Surviving Breast Cancer: Linda’s Story

Linds_lg

Linda

I’m Linda and I’m 68 years old. Three years ago, I was diagnosed with breast cancer. When I had my regular mammogram, something didn’t look right. They wanted me to come back for another mammogram and ultrasound. That showed a possible tumor and a biopsy revealed I had cancer. I also had an MRI that gave them a better picture of what was there.

Luckily, it was Stage 1A HER2 positive and I wasn’t in immediate danger. But I felt like everyone at Virginia Mason took it just as seriously as if it had been Stage 4. A meeting was quickly set up for me to talk to an oncologist, radiologist and surgeon. I felt that each one focused on me as a person, on my particular cancer and how it might be treated. They answered all my questions.

I decided to have a lumpectomy and that went well. I had a one-time intraoperative radiation treatment and was only in the hospital overnight. I did have some problems with the follow-up treatment because my wound was proving difficult to heal. It was a couple of months before I was able to receive chemotherapy once a week and had some difficulties with that, but a nurse was always available for me to talk to.

One of the oddest things was that I didn’t like the taste of silverware during my treatment. So I had to eat every meal with plastic utensils. But the good thing was that I didn’t eat as much and lost 55 pounds. I love to cook and bake and I knew I was too heavy.

Today, I am eating much better and I feel better because of it. I have rheumatoid arthritis and I need to stay active, so I exercise by doing water aerobics. My family has been terrific through all of this. When I was in treatment, my sister-in-law would visit every Tuesday. She knew I wouldn’t be feeling well that day because of the chemotherapy and she would bring me things I could eat.

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Linda’s daughter Traci

Just recently, my daughter, Traci, was diagnosed with breast cancer. When she found out about it, she knew immediately she wanted to be treated by the same doctors at Virginia Mason who treated me. It was also recommended that she visit Virginia Mason’s genetic counselor — and we went together.

I learned a lot from that visit. When you look at the big picture, you can see how cancer has affected my family through generations. I suppose that’s true for a lot of families, but it was surprising to realize how many of my relatives have had cancer.

I’m so glad that Virginia Mason was there for me and Traci. And in 2005, it was there for my husband, Otis, as well. He had prostate cancer and is doing well today — and so am I. Otis, Traci and I have all had the best care possible. I can’t say enough good things about the people at Virginia Mason who took such good care of us.


 

This story originally appeared on VirginiaMason.org. Meet other patients who bravely shared their stories of fighting cancer, and get the latest information on cancer treatment outcomes and wellness and support at Virginia Mason.

Getting a Mammogram: Why the Conflicting Recommendations?

Dr Peter R Eby_2014

Dr. Peter Eby

**By Peter R. Eby, MD, FSBI**

The controversy over when to start screening mammograms and how often to get them in average risk women has been around since the early 1990s. The American College of Radiology (ACR), United States Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) all agree that screening every year starting at 40 will save the most lives. And yet, all three organizations have different recommendations for patients about mammograms.

The ACR, along with the National Comprehensive Cancer Network (NCCN), American Congress of Obstetricians and Gynecologists, and American College of Surgeons recommend screening every year starting at age 40. The ACS recommends considering a mammogram between ages 40 to 44 then definitely getting one every year between ages 45 to 54, followed by continued screening every one to two years. The USPSTF draft for 2015 recommends starting at age 50 and getting a mammogram every other year. How can all these prestigious organizations, which are full of smart people, look at the same data and come to different conclusions?

The issue boils down to one important question: Should patients decide or should organizations decide for them?

Breast_Density_hires_NEW (002)
While all agree that starting at age 40 and getting a mammogram every year saves the most lives, the reason why they disagree about when to start has to do with the relative value that each group places on the potential risks and costs associated with screening mammography. These include the money and time spent on the exam, the anxiety it may cause and the possible additional tests that the mammogram may generate when cancer is not present. Different patients often value each of the risks and benefits from a mammogram differently. Some are more anxious than others. Some have greater concerns about the expense of the exams. And some have a more pressing need to know the results.

The UPSTF and the ACS have tried to weigh the life-saving benefit of mammograms against the risks and choose what is best for all patients. Unfortunately, the USPSTF recommendations are tied to insurance coverage through the Affordable Care Act. For women between the ages of 40 to 49 years old the Task Force has assigned mammography a grade C. A grade C does not require insurance coverage. While the words of the USPTSF suggest the freedom of choice, their actions may require patients to pay the full cost of a mammogram from their own pocket. Those with limited incomes may have no choice at all.

The ACR, NCCN and others recognize that women at average risk for breast cancer have different values and support continued insurance coverage for patients to get a mammogram and exercise their right to choose for themselves. The opportunity should be offered every year beginning at age 40 because – as the ACR, ACS and USPSTF agree – that is the schedule that saves the most lives.

Peter R. Eby, MD, FSBI, is section head of Breast Imaging in the Department of Radiology at Virginia Mason. He practices at Virginia Mason Hospital & Seattle Medical Center, Virginia Mason Kirkland Medical Center, Virginia Mason Issaquah Medical Center and Virginia Mason Federal Way Medical Center.

More Information: Two organizations in their own words

The ACS says

“Screening mammography in women aged 40 to 69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening for women 70 years and older who are in good health.”
[Oeffinger KC et al. Breast Cancer Screening for Women at Average Risk 2015 Guideline Update From the American Cancer Society JAMA. 2015;314(15):1599-1614]

The USPSTF says

“The USPSTF found adequate evidence that mammography screening reduces breast cancer mortality in women ages 40 to 74 years.”
http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1

 

 

A Labor of Love: Creating Hats for Hope

Kailey and John Ryan, MD, a retired Virginia Mason surgeon and longtime family friend.

Kailey and John Ryan, MD, a retired Virginia Mason surgeon and longtime family friend.

Kailey Druffel has visited Virginia Mason a number of times, but not as a patient. Her mother, Shelly, was a surgical technician at Virginia Mason when Kailey was young, before a long battle with breast cancer took Shelly’s life. Now her mom’s former colleagues are like extended family for Kailey, staying in touch with the high school graduate as she plans her own career in medicine.

Last summer, Kailey spent a week learning about orthopedic surgery at Virginia Mason, rounding with a surgeon who had worked with her mom, looking at X-rays and scrubbing in to observe procedures. The experience cemented her desire to become an orthopedic surgeon.

“I’d never been surrounded by so many people who absolutely love what they do,” says Kailey, who plans to study biochemistry at Washington State University this year. “The team at Virginia Mason loves teaching and sharing their passion for what they’re doing. It makes me excited about becoming a doctor.”

Kailey has always looked ahead with optimism despite also losing her father, who died in a boating accident just months before her mother died. Raised by her grandparents in Clarkston, Wash., Kailey grew into a community volunteer, working through her church to serve homeless families and administer other programs, and in her local Salvation Army soup kitchen.

In her junior year of high school, Kailey started the volunteer project that felt closest to her heart: Hats for Hope.

“As a kid I watched my mom go through cancer treatment and her head was always cold,” remembers Kailey. “I wanted to do something in her memory, something she would be proud of.”

So Kailey recruited an eager group of high school students – interestingly all boys – to learn how to crochet beautiful, toasty warm hats intended to comfort cancer patients undergoing treatment. Working during their free “flex time” earned by students doing well in their classes, Kailey and the Hats for Hope team created an impressive collection.

When it was time to find people who needed the hats, Kailey knew where she would go. She recently met with some of her mom’s friends and former colleagues at the Floyd & Delores Jones Cancer Institute at Virginia Mason, bringing along the donations from Hats for Hope.

“I want people to know they don’t have to be cold during treatment,” says Kailey. “There are people thinking about them, like secret angels, who want to help.”

Keeping Your Breasts Healthy Now and in the Years to Come

by Eva Khan, ARNP ***

Eva Khan, ARNP

Eva Khan, ARNP

Lumps, bumps, pain and wanting a different size. What is the common source of these problems?  If you haven’t guessed, it’s a woman’s breasts.

Breast issues can range from serious, like breast cancer, to cosmetic, which might include changing one’s breast size. Throughout a woman’s reproductive years and continuing after menopause, women have questions about breast health and may need medical evaluation for these types of issues.

Breast lumps

Although the majority of breast lumps don’t turn out to be cancer, having one can be an anxious experience for women and, although rare, men as well. The key to evaluating a breast lump is a thorough evaluation that includes a clinical exam, breast imaging (usually a mammogram and ultrasound) and sometimes a breast biopsy. Breast tissue is often lumpy and some breast lumps felt by women turn out to be normal glandular tissue. Other benign lumps are caused by cysts, which are fluid-filled lumps in the breast. Another type of non-cancerous lump is a ‘fibroadenoma,’ which is often found in younger women.

If mammogram and ultrasound do not answer the question of what is causing a lump, a biopsy is usually ordered. Breast biopsies are performed with a needle using a mammogram or ultrasound to guide placement or they can be done surgically by removing the entire lump.

Breast infections

Breast infections can occur when a woman is breastfeeding and even in a woman who is not breastfeeding. This is called ‘mastitis.’ It usually appears as a red, painful, swollen breast that is sometimes accompanied by fever and body aches. Although treated with antibiotics, it’s always important to document that the symptoms and abnormal appearance of the breast is resolved since a rare type of breast cancer – inflammatory breast cancer – also presents with a red, swollen breast.

Breast pain

Breast pain is a common problem and rarely a sign of breast cancer. It may be caused by hormonal changes or breast cysts and often resolves itself on its own. If the pain is always in the same place and persistent, it should be evaluated by exam and breast imaging. It may also be helpful to keep a calendar of the breast pain to see how it relates to a woman’s menstrual cycle.

Breast size

Wanting to change the size of one’s breasts is another reason to see a specialist, which will usually be a plastic surgeon who specializes in cosmetic breast surgery. Breast enlargement is called ‘augmentation’ and can be done with silicone or saline implants. However, breasts that are too large can also be a problem if they cause back or neck pain and result in poor posture. Breast-reduction surgery can be a welcome change that fixes this issue.

Breast imaging and screening

Breast imaging is an important component of breast care. Screening mammogram is done to look for cancer in the absence of symptoms. Diagnostic mammogram, which is often done in conjunction with a breast ultrasound, is performed when there is a specific diagnostic question to answer. 3D mammography is a type of mammogram that may help radiologists see through dense breast tissue to find cancer. Screening breast MRIs are a type of highly sensitive imaging that is used for women at high risk of cancer or who have already been diagnosed with breast cancer, and whole-breast ultrasound is a new way of screening for cancer that uses ultrasound.

Virginia Mason - University Village - Grand Opening

Virginia Mason University Village Medical Center

Breast health services available at Virginia Mason

Virginia Mason offers breast evaluations at their Breast Clinics in University Village, downtown Seattle and Federal Way. Breast imaging is done at multiple locations and includes screening mammogram, 3D mammography, ultrasound, breast MRI and whole-breast ultrasound. In addition, the Virginia Mason Breast Center offers women leading-edge breast cancer care, including Oncoplastic Breast Cancer Surgery and Intraoperative Radiation Therapy (IORT).

Eva Khan, ARNP, is an Adult Nurse Practitioner who specializes in breast health. She practices in the Breast Clinic at Virginia Mason University Village Medical Center (2671 NE 46th St, Seattle, WA 98105; 206-525-8000); www.virginiamason.org/universityvillage.  This story recently appeared on the Ballard News-Tribune website.   

Surviving Lymphoma: Matthew’s Story

Matthew-webMy name is Matthew. I’m a city manager and I live in Ellensburg, Wash., with my wife and two children. We love doing outdoor things like camping and bike riding and treasure our annual trip to Disneyland. We are all proper Disney nerds!

Two years ago, I found out I had cancer the day before leaving on our annual Disney trip. While lathering my neck for an old-fashioned razor shave, my barber noticed a big rock-hard lump. While she froze in terror, I immediately realized it was probably cancer and would explain the mysterious symptoms I’d been experiencing.

On Valentine’s Day, 2013, a diagnosis of Hodgkins lymphoma was confirmed. I was confused, but not scared at first. I remember thinking that getting treatment as soon as possible would be beneficial.

The first oncologist we visited was not at Virginia Mason and it was an awful experience. His office was dark and bleak. He sat me down and, without talking to me at all, began detailing a litany of procedures, exams and the like that I would need. When my wife and I left, we were scared and felt very alone.

I went to work the next day in a daze. A friend came by who had heard about my diagnosis and recommended I go to Virginia Mason for treatment. I called right away and found out I could be seen that weekend. It was an answer to my prayers.

From the start, I knew I was in the right place. I had done research before my appointment and found out how good the program was and that I would be seeing one of the top oncologists in the Pacific Northwest. He walked in and his first words were that while I had cancer, and we would treat that, he wanted to know about me as a person and human being. He asked about my hopes, my fears, whether I planned to have more kids and how chemotherapy might impact that.

He also went over a much smaller list of tests, letting me know that in his opinion the tests the other oncologist wanted (such as a bone marrow biopsy) were most likely not needed. He explained the benefits of a ‘port’ over other infusion methods and I left hopeful and confident we would beat Hodgkin’s!

My cancer treatment was “surreal” in a good way. Virginia Mason has gone to great lengths to make the experience as comfortable and stress-free as possible. I had several chemotherapy regimens and a stem cell transplant. It was a huge and unique benefit that all my care was provided in the same facility and test results were always returned the same day. I never had to ‘go home and wait.’ As anyone who has faced cancer knows, a long wait for test results is just dreadful!

Everyone we met — from the janitors, to the volunteer concierge cart folks, to people in radiology, general surgery and all throughout the organization — they all had passionately embraced a culture of service, positivity, safety and professionalism. We had a seemingly tireless team of health care professionals who fought the good fight with us, comforted us and helped us heal both emotionally and physically.

My daughter has severe anxiety disorder, so you might imagine what my diagnosis and treatment did to her. Virginia Mason staff went out of their way to include her where appropriate, empower her to help, and to understand the process. I could go on for quite some time bragging about so many amazing people at Virginia Mason!

All that said, it wasn’t an easy road. I remember just after one of my chemotherapy treatments that my kids woke me up one day and said, “Dad, we are so sorry to bother you, we know you’re sick, but can you please make us some breakfast? We don’t know how.” That broke my heart. My sweet kids, so compassionate and needing something so simple that was almost impossible for me to do.

This experience has taught me so much about the journey of life we are all on. I find myself wanting to give back, to comfort and help others as they face a cancer diagnosis. People tell me I am way more relaxed and ‘laid back.’ Having faced the shadow of death helps you figure out what’s truly important.

I think I am in a “new normal.” I am considered cancer free but I don’t want to forget the experience that has gotten me to this point. Today, I am grateful for everything and take nothing for granted, not one single moment…

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This story originally appeared on VirginiaMason.org. Meet other patients who bravely shared their stories of fighting cancer, and get the latest information on cancer treatment outcomes and wellness and support at Virginia Mason.

Think Pink This October

admin-ajaxOctober means pumpkins and Halloween costumes – and everything in the stores is a festive orange and black. But for those of us who know someone who has or has been through breast cancer, the only color that matters this month is pink for breast cancer awareness.

Breast cancer is the second most common kind of cancer in women, and many women can survive breast cancer if it’s found and treated early. Which is why during October, we want you to talk to your doctor about your risk for breast cancer and how often you should be getting mammograms.

Virginia Mason is celebrating this special month with two very special events – the opening of our new Breast Clinic and the Making Strides walk.

New Breast Clinic
We’re very excited to open the new Breast Clinic at the University Village Regional Medical Center during Breast Cancer Awareness Month. Starting Tuesday, Oct. 7, we will offer screening mammography at this site for scheduled and walk-in appointments. In mid-October, the clinic will also begin offering appointments with a breast health nurse practitioner to evaluate any concerns for women and men.

For more information on the University Village Breast Clinic, please visit VirginiaMason.org/breastclinic. For an appointment for a screening mammogram or with a Breast Clinic provider, call 1 (877) 433-9813.

Making Strides
Join the Virginia Mason team on Saturday, Oct. 18, for the American Cancer Society Making Strides Against Breast Cancer walk, as we help make breast cancer a disease of the past.

Since 1993, 9 million walkers in Making Strides events across the country have raised more than $528 million to support not only cancer research, but access to mammograms, information and services for women in need. Funds help pay for everything from transportation and lodging to support programs and financial assistance. Every Making Strides walker helps push research forward, maintain essential services and build awareness in their own communities.

When: Saturday, Oct. 18; walk starts at 9 a.m.
Where: Seattle Center
What: 5K (3.1 mile) non-competitive walk
Team Virginia Mason: Click here to register with the Virginia Mason team.

Want to learn more about breast health? Visit these past blog articles:

Breast Clinic Now Offers 3D Digital Screening for Cancer

Virginia Mason is now offering a new technology for screening women for breast cancer called Digital Breast Tomosynthesis, also known as DBT, which provides 3D mammography to help care providers make more accurate diagnoses.

Scan from DBT

“The Virginia Mason Breast Clinic, along with the American Cancer Society, recommends yearly 2D or 3D screening mammograms for women 40 and older,” says radiologist Peter Eby, MD, who specializes in breast imaging. “3D mammograms may be especially beneficial for women that are pre-menopausal or have dense breast tissue.”

DBT looks and feels just like a standard two-dimensional digital mammogram to the patient, but the images appear differently to the radiologist. While standard 2D mammography provides a single image of the entire breast, DBT provides multiple image “slices” of each breast that can be examined individually like cards in a deck.

Compared to 2D mammography, research shows DBT examinations are more sensitive and specific because of increased cancer-detection capability and decreased false positives. The improvement in test performance is achieved through the combination of advanced technology and an increased radiation dose (although the total dose for the exam remains low and is still within the federal limit for screening mammography).

The primary role of DBT is screening, especially for patients with dense breast tissue who may have the greatest benefit. DBT is currently available in the Breast Clinic in Lindeman Pavilion in Seattle. The examination can be ordered as a screening mammogram with request for DBT, and it is billed as a standard screening examination.

Please call  (206) 625-7250 for more information or to schedule an appointment.