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BREAST CANCER

AWARENESS

KANE COUNTY

CHRONICLE

GET INFORMED

GET SCREENED

GET IN THE FIGHT


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| Breast Cancer Awareness

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B R E A S T CANCER

AWARENESS 2013

AR TI CLE I NDE X Cancer Screening Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pg 3 Four Stages of Breast Cancer Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . Pg 4 How You can Lower Your Risk of Breast Cancer . . . . . . . . . . . . . . . . . . . Pg 6 Elburn Mom Leverages Local Resources in Breast Cancer Fight . . . . . . Pg 8 Food prep tips for Breast Cancer Patients . . . . . . . . . . . . . . . . . . . . . . Pg 10 Educating Young Women about Breast Cancer . . . . . . . . . . . . . . . . . . . Pg 12 Cancer Recurrence: A Difficult Message to Receive . . . . . . . . . . . . . . Pg 13 Famous Breast Cancer Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pg 14 Celebrities undergo Preventive mastectomy . . . . . . . . . . . . . . . . . . . . Pg 15

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C AN CE R S CR E E N IN G G U I DEL I N E S

Women should begin self-examinations of their breasts starting in their 20s. This helps women familiarize themselves with their breasts early on, which makes it easier to detect any abnormalities, including lumps, later in life.

In addition to breast self-exams, women should receive clinical breast exams, or CBEs, every three years while in their 20s and 30s, and then an annual CBE starting at age 40. The ACS also recommends women begin receiving annual mammograms starting at age 40. Some doctors may also recommend women with a family history of breast cancer or other significant risk factors receive an MRI in addition to a mammogram. These additional tests are rarely necessary, but women at a higher risk of breast cancer should discuss their options with their physicians.

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FAMILY PRACTICE Fox Valley Medical Associates Mark Bernhard, MD Sergio Mercado, MD Geneva Family Practice Christopher Fahey, MD Robert Rivers, MD Niraj Shah, MD Primary Care West, S.C. Josephine Mante, MD Rush Copley Medical Group Brian Adrian, MD John Davine, MD Karin Gustafson, DO Kinjal Kadakia, MD Neha Kapil, MD Garrett Katula, DO Patricia Kinsella-Stallter, DO Jennifer Kurka, DO Gina Lesnik, DO

Gregory Milani, MD Mary Nguyen, MD Daniel Novella, MD Deepak Patel, MD Diana Rosenberg, MD Christopher Stallter, DO Radka Todorova-Angelova, MD Nicholas Tzanetakos, MD Kristen Ufferman, MD Rush Copley Family Medicine Center Natalie Choi, MD Nicole Costello, MD Brenda Fann, MD Maria Lasher, DO Sandwich Medical Clinic Martin Brauweiler, MD Sugar Grove Health Center Hem Aggarwal, MD

St. Charles Family Medical Center, S.C. James Curtis, MD Michael Rivera, MD William Scurlock, MD

Medical Care Associates, Inc. Alfia Z. Nomani, MD

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PEDIATRICS

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Associated Pediatrics of Fox Valley, S.C. Nadia Abu-Nijmeh, MD Luis Bolanos, MD Hinna Khan, MD Jennifer Kleinfeld, MD

Rush Copley Medical Group Eva Alessia, DO Paul Granoff, MD Nicole Keller, DO Vrinda Kumar, MD Kyla Wiafe-Ababio, MD Suburban Physicians, S.C. Asma Bano, MD St. Charles Family Medical Center, S.C. Darryl Link, MD

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Gaining access to an FVM member physician is easy! FVM physicians participate with the following health plans: Aetna U.S. Healthcare BCBSIL Humana Senior Care Partners (Selected Plans) (BlueAdvantage HMOSM and HMO Illinois) (Selected Plans) (Humana Gold Plus HMO and HealthSpring) An FVM Member Advocate is eager to assist you in connecting with one of our outstanding FVM physicians. Please scan using your Smartphone to be directed to our website. Please call us at 630.482.9758 or visit our website at FVMedicine.com.

Breast Cancer Awareness | BXe\:flekp:_ife`Zc\&B::_ife`Zc\%Zfd›Kl\j[Xp#FZkfY\i)0#)'(*

E

arly detection of cancer greatly increases a person’s odds of surviving this potentially deadly disease. Screening can range from relatively simple self-examinations to more complicated procedures conducted by physicians. The following are the widely accepted screening guidelines, courtesy of the American Cancer Society.

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| Breast Cancer Awareness

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Four Stages of

Breast Cancer Diagnosis

U

pon receiving a breast cancer diagnosis, many women instantly want to know their chances for survival. Such a reaction is understandable when receiving a diagnosis of any disease, and especially one as potentially deadly as breast cancer. A breast cancer patient’s prognosis is often linked to the stage of the disease. Stages are used to make breast cancer more understandable to patients and to give them a basis for comparison relative to other patients. As with many diseases, breast cancer is best treated the earlier it is detected, and the various stages of breast cancer can offer some insight into how far along the disease has progressed.

Stage 0: During stage

0, cancerous cells have not broken out of the part of the breast in which they started or invaded neighboring tissue. The earliest stage of breast cancer, stage 0 breast cancer is considered noninvasive and is often successfully treated.

Stage I: Stage I breast cancer is divided into two subcategories and is an invasive cancer in which cancer cells have begun to invade normal surrounding breast tissue. Stage IA describes invasive breast cancer in which tumors measure up to two centimeters and the cancer has not spread outside the breast or to the lymph nodes. Stage IB is also invasive but does not necessarily feature a tumor in the breast. In such instances where there is no tumor in the breast, small groups of cancer cells no larger than two millimeters are found in the lymph nodes. When tumors are found in the breast, the tumors are no bigger than two centimeters and there are small groups of cancer cells in the lymph nodes.

Stage II: Stage II

breast cancers are divided into two subcategories depending on whether or not there is a tumor in the breast. Stage IIA can refer to invasive breast cancers in which no tumor is found in the breast but cancer has been found in one to three lymph nodes under the arm or in the lymph nodes near the breast. When there is a tumor in the breast during stage IIA, the tumor may be two centimeters or smaller and have already spread to the lymph nodes under the arm or the tumor may be between two to five centimeters but it has not spread to the lymph nodes under the arms. Stage IIB breast cancer may refer to an invasive breast cancer in which the tumor is between two and five centimeters and small groups of cancer cells have been found in the lymph nodes. This stage

is also used to describe tumors between two and five centimeters that have spread to the lymph nodes under the arm or near the breastbone, or tumors larger than five centimeters that have not spread tothe lymph nodes.

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cancers are characterized by two categories, stage IIIA and stage IIIB. During stage IIIA, the tumor is between 2 and 5 centimeters in size and has spread to at least nine underarm lymph nodes. During stage IIIB, the tumor has spread beyond the breast to tissues nearby, such as the skin, chest wall, ribs, muscles, or lymph nodes in the chest wall.

Stage IV: Stage IV breast

cancers describe invasive breast cancer that has spread beyond the breast and nearby lymph nodes to other parts of the body. These organs can include the bones, brain, distant lymph nodes, lungs, liver, or skin. Stage IV breast cancers are often described as “advanced” and could be a recurrence of a previous breast cancer that has spread to other parts of the body.

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Stage III: Stage III breast


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How you can

LOWER

B

reast cancer is the second most common cancer among women, second only to lung cancer. One in eight women is expected to develop breast cancer in her lifetime, and a recent survey by the Society for Women’s Health Research found that 22 percent of women named breast cancer as the disease they fear most. The specter of breast cancer makes it no surprise that women are eager to seek various ways to reduce their risks of developing this potentially deadly disease. Though cancer treatments continue to evolve, there remains no cure for breast cancer or any other types of cancer. However, there are steps men and women can take to reduce their risks of developing breast cancer. In fact, the National Cancer Institute says avoiding breast cancer risk factors is the best path to prevention.

Keep a healthy weight.

Obesity increases the risk of breast cancer, particularly in postmenopausal women. Healthy eating and exercise can help women control their weight while reducing their risks of developing breast cancer and a number of other diseases. Scientists at The Mayo Clinic believe

your risk of

BREAST CANCER

there is a link between estrogen production in fatty breast tissue and breast cancer.

Get your exercise.

Exercising four or more hours a week can lower breast cancer risk. Exercise need not be heavy lifting at the gym. Any moderate physical activity, from cycling to walking, can be effective. Exercise decreases hormone levels in the body that can impact breast cancer risk. Some studies indicate simply walking briskly for one to three hours per week can reduce a woman’s breast cancer risk by 18%.

Low-fat diet. The Women’s

Intervention Nutrition Study from the National Cancer Institute found that the highest rate of breast cancer reduction was among a group of women who ate a low-fat diet.

Reduce alcohol consumption. Various

studies have indicated that women who drink alcoholic beverages may develop cancer at a higher rate. Women who consume two to five drinks daily have a greater risk of developing breast cancer than those who abstain from alcohol.

Regular exercise can help women lower their risk of developing breast cancer


are mixed reviews on hormone replacement therapy, or HRT, for postmenopausal women. There may be a link between long-term HRT and breast cancer, particularly when estrogen and progesterone are used in combination. Some doctors advise estrogen-only hormone therapy for women who have had a hysterectomy.

Use of SERMs and aromatase inhibitors.

Selective estrogen receptor modulators, or SERMs, are drugs that act like estrogen on some bodily tissues but block the effect of estrogen on other tissues. Aromatase inhibitors decrease the amount of estrogen made by the body. Women with a high risk of breast cancer may benefit from taking a SERM or aromatase inhibitor.

Geneva 1705 South St. Phone: 630.208.3980 Dr. Ronald Wolfson specializes in a variety of allergy and asthma testing procedures and treatments for both children and adults. It’s important to recognize when it’s time to refer to an allergist. At the Allergy & Asthma Clinics of Fox Valley, S.C. we strive to treat all conditions while incorporating the most current available treatment modalities and medications. Many people simply become accustomed to living with allergy symptoms, such as constant postnasal drip or a nagging cough. However, the right diagnosis and treatment can reduce symptoms and in some cases, treatment may help prevent more serious allergic conditions such as asthma or eczema. Many people suffer year-round with symptoms that come and go and may be misdiagnosed as a sinus infection or cold but actually they may be suffering from allergies.

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Increase fruit and vegetable consumption. Carotenoids are

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Weigh the risks of hormone replacement therapy. There

cancer-protective pigments found in a vast number of fruits and vegetables. Researchers at New York University found women who had higher blood carotenoid levels had a significantly smaller risk of breast cancer than women with lower levels.

Go sparingly on antibiotics. New

evidence suggests that the more often a woman takes antibiotics, the higher her breast cancer risk. A study of more than 10,000 women found that women who took antibiotics for the equivalent of about 25 prescriptions over an average of 17 years were twice as likely to develop breast cancer than women who never took the drugs.

Breastfeed your children. Lactation

can suppress ovulation and the body’s production of estrogen, which has been linked to higher levels of breast cancer. Breastfeeding may drop a woman’s breast cancer risk by 4 percent.

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Sandy Bressner - sbressner@shawmedia.com Jen O’Connor of Elburn, with her daughters (clockwise from bottom left) Ailsinn, 3, Teagan, 9, Kelsey, 10, and Keelin, 5, was diagnosed with breast cancer in May 2012 and has since leaned heavily on the resources at LivingWell Cancer Resource Center in Geneva.

By NICOLE WESKERNA – nweskerna@shawmedia.com

ELBURN – With her active lifestyle and no family history, Jennifer O’Connor said she never thought she’d hear the words, “You have breast cancer.” O’Connor, 40, of Elburn, said she was diagnosed in May 2012, shortly after running a half marathon. She had gone to her doctor for a routine check-up and was alerted to what may have been an abnormality in her breast. O’Connor, who is also a nurse, said she got a mammogram a week later, and a biopsy later confirmed that she had Stage 2 breast cancer.

She said the news was surprising, to say the least. “I was in shock – scared,” she said. “I always tell my friends, if it happened to me, you need to go [get checked]. You need to be your own advocate. No one else is going to do it for you.” O’Connor started six rounds of chemotherapy in July and finished four to five weeks of radiation in January. After a double mastectomy, she is now breast cancer-free.

She said going through the experience as a single mother of four was eased thanks to support from the LivingWell Resource Cancer Center in Geneva. Though she’s cancer-free, O’Connor said she and her daughters, Kelsey, 10; Teagan, 9; Keelin, 5; and Ailsinn, 3, all still participate in support programs offered there. “Truly, these people have become part of my family,” she said. “They’re so welcoming. Every person there has been amazing.”


“You can tell someone who was just newly diagnosed. To see that fear – many times they can’t even say they have cancer. They just choke on the words,” Vance said. “Then they get a tour of the building, and they talk with someone and they walk out with a smile knowing they’re not going to walk alone. They can actually take a breath and know they’re not alone.” Sandy Bressner - sbressner@shawmedia.com Jen O’Connor chats with daughters Kelsey, 10, (left) and Teagan, 9, in the kitchen of their Elburn home. O’Connor was diagnosed with breast cancer in May 2012 and has since leaned heavily on the resources at LivingWell Cancer Resource Center in Geneva.

Nancy Vance, executive director of LivingWell Cancer Resource Center, which is affiliated with Cadence Health, said about 300 people walk through their doors each week, and about 40 of those they serve have breast cancer. LivingWell has 60 support programs, and everything it offers is free of charge, Vance said. The center has a nutrition program, family support programs, and oncology physicians come in and talk about the latest medical advances.

Vance said LivingWell has a presence at 15 hospitals and one of the mostused resources is the Connect to Care program, which pairs licensed professional counselors with patients to provide psycho-social support and measure levels of distress. Vance said once distress levels are identified and overcome, patients actually respond better to treatment, and the program helps improve outcomes.

O’Connor said going through breast cancer for the last year and a half actually helped her grow as a person, and she and her girls have done their best to stay positive by writing gratitude lists and continuing their involvement with LivingWell. She’s even planning to run the Chicago Marathon in 2014. “It really opened my eyes to take things one day at a time and find joy in my kids,” O’Connor said. “I never would have been able to meet all these awesome people. It’s been a growing process. It changed me completely, 100 percent.”

“We keep participants educated on what’s going on in the world of cancer. When they’re better informed, they make better decisions,” Vance said. “So, when the world is kind of spinning out of control, we provide support and hope. That’s our mission.” O’Connor said her doctor, Narha Lee, introduced her to the LivingWell Cancer Resource Center, and O’Connor said she stopped in after her surgery. She and her daughters are still active in the center’s Club Courageous, which is a support group for children ages 6 to 12 who have been affected by cancer. She said they’ve participated in holiday parties, fun craft activities, and her girls even went on a nature camp retreat for a few days. “I feel like it’s because of this resource that we’ve had something we get to look forward to,” O’Connor said.

Sandy Bressner - sbressner@shawmedia.com Jen O’Connor of Elburn, shares a laugh with her daughter Keelin, 5. O’Connor was diagnosed with breast cancer in May 2012 and has since leaned heavily on the resources at LivingWell Cancer Resource Center in Geneva.

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She said a newly diagnosed patient walks into the center nearly every day.


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| Breast Cancer Awareness

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Food prep tips for Breast Cancer Patients

B

reast cancer treatment can be exhausting, resulting in fatigue that can make it hard for patients to tackle all of the tasks that come with a typical day. That includes preparing meals, which is often the last thing a person fighting breast cancer wants to do after a day of treatment. But nutrition plays a vital role in beating cancer. A nutritious diet can promote strength and increase energy levels, something breast cancer patients know is not always easy to come by. The following are a few tips to help men and women undergoing breast cancer treatment maintain a nutritious diet throughout their treatments.

Plan ahead when you’re feeling strong.

Breast cancer patients often have good days and not-so-good days during the course of their treatments. When the latter comes around, everyday tasks like cooking meals can seem as exhausting as climbing Mount Everest. So breast cancer patients can plan ahead for such days by going the extra mile on those days when their energy levels aren’t compromised. Prepare meals in advance and freeze them so they require minimal effort on those days when energy levels are low.

Avoid empty calories. Empty

calories like those found in a bag of potato chips won’t help fight fatigue on those days when your energy levels are low. When eating, opt for foods that are rich in vitamins and nutrients but not heavy in calories. A meal that is dense in nutrients but not calories will benefit your energy levels, while a caloriedense meal will only foster feelings of fatigue.

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Educating Young Women About Breast Cancer

A

t the age of 12 to 15, many young women are experiencing the body and life changes that accompany adolescence. It can be difficult to imagine that breasts that are just beginning to develop may contain cancer. But such is the reality for some girls. The majority of women who receive a breast cancer diagnosis are over the age of 40. Experts at Monroe Carell Jr. Hospital at Vanderbilt University note that only 5 percent of breast cancer cases are found in women under the age of 40. However, the hospital recently treated a 14-yearold girl who found a lump and learned she had a rare form of breast cancer called a phyllodes tumor. In 2009, a 13-year-old from Little Rock, Ark. found a quarter-sized lump in her right breast, while a 19-year-old student at the College of New Jersey was diagnosed with cancerous cells and underwent a bilateral mastectomy. Though such cases are rare, it behooves teenage and adolescent girls to familiarize themselves with the disease and be mindful of their breast health.

Some organizations have increased breast cancer messages for young girls, and it is not uncommon to find young women participating in runs and fundraisers for breast cancer research. Some organizations even conduct breast cancer workshops to educate young women about breast health. Dorothy Paterson of Texas, a former Girl Scout leader who was diagnosed with breast cancer herself, began conducting workshops for Girl Scouts in 2007. The idea isn’t to scare girls into believing they have the disease, but rather to increase their awareness of changes in their bodies that may or may not be normal. Some parents worry that educating children about breast cancer may cause them to worry unnecessarily, especially considering a young girl’s risk of developing breast cancer is so minimal. However, others see the importance in schooling girls early on about a disease that is so common. Advocates of teaching young girls about breast cancer often note that any effort to help save lives and promote health is worthwhile.

Just as with older women, adolescents and teens should realize that eating healthy foods, exercising, avoiding alcohol and tobacco, and maintaining annual physical exams with a doctor are key ways to reduce the risk for cancer.


A

A Difficult Message to Receive

cancer diagnosis is never welcome news, especially when it comes unexpectedly. Cancer patients may undergo treatment for weeks or months, all the while hoping that treatment will ultimately prove effective. But cancer can return even when it is successfully treated, and the prospect of that return understandably induces concern.

A cancer recurrence can be difficult news to receive. But past experience battling the disease can help men and women as they begin their fight anew.

The risk of recurrence is different for each person and typically depends on a host of factors. The type of cancer, how much time has passed since treatment, the type of treatment received, and how well a person has been taking care of himself or herself since treatment ended can all influence a person’s risk of recurrence. Eating right, exercising and seeing the oncologist for follow-up visits are key to good health. But the American Cancer Society notes that nothing can be done to guarantee your cancer won’t recur. Cancer recurrence is defined as the return of cancer after treatment. The same type of cancer may return in the same area of the body, such as breast cancer returning in the same breast. In some instances, the cancer may return elsewhere in the body. But it is still referred to as a breast cancer recurrence, even if

the next incidence is elsewhere. The length of time between the first bout of cancer and the next can vary. When cancer gets worse, this is called a progression. Sometimes it can be difficult to discern whether a recurrence is truly a recurrence or a progression. When only a short amount of time has lapsed since the initial diagnosis, then chances are the cancer is a progression. After cancer goes into remission, a doctor usually sets up a schedule of follow-up appointments to check for cancer recurrence. A local recurrence, or one in the same spot as before, may be easy to treat. Many advancements have been made regarding the treatment of cancer. However, for many cancers, a recurrence at a distant site can mean the chance for successful treatment is not very likely. Learning of a recurrence can elicit anger, fear and fatigue, especially after working so hard and suffering through so much to push cancer into remission. Focusing on the future and not growing discouraged about beginning the battle anew are keys to fighting cancer again. But this time you will know what to expect and can plan accordingly.

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A member of Cadence-Community Health System 975 North Fifth Avenue, St. Charles, IL

Breast Cancer Awareness | BXe\:flekp:_ife`Zc\&B::_ife`Zc\%Zfd›Kl\j[Xp#FZkfY\i)0#)'(*

CAN CER RECURRENCE:

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Famous breast cancer patients

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erhaps because they are thrust into the spotlight so often and have quite a large amount of money at their disposal, people believe that celebrity musicians, actors and sports figures are invincible. Yet, just like regular people, celebrities are susceptible to the same illnesses as private citizens.

Many well-known women have battled breast cancer. Some have beaten the disease, while others succumbed to it after a brave battle. Each of these prominent figures can help shed light on just how pervasive breast cancer can be and how no one is immune.

Famous breast cancer patients sAnastacia, pop singer sChristina Applegate, actress sBrigitte Bardot, actress sMerideth Baxter,actress sIngrid Bergman, actress sShirley Temple Black, actress sNancy Brinker,founder of Susan G. Komen for the Cure sAgnes Chan,singer sSheryl Crow, singer sBette Davis, actress sBarbara Ehrenreich,author sMelissa Etheridge, singer sEdie Falco, actress sPeggy Fleming, ice skater sJill Ireland, actress sKate Jackson, actress sBetsey Johnson, clothing designer

sSusan Kadis, Canadian politician s Hoda Kotb, TV host sLinda McCartney, singer sKylie Minogue,singer sDiana Moran,model sJanet Napolitano, U.S. Sec. of Homeland Security sOlivia Newton-John, singer sGuliana Rancic, TV personality sNancy Reagan,former First Lady sLynn Redgrave,actress sRobin Roberts, TV host sCarly Simon, Singer sJaclyn Smith, actress sDame Maggie Smith, actress sSuzanne Somers,actress sDusty Springfield, singer sWanda Sykes, comedian/actress sMaura Tierney, actress


PREVENTIVE MASTECTOMY

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eople around the world were shocked to learn that actress and activist Angelina Jolie opted to have a double mastectomy in 2013 to reduce her risk of breast cancer. Jolie, who was 37 years old at the time of the procedure, reportedly learned that she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer. In addition, the actress has a family history of cancer. Her mother, Marcheline Bertrand, died of ovarian cancer in 2007 at the age of 56. By having a preventive mastectomy, Jolie reduced her breast cancer risk from 87 percent to 5 percent, according to an op-ed piece she authored in The New York Times. Jolie is not the only well-known actress to opt for a preventive mastectomy, as fellow thespian Christina Applegate had a similar procedure in 2008 after learning she had a mutation of the BRCA1 gene. These highly publicized cases have left many women wondering if a preventive mastectomy is something they should consider. BRCA stands for “breast cancer susceptibility genes,” a class of genes known as tumor suppressors, says the National Cancer Institute. Mutations in these

genes have been linked to hereditary breast and ovarian cancer. A person’s risk of developing breast and/or ovarian cancer is greatly increased if he or she inherits a harmful mutation in BRCA1 or BRCA2. Mutations in these genes could also put a person at increased risk for other cancers. Genetic tests can check for mutations in BRCAgenes. During such a test, a blood sample is taken, and if a mutation is found, a person may get genetic counseling and work with a doctor to develop a plan of action. It is important to note that not all people with a genetic mutation will get breast cancer or ovarian cancer. The National Cancer Institute’s “SEER Cancer Statistic Review” states a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation. Although there is no surefire way to determine if a person with a mutated gene will develop breast cancer, many women who are considered high risk opt for a preventive mastectomy to reduce their risk. Women who have a family history of breast cancer, have received positive results from gene testing, have already had cancer in

one breast, or have dense breasts that make testing difficult may want to get a preventive mastectomy. The decision to get a preventive mastectomy is not one to take lightly. Many breast centers are staffed with breast-health specialists, genetic counselors, breast surgeons, and reconstructive surgeons who can help patients make the best decision. Second opinions are strongly recommended for women considering a preventive mastectomy.

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NEW CUSTOMER SPECIAL OFFER

*To earn up to a $100 cash bonus: open a new U.S. Bank Silver, Gold or Platinum Checking Account by December 31, 2013, and establish a recurring direct deposit of at least $100 within 60 days of account opening. The cash bonus will be deposited into your new checking account within 60 days of direct deposit verification. Bonus will be reported as interest earned on IRS form 1099-INT and you are responsible for any applicable taxes. Offer is not valid if you have an existing U.S. Bank checking account or if you have received a cash bonus in the prior 6 months, and it cannot be combined with any other checking offers. A minimum deposit of $25 is required to open a U.S. Bank Package checking. Other restrictions may apply. Offer valid at the U.S. Bank listed below. Deposit products are offered by U.S. Bank National Association, Member FDIC.

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*Enrollment is required. A qualifying transfer from your Package Checking account to your Package Money Market Savings account must be scheduled and maintained. You must open and/or maintain an active U.S. Bank Package, including a Silver, Gold or Platinum Checking account AND a Money Market Savings account. Program is subject to change. See the S.T.A.R.T. Program Agreement for detailed information. The U.S. Bank Rewards Visa Card cannot be reloaded with additional funds, nor can it be used at an ATM. Terms and conditions apply and other fees may apply to Rewards Cards. For complete terms and conditions, see the “U.S. Bank Rewards Visa Card Cardholder Agreement” available at www.myusbankcororaterewards.com. Deposit products offered by U.S. Bank National Association. Member FDIC.

CERTIFICATE OF DEPOSIT SPECIAL! *Annual Percentage Yield (APY) assumes principal and interest remain on deposit for the term of the certificate and is good for balances up to $25,000. Offer is only available at the branch location(s) listed below. One CD per household. $1,000 minimum deposit required to open the CD at the stated APY. Funds used to open a certificate at the stated rate must come from a source outside of U.S. Bank. All interest payments for the advertised APY will be made at the end of the term or annually, whichever occurs first. Penalty will be imposed for early withdrawal. Offer and same terms will apply for business CDs and individual Retirement Accounts. Not valid for brokerage deposits, Institutional investors, public funds, or in conjunction with other promotional offers. Offer is valid only for existing or new U.S. Bank Consumer Checking Account customers. Limited time offer. APY good as a October 1, 2013 APY is subject to change. All regular account opening procedures apply. A minimum of $25 required to open a U.S. Bank Checking account. Deposit products are offered by U.S. Bank National Association, Member FDIC.

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CELEBRITIES UNDERGO

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Save More. Earn More. Do More.

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Breast Cancer Awareness