  Life is not going to be what it was before the cancer diagnosis.  Somewhere in the back of my mind, I believed that someday, somehow, everything would shift and it would be business as usual, and my pre-cancer life would come back magically.   I kept waiting for it.

This all started because one morning as I was donning my Lymphedema gear, taking my medicine cabinet full of pills and supplements, trying to walk because of the severe pain (side effect of the drug Arimidex), and inserting my prosthesis in place of my amputated breast,  it finally hit me that “this is the way it is going to be and you damn well better get used to it.”

I was praying and asking for guidance about what I need to do so I can move forward and not stay stuck. The big, burly, bearded husband of Food Network television’s star Southern cook, Paula Deen, popped into my head.  Why is he in my head, I wondered? I don’t even know his name!  So I googled “Paula Deen’s husband” and interestingly, I found out his name is Michael Groover and he is a Harbor Pilot.   Hmmm, I thought, what does that mean for me?

I found this definition and explanation:   A harbor pilot, often known as a maritime pilot, is a boat pilot with specialized knowledge of a particular port or harbor. The pilot is needed to direct large ships into a port where there are specific deep water channels surrounded by shallower flats.     Without the services of a harbor pilot, docking ships would become a big hazard. There would be a real chance of running aground and damaging the ship and the cargo.   It’s precision work, and as with the many steps and players involved, safe docking and undocking is crucial to the ultimate success of the voyage. 

Wow, I need a Harbor Pilot to help me with this part of my journey as I do not have the knowledge or tools to navigate these unchartered waters of Cancer SurvivorSHIP.  While I was out to sea in cancer treatment world, my medical team did all the captaining of my ship.  Now, I needed someone experienced in the hazards of maneuvering my ship into this new port.  And it is okay because I have never been here before, and it is all new to me.

A friend had told me a former pastor of mine from 20 years ago, who was a gifted counselor and a cancer survivor, would be glad to speak with me.   He is a survivor of a rare cancer.  He was not expected to live, but 4 years later, he is still here and celebrating life.  We shared cancer stories.  And when I heard about all that he had to deal with on an everyday basis because of all the damage done because of Chemo and high dosages of Radiation, it was inspiring and uplifting.

He then listened to me and was able to immediately assess where I was on my survivor journey.  “AA” he said, “Adapt and Adjust.”  He told me that the biggest learning curve for him in the past 4 years was adapting to what he can do, eliminating what he cannot do, and adjusting to new, yet exciting ways to live life. 

Two simple words, but because he has been there, he knew exactly what I needed.  He is a Harbor Pilot.    The imagery of my Cancer SurvivorSHIP coming into a new port, with new things, new possibilities, and new opportunities resonated with me.  Sure, in order to adapt and adjust, I have and will have to give up things that I can no longer do, no longer take care of, or that no longer serve me.   But I have, I can and I will. For the first time in a very long time, I felt real hope and not manufactured hope!   There is a big difference.

If you are a Cancer Survivor, please take time to focus on those simple words – adapt and adjust.  Perhaps, like me, you have been waiting for life to go back to the way it was before cancer.  Unfortunately, it will not go back.   But with some adapting and adjusting, you can be ready to accept the new life that awaits you.  Also, look for a Harbor Pilot to help guide your way to this new port – a support group, a counselor, or someone who has been there.  You cannot navigate these treacherous waters alone.

I had this Inspirational Subway Sign made for my www.hellocourage.com  store.  These are the words that I realize it takes to transition from cancer patient to cancer survivor.  These have FREE SHIPPING to the Continental USA and are solid wood and beautiful!!   Click on picture for more details!

Survivor Sign Black

If you are not a Cancer Survivor, I’m not going to let you off the adapting and adjusting hook!  Perhaps it is time to review your life and see what you are holding onto that no longer serves you.  Oh, there can be many things:   a job, a relationship,  a certain way of doing things, a grudge, old habits, clutter, painful thoughts…the list goes on.  Time to adapt and adjust to new ways, new thoughts, new ideas, and new hope!  And if you cannot maneuver those waters of change, find or hire a Harbor Pilot to help you.

I would love to hear your stories!     Denise