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Monthly Archives: October 2015

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By Bill Landon

After leading by two sets, the Ward Melville boys’ volleyball team dropped the next two to send the match into a decisive fifth set, where the Patriots overcame a six-point deficit to defeat the Tigers.

Ward Melville's Matt Lilley leaps up for the block against Northport's Nick Bitteto. Photo by Bill Landon
Ward Melville’s Matt Lilley leaps up for the block against Northport’s Nick Bitteto. Photo by Bill Landon

Both teams fought for every point in the first set, which was tied 21-21 before Ward Melville put the set away, 25-23.

The second set was a lot like the first. Both teams tied at 9-9 and again at 17-17, with neither team giving an inch. The Patriots edged ahead 22-20, and were able to take the set, 25-21.

“We were fortunate, early on, to go up 2-0, but we knew they would come back and force that game four,” Ward Melville head coach Chris Holden said. “They’re not a team that’s going to back down and go out without a fight.”

Northport was hanging by a thread, and although the team broke out to a three-point lead, Ward Melville’s Matt Lilley, on a service tear, put his team out in front 13-12, before the teams tied it 14-14. The Tigers edged ahead 19-17, and put the set away, 25-22.

Although his team was down two sets, Northport senior Dom DellaMarco said he was confident his team could turn it around and avoid a shutout.

“In that third set, we knew we had to come together as a team, dig deep and keep pushing,” DellaMarco said. “We can’t let up and we can’t get down on ourselves.”

Northport led the fourth set like it did in the third, and the Tigers surged ahead 21-13 before the Patriots rallied back to trail 24-20.

“We were pretty confident going into that third set, but I think we took a little bit for granted — some of us thought that team would just roll over,” Ward Melville’s Chris Allen said. “But Northport showed us that wasn’t going to happen. They fought back. They’re a quality team.”

Northport senior Nick Bitetto said his team had to leverage their victory in the third set and bring that energy to the fourth.

Chris Allen sends the ball over the net for Ward Melville. Photo by Bill Landon
Chris Allen sends the ball over the net for Ward Melville. Photo by Bill Landon

“I knew we just couldn’t give up — we had to come together and we had to build momentum,” Bitetto said. “We had to fight. We didn’t come this far to lose.”

Northport scored next to win the fourth set 25-20, and force a decisive fifth.

Ward Melville stayed one step ahead of its opponent, as they stretched their legs to lead 15-10. Both teams traded points, and minutes later the Patriots had a 20-15 lead.

Northport wasn’t about to go quietly, and the Tigers closed to within two, 22-20, late in the set.

“We were well prepared; we saw them in a couple of tournaments where we went head to head with them — starters against starters — and we came out on top all three times,” Northport head coach Robert Hamel said. “We knew we matched up well with them. We knew it was going to be a playoff-type of game.”

After several long ball rallies, Ward Melville won the final set, 25-21.

“We knew we needed our passing to come down — when we’re in system, we know we can beat any team we need to,” Lilley said. “We did well in our transition, passing and hitting, and because of that, we got better and better in the fifth set.”

With the win, the Patriots improve to 10-3 and Northport fell to 8-6. Both teams are still headed to the playoffs, which begin Nov. 3.

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General Theory of Walkability forum at Setauket Neighborhood House

Former county Legislator Vivian Viloria-Fisher voices her opinion at The General Theory of Walkability forum. Photo by Giselle Barkley

To have sidewalks or to not have sidewalks — that was the topic of debate for residents and town and county officials during a forum, The General Theory of Walkability, on Oct. 22 at the Setauket Neighborhood House.

Brookhaven Councilwoman Valerie Cartright (D-Port Jefferson Station), Suffolk County Legislator Kara Hahn (D-Setauket), members of the Three Village Community Trust and residents gathered to listen to residents’ thoughts about establishing sidewalks along various roads and areas like the Three Village and suggestions about how to make the roads safer for pedestrians.

Former county Legislator Vivian Viloria-Fisher was among the members in the audience. Fisher, an avid walker, was shocked with how many people weren’t in favor of sidewalks after speaking to residents at the event. Fisher said many people didn’t want to take on the responsibility of having a sidewalk in front of their home, or they didn’t want to disturb the rural appeal of the area by introducing sidewalks.

A New York Metropolitan Transportation Council study from 1994 to 2004, referred to during the debate, indicated a 25 percent decrease in pedestrian fatalities in New York state with the exception of Suffolk County. The county experienced a 104 percent increase in these fatalities in that 10-year-or-so period.

Sidewalks were introduced as an idea to combat the issue of pedestrian safety especially for children and those who enjoy walking or biking. According to Jenanne Hominick, who serves as a crossing guard under Suffolk County Police Department’s 6th Precinct, sidewalks are fine as long as they are established in an appropriate area.

“[Route] 25A [needs sidewalks] without a doubt. You got college students coming. They have no transportation. These guys are from Japan and all over the world,” Hominick said in an interview after the event.

She added that sidewalks in residential areas might not be necessary.

While sidewalks and were the main issue, panelist Ann Fangmann, director of programs at Sustainable Long Island, said sidewalks or complete streets, which includes sidewalks and a designated turning lane among other features, weren’t the only way to promote pedestrian safety.

“There’s so many different communities on Long Island and they each have their own character,” Fangmann said during the event. “They each have their own setup. It’s really about planning in a way that is inclusive of that community character and not take away from it.”

She suggested that designating a portion of the road for pedestrians is an option.

Others also suggested establishing sidewalks starting with schools to help keep children safe when its time to go home. Using speed bumps to help people slow down and adhere to the speed limit as well as stop signs was another suggestion. Elena Sadov of Setauket was one of the few members who pointed out that more advanced cars are part of the issue when it comes to pedestrian safety.

“When you look at historic pictures of our town, we were able to coexist with horse traffic,” Sadov said. “Because horses were slower we did not need sidewalks. Now the seed of travel has improved tremendously.”

Friends of the Greenway member, among others, Herb Mones added to the conversation saying that the current “car culture” is oriented toward “performance, acceleration and stunts.” He added that the people in the audience were also part of the issue.

“I can almost guarantee 70 percent of the people in this audience … will not come to a stop, you will not observe the speed limit, you will not be the good driver that you pretend to be,” Mones said. “But you will be when you turn onto your street.”

Although some residents disagreed with others Hahn said these debates help members in the community tackle problems like the issue of pedestrian safety.

“I think that when a community plans what the solutions are, you get solutions that are more acceptable to everyone — and it sounds like there are a lot of different options to make the roads safer,” Hahn said.

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Inside this issue is a treasure trove of first-hand information about the candidates and the issues in the coming election. How do I know? Because we, the different members of the editorial board of Times Beacon Record Newspapers, personally interviewed 16 people running for office across the three towns that we serve: Brookhaven, Smithtown and Huntington. The offices the candidates are running for are all local, which means that these are the officials who will have the most direct effect on our lives. The positions range this year from county executive and county legislator to town supervisor and town council, to highway department supervisor and family court judge.

We asked them questions without bias, seeking only to understand who they were, what they believed and what we could expect from each of them, should they be elected — or re-elected, as the case might be. The setting in our conference room was relaxed, and we hoped comfortable, with opponents for each office seated together around the table responding to questions put to them by our editors and reporters.

Sometimes there were four candidates, sometimes only one who might be running unopposed or against a shadow opponent, but mostly there were two during each session. Most of the time, the hour goes by calmly, but occasionally the opponents get testy with each other — they may even become openly hostile.

At one such session some years ago, one of the candidates invited the other out to the back parking lot “to settle things.” When the other began to take off his jacket, we quickly intervened. But there was no such flare-up this year.

The answers were timed in an attempt to get to the main ideas without running on too long. There was ample time at the end for each visitor to tell us anything more that perhaps we hadn’t elicited with our questioning.

We have written up the details of each interview in a separate article for the election section. And we discuss the candidates at the end of each hour and come to a conclusion for the endorsement.

Most of the time, the editorial group was unanimous because the choices were fairly direct. But for a couple of races, we talked over the pros and cons of each candidate at length before making the selection. These endorsements are based on both the in-depth interviews and the considerable information we know about the incumbents since we have been covering them closely throughout their terms in office. Of course, after reading the stories, you may or may not agree with our conclusions. Our job is to get you thinking.

The many hours that are given to this task, throughout the month of October, are a service for our readers. We are privileged to enjoy an extended face-to-face time with those standing for election, and we feel an obligation to pass along whatever information, facts and impressions we gather during these sessions. We sincerely hope we help in the sometimes-difficult job of casting a responsible vote.

Each year we include in the election section a sample ballot that we are able to procure, with greater or lesser difficulty, from county election officials. This year the effort took most of an entire day until we got to the right person. It was finally our art director who located the prize. We believe it was well worth the trouble, because readers have told us that it is a great advantage for them to receive the ballot at the voting poll already knowing how it is laid out.

Our editorial board is made up of staffers with different political leanings, but when we put our journalists’ hats on, we try to judge each race strictly on the merits of the opposing candidates. And while it is technically possible for me to be tyrannical about the final selections, that is almost never the case. We decide by majority rule.

Sincere thanks to the talented staff who join in this extra work each year. We truly believe that we are watchdogs for the people, and nowhere is that more necessary than in reporting about government and its office holders. We hope we have helped you, whether you read by newspaper and/or online. Now please vote.

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The first few moments
after we open our eyes, our minds process everything around us. Wait, what day is it? Hmm, did we dry clean the right suit for today? Do we really have to do that presentation? Could it possibly have snowed and might we have a day when we can relax at home?

Somewhere in those moments when we put the pieces of our lives and minds together, we might take stock of how we feel about the coming day and its challenges. Are we going to puff out chests, knowing that we’re going to ace that test, that we’re going to give the perfect presentation or that we’re going to do so well in that job interview that the company will not only offer us a position but will give us a higher salary than they had intended.

Where do we find the zen, strength and confidence to succeed, while having something to offer? And why, like a reputation, does it so often seem so fragile?

Let’s take a look at children. They are smaller versions of us — up until high school — and some of the thoughts, emotions and reactions to experiences that they have are more visible. They haven’t learned how to cover so much of themselves up.

When they play their musical instruments, for example, we can tell that they’ve played the wrong note by the color of their faces and by the way they slump their shoulders when they stand with the group for a final applause. We can watch them pull their hats low over their eyes when they throw a ball into right field from shortstop or when they shake their heads and roll their eyes at their misfires.

Even surrounded by a large collection of friends and family, our children can so readily believe the worst about themselves. In a way, I suppose, believing that we can and should be better could be motivational. We’re not where we want to be, we’re not who we want to be, and we have to figure out how to get from the now of point A to the goal of point B.

It’s also important for us to find some humility. If we walked around town, the house or school acting as if we were the preordained future leader of the free world, we would be insufferable, irritating and ridiculous.

Still, when it comes to that balancing act, we seem so much more likely to look down on ourselves, our efforts and our achievements. No matter how much our parents or friends tell us we’re fantastic and that we contributed something extraordinary, we are still ready to home in on the imperfections and wonder whether we’ll ever live up to our own expectations.

We read inspirational books, follow the examples of people who have achieved what we’d like to do and surround ourselves, sometimes, with sayings like, “Today is the start of something incredible.” Along the way, however, someone nudges us off the tracks and we hope that tomorrow might be the real start of something spectacular.

Maybe there are people who have become so effective at becoming “nattering nabobs of negativity,” to borrow from former Vice President Spiro Agnew, that we are ready to believe them. It’s easier, after all, to knock someone off a mountain than it is to climb one yourself.

Maybe, in addition to all the diet plans to help us avoid giving in to our cravings for the sugar our country produces and uses to celebrate so many occasions, what we need is a new industry: Mojo Inc.

This could allow us to succeed in a humble way, perhaps, while refueling us with positive energy.

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‘Metamorphosis,’ Best in Show Senior Division by Jeanette Wells

Just in time for Halloween, the Huntington Arts Council’s annual Nightmare on Main Street — Student Art Exhibit is currently on view at the Main Street Gallery in Huntington through Saturday, Oct. 31.

‘The Bride of Frankenstein’ by Cameron Matassa, Grade 11, Massapequa Park
‘The Bride of Frankenstein’ by Cameron Matassa, Grade 11, Massapequa Park

Now in its 4th year, “the inspiration for Nightmare on Main Street came from the dramatic holiday Windows at Macy’s in New York City. We wanted to take advantage of the beautiful windows that frame the gallery at the Huntington Arts Council and turn the actual windows into a work of dramatic art,” said Andrea Maire, immediate past president of the Huntington Arts Council.

“Once inside the gallery, visitors would find that even the gallery floors and walls had been treated with similar flair. We chose Halloween because the many possible interpretations of the season would give our young participating artists the most choices in creating their works,” she said.

Thirty-four student artists in grades K through 12 were selected as finalists including Sarah Ansman, Eleana Canas, Kianna Criscuola, Andrew Davis, Katie Elkowitz, Katie Eng, Jessica Garcia, Allie Giordano, Claire Hannon, Jackie Hawkins, Ashley Herkommer, Julie Jankowski, Aisha Khan, Tateana Khokhar, Sarah Kimmel, Tyler Kiser, Lauren Landolfi,  Cameron Matassa, Jean Miller, Ruth Mistretta, Eli Mollineaux, Theresa Moreno, Erin O’Kelly, Martin Perez, Kenya Pinos, Maheen Rahman, Claudia Reese, Nicole Ruiz, Jack Ruthkowski, Jordan Shaked, Dipti Sharma, Michelle Shin, Aidan Spencer and Jeanette Wells.

The exhibit was juried by Michelle Carollo, an installation artist, administrator, teacher and community organizer whose work has been shown across the United States. The recipient of many awards, she was recently a select finalist for the NYC Public Art in Public Schools.

‘VooDoo Doll,’ Best in Show Junior Division, by Jack Ruthkowski. Image from Huntington Arts Council
‘VooDoo Doll,’ Best in Show Junior Division, by Jack Ruthkowski. Image from Huntington Arts Council

On exhibit is artwork that has been inspired by Halloween whether it be ghoulish, gross or somewhat gruesome. “The works in this show capture the true spirit of Halloween, whether it be playful, psychological or physical, the spectator soon realizes the power of the imagination is the scariest of all,” said Carollo in describing the students work.

Two winners were ultimately chosen for Best in Show in the Junior Division (Grades K to 8) and Senior Division (Grades 9 to 12) category. Congratulations to 9-year-old Jack Ruthkowski  of Huntington for Best in Show in the Junior Division for “VooDoo Doll” and Jeanette Wells, an 11th-grader from Northport for Best in Show in the Senior Division  for “Metamorphosis.” Both artists will receive a check for $50.

“The Nightmare on Main Street exhibit continues to draw talented student artists. It is wonderful to see how young people interpret the Halloween theme. The creativity, skill, technique and enthusiasm for the show are all part of what makes this program so rewarding for us,” said Marc Courtade, executive director of the Huntington Arts Council. “It is our pleasure to provide this opportunity to student artists throughout the community,” he added.

A costume party will be held at the gallery on Oct. 30 from 6 to 8 p.m. where the two winners will be presented with awards. All are welcome to attend this free event and costumes are encouraged. Refreshments will be served.

The Main Street Gallery, 213 Main St., Huntington, is open Monday to Friday from 9 a.m. to 5 p.m. and Saturday from noon to 4 p.m. For more information, call 631-271-8423 or visit www.huntingtonarts.org.

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Prof. W. Richard McCombie works in his lab at CSHL. Photo from CSHL

It’s an issue that attracts debate because there are large enough overlapping or gray areas that make it challenging to offer a definitive answer across a range of circumstances.

“I had a professor in graduate school who put it this way: If you have the genetic variant for Huntington’s disease, you will get Huntington’s disease,” said W. Richard McCombie, a professor and director of the Stanley Institute for Cognitive Genomics at Cold Spring Harbor Laboratory. “If you walk in front of a truck that’s going 70 miles per hour on an interstate, your genes are irrelevant. Everything else is in between.”

Indeed, McCombie and his lab have become something of expert genetic speed readers, looking at enormous multiples of genes that were almost unthinkable just a decade or so ago.

“Next-generation sequencing has dramatically changed the field of genomics, allowing researchers to access an unprecedented amount of data,” he said. “The challenge lies in the analysis of these large data sets.”

The sequences he describes are the combination of the four base pairs, adenine, guanine, cytosine and tyrosine, strung together in a double-helix ladder design.

The implications of these new genetic sequences and libraries range from generating personalized medicine and understanding the prognosis for different diseases and likelihoods of effective therapy to seeking ways to enhance the production of food and energy crops.

The basic question he’s asking is “what’s the correlation between the structure and function of a living organism, in terms of the genome?”

From a practical standpoint, working in different systems helps when McCombie is applying for funding, he suggested.

The technology and expertise he develops also have applications across systems. When he gets funding to explore the sequence of large plant genomes, he can then use what he learns from that to work on studying cancer.

McCombie’s contributions have spanned several areas, including developing next-generation sequencing, contributing to plant genome sequencing and studying the genetic basis of cognitive disorders, said Greg Hannon, the Royal Society Wolfson Research Professor at the Cancer Research UK Cambridge Institute at the University of Cambridge, who has co-authored 17 papers with McCombie.

“He has made tremendous impacts across multiple fields,” Hannon said,

McCombie is “a real hero of the lab,” and Hannon said he “can’t think of anyone else who has had the diversity of impact he has.”

Sequencing in general has involved instruments that look at small bits of data at a time, around 100 base fragments. Using something called long-read technology, researchers can now examine pieces that are around 10,000 base pairs.

This technology is “really coming along” and has implications for cancer, where tumors are often due to rearrangements, insertions or deletions, while it also might impact plant genomics, where the long-read technology can be 100 to 1,000 times as effective as the short-read technology, McCombie said.

Sequencing pieces of genes is like taking a picture of, say, the Grand Canyon and turning that into a jigsaw puzzle. In the short-read technology, the pieces are smaller and, in some cases, show some of the same features. In the long-read technology, the pieces are much larger, turning the picture into something closer to a small child’s puzzle.

The long reads have a lower raw accuracy, he said, but with enough coverage, scientists can achieve a high consensus accuracy because the errors are mostly random.

The long-read technology is like having a puzzle with four pieces, instead of 1,000, he said.

The process of comparing genes or looking for a smoking gun causative set of genes involved in disease can be and is difficult, especially when comparing the genes of an individual with a representative healthy set of genes.

“Searching for causative genes can be very challenging particularly in complex diseases where more than one gene (and often many genes) contributes to the disease,” McCombie explained. “Trying to pinpoint causative variants is complicated by the normal background variation.”

Indeed, it’s more productive and instructive to look at larger sample sizes of people or to examine trios — the genes of parents unaffected by a genetic disease and their affected child.

Using these trios, McCombie and other scientists have found some overlap in potentially causative genes across disorders from schizophrenia and bipolar disorder to autism and intellectual impairment. McCombie is currently exploring multiple sets of genes in cases of depression.

McCombie and his wife Janice, a computer technician who works in Manhattan, live in Port Washington, which, he says, is convenient to the many operas they enjoy.

Given the flood of information available through all the genetic data that comes out daily, McCombie said scientists entering this field have to have some skill and understanding of bioinformatics, which makes sense of vast amounts of data.

“I give a short talk to the first-year grad students on their research every year,” he said. “One of them asked me if I thought bioinformatics was important in biology research. To be realistic, people in [the next generation] have no future if [they’re] not adept at working on computers and don’t understand bioinformatics.”

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From left, Olivia Publisi, Paul Graf, Christine Sullivan and Michael Puglisi in a scene from ‘Reset.’ Photo by Michael Leinoff

By Charles J. Morgan

The Minstrel Players of Northport, now “under new management,” opened last Saturday, Oct. 24, with its 4th annual original play festival, “Back to the Zone.”

A panorama of seven short, one-act plays in the style of Rod Serling’s “The Twilight Zone,” it showed the sure hand of Evan Donnellon, the Minstrel’s new executive producer.

In “Death Here” by Steven Gianturco, the figure of Death, played by John Leone, black hood and plastic scythe, gets a phone call announcing the arrival of another deceased, Gil Joe Lesko, who arrives “early.” A madcap dialog ensues between the two. Three parts of standard eschatology’s four divisions rapidly envelopes their trigger-tongued discourse: Heaven, Hell, Death … missing was Punishment. In fact Lesko manages to in the “argument” about the afterlife. Total resolution … to be seen.

Leone is overpowering in his role; the overworked office worker, constantly pushed to get more paperwork done, handle files and phone calls. His projection was excellent. Lesko discharged his part with integrity. He is possessed of a truly theatrical face, reminiscent of the elder Paul Guilfoyle with a touch of Harry Langdon.

“Isabelle” by Ceara Lee Taylor is a two-character effort featuring Tricia Ieronimo in the title role and Brian Hartwig as boyfriend Michael. The two are on a park bench reminiscing about old times like old lovers until it is realized that one of them is long dead. This is a vignette literarily influenced by James Joyce’s “The Dead.” Ieronimo is competent and Hartwig is consistent in characterization.

“Baby Monitor” by Ray Palen is a three-character play with Mark Swinson and Stephanie Leinoff as husband and wife Rick and Amy. They have purchased an electronic “baby monitor,” presumably to “baby sit” their newborn. Later Amy is convinced extra-terrestrials are being introduced through the monitor. They call in a psychic. Here enters Roseanne Baldanza as Thaniel. Baldanza is outstanding with deadpan pseudo-mystical gestures, a haunting voice and extra precise timing … a serio-comic role played to the hilt.

“Reset” by Jerry Eitel features Paul Graf as Man, Christine Sullivan as Woman and Michael and Olivia Puglisi as Boy and Girl. John Wolf crashes on as Gangster. The thesis of the play is that Man and Woman have no idea of their identity; they do not know even their names or whereabouts. Only later the two children provide a rationale for their existence. Graf projects well and is almost Hamlet-like in his groping for reality. Sullivan is all charm, but neither of them can break the closeted psyches until the children come on stage. They help the two become real. The kids’ delivery was a tad recitative, but they were obviously at home on the bards. Wolf, in a loud pin-striped suit and armed is the oppressive, arrogant hood demanding to know his identity. He too is “realized” by the kids.

A late-hours, closing time barroom is the setting for “Deathless” by Evan Donnellan, the heaviest of the seven. A character billed only as Stranger enters looking for just one more drink. The actor is Carl Nehring, and his tour de force about being deathless, unable to die, is a monument to skilled acting, articulate in form and consistent in delivery. The tired, bored bartender is Lou Lentino. He is the perfect foil for Nehring’s diatribe. Lentino understates the role with precision. The interfacing of the two is the armature of the show, and it is no less than riveting. Even the one word “God!” spoken during the blackout unravels the thesis penetratingly. It was a truly captivating theatrical experience.

“The Waiting Room” by Dave Buscema features two characters here in neat business suits — Paul Graf as Mr. Lanes and Bob Oliver as Man but who acts as Lanes’ conscience. Lanes is waiting to be called into the boss’s office to hear of his much sought after promotion up the corporate ladder. Oliver delivers a scathing, but soft rundown of Lanes’ past peccadilloes as well as his cheating and hubris. Graf does the rendition drill quite well. He displays disbelief, insult, anger and eventually self-righteousness with plasticity. Oliver handles the role of unerring conscience with icy persistence. Lanes is called in as his wife Amy, played by Christine Sullivan, enters. In his arms they both face a prosperous future as Oliver simply glowers.

In “The Cook Book or the Cupcake Recipe” by Jordan Hue, four characters arrive at an unexplainably messy old house intent on a weekend of fun. They are Jes Almeida as Carly, Emily Dowdell as Devon, Christina Corsaro as Hope and Brian Hartwig as Walter. Later Carl Nehring will appear as Bill. As they are unpacking, Devon finds what looks like an ancient cookbook but is really a grimoire, a textbook of magic. Its effect on all of them is to repack and get out of there. A blackout is used here to express passage of time. With lights up, one of them is close to newly arrived Bill as they pore over the dusty grimoire. All acting in this performance was first rate. Special kudos go to Emily Dowdell who developed Devon as real, individuated and dominant with a controlled approach that made her outstanding.

Undoubtedly, the persistent theme of death was notably seen in practically all of the seven. One asks was this a reflection of the secular humanist culture in which we find ourselves, or was it just the deliberate objective of the new, young playwrights?

The Minstrel Players will present “Back to the Zone” at Trinity Episcopal Church’s Houghton Hall, 130 Main St., Northport, on Nov. 1 at 3 p.m., Nov. 7 at 8 p.m. and Nov. 8 at 3 p.m. Tickets are $20 adults, $15 seniors and children under 12. For more information, call 516-557-1207 or visit www.minstrelplayers.org.

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We talk a good story about prevention, but most of the time, we in the medical community are guilty of confusing primary prevention with early detection. Breast cancer is no exception.

If you’re a woman and thought that there was not enough intrigue during a doctor’s appointment, the new recommendations from the American Cancer Society (ACS) and the results from the recent ductal carcinoma in situ (DCIS) study should help spice up the conversation with your physician.

For the first time since 2003, the ACS has changed its recommendations for the use of mammography in the early detection of cancer. The guidelines have become less aggressive. We will review this in greater detail.

What about DCIS? This is where atypical cells that look like potential cancer cells that may metastasize can be picked up on mammography. DCIS is known as stage 0 cancer. DCIS is found specifically in the mammary glands (milk ducts). The in situ portion of the phrase means “in place.” The current treatment regimen almost certainly involves surgery — a lumpectomy, mastectomy (complete removal of the breast), or even double mastectomy. DCIS has the potential to progress to invasive cancer, or it may be cancer in its own right.

However, it may not. This is where the quandary begins. It may just be another potential risk factor for those with average risk. We are not talking about those with high risk, either personal or family history. This is a different category.

DCIS used to make up 3 percent of breast cancer diagnoses. But now, it has increased to approximately a quarter of breast cancer diagnoses in the United States (1), in large part due to the use of mammography. The expected number of women diagnosed with DCIS in 2015 is 60,000 (2).

And then there is diet, which may help with the primary, or “true,” breast cancer prevention. Let’s look at the research.

How have the ACS guidelines changed for mammography?

Ironically, during breast cancer awareness month, the ACS, a well-respected organization, loosened the guidelines for average-risk patients (3). Changes include the age and frequency of mammography, based on data from randomized controlled trials, observational trials and modeling studies done since 2003. ACS increased the recommended mammography age from 40 to 45 years old. Then recommending patients be screened by mammography annually until age 54. After 54, the exam should be biennial (every other year), as long as the predicted reasonably healthy life span is at least 10 years.

However, women may use their own prerogative to obtain mammograms annually between 40 and 44 years old and after 54. The ACS no longer recommends clinical (in-office) breast exams in average-risk women. It may not seem like a large difference, but after having talked to some gynecologists, they are more comfortable with starting patient screening at age 45.

The reasons for these changes include the recognition that mammography is less than perfect and may result in recall, especially in younger women, and a potential for false positives, which can lead to invasive biopsies. Also, the clinical breast exams data is very low quality (4).

Unfortunately, there is no uniformity among the recommendations. The ACS recommendations are not as radical as the United States Preventive Services Task Force (USPSTF), though they are getting closer. In 2009, USPSTF recommended women undergo mammography starting at age 50 and every other year until 75 (5). Like ACS, USPSTF doesn’t recommend clinical breast exams.

Stage 0 breast cancer — DCIS

We used to think there was a linear relationship in cancer, where early-stage cells would eventually become malignant. However, this may not always be the case. In fact, we may be overtreating DCIS, this early form of breast cancer. In the SEER study, results showed that, at the 20-year mark, mortality rate was similar, 3.3 percent, regardless of surgical treatment with either lumpectomy with or without radiation or a mastectomy (6). This percent is similar to ACS’s estimated average risk of women in general dying from breast cancer.

However, the rate of mortality was greater in those who were under 35 years old, compared to older women and for those who were black, with a 2.5-fold increased risk for both groups. Many times, those under ages 35 to 40 with DCIS are symptomatic, presenting with a significant mass and blood discharge from the nipple. Certain characteristics increase risk of DCIS mortality, such as estrogen receptor status, the size of the mass, as well as grade of DCIS. If the DCIS developed into invasive breast cancer, then the risk of death went up 13 to 18 times.

The problem is, it is not clear who will develop DCIS that will result in mortality in its own right or develop invasive breast cancer. Recurrence of DCIS did not have an increase in mortality. There were approximately 100,000 women in this large observational study. We need randomized controlled trials as follow-up to this data before more definitive statements can be made. Interestingly, this is eerily similar to early-stage prostate cancer, where the younger male population and blacks have higher risks of advanced disease and death.

The incidence of breast cancer mortalities should have declined as more and more DCIS cases were identified. Unfortunately, there has been no significant change in mortality from breast cancer (7). Aggressive treatments with radiation after lumpectomy did not result in any more favorable results than without radiation. Some gynecologists have suggested that, if you receive a DCIS diagnosis, a second pathology consult might be in order to confirm that it’s DCIS.

Lifestyle to the rescue

In the PREDIMED trial, results show that with the Mediterranean-type diet that includes supplemental olive oil, the risk of malignant breast cancer was reduced by a significant 68 percent, compared to the control arm (8). The control arm was based on a low-fat diet. The strengths of this trial were that it was the first randomized controlled trial with diet and breast cancer, as well as having 4,152 participants and a solid duration of 4.8 years.

Unfortunately, there were weaknesses; breast cancer was a secondary end point, so not everyone received a screening mammography at baseline, and there was a low overall incidence of breast cancer. Still, this is an exciting trial that needs to be repeated. The diet may have been advantageous because of its antioxidant properties. There were no adverse reactions to the Mediterranean diet; in fact, this trial was stopped early because of positive cardiovascular results, the primary end point.

It could be summed this way: If you want simple, true prevention, then think diet! If you have DCIS, you will likely have a stimulating conversation with your doctor about options. There is even a breast surgeon at UCSF, Laura J. Esserman, M.D., who is willing to put average-risk DCIS patients on active surveillance instead of surgery, though she is in the minority. And for all of you who hate the pain of having your breasts crushed during mammography, you can thank the ACS for the guideline changes.

References:

(1) www.cancer.org/acs. (2) CA Cancer J Clin. 2015;65(1):5. (3) JAMA. 2015;314(15):1599-1614. (4) JAMA. 2015;314(15):1569-1571. (5) uspreventiveservicestaskforce.org. (6) JAMA Oncol. 2015;1(7):888-896. (7) JAMA Oncol. 2015;1(7):881-883. (8) JAMA Intern Med. online Sept. 14, 2015.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com or consult your personal physician.

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Rocky Point Board of Education members announce the results for the bond. Photo by Giselle Barkley

After much anticipation, the Rocky Point Board of Education members revealed the results for the school district’s $20.4 million maintenance bond after voting took place on Monday, and the results were less than impressive.

The bond’s $17,478,513 Proposition 1 received 396 votes in opposition and 320 votes in favor. Proposition 2 was also defeated, 465 to 233 votes.

The bond aimed to target repairs and renovations to the facilities, as well as health and safety projects. Proposition 1 focused on major projects, like bathroom repairs, upkeep, or additions, like outdoor bathrooms; fixing boilers; lighting ceilings; air conditioning; and locker room renovations, among other projects. Proposition 2 dealt with what some residents perceived as minor projects. This included funding items like artificial grass.

Less than 1,000 residents went to the Rocky Point High School gymnasium and voted on the bond. Wendy Guthy, of Rocky Point, whose third child recently graduated from the high school, was one of many residents who voted against the bond.

“There are things that the community doesn’t feel is necessary based on what [the Board of Education] told us two years ago,” Guthy said.

She said the board informed residents that the institution was in good standing in 2013. Guthy also added her thoughts on some renovations she found unnecessary, like repairs to the turf on the athletic field. Other residents shared Guthy’s same opinion regarding the bond’s minor projects. Rocky Point resident Judy Stringer said the bond’s propositions had “too much fluff and too many wants…instead of needs.”

“All those extra bathrooms and turf is not needed,” Stringer said in a phone interview. “Things that should be taken care of [are] the high school bathrooms and the Frank J. Carasiti bathrooms. Those things are important and necessary for the children.”

While Guthy said no to the renovations, it is not because she wants to deprive students of the renovations, but thinks about the pressure it would put on parents’ wallets.

“It’s difficult to say, ‘No,’ to the kids,” Guthy said. “But you have to be budget-minded too.”

According to the board’s newsletter regarding the bond, the state would have funded the majority of the bond, which requires taxpayer dollars. Despite this, the board’s newsletter claimed that Rocky Point taxpayers would pay less than $8 monthly to fund the propositions. Residents would have experienced a total tax impact of $92.35 if the bond was passed. Even if Proposition 2 passed, the approval of the entire bond would depend on whether the first proposition passed.

One resident, who did not want to give her name directly after voting, said she felt bad voting in opposition of the bond but she “wanted to send a message, that [the Rocky Point Board of Education]…shouldn’t tack on those extra things.” While this resident admitted that a new heating system was in order among other necessities, she said minor projects deterred her from voting for the bill. At the time, she believed the bond would pass.

During the Aug. 31 Board of Education meeting, some individuals from the New York State United Teachers School Related Professionals Association gathered to voice their opinions regarding teaching assistants versus teaching aides, and added that they would not vote in favor of the bond if the board were to eliminate teaching aide positions. Jessica Ward’s position as a teaching aide was eliminated during that meeting.

Many of these individuals attended the Monday meeting.

Rocky Point BOE President Susan Sullivan said the board tried to address the needs of the school and was disappointed with Monday night’s results on the bond.

“As elected representatives of our community, the Board of Education worked to present a bond that struck a balance between the infrastructural needs of our buildings and repairs that would preserve the integrity of our schools in a financially responsible manner,” Sullivan said in an email. “It is disappointing that the proposal presented did not garner the support of our community. We are committed to continuing to provide our students and staff with a safe and secure learning environment and will work together with our community to discuss ways to properly support our educational facilities.”

Despite the results, Superintendent of Schools for Rocky Point school district, Michael Ring, still appreciated residents’ participation with the bond.

“The district thanks the public for their participation in the bond vote,” Ring said in an email. “Moving forward, the district will continue to review its facilities’ needs in order to determine actions that may be necessary to sustain the integrity and maintenance of our buildings and grounds.”

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Miller Place's Kristin Roberto and Comsewogue's Brooke Cespites fight for possession in a semifinal game. Photo by Desirée Keegan

Comsewogue field hockey has come far this season.

After making it to the playoffs with a 9-5 overall record, the No. 4-ranked Comsewogue Warriors made it past the first round of playoffs for the first time in school history, topping No. 5 Bayport-Blue Point, 1-0.

Unfortunately for the girls, their undefeated semifinal opponent, No. 1-seeded Miller Place, wanted to stay that way, and eliminated the team from the postseason with a 4-0 shutout Monday.

Comsewogue's Brooke Cespites and Miller Place's Arianna Esposito fight for possession in a semifinal match. Photo by Desirée Keegan
Comsewogue’s Brooke Cespites and Miller Place’s Arianna Esposito fight for possession in a semifinal match. Photo by Desirée Keegan

“It’s awesome to make history — I’m really proud of our team,” Comsewogue junior defender Megan Turner said through tears. “It’s awesome. I really love these girls.”

Both teams stormed the field, playing with intensity and pressing for possession.

“I think they came out really, really strong,” Comsewogue head coach Katy Dornicik said. “We didn’t have a lot of scoring opportunities, but I feel like in the middle of the field we were evenly matched, we just didn’t come out strong at the end.”

With 26:42 left to play in the first half, Miller Place senior forward Danielle Powers broke the ice when she scored off a corner with an assist from junior Arianna Esposito.

“A lot of their passes were connecting, they were looking up, which was great,” Miller Place head coach Alana LaMorte said. “That’s what we want to do, and their corners were phenomenal today.”

Comsewogue came through with some big blocks off more corners to stay in the game, but after the Panthers called for a timeout, the team kicked it into high gear, leading to another goal off a corner, this time by senior forward Alyssa Parrella, off an assist from sophomore Crystal Esposito.

Miller Place's Emily Contrelli catches a loose ball in a semifinal game against Comsewogue. Photo by Desirée Keegan
Miller Place’s Emily Contrelli catches a loose ball in a semifinal game against Comsewogue. Photo by Desirée Keegan

Coming out of the halftime break with a 2-0 lead, Miller Place cheered and shouted to build up the intensity as the team took the field. That strategy worked — the last two goals for Miller Place were again scored off of corners. With 13:59 left to play, Parrella found the right corner of the box from the far left side, off an assist from junior Julia Burns, and rounding out the scoring with less than five minutes left to play was Powers, off an assist from the younger Esposito.

“It feels great, but we’re looking forward to the next one,” LaMorte said of the win. “I think they both came out really intense. I do think that Comsewogue really put up a very big fight. It was not easy for us even though the score differential says otherwise. I think both teams came out tight, we just were able to put it in.”

Miller Place moves on to face Rocky Point in the Class B finals on Thursday at Dowling College at 4 p.m., while Dornicik is forced to say goodbye to some of the girls she’s coached since they were in seventh and eighth grade.

“It’s rewarding to see how far they’ve come now that I’m the varsity coach,” she said. “I’m very proud of them.”

Turner said her Warriors team had a lot of confidence coming into the game and believed it could overthrow its No. 1-seeded opponent. She said the team, the coaches and the fans have been nothing but supportive throughout this season’s journey.

“We were all there for each other, we really tried our hardest and this is definitely one of the best teams I’ve ever been on,” she said. “I think it’s a very big self-esteem booster considering how far we made it.”

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