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Breast Cancer Awareness 2021
FRIDAY, OCTOBER 1, 2021
Diversity, equity and inclusion in breast cancer outcomes Special to The Enterprise It is hard to believe that the diagnosis and treatment of breast cancer can vary so much based on where you live and your ethnic background. Whether it be the lack of access to medical care and treatment, inadequate screening or poor patient outcomes, breast cancer appears to be a more dire prognosis in underserved communities. This can be exacerbated by a lack of education, outreach and affordable care. Indeed, recent data suggests that “African American women are 42 percent more likely to die of breast cancer, as compared to their white counterparts. Higher death rates among African American women likely reflect a combination of factors, including differences in stage of cancer at diagnosis, comorbidities, obesity rates, tumor characteristics, as well as timely access to screening, diagnostic and treatment services.” In her Yolo County practice, Dr. Alicia Silva, a Thriving Pink board member, has seen that women of color have a higher incidence of breast cancers that can be more difficult to treat. Dr. Silva tells a
Mary Yin Liu, Thriving Pink executive director, presents a financial grant to Colleen Eberly. Courtesy photo
story of a young Latina mother who was diagnosed with triple negative cancer and discovered to have the BRCA 1 mutation. She was facing a difficult diagnosis and treatment plan, but was fortunate to be scheduled. We also know that breast cancer disproportionately affects transgender individuals, and poses several additional challenges for men at high risk for breast cancer. Since there are no formal protocols outlining surveillance for men, they are more likely to be diagnosed with advanced breast cancer than women. Additionally, inherited pathogenic (disease-causing) genetic variations in BRCA1 and BRCA2 show that these well-studied breast cancer susceptibility genes are rare (about 1 in 400) in the general population, but occur more often in certain ethnic or geographically isolated groups, such as those of Ashkenazi (Eastern European) Jewish descent (about 1 in 40). Recent studies also document increased frequency of BRCA mutations among black and Hispanic breast cancer patients. Dr. Silva has seen many of these
Courtesy photo
Thriving Pink board members Guillermina Campos Perez and Dr. Alicia Silva, provide translation services for Spanish speaking breast cancer survivors who are seeking support. issues right here at her practice at Sutter Hospital in Davis. “I have definitely seen women of color with increased obstacles to access, treatment and support,” Silva said. “Language plays a big
role in limiting outreach to nonEnglish speaking people.” She went on to talk about how decreased rates of screening mammograms lead to women presenting at more advanced stages of
breast cancer. “I have seen post menopausal women diagnosed with advanced breast cancer who have never had a screening mammogram,” Silva said. “Treatment can be limited by decreased financial resources and lack of insurance. Here in Yolo, I see agricultural, factory and domestic workers who can't afford to stop working to undergo treatment. There can be delays in treatment when underinsured patients have to wait for authorization for referrals to oncology, radiation oncology and genetic testing. Those who don’t have insurance have to wait to qualify for charity care or special programs in order to obtain care.” An increased awareness of these disparities in breast cancer treatment is necessary in order to improve access to high quality breast cancer care and treatment. The biggest changes need to be made at the macro level with sweeping changes to the health care system, which would allow for easier access to quality health care, increased diagnostic testing and screenings. — Thriving Pink Board of Directors
Thriving Pink recognized Lesli and John Chuck with a Community Service Award at the Pink Gala this past year. Other honorees include the National Charity League (Davis Chapter), and Patti Hadrava, a local survivor who leads the Stitches of Love workshop group for Thriving Pink. Courtesy photo
Breast Cancer Awareness 2021
FRIDAY, OCTOBER 1, 2021 3
Self-detection saves lives Special to The Enterprise Women often detect breast cancer themselves. “My sister did, twice,” said Raychel Kubby Adler, a committee member for Thriving Pink. “The first time, her doctor sent her home after telling her that the lump in her breast she found while in the shower was likely mastitis — a clogged milk duct caused by her nursing baby. Only it wasn’t. She quickly realized that she had to become her own best advocate for her health and ask the hard questions.” A study in the Journal of Women’s Health found that more than half of female survivors reported that they had detected their breast cancers on their own instead of by a mammogram exam. Indeed, “women often detected breast cancers themselves, either by self-examination (25 percent) or by accident (18 percent).” Brelle Albert, Thriving Pink past president, was in the shower when she felt something under her armpit. Not only was this Brelle’s second occurrence, but this lump had grown despite the fact that she had endured a double mastectomy and chemotherapy treatment eight years prior. Even though her genetic mutation put her at advanced risk for breast cancer, Brelle was no longer undergoing any breast surveillance protocol since she had no breast tissue after her mastectomy. Fortunately, she discovered the lump on her own and immediately made an appointment. For Denise Rose, a
“Using my eyes and taking action made a life-saving difference for me. For this I am so grateful.” Denise Rose Thriving Pink board member, it wasn’t even something she felt that set off alarms. For her, it was a dimpling on the side of her right breast that she noticed one January day as she dried off in the shower. Since she had recently had a clear mammogram, she didn’t think much about it at first. But after a few weeks, she called her primary doctor who also didn’t feel a lump. A more detailed mammogram was ordered that also came up clear. Then an ultrasound result indicated a subtle finding. After a needle biopsy, Rose was diagnosed with inflammatory, lobular breast cancer. This less-known kind of cancer only accounts for about 15 percent of the cases, and is more difficult to detect with a mammogram. “Using my eyes and taking action made a lifesaving difference for me. For this I am so grateful,” Rose said. Rose reminds us that a self-exam includes looking at your breasts, as well as touching them — and use a mirror for extra help. She also wants to assure other women, “Don’t let fear or other excuses keep you from
doing a self-exam in the first place. If you think you see or feel something, contact your primary care physician immediately. Don’t let anyone explain it away.” A monthly breast selfexam that you do for breast awareness helps you understand the normal look and feel of your breasts. Most self-exam findings are not signs of breast cancer. But, you should still call your healthcare provider if you notice any: ■ Change in the look, feel or size of the breast or nipple. ■ Dimpling or puckering of the skin ■ Lump or thick spot in the breast tissue ■ Nipple discharge or rash ■ Nipple or other area pulling inward ■ Pain in one spot that won’t go away ■ Swelling of one or both breasts ■ Warmth, redness or dark spots on the skin With each breast selfexam, you will become more familiar with your body. When you know what’s normal for you, you will be more aware when changes occur. If you or a loved one are diagnosed with breast cancer, and you are seeking peer support, please email info@thrivingpink.org and a local breast cancer survivor from Thriving Pink’s Mentoring Pink Program will contact you. There are many women (and men) who are diagnosed every year, and it is helpful to talk to someone who really understands, can listen and provide meaningful support. — Thriving Pink Board of Directors
Showing up matters A local Yolo County breast cancer survivor is embraced by two friends at a Thriving Pink event. Courtesy photo
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Breast Cancer Awareness 2021
FRIDAY,OCTOBER OCTOBER 1, 1, 2021 FRIDAY,
OCTOBER IS Helping those in Yolo County impacted by breast cancer to thrive with a compassionate network of resources and support.
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PINKtober calendar Special to The Enterprise The Pink Team at the local nonprofit Thriving Pink is volunteerdriven and committed to supporting those impacted by breast cancer throughout the year. Many of the women know firsthand how difficult this journey is because they have been diagnosed at one point in their lives as well. Thriving Pink’s mission is to help those in Yolo County impacted by breast cancer to thrive by providing a compassionate network of support and resources in partnership with the community. It is the only nonprofit in Yolo County which focuses on serving and supporting local breast cancer survivors. In addition to annual financial grants to help local breast cancer survivors with immediate and direct needs, such as medical care, Thriving Pink also provides wellness and educational workshops, peer mentorship, and professionally-facilitated support groups at no cost to the community. In October, the Thriving Pink Team invites the community to embrace this worthy cause and mission through PINKtober. Since its inception, Thriving Pink has brought attention to National Breast Cancer Awareness Month. As a part of this campaign, volunteers reach out to the local business community to seek their support and partnership. And, a special thank you to the following local
Mara Lindsay, a local breast cancer survivor, helps to lead monthly walks for Thriving Pink. The next walk will be Saturday, Oct. 23, at 8:30 a.m. at the Shovel Gateway entrance to the UC Davis Arboretum. Courtesy photo
FRIDAY, OCTOBER 1, 2021
PINKtober calendar Please join us to support our community ■ Fri. 10/1, 4 to 7 p.m. — Esparto Farmers Market ■ Fri. 10/1 — The Art of Color Workshop, The Wardrobe ■ Sat. 10/2, 8 a.m. to 1 p.m.— Davis Farmers Market ■ Tue. 10/5, 6:30 p.m. — Davis City Council Recognition (virtual) ■ Mon. 10/11, 7 to 8:30 p.m. — Pink Speaker Series (Boundaries for Self Care), Dr. Petruzzelli ■ Tue. 10/12, 3:30 p.m. — Davis High School Field Hockey team goes PINK! Ron Brown Stadium ■ Sat.10/23, 8:30 a.m. — Morning Walk Davis Arboretum (Shovel Gateway entrance) ■ Mon. 10/25, 7 to 8:30 p.m. — Peer to Peer Workshop (for local survivors) ■ Wed. 10/27, 3 to 6 p.m. — Davis Farmers Market ■ Sat. 10/30 — SwimAmerica Davis (Halloween Special Event) ■ Sat. 10/30, 9 a.m. to noon — Woodland Farmers Market businesses for sending in their support early to participate in PINKtober: Pomegranate Hair Salon, Renewable Jewels, SwimAmerica Davis, Madi Ditler Fitness, Cedarwood Financial Services, Balance Point Pilates, Brooks Painting, Davis Food Co-op, Davis
Enterprise, Woodland McDonald’s, KLJ Studios, Visse P. Storm, DDS, Inc, Vickers Automotive, The Wardrobe, Tandem Properties, Inc, Zia’s Delicatessen, Matthew L. Molitor, DDS, Laura Nathan Design, Rainbow Auto Sales, Yolo County Library, and many others. We are very grateful for your partnership and generous support! To learn more, attend a free workshop or support Thriving Pink, please email info@thriving pink.org or visit https://www. thrivingpink.org/give/. — Thriving Pink Board of Directors
RIGHT, Heather Caswell, owner of The Wardrobe, is supporting Thriving Pink’s PINKtober campaign by donating proceeds from an Art of Color class on Friday, Oct. 1. Courtesy photo
Courtesy photo
Sandy Walsh established the Pink Speaker Series led by Thriving Pink with a focus on breast cancer research and healthcare. Dozens of oncologists, nurses and medical professionals are guest speakers throughout the year.
Breast Cancer Awareness 2021
FRIDAY, OCTOBER 1, 2021 7
Are there different types of breast cancer? Special to The Enterprise Millions of women are diagnosed with breast cancer every year. According to the Breast Cancer Research Foundation, more than 2.3 million women across the globe were diagnosed with breast cancer in 2020. The BCRF also notes that breast cancer is the most frequently diagnosed cancer among women in 140 of 184 countries worldwide. Breast cancer statistics can give the impression that each of the millions of women diagnosed with the disease is fighting the same battle, but breast cancer is something of an umbrella term. In fact, there are various types of breast cancer, including ductal carcinoma in situ, invasive ductal carcinoma, inflammatory breast cancer, and metastatic breast cancer. Learning about each type of breast cancer can help women and their families gain a greater understanding of this disease.
Ductal carcinoma in situ (DCIS) DCIS is a non-invasive cancer that is diagnosed when abnormal cells have been found in the lining of the breast milk duct. The National Breast Cancer Foundation notes that DCIS is a highly treatable cancer. That’s because it hasn’t spread beyond the milk duct into any surrounding breast tissue. The
American Cancer Society notes that roughly 20 percent of new breast cancer cases are instances of DCIS.
Invasive ductal carcinoma (IDC) IDC is the most common type of breast cancer. The NBCF reports that between 70 and 80 percent of all breast cancer diagnoses are instances of IDC. An IDC diagnosis means that cancer began growing in the milk ducts but has since spread into other parts of the breast tissue. This is why IDC is characterized as “invasive.” Though IDC can affect people, including men, of any age, the ACS notes that the majority of IDC cases are in women age 55 and older.
Inflammatory breast cancer (IBC) The NBCF describes IBC as an “aggressive and fast growing breast cancer.” Breastcancer.org notes that IBC is rare, as data from the ACS indicates that only about 1 percent of all breast cancers in the United States are inflammatory breast cancers. Many breast cancers begin with the formation of a lump, but Breastcancer.org reports that IBC usually begins with reddening and swelling of the breast, and symptoms can worsen considerably within days or even hours. That underscores the
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Women diagnosed with breast cancer may each face a different battle, as there are many different types of the disease. importance of seeking prompt treatment should any symptoms present themselves.
Metastatic breast cancer Metastatic breast cancer may be referred to as stage IV breast cancer. When a woman is diagnosed with metastatic breast cancer, that
means the cancer has spread, or metastasized, into other parts of the body. The NBCF indicates that metastatic breast cancer usually spreads to the lungs, liver, bones, or brain. Symptoms of metastatic breast cancer vary depending on where the cancer has spread. For example, if the cancer has spread to the lungs, women may
experience a chronic cough or be unable to get a full breath. These are not the only types of breast cancer. A more extensive breakdown of the various types of breast cancer can be found at https://www.breastcancer.org/ symptoms/types. — Metro Creative
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Breast Cancer Awareness 2021
FRIDAY, OCTOBER 1, 2021
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