IMPACT OF YOUR GIVING
in support of the Sandra Levine Young Women’s Breast Cancer Program
presented with gratitude to The Leon Levine Foundation
The Sandra Levine Young Women’s Breast Cancer Program (YWBP)
A cancer diagnosis can be overwhelming at any age. However, young women often face unique medical and emotional challenges that differ from those experienced by older patients. They may be navigating concerns such as fertility, educational plans, early career development, interpersonal relationships, intimacy, parenting responsibilities, and body image.
To address the specific needs of this population, the Sandra Levine Young Women's Breast Cancer Fund was established at Atrium Health Foundation in 2017, thanks to a generous gift from The Leon Levine Foundation.
The Sandra Levine Young Women’s Breast Cancer Program began enrolling patients in January 2018. Currently, only a limited number of breast cancer programs nationwide are dedicated exclusively to young women.
We believe in the power of shared experience and informed decision-making. Through personalized support and education, we empower patients and their care partners to better understand the diagnosis, explore treatment options, and manage the physical and emotional effects of care.
Program Leadership
Lejla Hadzikadic Gusic, MD, MSc, FACS, FSSO
Co-Director, Sandra Levine Young Women’s Breast Cancer Program
Specialties: Division of Surgical Oncology, Department of Surgery
• Doctor of Medicine and Master of Science, Georgetown University
• Fellowship, University of Pittsburgh & Boston University Medical Center
• Residency, Boston University Medical Center
• Program Director, Breast Surgical Oncology Fellowship, AH Levine Cancer
• Associate Professor
• Advisory Committee on Breast Cancer in Young Women (ACBCYW), potential primary nominee for 2024-2027 membership. The ACBCYW provides advice and guidance to the Secretary, US Department of Health and Human Services and the Director, Centers for Disease Control and Prevention
Julie Fisher, MD
Co- Director, Sandra Levine Young Women’s Breast Cancer Program
Specialties: Division of Medical Oncology, Department of Oncology
• Doctor of Medicine, Medical University of South Carolina
• Fellowship, Columbia University Medical Center
• Residency, Mount Sinai Medical Center
• Associate Program Director, Hematology/Medical Oncology Fellowship, AH Levine Cancer
• Director, Resident and Student Education, Atrium Health Levine Cancer
Maria Rozhin, MEd, BS
Program Manager, Department of Supportive Oncology
Adolescent & Young Adult Program: Disease-Specific
Program Coordinator, Sandra Levine Young Women’s Breast Cancer Program
• Master of Education, University of Colorado Denver
• Bachelor of Science, The Ohio State University
• Joined Atrium Health in 2013
Courtney Schepel, BS, BA, CCRP
Project Manager – Oncology Research Consultant
Non-Interventional & Retrospective Research
Research Coordinator, Sandra Levine Young Women’s Breast Cancer Program
• Bachelor of Science, The University of North Carolina at Chapel Hill
• Joined Atrium Health in 2020
Sandra Levine Young Women's Breast Cancer Program – Program Highlights
• Targeted Support and Education:
Provides tailored resources and education on breast cancer topics relevant to women 45 and under. The program embraces a patientcentered, holistic approach—addressing the mind, body, and spirit—to support young women through diagnosis, treatment, and recovery. Educational content includes nutrition, coping with stress, managing the short- and long-term effects of treatment, heart health, and sexual health all designed to empower patients with knowledge and tools for whole-person wellness.
• Peer Connection:
Facilitates opportunities for young women to connect with others who have been impacted by breast cancer, fostering a sense of community, shared understanding, and mutual support.
• Research and Outcomes:
Maintains a dedicated research database for data collection and analysis aimed at improving outcomes and enhancing care for this demographic. The program actively collaborates with clinicians and researchers to explore key questions and emerging topics in young women’s breast cancer. It also advocates for and enables the meaningful inclusion of young women in breast cancer research, ensuring their unique needs and experiences are represented in scientific studies. To date, the program has contributed to13 published research works.
• Clinical Trial Access:
Promotes awareness of and access to clinical trials that are relevant and appropriate for younger patients, helping to advance research and expand treatment options.
• Outreach and Awareness:
Features a dedicated landing page at www.AtriumHealth.org/YWBP and maintains an active social media presence on X (formerly Twitter) at @LCI_YWBP.
• Professional Education:
Sponsors an annual symposium for physicians and healthcare staff, offering continuing medical education (CME) credits to support professional development and best practices in young women’s breast cancer care. Save the date, October 3: Sandra Levine Young Women's Breast Cancer Symposium 2025.
Sandra Levine Young Women's Breast Cancer Program
• Program Pillars (Slide 7)
o Clinical Care (Slide 8)
o Support, Education & Community (Slide 9)
▪ Online Support Group for Young Women (Slide 10)
▪ New Patient Folder, Resources at LCI and Atrium Health, Resources Outside of Atrium Health (Slides 11 –12)
▪ Patient Education (Slides 13 – 14)
▪ Patient/Provider Fashion Show Fundraiser: Beyond the Pink Runway 2024 (Slides 15 – 23)
▪ Provider & Staff Education: Sandra Levine Young Women's Breast Cancer Symposium 2024 (Slides 24 – 26)
o Research and Clinical Trials
▪ YWBP Enrollment totals since 2018 (Slide 27)
▪ Research: Published since 2022 (Slides 28 – 30)
▪ Research In Progress (Slides 31 –32)
▪ Clinical Trials Enrolling Patients (Slides 33 – 34)
▪ Clinical Trials in Development (Slide 35)
▪ Research Presentations Made Nationally (Slides 36 – 47)
• YWBP in the News (Slides 48 - 51)
• Ongoing and Future Program Development
o Local (Slide 52 )
o Regional (Slide 53)
o National (Slide 54)
Program Pillars – A Multidisciplinary and Coordinated Approach to Care Clinical
Multidisciplinary Cancer Team And Person-Centered Care
Atrium Health Levine Cancer (AHLC) provides patients with world-class care and a multidisciplinary team of providers. Patients benefit from the expertise of multiple specialists, across a variety of disciplines – all in one place.
Breast Nurse Navigator
Breast Cancer Care Team
• Weekly Breast Tumor Board
• Weekly Breast Team Meeting
• Breast Surgical Oncology Fellowship
Surgical Oncology
• Biopsies, Lumpectomy
• Mastectomy, Axillary Surgery
Medical Oncology
• Chemotherapy
• Endocrine (Hormone) Therapy
• Targeted Therapy
High Risk Genetics
• Counseling, Screening, and Testing
Radiation Oncology
• Radiation Therapy
Charlotte Radiology
• Serving over 100,000 women/year
• Screening and Diagnostic (MXR, Ultrasounds, Breast MRI)
• Stereotactic Biopsy, Pre-Op Needle vs Seed Localization
Dedicated Pathology
Reconstructive Surgery
• Benign Breast Care
Fertility and Reproductive Services
Center of Supportive Oncology
For the management of physical and psychological symptoms and side effects, across the continuum of the cancer experience – from diagnosis through treatment to post-treatment care. AHLC programs and services are offered to enhance cancer rehabilitation, well-being, secondary cancer prevention, survivorship, and more.
• Cancer rehabilitative services and Lymphedema Clinic
• Integrative Oncology Clinic
• Oncology nutrition & wellness Programs
• Psycho-oncology: psychiatry, psychology, clinical social work, support groups
• Neuropsychology Clinic
• Cardio-Oncology Clinic
• Cancer Survivorship Medical Clinic
• Oncology Palliative Medicine
Clinical Care
Program Elements
Support
• Online patient support group for young women with breast cancer, facilitated by a licensed clinical social worker
• New Patient materials in English and Spanish
• Monthly e-newsletter as a reminder of upcoming support group and events
Education
Patient education
• The Mind-Body-Spirit Connection, an online breast cancer patient education series Medical education for providers
• Young Women's Breast Cancer Symposium Annual YWBPsponsored event with continuing medical education (CME) credit for physicians, PAs, NPs, RNs, PharmDs and LCSWs.
Community
YWBP is online
• Promotes support group and educational events on X: @LCI_YWBP
• www.AtriumHealth.org/YWBP
YWBP’s patient advisory group
Engagement for patients and teammates
• Project PINK events (Pink Pint Night, Pink Knights)
• Komen Charlotte's MORE THAN PINK Walk for breast clinic staff and patients
• NFL’s Crucial Catch Intercept Cancer: YWBP patients serve as honorary coin-toss captains for Panther's game.
Online Support Group for Patients
Building a community of support
• Young women aged 18–45 receiving breast cancer treatment at any Atrium Health Levine Cancer or Wake Forest Baptist location are invited to join the online support group
• Facilitated by the Department of Supportive Oncology's team of licensed clinical social workers (Dulce Mange and Laura Khan)
• Occurs the second Friday of every month at noon.
Nurse Navigators use the YWBP folder for new patient materials; then add additional materials based on each patient’s situation. Connecting patients to resources
Currently being updated for 2025
Connecting patients to resources
YWBP new patient materials are also available in Spanish.
Patient Education
The Mind-Body-Spirit Connection monthly online speaker series
• HER2 Positive Breast Cancer, by Neelam Desai, MD, breast medical oncologist, Atrium Health Levine Cancer (May 1, 2025)
• Update on Triple-Negative Breast Cancer, by Antoinette Tan, MD, breast medical oncologist, Atrium Health Levine Cancer (March 27, 2025)
• Breast Cancer & Heart Health, by Amar Parikh, MD, onco-cardiologist, Atrium Health Sanger Heart & Vascular Institute (February 2025)
• Self-Compassion Following a Breast Cancer Diagnosis: Implications for Parenting, Body Image, and Sexuality, by Kaitlin Forestieri, PsyD, Psychologist, Atrium Health Levine Cancer (January 2025)
• Ask-the-Experts: Q&A on Breast Cancer (Multidisciplinary Panel): Drs: Gremillion, Voci, Desai, Robinson, Hill, Fasola and Claire Arnold (Oct 2024)
• Managing Breast Cancer Medical Bills and Expenses, presentation by Wendy Jo Turan, Sharon Hurff, Dulce Mange, Angela Hamilton (Sept 2024)
• Stay Cool During Chemo, Minimizing hair loss, FAQs on Cooling Cap Systems, presentation by DIGNICAP (August 2024)
• Writing for Well-Being with Breast Cancer, Online interactive workshop with Amanda White, MDiv, MTh (July 2024)
• HER2 Positive Breast Cancer, presentation by Neelam Desai, MD, breast medical oncologist (June 2024)
• Skin Care During Cancer Treatment, presentation by Shahab Babakoohi, MD, oncologic dermatology (May 2024)
• Triple-Negative Breast Cancer Update, by Antoinette Tan, MD, MHS, medical oncologist and Angela Hamilton, oncology nurse navigator (March 2024)
• Heart Health & Breast Cancer, by Amar Parikh, MD, Sanger Heart & Vascular Institute Adult Cardiology, Cardio-Oncology Clinic at AHLC (Feb 2024)
• Managing Menopausal Symptoms on Endocrine Therapy, by Arielle Heeke, MD (Jan 2024)
Patient/Provider Fashion Show Fundraiser: Beyond the Pink Runway – March 2, 2024
Over $200,000 Raised in 2024 for the Sandra Levine Breast Cancer Fund
Learning Opportunities for Patients and Staff
Learning Opportunities for Patients and Staff
Sandra Levine Young Women's Breast Cancer Symposium
Keynote Speakers
• Upcoming: October 3, 2025, Carey K. Anders, M.D., Duke Cancer Institute
• October 4, 2024, Marissa Howard-McNatt, M.D., Atrium Health Wake Forest Baptist Comprehensive Cancer Center
• October 6, 2023, Wendy A. Woodward, M.D., Ph.D., The University of Texas MD Anderson Cancer Center
• October 7, 2022, Kevin Kalinsky, M.D., M.S., Emory University School of Medicine, Winship Cancer Institute of Emory University, Glenn Family Breast Center
• October 1, 2021, Virginia Borges, M.D., CU School of Medicine: University of Colorado Cancer CenterAnschutz Medical Campus, Diane O’Connor Thompson Breast Cancer
• October 2, 2020, Gretchen Ahrendt, M.D., UCHealth-University of Colorado Hospital, Diane O’Connor Thompson Breast Cancer
Learning Opportunities for Patients and Staff
Save the Date: Friday, October 3, 2025
Fifth annual regional symposium through South Piedmont AHEC, with continuing medical credits.
Hosted and sponsored by Sandra Levine YWBP.
Learning Opportunities for Patients and Staff
YWBP Enrollment Totals
To date, approximately 900 patients have been impacted by the Sandra Levine Young Women's Program.
The YWBP database contains approximately 1,5000 cases from 2010 to 2025, which are used for ongoing analysis and research.
Published Works November 2022 - Present
1. Warren, E. Y., Jr., Hecksher, A., Schepel, C. R., Trufan, S. J., Greiner, R. S., Yaguda, S., Bailey-Dorton, C., Fisher, J. G., White, R. L., Jr., & Hadzikadic-Gusic, L. (2022). Integrative oncology therapy in young women with breast cancer. Oncology (Williston Park, N.Y.), 36(11), 658–663. https://doi.org/10.46883/2022.25920978. https://www.cancernetwork.com/view/journal-integrative-oncology-in-young-women-with-breast-cancer and https://doi.org/10.46883/2022.25920978.
2. Hudson, L., Reese, E., Hecksher, A., Schepel, C. R., Trufan, S. J., Cruz, A., Verbyla, A., White, R. L., Jr., & HadzikadicGusic, L. (2022). Single surgeon versus co-surgeon bilateral mastectomy: Comparing outcomes and costs based on health economic modeling from the perspective of the hospital system. Journal of Surgical Oncology. 126(2), 239–246. https://doi.org/10.1002/jso.26891 and https://doi.org/10.1002/jso.27019
3. Graham, E., Bennett, K. J., Boselli, D., Hecksher, A., White, R.L., Jr., Hadzikadic-Gusic, L. Young age as an independent predictor of chemotherapy recommendation and treatment in breast cancer (2023). Young Age as a Predictor of Chemotherapy Recommendation and Treatment in Breast Cancer: A National Cancer Database Study. Journal of Surgical Research, 296(4), 155-164. https://doi.org/10.1016/j.jss.2023.12.023 and Young Age as a Predictor of Chemotherapy Recommendation and Treatment in Breast Cancer: A National Cancer Database Study - Journal of Surgical Research
4. Fasola C.E., Graham E., Sha W., Schepel C.R., Trufan S.J., Hecksher A., White R.L. Jr., Hadzikadic-Gusic L. Assessment of Postmastectomy Radiation Therapy Receipt by Age and Association With Outcomes in Women With Breast Cancer. Clinical Breast Cancer. 2024 Feb 28:S1526-8209(24)00057-0. doi: 10.1016/j.clbc.2024.02.021. Epub ahead of print. PMID: 38492996.
5. Fasola C.E., Sharp H.J., Clavin N.W., Sha W., Schepel C.R., Trufan S.J., Graham E., Hecksher A., White R.L. Jr., HadzikadicGusic L. Effect of Delayed Oncoplastic Reduction Mammoplasty on Radiation Treatment Delay Following BreastConserving Surgery for Breast Cancer. Annals of Surgical Oncology. 2023 Dec;30(13):8362-8370. doi: 10.1245/s10434-023-14177-w. Epub 2023 Aug 21. PMID: 37605081.
Published Works November 2022 - Present, continued - - -
6. Fasola, C. E., & Hadzikadic-Gusic, L. (2023). ASO Author Reflections: Oncoplastic Reduction Mammoplasty Appears Safe for Patients with Early-Stage Breast Cancer Albeit with Delays > 8 Weeks to Adjuvant Radiation. Annals of Surgical Oncology. 2023 Sept 13; 30, 8460–8461 (2023). https://doi.org/10.1245/s10434-023-14260-2
7. Elder E., Fasola C., Clavin N., Hecksher A., Trufan S., Schepel C., Donahue E., Warren Y., White R.L. Jr., Hadzikadic-Gusic L. Anatomic Location of Tissue Expander Placement Is Not Associated With Delay in Adjuvant Therapy in Women With Breast Cancer. Annals of Plastic Surgery. 2023 Dec 1;91(6):679-685 https://doi: 10.1097/SAP.0000000000003694. Epub 2023 Sep 12. PMID: 37856209.
8. Costa L, Kumar R, Villarreal-Garzac C, Sinha S, Saini S, Semwal J, Saxsena V, Zamre V, Chintamani C, Ray M, Shimizu C, Hadzikadic-Gusic L, Toi M, Lipton A. Diagnostic Delays in Breast Cancer Among Young Women: An Emphasis on Healthcare Providers. The Breast. 2024 February. Diagnostic delays in breast cancer among young women: An emphasis on healthcare providers - ScienceDirect
9. Hadzikadic-Gusic, L.; Bilz, J.; Boselli, D.; Wallander, M.; Danile, L.; Sobel, A.; Livasy, C.; Sarantou, T.; Voci, A.; Sarma, D.; Forster, M.; Scott, S.; Mitchelides, W.; Shah, S.; Begic, X.; Flynn, C.†; Verbyla, A.; Cruz, A.; Sejdic, A.; Schepel, C.; White, R. L.. A Randomized, Single-Center, Superiority Trial of Radioactive Seed Localization versus Wire Localization for Malignant Breast Disease. Annals of Surgery. 2024 May 24:10.1097/SLA.0000000000006356, DOI: 10.1097/SLA.0000000000006356. Annals of Surgery (lww.com)
10. Heeke, A. L., Sha, W., Feldman, R., Fisher, J. G., Hadzikadic-Gusic, L., Symanowski, J. T., White, R. L., Jr., & Tan, A. R. The genomic landscape of breast cancer in young and older women. Clinical Breast Cancer Journal. 2024 Aug 20; 1-9. The Genomic Landscape of Breast Cancer in Young and Older Women - ScienceDirect
Published Works November 2022 - Present, continued
11. Aktas A, Greiner RS, Hadzikadic-Gusic L, Boselli D, Walsh D. “The Muscle Metric: Re-evaluating Prognostic Markers in Metastatic Breast Cancer.” BMJ Supportive & Palliative Care. 2025 Jan 23:spcare-2024-005328. doi:10.1136/spcare2024-005328. Epub ahead of print. PMID: 39848707.
12. Aktas A, Greiner RS, Flores M, Boselli D, Stone T, Wang E, Hadzikadic-Gusic L, Wallander ML, Hecksher A, BaileyDorton C, Walsh D. “Association of skeletal muscle mass and muscle quality at diagnosis with survival in young women with breast cancer: Retrospective observational study.” Clinical Breast Cancer. 2025 Apr; 25(3):223-232. doi: 10.1016/j.clbc.2024.10.014. Epub 2024 Oct 28. PMID: 39578152.
13. Matusz-Fisher, A., Chen, A., Donahue, E., Schepel, C., Wallander, M., Livasy, C., White, R., Tan, A., Hadzikadic-Gusic, L. Histologic pattern and outcomes in high-grade metaplastic breast cancer compared to triple-negative ductal breast cancer: a single institution study. Clinical Breast Cancer Journal. In press, May 2025, ISSN 1526-8209.
