2017 paint it all pink

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Breast self-exams and annual mammograms save lives for women of ' all ages. AST Health wants you to know you can call and schedule your own screening mammogram without a doctor referral. (For diagnostic mammograms, a doctor referral is required.) This is about being strong, proactive and powerful. As women, that is who we are. So make the call, schedule a mammogram today.

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This October, First National Bank & Trust Co. celebrates the women in our community who have survived breast cancer, stands with those who continue to fight the battle, and honors those who are no longer with us. Your strength and courage is a daily inspiration to us all.

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BREAST CANCER PROFILE:

CINDY LANTZ

Wednesday.

“I was diagnosed with Stage 1 Infiltrating Ductal Carcinoma, Grade 2,” she said. “My doctor told me this was just a bump in the road of life. It was not the end of the road, just a detour.”

Since her tumor was caught early, she had no lymph node involvement and needed radiation treatments. Lantz had a lumpectomy in December 2015.

During treatment, she had a Savi Catheter. And while it was awkward for 10 days, she just kept telling herself she could get through it. She had treatments twice a day, once in the morning and late afternoon, for five days.

By Kim Morava kimberly.morava@news-star.com @Kim_NewsStar

B

ack in October 2015, life was busy and hectic for Cindy Lantz of Shawnee.

She always had regular mammograms every October because of a family history. And each time, everything was fine. So when her scheduled mammogram appointment approached, she contemplated skipping it for a year.

“Life was busy, my work schedule was extremely busy and I just didn't want to take the time,” she said. “I justified it all in my head and told myself, 'oh I would know if something was wrong, I always have good results so going every other year will be okay.'”

But at the same time, she had been extremely tired, attributing that to her busy life. Her daughter, Melissa, kept encouraging her to go for the appointment.

“Thank goodness I did,” Lantz said.

“I know how lucky I am that my cancer was caught early.”

She had her mammogram on a Friday. Her doctor called her Monday telling her to come in for a biopsy on

“My husband named the catheter Charlotte because it looked like a spider with its head buried and its legs sticking out (the leads for radiation seeds),” she said. “We had to find some humor I guess. My doctors and treatment team got a good laugh out of that.”

At first, Lantz said she was scared about the diagnosis, even though she felt she would be cured. She said her mother and two aunts are breast cancer survivors — her mother is now 86 and one of her aunts just celebrated her 102nd birthday.

“When I would find myself getting antsy, I would calm myself, especially during treatments by remembering my favorite Bible verse, “Be still and know that I am God,'” she said. “So that is what I did. I knew that this was beyond my control and I had faith that God would orchestrate it all.”

okay,” she said. “When I was checking in for my first radiation treatment, I was pretty nervous and I looked down on the floor right by my foot and there was a penny. I like to think it was my penny from heaven letting me know he was thinking about me and 'it would be okay.' I still have the penny. Whether it was or not, it gave me peace and courage when I needed it.”

Because her cancer was estrogen fed — or sensitive — she is on a hormone blocker for probably five or six years.

Some of the medication side effects have been rough, she said, mainly the joint pain, but it is starting to adjust somewhat.

She now has a mammogram every six months and will probably do so for another year or so, then hopefully she will be able to go to once a year screen-

ings again.

Now that she's experienced the detour in life called cancer, Lantz said tries not to take life for granted and enjoy and love the people God has placed in her life.

“I want to reach out and be supportive of other people who may be going through their own battle. It meant so much when someone that has been there took the time to reach out to me,” she said.

Lantz also encourages women to get their mammograms.

“Get your mammogram done every year. Take the hour or so that you need to get it done, everything else can wait,” she said. “If I would have put mine off my story could be very different.”

We support breast cancer awareness

Her husband, Alan, was by her side at every appointment, she said. She knew she had an amazing family and her friends and co-workers also were supportive, but she also had other signs of encouragement.

“I do believe our loved ones that have gone before us send us signs sometimes. My dad would always tell me when I was worried about something, 'it will be okay.' He passed in 2010 and I believe I received a sign that I would be

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BREAST CANCER PROFILE:

DEBBIE SEATON

By Vicky O. Misa

said.

Vicky.misa@news-star.com (405) 214-3962 Twitter: @Vicky_NewsStar

Though Seaton is in remission, since the cancer is in her bones, she said she will have to remain on medication the rest of her life.

D

ebbie Seaton is no stranger to cancer.

In 2008, she said her father's cancer had returned.

While she was taking care of him, she began noticing some oddities of her own, but initially ignored them.

Later she scheduled a mammogram, which resulted in an immediate diagnosis. That very afternoon she was told she had a fairly large tumor at stage 2.

But things were not as they seemed.

After checking more thoroughly her diagnosis was changed to stage 3 and by the time her surgery arrived, she was looking at stage 4 — and the cancer had spread to two places on her spine.

By 2009 Seaton was on chemotherapy and radiation treatments.

At the time of Seaton's experience, she built a close bond with another local woman, Kinlee Farris, who worked at the Greater Shawnee Area Chamber of Commerce at the time.

“Kinlee was diagnosed as stage 1 just two weeks before I had my diagnosis; she really battled with hers,” Seaton said. “It's been almost a year ago now since we lost her.”

Seaton said her friend always stayed so positive through the ordeal — an attitude Seaton said she has also aimed to maintain.

Seaton continued working full time as she dealt with her illness and treatment.

“Many people didn't even realize I was sick because I looked so healthy,” she said.

She said she had hormone-related medications, but after three years it quit working.

“The cancer on my spine flared and I had to get shots every four weeks,” she

Though her world has significantly changed — and in the beginning she wondered 'why her?' — she assures it has not been for nothing — God has directed her steps through the journey.

Seaton said she had just lost her father before her diagnosis. She said she prayed for direction, and within no time women were showing up with stories and suggestions.

“Five people recommended a specific doctor to see,” she said. “Dr. Denise Rable is a breast surgeon whose grandmother also had been through cancer.”

Seaton said Rable's experience with the illness shaped a perspective that was very compassionate and caring.

She said people are unique and react differently to the illness and/or treatment.

“A lot go through it and never have trouble again,” she said. “While others are dealing with it over and over.”

She said it's scary sometimes, but she thanks God every day for her life and the path she now walks.

“Any cancer is serious — whether it's stage 1 or 4 doesn't matter,” she said.

“I know people who were stage 1 and aren't here anymore.”

She said someone's physical ability to fight off the disease is only part of the puzzle.

“A lot of it depends on your outlook,” she said.

Seaton said one person's journey isn't going to look like someone else's;

they won't be the same — they can't be compared.

“The important thing is to never give up,” she said.

She said she feels so good now she sometimes has to remind herself that she has a serious illness.

“She took care to weigh the cosmetic side of things, and considered those when advising what needed to be done,” Seaton said.

She said God guided her to select that doctor, and it afforded her a more positive approach to handling the issues she was facing.

Seaton said she has learned to look at the whole experience as a tool for ministry.

“You don't realize when you are battling something, how much you are ministering to others,” she said.

Seaton said it's been an opportunity to be an encouragement.

“It's changed my life, sure, but it's made me stronger,” Seaton said. “And it's opened doors to minister to people I wouldn't have had the opportunity to otherwise.”

There's one thing Seaton said she knows for sure.

“The journey is different for each person,” she said. “Everyone responds differently to it.”

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“When patients are diagnosed with cancer, there’s this rush to get through the treatment process. But for patients with early-stage breast cancer, they have some time to decide on their treatment choice.”

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Dr. Lauren P. Wallner, University of Michigan

By Melissa Erickson More Content Now

W

hen facing a breast cancer diagnosis, there’s strength in numbers. A new study finds that half of women relied on three or more people to help them process breast cancer treatment options.

“The big takeaway is that most women with early-stage breast cancer are involving multiple people — not just a spouse or partner — but other family, friends and colleagues to help them make informed decisions,” said Dr. Lauren P. Wallner, assistant professor of general medicine and epidemiology at the University of Michigan and lead author of the paper, published in the journal Cancer.

The size of a woman’s support network matters.

“People faced with a new cancer diagnosis are still processing the information. They are often scared and overwhelmed.

They are not able to grasp all the details. It’s helpful to have support, someone with them who can help weigh the pros and cons of what the doctor is saying and the different treatment options,” Wallner said.

Larger support networks were associated with more deliberation about treatment, which is critical as treatment options become more complex, Wallner said. More deliberation suggests patients are thinking through pros and cons, discussing it with others and weighing the decision carefully. The more people a woman has supporting her, the better her decisions are, Wallner said.

“When patients are diagnosed with cancer, there’s this rush to get through the treatment process. But for patients with early-stage breast cancer, they have some time to decide on their treatment choice,” Wallner said. “The idea that women are discussing their options more with their family and friends and

potentially thinking through that decision more carefully is reassuring. Engaging these informal support networks could be a way to prevent women from rushing into something.”

The study found that only 10 percent of women said they had no personal decision support network. Nearly three-quarters said their support network talked with them about their treatment options and frequently attended their appointments.

African-American and Latina women reported larger networks than did white women. Women who were married or partnered also reported more support.

Even among women without a partner or spouse, many had large support networks. Women reported children, friends, siblings, parents and other relatives were involved in their decision-making.

How you can help Offer to go with to an appointment and take notes. “It is

incredibly helpful to have another set of eyes and ears,” Wallner said.

Help with research “If you’re internet-savvy, help do research and track down information,” Wallner said.

Just be there “On a basic level, just being present lets the patient know she is not alone,” Wallner said.

Doctors need to involve others “Physicians should be aware that women want to include others in their treatment decisions,” Wallner said.

A woman without a support network may need extra help or information during the decision process.

“It starts with something as simple as physicians asking patients who is helping them make their treatment decisions.

That can then guide the conversation, such as the amount of resources the physician provides and to whom they communicate that information,” she said.

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Think Pink-October is Breast Cancer Awareness Month Come Oct. 1, be prepared for the pink-out. For more than 30 years, October has been observed as Breast Cancer Awareness Month.

contributes to increased rates of 13 different cancers, including several found either exclusively or predominantly among women, such as breast, ovarian and cervical.

About 40,000 women and 2,000 men annually are diagnosed with the disease, Centers for Disease Control and Prevention data show.

Those figures do not include recently published American Cancer Society study results projecting a six-fold increase in cancer mortality rates in the next two decades.

The increased risk associated with obesity comes on multiple fronts. In addition to upping the risk for diabetes and heart disease, extra fat cells increase the amount of estrogen circulating throughout the body, which has been linked to increased breast cancer rates in both pre- and postmenopausal women.

The projected spike is credited in large part to the increase in obesity, with two-thirds of adults now considered obese or overweight. Obesity

Nationally, American Indian and Alaska Native women have lower rates of breast cancer than their non-Native neighbors, with one in eight indigenous

women diagnosed. However, it is less likely to be diagnosed before the disease reaches an advanced stage, thus increasing the mortality rate.

Kris Rhodes is the executive director of the American Indian Cancer Foundation, a national nonprofit that works to lower cancer rates in Indian Country through culturally appropriate programming, increasing the availability of reliable data that includes indigenous communities and capacity building through training and providing technical assistance.

Among the breast cancer outreach programs hosted by the foundation is an annual Indigenous Pink Day each October. Scheduled Oct. 19, participants are encouraged to wear pink in support of breast cancer awareness and post a selfie tagged #IndigenousPink to social media.

For Rhodes, the higher breast cancer mortality rates, while disappointing, are not entirely surprising. In addition to the large swaths of Indian Country that do not have regular access to mammograms or other forms of preventative care, fear and modesty often keep many women from getting checked.

Despite that hesitation, the need for routine screening is still there.

“Cancer is showing in American Indian and Alaska Native women in younger ages,” she said. “We encourage

women to start screening as early as their doctors will let them — 40 and up.

“Women have to be an advocate for themselves — it can make a huge difference.”

Some of the risk factors for the disease are preventable, such as binge drinking and not regularly exercising. However, others are unavoidable, including age, having a personal or family history of breast cancer, mutations to the BRCA1 and BRCA2 genes, starting menstruation before age 12 or having dense breasts, which have more tumormasking connective tissue.

“It’s a common misconception that breast cancer is always genetic or that you only have to worry about it if someone in your family has had it,”

Rhodes said. “However, the truth is that anyone can get breast cancer. In America today, though, if it’s caught early enough, it’s treatable.”

Early warning signs of breast cancer: • New lumps in the breast or armpit • Thickening or swelling of parts of the breast • Irritation or dimpling of breast skin • Redness or flaky skin around the nipple • Nipple discharge other than breast milk or colostrum • Any change in the size or shape of the breast • Breast pain For more information, visit americanindiancancer.org.

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BREAST CANCER PROFILE:

KAREN SPARKS Survivor: Don’t put off that mammogram

By Kim Morava kimberly.morava@news-star.com @Kim_NewsStar

K

aren Sparks of Tecumseh is a 14 year survivor of triple-negative breast cancer.

“When they first tell you ‘you have cancer,’ it’s like someone is speaking a foreign language. You hear what they say, but you don’t understand it,” she said. “It feels like it’s the first time you have ever heard the word, and all at once your world goes in slow motion, while all the world around you continues on at regular speed.”

Sparks said with the love and support of her family and friends, she made it through.

“There were days I didn’t think I could draw on eyebrows one more time, and days I didn’t want to even walk out my front door, yet you have to keep going,” she said. “I decided early on that I was determined to beat cancer, it wasn’t going to beat me. There was fear, laughter, tears and prayers, and I think the combination of all of those things is what got me through it. Looking back now it wasn’t so bad, but at the time it certainly had my full attention.

As someone who has been through it, she said she can help others by sharing her story.

“The best advice I received while going through treatment was to do what you feel like doing….cry, laugh, rest,

play…whatever the day brings,” she said. “My positive inspiration was my personal motto at the time: ‘You can’t get to the top of the stairs by standing on the bottom step.’ I was ready to get treatment started, get it behind me and get on with life.”

Through the experience, she also learned a lot about herself.

“I learned I was stronger than I gave myself credit for, and I had so many more friends than I thought, and that people truly want to help if you’ll just let them,” she said. “So many people feel helpless and don’t know what they can do to help, and if you’re like me you don’t like asking for help, but it’s the little things that can sometimes feel like the biggest mountains. Let your

neighbor run to the store for you, or whatever you are needing done…people wouldn’t ask if they didn’t want to help.”

After going through such an ordeal, it also brings up gratitude for those who Continued on page 9

THINK PINK

L Let’s work together to raise awareness of breast cancer and the importance of early detection.

Breast cancer is one of the most common cancers among women in the United States, and is the second leading cause of cancer death in American women. Early detection saves lives, so make a monthly breast self-exam part of your regular routine and see your doctor if you experience any breast changes. If you’re a woman age 40 or older or have a history of breast cancer in your family, be sure to schedule an annual mammogram and physical exam by your doctor.

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“For a woman with average risk of developing a breast cancer in the second breast, a contralateral prophylactic mastectomy does not increase survival rates.”

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Study finds many double mastectomies unnecessary

Susan Brown, Susan G. Komen

By Melissa Erickson More Content Now

W

omen with early-stage cancer in one breast are increasingly choosing double mastectomies — even if they are at low risk of developing breast cancer in the other, healthy breast, a new study published in JAMA found.

Nearly half of women with early-stage breast cancer consider having a double mastectomy, and one in six received it.

“That one in six breast cancer patients chose bilateral mastectomy is really striking. We knew it was increasing, but I don’t think many of us realized just how frequent this is,” said study author Dr. Reshma Jagsi, professor and deputy chair of radiation oncology at the University of Michigan.

Myths and facts The procedure is known as contralateral prophylactic mastectomy, in which the healthy breast is removed along with the cancerous breast. It’s an aggressive form of treatment that is recommended for women “who are at a very high risk of developing a new breast cancer” such as those with BRCA 1 or 2 mutations, family history or

SPARKS From Page 8

stood by her side.

“I have a greater appreciation for my family and friends…they are the true heroes in my book,” she said. “It’s much harder being the caregiver than it

other risk factors, said Susan Brown, senior director of education and patient support for Susan G. Komen.

Especially concerning is the lack of knowledge about the procedure and its benefits, Brown said.

Many women diagnosed with early-stage breast cancer decide on the most aggressive treatment with the belief that it will increase their rate of survival, Brown said.

“For a woman with average risk of developing a breast cancer in the second breast, a contralateral prophylactic mastectomy does not increase survival rates,” Brown said.

Among patients who considered double mastectomy, only 38 percent knew it does not improve survival for all women with breast cancer, the study found.

Other misinformation muddies the decision-making process. For example, some patients think having a mastectomy on a healthy breast will stop them from having to undergo chemotherapy or other targeted therapies, but that is not true, Brown said.

“Contralateral prophylactic mastectomy will only reduce the risk of breast cancer developing in the healthy breast, but it doesn’t reduce the risk of breast cancer returning in the original breast

is being the patient. When you are sick, or have a health challenge in general, your focus is on yourself to get better, but the caregivers have that focus, plus all their other obligations to juggle at the same time.”

Sparks has some sound advice for other women.

“My advice to others would be keep

or coming back later in another part of the body,” Brown said.

What you need to know “Every surgery we perform can have potential complications. These need to be discussed and need to be taken into account carefully before decisions are made,” said Dr. Virginia Kaklamani, a medical oncologist and head of the breast cancer program at University of Texas Health San Antonio.

It’s important to understand the risks and benefits of treatment and how likely treatment is to positively affect survival rates, Brown said.

There may also be post-operative complications, additional costs, and issues related to long-term suffering and quality of life, Brown said.

In the study, almost all patients said peace of mind motivated them to choose double mastectomy.

“They are afraid of another breast cancer, of more biopsies of going through this again,” Kaklamani said.

In these circumstances, a double mastectomy “can avoid years of anxiety and ongoing fears. For some women that’s a great benefit,” Brown said.

your chin up. Make friends with other survivors, join a support group,” she said. “Some of the people you meet along the way are absolutely amazing and you just might inspire others. I think a positive outlook is half the battle. Some days are harder than others, but at the end of the day you still get to see the sunset, and hug your loved

ones.

And she also wants all women to be proactive with their health.

“Don’t put off that mammogram,” she said. “And listen to your body... you know it better than anyone else. I dream of a day when there is no more cancer, but until then we must be aware and fight on.”

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MOVING FORWARD It can be difficult, but exercise is key during cancer fight

By Melissa Erickson More Content Now

E

xercise helps keep a body healthy and lowers risk of some diseases. For women with cancer, physical activity can do many things, including control weight, improve mood, boost energy, increase sleep, and be fun and social — as long as exercise is done safely.

So why aren’t more oncologists discussing exercise with their patients? A focus group study from Gundersen Health System in Wisconsin found that 95 percent of patients surveyed felt they benefited from exercise during treatment, but only three of the 20 patients recalled being instructed to exercise.

The investigators interviewed nine practitioners plus 20 patients 45 and older with two kinds of cancer: non-metastatic cancer after adjuvant therapy and metastatic disease undergoing palliative treatment, both across multiple tumor types. While the sample size is small, the study provides an understanding of how the group as a whole has the potential to influence the practice of physical

A focus group study from Gundersen Health System in Wisconsin found that 95 percent of patients surveyed felt they benefited from exercise during treatment, but only three of the 20 patients recalled being instructed to exercise. activity recommendations.

The results indicated that exercise is perceived as important to patients with cancer, but physicians are reluctant to consistently include recommendations for physical activity in patient discussions, said Dr. Agnes Smaradottir, medical oncologist and lead investigator of the focus group study, which was published in the Journal of the National Comprehensive Cancer Network in May. A key finding was that physicians expressed concerns about asking patients to be more physically active while undergoing

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It is well-documented that physical activity benefits patients with cancer, both during and after treatment. Exercise helps patients combat physical and psychological impacts of cancer treatment, giving them a sense of well-being, control, stress reduction and empowerment.

arduous cancer treatments.

to the goal of 150 minutes a week.

“Regular exercise has been a part of the breast cancer treatment plan for years,” Smaradottir said.

“Exercise regularly from the day you are diagnosed and beyond and have exercise be an important part of your life. Carve out time for exercise at least every other day. It is that important.”

• For women already exercising, continue the exercise plan with adjustments during chemotherapy and radiation.

For breast cancer patients, Smaradottir’s recommendations for exercise are: • 150 minutes a week (30 minutes a day, five days a week) of moderate exercise or 75 minutes of vigorous activity.

• In addition, two to three sessions per week of strength training that includes major muscle groups and stretching.

• For women who have never exercised, start slower, working up

Before starting an exercise regime, talk to your doctor about weight loss, weight management and what types of exercise are safe for you to do. Walking is probably the simplest, easiest and the most inexpensive way to remain fit.

Studies presented at the American Society of Clinical Oncology conference reported that just 25 minutes of brisk walking every day not only cuts the risk of cancer but also helps people battling the disease.

For moderate exercise, try walking briskly at a pace where you are able to talk but not sing, Smaradottir said.

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BREAST CANCER PROFILE:

KIM MUIRHEAD

By Kim Morava kimberly.morava@news-star.com @Kim_NewsStar

W

hen she turned 40 in October 2010, Kim Muirhead scheduled a mammogram.

That screening would end up changing — and saving — her life and now she's seven years cancer free.

When she went for her first mammogram at age 35, she got a baseline result and everything looked good.

“Unfortunately, when I went at 40, they saw something and scheduled me for an ultrasound,” she said, and then she had a lumpectomy.

“That was the day that changed my life — I was told that I did have breast cancer,” she said.

“I went to oncologist and they threw so many things at me,” she said, but “I did find out it was caught early at Stage 1.”

After that, she had to endure four chemo treatments, she said, which was hard with two boys who were active in sports. But she was determined to make it through.

Her advice to women going through this is to “have faith in God,” she said.

“He will get you through this,” she said. “I was inspired to stay positive for my family. I had two boys to raise and had to stay positive.

She also discovered her own inner strength.

“I was surprised how strong I was during my whole ordeal,” she said. “It did change my perspective on health and life showing that I was given an extra chance in life and to live life to the fullest.”

And when a spot on her other breast was found, Muirhead didn't hesitate taking a stand for her own health.

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“I ended up having a spot on my other breast and chose to do a total mastectomy,” she said. “It was not tough at all to decide on total mastectomy — I wanted to live and that was the best option.. I'm so glad I took that step. I am now seven years cancer free.”

For others going though breast cancer, “I would tell them to stay positive and give everything to God,” she said.

“I urge everyone to get their annual exams to make sure to catch it early. That is what saved my life.”

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In support of Breast Cancer Awareness, we would like to thank these ladies for sharing their stories and we would also like to thank the sponsors for donating to the gift bags.

From left, Linda Painter, Cindy Lantz, Christina Walker, Karen Sparks, Kim Muirhead and Debbie Seaton. All six have something in common — being diagnosed breast cancer. Walker is just beginning her treatment journey, while the others have been through treatment, a journey that was different for each of them. See their stories in this publication.

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BREAST CANCER PROFILE:

LINDA PAINTER She is thankful she did not have to go through chemotherapy or take other medications.

By Vicky O. Misa Vicky.misa@news-star.com (405) 214-3962 Twitter: @Vicky_NewsStar

Except for one incident, treatment went pretty well for Painter.

A

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s far as having cancer goes, Linda Painter said she couldn't have been more fortunate.

In 1995, through a regular mammogram, she said the attending radiologist was able to spot the issue at its

“It was not a typical situation,” she said. “You just don't catch it sooner or smaller than that.”

Painter went on to say her lumpectomy results were fine — nothing else was affected.

She said having to be in the radiation room all by herself was a cause for some tears, but ultimately she wasn't frightened.

Painter said she sailed through her roughly eight months of radiation, which she would fit into her lunch breaks.

She said in the summer she became blistered once after radiation, so her treatments had to stop for awhile to give her skin time to heal.

“Generally, at the worst I would feel tired, but not sleepy,” she said. “I had no energy, but that's all.”

Though the treatment did not noticeably weaken Painter at the time, she does acknowledge that there has been some decline in her health that began from that point.

“It's important to take care of yourself while you're going through treatment,” she said. “I didn't know to make an extra effort to eat well and exercise.”

Painter is celebrating her 69th birthday this month.

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Some of the signs of potential breast cancer:

Red, inflamed breast A swollen and sometimes warm, red breast should be evaluated promptly, Bevers said.

Inflammatory breast cancer is a rare but aggressive disease. Swelling and redness affecting one-third or more of the breast is cause for concern. Smaller changes, like the size of a half-dollar, are probably not breast cancer, “but get it diagnosed,” Bevers said.

Peeling, scaling

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Flaky, peeling or scaling skin on the breast could be a sign of Paget’s disease, a type of breast cancer, or it could be minor skin irritation, Bevers said. Watch for whether the skin changes only occur in one breast, often starting in the nipple area, and spread from there.

Dimpling of the skin

POTENTIAL

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eeling a lump in the breast is a classic sign of breast cancer, but there are other less-well-known signals that can tip off potential trouble.

“The hope is that women know their own bodies and would find a mass before it becomes palpable, but the truth is that radiologists can find tumors so small — 3, 4 or 5 millimeters — that it’s rare to be able to feel a small tumor before it can be discovered by mammogram,” said Dr. Therese Bevers, medical director of the Cancer Prevention Center at MD Anderson in Houston and an expert in breast cancer screenings.

Today, breast self exams are not widely recommended, but that doesn’t mean you should stop investigating your breasts, Bevers said.

“You know how your breasts look and feel. If something feels different, have it checked out.”

Dr. Therese Bevers

The keywords now are “breast awareness. You know how your breasts look and feel. If something feels different, have it checked out,” Bevers said.

Women themselves discover “a substantial amount of breast cancer because nobody knows a woman’s body as well as she does herself,” said Dr. Rachel Brem, director of breast imaging and intervention at The GW Medical Faculty Associates in Washington, D.C. “Women have to understand that mammograms are imperfect. Fifteen percent of breast cancers cannot be seen on mammograms. The death rate of breast cancer has decreased 35 percent in the past few decades, and mammograms are one part of that. They’re one tool in our toolbox, but there’s other things like MRIs, diagnostic ultrasounds and molecular breast imaging,” Brem said. “We have many kinds of technology; no one size fits all.”

“A dimpling on the skin of the breast like a pimple that doesn’t heal” can also be a sign of breast cancer, Brem said. The nipple may also become retracted because there’s a tumor pulling it inward, Bevers said. The dimpling might be subtle and noticeable only at certain times, for example, when you stand in front of a mirror and raise your arms to brush your hair, Bevers said.

Nipple discharge Most nipple discharge is not breast cancer, but it is of more concern if it is spontaneous, from one breast only, or clear rather than milky or greenish, Brem said. Nipple discharge may not have a high suspicion rate, but have it checked out.

Mass in the armpit An ancillary mass in the region, such as a lump in the armpit, could be breast cancer in the lymph nodes, Bevers said. “Not all lumps in the armpit are breast cancer. It could be an ingrown hair, but it needs to be checked out,” she said.

A thickening If your breast feels firmer than before, that change should be evaluated by a doctor. “If it’s a change to you, it doesn’t matter what you can see or feel,” Bevers said. Use your awareness of your breasts. If something doesn’t feel normal, get it checked out.

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Gene mutations and breast cancer Only about 5 to 10 percent of all breast cancers diagnosed in the United States are due to inherited gene mutations known to increase risk, according to the American Cancer Society.

United States are due to inherited gene mutations known to increase risk, according to the American n the fight for a cure for breast Cancer Society. BRCA mutations cancer, BRCA1 and BRCA2 get affect men, too. Men with BRCA2 a lot of attention, but many mutations are at an increased risk people don’t understand how for getting prostate cancer.

A new study published in JAMA these genes’ mutations affect their reveals how much having “breast risk of developing the disease. cancer genes” increases the risk BRCA1 and BRCA2 (short for BReast CAncer 1 and 2) are human of cancer. Women with genetic mutations in the “breast cancer genes that produce tumor-supgenes” have about a 70 percent pressor proteins, according to the National Institutes of Health. chance of developing breast cancer in their lifetimes. The These proteins help repair damfindings are based on an analysis aged DNA and play a role in cell of nearly 10,000 women with growth and cell division. mutations in either the BRCA1 or These are genes we all have in BRCA2 gene. our bodies. It’s when these genes The risk of developing breast have mutations — or mistakes cancer varies — it can double — — that a person’s risk rises for depending on specific mutations developing breast and other within the genes, the study found. forms of cancers, according to Memorial Sloan Kettering Cancer Having close family members with breast cancer also increased Center.

Only about 5 to 10 percent of all risk.

Other key findings: breast cancers diagnosed in the

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• Among women who had not been diagnosed with breast cancer before the study, those with BRCA1 mutations faced a 72 percent chance of developing breast cancer by age 80, and the BRCA2 carriers had a 69 percent chance of developing breast

cancer by age 80.

• The rate of new breast cancer cases increased rapidly among younger women, but leveled off around ages 30 to 40 for BRCA1 carriers and 40 to 50 for BRCA2 carriers.

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