PBCC Frontline Edition III, 2020

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Edition III, 2020

IT'S LAW! Governor Wolf Signs PBCC Bill for Breast MRI, Ultrasound Coverage SENATE BILL 595



overnor Tom Wolf signed the PA Breast Cancer Coalition's Senate Bill 595 (Act 52), requiring insurers to cover breast MRIs and ultrasounds for women with very dense breasts and other high-risk factors. The legislation, sponsored by Sen. Bob Mensch (R-24), covers women with extremely dense breasts, women with high-risk factors like a personal history, family history or genetic predisposition to breast cancer, and women with heterogeneously dense breasts with one other high-risk factor. Thank you, Governor Wolf! Thank you, Sen. Bob Mensch! Thanks to all of YOU who shared stories, called, emailed, visited and tweeted to make this happen! Your action will save lives! Learn more >> pbcc.me/sb595law

PBCC Virtual T Conference!


xperience the PA Breast Cancer Coalition Conference like never before! Join us virtually Friday, October 16 as we honor distinguished awardees including world-renowned radiologist and researcher Dr. Mitchell Schnall of Penn Medicine, breast cancer survivor and advocate Honi Gruenberg and breast cancer survivor and NBC News Chief Foreign Affairs Correspondent Andrea Mitchell. Hear from breast cancer experts on topics including: metastatic breast cancer, cancer in the time of coronavirus, pilates, breast cancer and racial disparities, humor and healing, nutrition and more! Earn up to 10 Continuing Education units! Don't miss it!

Register today! >> pbcc.me/conference

more info inside!




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Up to 10 Continuing Education units available!

Honi Gruenberg

Tell us about the moment you learned you had breast cancer. HONI: I had ignored my health for several years. A friend asked if she made an appointment would I go to her doctor. I agreed and in the meantime canceled the appointment because I was traveling throughout the country doing sales presentations. As I traveled throughout the country, I found a lump which I swear was getting bigger in every city I visited. Once I visited the doctor, he could immediately get me into get a mammogram and see a surgeon in the same day. Not a good sign! The surgeon explained that he could do a "surgical biopsy” and I could get the results right away or wait for the results with the non-surgical biopsy. I chose the “surgical biopsy” which indeed said that I had breast cancer. The nurse mentioned that young women don’t do as well as older women. I was almost 45.

How did you find support? HONI: I had reconstructive surgery in February, which I

believe was too soon, after treatment ended. I was still feeling down and joined a support group in February 1999. I felt at home. I met so many people who became my best friends and we could talk about things that our family just could not understand or didn’t want to hear or that we didn’t want to share. After years in the software business, I was starting to use my social work degree and became the facilitator of the support group. I started lecturing on breast cancer, became involved with the American Cancer Society, joined Rotary and then in October 1999 attended

2020 Pink Ribbon Awardee

my first PA Breast Cancer Coalition Conference! Such positive energy! The ladies in the support group were ready to do our first 67 Women, 67 Counties: Facing Breast Cancer in Pennsylvania Photo Exhibit. Working with the women of the PBCC was amazing. They were dedicated, fun, warm and caring. They understood the bond of being a survivor or the loved one a survivor. They really were like family to me.

You were a tireless advocate for Senate Bill 595 (now law!) for breast MRI and ultrasound insurance coverage. Why were you so passionate about the legislation? HONI: I felt empowered in taking charge of my health. My doctors were wonderful. They offered emotional and physical support. Being a survivor, you spend a great deal of unproductive time, waiting for the other shoe to drop. Those yearly mammograms are reassuring but often for women with dense breasts or a strong history of breast cancer, the mammograms are not enough. When Pat asked me to reach out to my senator, I was more than happy to do so. Senator Scavello was very receptive to listening to my story and I found it easy to encourage (and push a little) to get him to support and ultimately co-sponsor SB595. Like many of us, the senator had friends and family who had breast cancer. We shared photos of our granddaughters and spoke of what living with breast cancer is like and what we could do for our daughters and granddaughters. When SB595 passed unanimously in the Senate and all the senators turned and clapped at us with the PBCC in the galley, I was in tears. We can unite to fight this disease for our daughters and granddaughters! Read more >> pbcc.me/HonisStory

What does the PBCC's mission mean to you? When I started this journey, my daughter was 14. I wanted to see her graduate high school... graduate college... grad school... get married and have kids. She’s done all that and more. I want my daughter and granddaughters to experience the rich life that I have been privileged with. I do want to find a cure, so they won’t have to.





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2020 Shining Light Awardee:

Thank you, Penn State Health for your contributions to the hands-on education and empowerment of our PBCC C.A.R.E.S. (Community, Advocacy, Research and Education for Students) budding scientists and medical professionals. The future is bright!

UPCOMING EVENTS 6th Annual Toasting a Cure at the Vineyard Tickets valid through December 27, 2020 Silent Auction October 8-18, 2020 Tickets include 4 wine tastings, a FREE wine glass and special discounts! Bucks Valley Winery & Vineyards pbcc.me/2020Toasting

Turn the Capitol Fountain Pink Thursday, October 1, 2020 State Capitol East Wing Fountain Harrisburg, PA pbcc.me/pinkfountain

PA Breast Cancer Coalition Conference Friday, October 16, 2020 **All Virtual Event** pbcc.me/conference

Sutter Home Text-2-Give Fundraiser Monday, Oct. 5 - Nov. 5, 2020 Text ‘HOPEPA’ to 89800 and Sutter Home will donate $5 to the PBCC!

Host a virtual fundraiser or future event in your community! Visit pbcc.me/hostevent and get started!

MEDICAL NEWS Potamkin Prize Winner Shares Results of Landmark MRI Trial Mitchell D. Schnall, MD, PhD

Chairman, Department of Radiology Perelman School of Medicine at the University of Pennsylvania

Over the last decade there has been grassroots advocacy to increase the public awareness of the challenges that women with radiographically dense breasts face with traditional screening and to empower women to seek supplemental screening. Although the traditional approach to supplemental screening had been whole breast ultrasound, there have been multiple studies that have shown that MRI detects significantly more breast cancer than ultrasound in women with dense breasts. A prior ECOG-ACRIN study (ACRIN 6666) showed supplemental MRI detected more than twice the number of cancer than supplemental ultrasound. The high cost of MRI has traditionally relegated it to use in women at extremely high risk. Christiana Kuhl, a radiologist in Germany, challenged this traditional dogma by introducing a short MRI examination (abbreviated breast MRI or ABMRI) in an effort to reduce cost and expand its use into a broader population of women. Her early results were promising.

Have a

On that basis of these early results, the cancer cooperative group, ECOG-ACRIN, teamed up with Dr. Kuhl to perform a study (EA1141) comparing an abbreviated breast MRI exam with tomosynthesis, also known as 3D mammography, in the detection of cancer in women with radiographically dense breasts. We chose to compare to 3D mammography as it is more sensitive than traditional mammography and is quickly becoming the standard of care in the US.



t is well known that traditional mammogram screening is less sensitive in detecting breast cancer in women with radiographically dense breasts. It is also believed that the increased density is an independent risk factor that increases a women’s risk of breast cancer.


Abbreviated MRI is an effective screening test for women with radiographically dense breasts, resulting in almost two and half times more cancers detected.

The study included 1444 women across the North America and Germany with heterogeneously dense or extremely dense breast who underwent tomosynthesis and ABMRI screening in parallel, with the order of the examinations

question for Dr. Schnall?

randomized to prevent bias related to knowledge of the other exam. The study population included mostly women with heterogeneously dense breast at a 5 to 1 ratio to women with extremely dense breasts. The study was designed to detect differences in invasive cancer detection, wanting to minimize the impact of overdiagnosis on the results. Abbreviated MRI detected 17 invasive cancers compared to 7 for 3D mammography. All 7 of the cancers detected on 3D mammography were detected by ABMRI. However, there was a downside in that ABMRI resulted in 107 biopsies compared to 29 for 3D mammography. Even with increased cancer detection, the percentage of positive biopsies was approximately 31 percent for 3D mammography and 20 percent for ABMRI. The ECOG-ACRIN trial offers well controlled multicenter data that clearly shows ABMRI is an effective screening test for women with radiographically dense breasts, resulting in almost 2 and half times more cancers detected at the cost of almost 4 times the number of biopsies. There are many unanswered questions remaining including whether screening intervals may be extended with ABMRI due to the high sensitivity and what the impact of the additional cancers detected is on cancer mortality.

Send it to us and we’ll ask him during the Conference Opening Session! >> Email question to Info@PABreastCancer.org


Virtual Conference Friday, October 16


The Emerging Role and Value of Abbreviated MRI: Screening Options for Women with Dense Breasts Mitchell Schnall, MD, PhD, Chairman, Department of Radiology, Perelman School of Medicine, University of Pennsylvania

Cancer Care in the Time of COVID-19 Lawrence Shulman, MD, Deputy Director for Clinical Services, Abramson Cancer Center at the University of Pennsylvania

Navigating the Marketplace: Health Insurance in PA Joanne Grossi, MiPP, Pennsylvania State President, AARP & Executive Vice President, PA Breast Cancer Coalition

Exercise and Breast Cancer: What, Why and How Kathryn Schmitz, PhD, MPH, Professor, Dept. of Public Health Sciences Division of Health Services & Behavioral Research and Professor, Dept. of Physical Medicine & Rehabilitation, Penn State Health

Life, Redefined: Living with Metastatic Breast Cancer Kristen Whitaker, MD, MS, Clinical Genetics, Fox Chase Cancer Center

Breast Cancer Screenings: 3D Mammography, MRI, Ultrasound? Which is Best for You? Wendie Berg, MD, PhD, FACR, Professor of Radiology, Magee-Womens Hospital at the University of Pittsburgh Medical Center Rebuilding the Foundation: Pilates for Breast Cancer Patients & Survivors Allison Zang, Owner & Instructor, Absolute Pilates Nutrition and Breast Cancer: Tips for Maintaining a Healthy Diet Beth Stark, RDN, LDN & Emily Bumgarner, RDN, LDN, Registered Dietitian Nutritionists, Weis Markets The Value of Humor when Confronted with Breast Cancer Lillie Shockney, RN, BS, MAS, Patient Advocate & Speaker

Prosthesis Options: Getting Your Symmetry Back after Breast Surgery Terry Scott, Owner, Perfect Match Boutique Triple-Negative Breast Cancer and Racial Disparities Edith P. Mitchell, MD, MACP, FCPP, Clinical Professor of Medicine and Medical Oncology, Dept. of Medical Oncology, Director, Center to Eliminate Cancer Disparities, Associate Director, Diversity Affairs Sidney Kimmel Cancer Center at Jefferson, 116th President National Medical Association Plastic and Reconstructive Surgery: Meeting Patients’ Needs Michele Manahan, MD, Department Director of Patient Safety, Department of Plastic and Reconstructive Surgery, Johns Hopkins Medicine Physical Therapy After Breast Cancer: Common Problems, Simple Solutions Linda Miller, PT, DPT, CLT, NovaCare Rehabilitation

Meet the Awardees

GRUENBERG PINK RIBBON AWARDEE Breast Cancer Survivor Legislative Advocate PBCC County Captain


NBC News Chief Foreign Affairs Correspondent Host, MSNBC's "Andrea Mitchell Reports" Breast Cancer Survivor

SCHNALL POTAMKIN PRIZE WINNER Chairman, Department of Radiology Perelman School of Medicine at the University of Pennsylvania

Register today! >> pbcc.me/conference

2397 Quentin Road, Suite B, Lebanon, PA 17042 800-377-8828 PABreastCancer.org

From the bottom of our hearts,

Thank you.

The PBCC is proud to offer FREE Conference registration and up to 10 continuing education units to frontline workers and essential employees. We salute you. We appreciate you. We're all in this together.


Andrea Mitchell Breast Cancer Survivor, NBC News Chief Foreign Aairs Correspondent

Friday, October 16 R E G I S T E R N O W for $ 2 5 ! pbcc.me/conference

Presented by: Anne M. & Phillip H. Glatfelter III Family Foundation