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Breast Cancer Awareness Month

Participants rush toward frigid water at Cedar Beach in Mount Sinai during the Town of Brookhaven’s 2022 Freezin’ for a Reason Polar Plunge event. This year’s plunge will take place Nov. 18. File photo by Raymond Janis
By Samantha Rutt

Town of Brookhaven Supervisor Ed Romaine (R) started last Thursday’s Oct. 19 Town Board meeting with a moment of silence acknowledging the foreign conflicts overseas in Gaza and Ukraine. Romaine encouraged the board and all attendees to “pray for peace in this troubled world of ours.”

Before addressing the amendments, authorizations and related public business, Councilwoman Jane Bonner (R-Rocky Point) held a presentation introducing the Town of Brookhaven’s annual Freezin’ for a Reason Polar Plunge event. The event will take place Nov. 18 at Cedar Beach in Mount Sinai.

The board approved a designated area in the Smith Haven Mall to be a drop-off center for toys in conjunction with the 2023 Toy Drive, held yearly during the holiday season.

The board then set a date for a public hearing on the renewal of the Cable Television Franchise Agreement between the Town of Brookhaven and Suffolk Cable Corporation (Cablevision/Altice). The public hearing for this case will be held Nov. 16 at 2:30 p.m.

The board amended the Policies and Procedures Manual for the Home Investment Partnership Program. The H.O.M.E. program is a federal initiative funded by the U.S. Department of Housing and Urban Development that aims to provide state and local governments with funds to support affordable housing initiatives, especially for low-income individuals and families.

October is National Breast Cancer Awareness Month. The board acknowledged those diagnosed with breast cancer in the Town of Brookhaven each year, declaring October 2023 Breast Cancer Awareness Month, promoting breast cancer awareness and drawing attention to thousands of individuals facing breast cancer diagnoses each year.

With Halloween fast approaching, the Teal Pumpkin Project is back once again. The TPP was established to provide nonfood treats on and around Halloween for children with food allergies, medical digestive disorders and other dietary restrictions. In this week’s meeting, the board noted its support for the seasonal project, which seeks to benefit all children through nonfood treat options for trick-or-treaters. To participate in the project, participants should print the Teal Pumpkin Project sign and display it where it is visible for trick-or-treaters.

To continue inclusivity and community engagement, the board declared Nov. 15 as the Town of Brookhaven Recycles Day to further promote local awareness and participation in the town’s recycling efforts. 

The board will meet again Thursday, Nov. 9, at 5 p.m. for the budget public hearing.

By Aidan Johnson

Over 150 people participated in the Stony Brook Rotary Club’s Oktoberfest 5K Run Sunday, Oct. 15.

The event, which saw clear skies and mild temperatures, raised money for the Stony Brook Cancer Center’s Mobile Mammography Van, which goes around to different communities to offer free breast cancer screenings.

“This year, we started our new pledge to Stony Brook Cancer Center, who sponsored the mammogram bus,” explained Debbie Van Doorne, president of Stony Brook Rotary. 

The fundraiser was timed well since October is Breast Cancer Awareness Month, followed by “Movember,” which raises awareness of breast cancer in men, Van Doorne added.

The Bench Bar & Grill on Route 25A in Stony Brook was the starting and finishing point. As runners returned, they were greeted with refreshments and live music by the band Alternate FRED.

 

Breast cancer myth busters

By Melissa Arnold

Each October, it seems like the whole world turns pink in the name of breast cancer awareness. From fundraisers to billboards, clothing and social media campaigns, that ubiquitous pink ribbon is everywhere. Of course, there’s a clear need for awareness, as 1 in 8 women on Long Island will develop invasive  breast cancer in their lifetime. But even with the October blitz, myths and misconceptions remain widely circulated among women of all ages.

Susan Samaroo is the executive director of The Maurer Foundation (www.maurerfoundation.org), a nonprofit organization in Melville established in 1995 with one goal in mind — to save lives through breast education. Their interactive workshops held in schools, colleges and community locations debunk long-held breast cancer myths, teach people how to lower their risk through lifestyle modification, and provide instruction to find breast cancer in its earliest stages when it is easiest to treat.

“We believe that it’s important to educate young people specifically and give them the information they need early on,” said Samaroo. “It’s never too early to learn what to look for and how to make positive changes that reduce breast cancer risk.”

The foundation educates roughly 20,000 people each year, the majority in co-ed settings. And Samaroo noted that they tend to hear the same rumors about breast cancer year after year. Let’s set the record straight on some of the most common myths.

MYTH: If you don’t have a family history, you won’t get breast cancer.

FACT: While family history is an important factor when considering potential risk, the National Institutes of Health reports that around 85 percent of people diagnosed with breast cancer do not have a family history.

For people that do have a family history, it’s critical to have a conversation with your doctor as soon as possible. Mammograms and other screening may be recommended as early as age 25, and in some cases, genetic testing is warranted. Having certain genetic mutations causes an individual’s risk to skyrocket, and preventative medication or surgery could be necessary.

MYTH: Only older women get breast cancer.

FACT: There are actually two false statements here. First, the age factor. According to Eileen Pillitteri, program manager of The Maurer Foundation, approximately 12,000 women in their 20s and 30s receive a breast cancer diagnosis each year.

Furthermore, men can and do get breast cancer. The Centers for Disease Control and Prevention (CDC) states that 1 in 100 breast cancers patients are men, making it critical for both men and women to familiarize themselves with the look and feel of their breasts and check regularly for lumps, discharge and changes in appearance.

MYTH: Size matters.

FACT: Some people believe that having larger breasts reflects a greater risk of cancer, but that doesn’t matter. It’s worth noting, however, that some women’s breasts are more difficult to screen for abnormal growths.

“An annual mammogram is the best overall screening test for breast cancer. There are some limitations, especially in women with dense breast tissue,” said Dr. Erna Busch-Devereaux, chief breast surgeon at Huntington Hospital, Northwell Health. “Having dense breasts means that there is not a lot of fatty tissue present in the breasts. These breasts are mostly glandular and the X-rays don’t penetrate that tissue as well, so the picture is not as clear. Finding cancer can be more difficult with dense breasts — it’s like finding a snowball (cancer) in a snowstorm (background breast tissue).”

Your doctor will let you know if you have dense breasts. Different types of screening, such as 3-D mammograms, ultrasound or MRI might be suggested for a clearer picture.

MYTH: Your deodorant or your bra could give you cancer.

FACT: As of right now, there is no scientifically-backed evidence showing an increase in breast cancer risk for women who use antiperspirants or deodorants, though there are “general concerns surrounding the impact of environmental and consumed chemicals on our health,” Busch-Devereaux said, adding that more study is needed.

And as for the rumor that wearing tight bras with underwire or any other type of bra can cause breast cancer by obstructing lymph flow? “That’s completely unfounded,” Pillitteri said.

MYTH: Lifestyle doesn’t change your cancer risk.

FACT:  Across the board, limiting or avoiding alcohol consumption and eating a well-rounded, nutritious diet can help lower your risk of many cancers.

When it comes to breast cancer specifically, other choices you make can make an impact as well, but the specifics can be complicated. 

“Having children at a young age and having multiple children results in a reduced breast cancer risk, but this protection is seen decades later. In the short term, there is an increased risk for breast cancer after having a child which is associated with pregnancy-related hormone surges,” Pillitteri explained.

Contraception is another tricky topic. Hormonal IUDs and oral birth control pills can increase breast cancer risk, but they can also greatly reduce the risk of ovarian and endometrial cancers, Pillitteri said.  Other health professionals, including Dr. Busch-Devereaux, said that birth control pills don’t appear to increase overall breast cancer risk.

Healthcare organizations agree that most types of hormone replacement therapy (HRT) to cope with symptoms of menopause does increase breast cancer risk.

The takeaway: “It’s important to talk to your doctor about the products that are right for you based on your individual risk factors,” Pillitteri said.

Be proactive

In the end, risk of breast cancer can vary from person to person based on genetics, body type and lifestyle. But it’s never too late to make positive changes.

“Eat a healthy, well-balanced diet, exercise, maintain an average weight, avoid smoking or vaping, and limit alcohol — things that are good for overall health are good for the breasts,” Busch-Devereaux said. 

Make sure you have an annual mammogram screening beginning at age 40. If you have a family history or genetic mutations, talk to your doctor about when to start screenings.

And don’t be embarrassed if it’s been a while since your last mammogram. The important thing is to go.

“Sometimes women are too worried to go for a mammogram, or they delay seeking care because they’re afraid,” Busch-Devereaux said. “We stand an excellent chance of curing cancer when it is found early, so mammograms are very important and should always be encouraged. Additionally, women shouldn’t feel afraid or embarrassed to come in for an evaluation if they feel a lump or notice a change in their breast and haven’t gone for a mammogram. We’re here to help.”

This article first appeared in TBR News Media’s Focus on Health supplement on Oct. 20, 2022.

Paint Port Pink, Mather Hospital’s annual month-long breast cancer community awareness outreach, kicked off Oct. 1 with the lighting of pink lights by community partners in Port Jefferson, Port Jefferson Station, and surrounding communities. Lamp posts along Main Street in Port Jefferson are aglow with pink lights, along with the Theatre Three marquee and many store windows.

Paint Port Pink’s goal is to raise awareness about breast cancer, encourage annual mammograms, and bring the community together to fight this disease.

A pink pumpkin by Kathleen Fusaro.

Breast cancer is the most common cancer in women in the U.S., except for skin cancers, representing about 30 percent (or one in three) of all new female cancers each year. It is the second leading cause of cancer deaths for women in the U.S. after lung cancer, according to the American Cancer Society. Every two minutes someone is newly diagnosed with invasive breast cancer (Breast Cancer Research Foundation).Only one in three women over 40 have an annual mammogram. 

Paint Port Pink will feature a special HealthyU webinar on Women’s Health on Tuesday, Oct. 11 at noon. Three physicians will talk about breast cancer, menopause, and mental health during the pandemic. Register at matherhospital.org/healthyu 

Oct. 14 is “Wear Pink Day” and everyone — and their pets — are encouraged to get their pink on to raise awareness. Post photos on social media with #paintportpink and send them to [email protected] to be posted on our Facebook page.

Decorate your business window for a chance to win tickets to a 2023 concert at Jones Beach. Send photos of your window by Oct. 20 to [email protected]

The event’s popular “Pink Your Pumpkin” contest returns and encourages everyone to get creative with their pumpkins for a cause. Photos should be emailed to [email protected] by Oct. 24 and posted on social media with #paintportpink. The winner will be chosen Oct. 25 and will receive a $100 gift card. 

Paint Port Pink community sponsors include New York Cancer & Blood Specialists, Lippencott Financial Group, Riverhead Toyota, and Accelerated Services Inc., Po’ Boy Brewery , Tuscany Gourmet Market, Bohemia Garden Center, Brookhaven Expeditors, C. Tech Collections,  Michael R. Sceiford  Financial Advisor/ Edward Jones, PAP Landscape and Design, Inc., Precision Lawn Irrigation, and Swim King Pools and Patios.

A full calendar of events and a list of Paint Port Pink community partners offering promotions to benefit The Fortunato Breast Health Center is available at www.paintportpink.org. Call 631-476-2723

From despair to hope: A breast cancer survivor’s story

By Jennifer Van Trettner

Jennifer Van Trettner

It was late Friday morning on a cool December day when my phone rang. It was the (Fortunato) Breast Center calling about my routine mammogram that I had two days prior. I took a deep breath and hesitantly answered the phone. Marianne, the nurse on the other end, introduced herself and told me in a kind, warm voice that the doctor saw something of concern on my imaging and asked if I could come in for a biopsy within the hour. I said yes before I even had time to exhale.

I drove to the Breast Center alone. All sorts of thoughts were running through my head. Shortly after arrival, I was escorted to the sonogram area by a friendly woman and was given a warm gown. I undressed, wrapped myself in the warm, pink gown, and sat in the waiting room. 

A few minutes later, I was called into the sonogram room. The technician, whom I had met on several occasions, was lovely. The doctor was the same one who did my last biopsy. She explained to me that six tissue samples would be taken from my left breast. 

On Tuesday, December 21, 2021, the Breast Center called. I felt my heart plummet into my stomach and knew my life was about to change forever. As if in slow motion, I answered the call. If I close my eyes, I can still hear Marianne’s voice saying they received my biopsy results and asking if I could come to the breast center that day. This time I didn’t want to go alone. My mother-in-law, a breast cancer survivor, went with me (my mother, also a breast cancer survivor, lives in Georgia). 

With masks on, we walked into the Breast Center and were immediately brought into the office. It was warm and inviting. The doctor came in, introduced herself to my mother-in-law and sat in a chair at the end of the desk, almost directly in front of me. I could feel my eyes welling with tears.

I was told my biopsy was positive for IDC (Invasive Ductal Carcinoma) breast cancer. It was stage 1, estrogen positive, and Her2+. Relatively speaking, it was a good scenario. Marianne held up a pretty, clear box of pearls ranging from 2mm up to 20mm. She took out a 10mm pearl, placed it in my hand and told me this was the approximate size of my cancer. As I held the pearl in my hand, I thought what a nice, kind, warm, and non-scary way to confirm a woman’s fear.

Marianne, having years of my personal information in front of her, explained how she already called and made appointments with the doctors I would need to see. 

I called my mom from the office. I really needed to hear her voice. I asked her to get dad and put the phone on speaker. Telling my parents, from hundreds of miles away, their eldest daughter had breast cancer was not easy. I found myself standing at the entrance to a new path, and I wasn’t quite sure how to take the first step. One thing I knew for sure was that I wouldn’t have to take the first step alone. After hanging up with my parents, I was escorted to have an MRI. A few hours later and completely emotionally exhausted, we headed home.

On the morning of December 30, 2021, I saw my surgeon who would remove the cancer and sentinel lymph nodes. In the afternoon I saw the oncologist who had done genetic testing on me two years earlier (all of which were negative). He explained my cancer and the treatment it would require. I would need 12 weeks of chemotherapy and Herceptin infusions once a week for three to seven hours followed by an additional 13 Herceptin infusions every three weeks. Once those were finished (anticipated finish date: 2/8/23), I would need 10 years of Tamoxifen. The same evening, I had a PET scan. Thankfully, there were no surprises.

I started to tell family, friends, and colleagues of my diagnosis. I was immediately touched by the outpouring of love and concern. Helpful gifts began to arrive. The best gifts of all were the arrival of my parents a few days prior to surgery. 

My surgery at Mather Hospital was scheduled for January 25, 2022, which at the time of diagnosis felt like years away. In the back of my head was a little voice wondering if my aggressive cancer would get larger and spread during those weeks of waiting. I started an online journal and invited those closest to me to follow. 

The warrior in me began to take charge of my treatment, familiarize myself with my cancer, mastectomy options, implant options, and read from cover to cover the amazing book the breast center gave me at time of diagnosis. I reviewed all possible side effects. After that I never looked back. 

On the day of surgery, I arrived at the hospital anxious, nervous, and prayed that waking up after surgery was God’s will. I worried about what would happen to my husband and adult children if I didn’t. 

I  was brought into a large operating room. I fell asleep within seconds of speaking to the anesthesiologist and woke up seven hours later in recovery. The nurses were wonderful. Two of my former students, now nurses working the night shift, visited me bringing with them my favorite sweets, Swedish fish. Seeing familiar, friendly faces that night made my heart happy

Since my surgery, life has had many challenges. The first two weeks post-surgery I spent on the couch with my parents taking care of all household things while my husband went to work. April 14th, I tested positive for COVID, which set me back a week in treatment. Thankfully my oncologist prescribed an antiviral. It helped with my recovery and got me back on track with the infusions.

Treatments began with inserting the IV needle, blood work, Herceptin, a bag of Zofran, a bag of Benadryl and lastly chemo. By treatment six, my hair was very thin, so I decided to take control and shave what was left. The last day of chemo was May 21st, and on May 28th, I began my tri-weekly Herceptin infusions.

Throughout this journey, I have posted consistently on social media. I was born a teacher, and as such I felt it important to share my journey with anyone who wanted to follow. I believe it’s important for me to show my strengths and weaknesses, to be real, raw, and honest. This is a club no one wants to join. In the United States breast cancer affects 1 in 8 women, and on Long Island it’s 1 in 6. I had a support system like no other to help me get through this.

Schedule a mammogram today!

The Fortunato Breast Health Center at Mather Hospital, 75 North Country Road, Port Jefferson uses state-of-the-art breast imaging technology in a warm and assuring environment with a commitment to giving you personalized breast healthcare. 

Their staff of professionals provides 3D mammograms and offers individualized follow-up care, education for patients, families, and the community, as well as breast cancer support groups. 

Their Breast Center radiologists are specialists who only read breast imaging studies and look back as far as possible at your history of breast images for any subtle changes or abnormalities to provide the most accurate reading.

The Breast Health Center has also partnered with the Suffolk Cancer Services Program (CSP) to provide free breast cancer screenings to individuals who qualify. The CSP provides breast cancer screenings to women age 40 and older without health insurance in Suffolk. If any follow-up testing is needed, the CSP will provide those tests too. If cancer is found, CSP will help enroll people who are eligible in the NYS Medicaid Cancer Treatment Program for full Medicaid coverage during treatment. 

To find out if you are eligible for free screenings or to schedule your annual mammogram, call 631-476-2771. 

All photos courtesy of Mather Hospital.

 

October is Breast Cancer Awareness Month. METRO photo

Understand your risk profile and design a screening plan with your physician

By David Dunaief, M.D.

Dr. David Dunaief

Get out your pink attire, because October is Breast Cancer Awareness Month.

The most common cancer diagnosed in U.S. women, an estimated 30 percent of 2021 cancer diagnoses in women will be breast cancer (1). Of these, 85 percent of cases occur in those with no family history of the disease, and 85 percent of new cases will be invasive breast cancer.

A primary objective of raising awareness is to promote screening for early detection. While screening is crucial, prevention should be just as important, including primary prevention, preventing the disease from occurring, and secondary prevention, preventing recurrence.

Here, we will discuss current screening recommendations, along with tools to lower your risk.

At what age and how often should we be screened?

Here is where divergence occurs; experts don’t agree on age and frequency. The U.S. Preventive Services Task Force currently recommends mammograms every other year, from age 50 through age 74, with the option of beginning as early as age 40 for those with significant risk (2). It’s important to note that these guidelines, published in 2016, are currently being refined and are pending publication.

The American College of Obstetricians and Gynecologists recommends consideration of beginning annual or biennial mammograms at 40, but starting no later than 50, and continuing until age 75. They encourage a process of shared decision-making between patient and physician to determine age and frequency of exams, including whether to continue after age 75 (3).

The American Cancer Society’s physician guidelines are to offer a mammogram beginning at age 40 and recommend annual or biennial exams from 45 to 54, with biennial exams after 55 until life expectancy is less than 10 years (4).

While the recommendations may seem nuanced, it’s important to consult with your physician to determine your risk profile and plan or revise your regular screening schedule accordingly.

Do bisphosphonates help?

Bisphosphonates include Fosamax (alendronate), Zometa (zoledronic acid) and Boniva (ibandronate) and are used to treat osteoporosis. Do they have a role in breast cancer prevention? It depends on the population, and it depends on study quality.

In a meta-analysis involving two randomized controlled trials (RCTs), FIT and HORIZON-PFT, results showed no benefit from the use of bisphosphonates in reducing breast cancer risk (5). The study population involved 14,000 postmenopausal women from ages 55 to 89 women who had osteoporosis, but who did not have a personal history of breast cancer. In other words, the bisphosphonates were being used for primary prevention.

In a more recent meta-analysis of 10 studies with over 950,000 total participants, results showed that bisphosphonates did indeed reduce the risk of primary breast cancer in patients by as much as 12 percent (6). However, when the researchers dug more deeply into the studies, they found inconsistencies in the results between observational and case-control trials versus RCTs, along with an indication that longer-term use of bisphosphonates is more likely to be protective than use of less than one year.

Randomized controlled trials are better designed than observational trials. Therefore, it is more likely that bisphosphonates do not work in reducing breast cancer risk in patients without a history of breast cancer or, in other words, in primary prevention.

A Lancet metanalysis focused on breast cancer recurrence in distant locations, including bone, and survival outcomes did find benefits for postmenopausal women (7). A good synopsis of the research can be found at cancer.org.

How much exercise?

We know exercise is important in diseases and breast cancer is no exception. In an observational trial, exercise reduced breast cancer risk in postmenopausal women significantly (8). These women exercised moderately; they walked four hours a week over a four-year period. If they exercised previously, five to nine years ago, but not recently, no benefit was seen. The researchers stressed that it is never too late to begin exercise.

Only about one-third of women get the recommended level of exercise every week: 30 minutes for five days a week. Once diagnosed with breast cancer, women tend to exercise less, not more. We need to expend as much energy and resources emphasizing exercise for prevention as we do screenings.

What about soy?

Contrary to popular belief, soy may be beneficial in reducing breast cancer risk. In a meta-analysis, those who consumed more soy saw a significant reduction in breast cancer compared to those who consumed less (9). There was a dose-response curve among three groups: high intake of >20 mg per day, moderate intake of 10 mg and low intake of <5 mg.

Those in the highest group had a 29 percent reduced risk, and those in the moderate group had a 12 percent reduced risk when compared to those who consumed the least. In addition, higher soy intake has been associated with reduced recurrence and increased survival for those previously diagnosed with breast cancer (10). The benefit from soy is thought to come from isoflavones, plant-rich nutrients.

Hooray for Breast Cancer Awareness Month stressing the importance of mammography and breast self-exams. However, we need to give significantly more attention to prevention of breast cancer and its recurrence. Through potentially more soy intake, as well as a Mediterranean diet and modest exercise, we may be able to accelerate the trend toward a lower breast cancer incidence.

References:

(1) breastcancer.org. (2) uspreventiveservicestaskforce.org. (3) acog.org. (4) cancer.org. (5) JAMA Intern Med. 2014;174(10):1550-1557. (6) Clin Epidemiol. 2019; 11: 593–603. (7) Lancet. 2015 Jul 23. (8) Cancer Epidemiol Biomarkers Prev. 2014 Sep;23(9):1893-902. (9) Br J Cancer. 2008; 98:9-14. (10) JAMA. 2009 Dec 9; 302(22): 2437–2443.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com. 

Photo by Julianne Mosher

Mather Hospital’s annual month-long breast cancer awareness community outreach event, Paint Port Pink, kicked off this week in Port Jefferson village. 

Pink lights were lit on Oct. 1 across the village and throughout surrounding communities to honor and raise awareness for breast cancer during Breast Cancer Awareness Month. 

Several dozen local businesses are participating, adding the sparkling lights to their storefronts, windows and doors. 

Lamp posts along main street in Port Jefferson shine bright pink with the goal to raise awareness about breast cancer and the importance of early detection, encourage annual mammograms and bring the community together to help fight this disease.

One in eight women will develop breast cancer during their lifetime, according to Mather Hospital. In 2021, an estimated 281,550 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 49,290 new cases of non-invasive (in situ) breast cancer. 

About 2,650 new cases of invasive breast cancer are expected to be diagnosed in men in 2021. 

As of January 2021, there were more than 3.8 million women with a history of breast cancer in the U.S. This includes women currently being treated and women who have finished treatment. 

Oct. 15 is Wear Pink Day, and people are encouraged to dress themselves — and their pets — in pink and post their photos on social media with #paintportpink. 

Then send those photos to [email protected] they will be included in a collage on the hospital’s Facebook page.

Daily exercise is protective against breast cancer. METRO photo
Exercise and diet can significantly reduce risk

By David Dunaief, M.D.

Dr. David Dunaief

October is Breast Cancer Awareness Month, and everyone agrees that awareness is crucial. The incidence of invasive breast cancer in 2020 in the U.S. is estimated to be over 270,000 new cases, with approximately 40,000 patients dying from this disease each year (1).

A primary objective of raising awareness is to promote screening for early detection. But at what age should screening start and how often should we be screened?

Here is where divergence occurs; experts can’t agree on age and frequency. The U.S. Preventive Services Task Force recommends mammograms every other year, from age 50 through age 74 (2). The American College of Obstetricians and Gynecologists recommends consideration of beginning mammograms at 40, but starting no later than 50, and continuing until age 75. They encourage a process of shared decision-making between patient and physician (3).

Just as important as screening is prevention, whether it is primary, preventing the disease from occurring, or secondary, preventing recurrence. Potential ways of doing this may include lifestyle modifications, such as diet, exercise, obesity treatment and normalizing cholesterol levels. Additionally, although results are mixed, it seems that bisphosphonates do not reduce the risk of breast cancer.

Bisphosphonates

Bisphosphonates include Fosamax (alendronate), Zometa (zoledronic acid) and Boniva (ibandronate) used to treat osteoporosis. Do they have a role in breast cancer prevention? It depends on the population, and it depends on study quality.

In a meta-analysis involving two randomized controlled trials (RCTs), FIT and HORIZON-PFT, results showed no benefit from the use of bisphosphonates in reducing breast cancer risk (4). The study population involved 14,000 postmenopausal women from ages 55 to 89 women who had osteoporosis, but who did not have a personal history of breast cancer. In other words, the bisphosphonates were being used for primary prevention.

In a more recent meta-analysis of 10 studies with over 950,000 total participants, results showed that bisphosphonates did indeed reduce the risk of primary breast cancer in patients by as much as 12 percent (5). However, when the researchers dug more deeply into the studies, they found inconsistencies in the results between observational and case-control trials versus RCTs, along with an indication that longer-term use of bisphosphonates is more likely to be protective than use of less than one year. 

Randomized controlled trials are better designed than observational trials. Therefore, it is more likely that bisphosphonates do not work in reducing breast cancer risk in patients without a history of breast cancer or, in other words, in primary prevention.

Exercise

We know exercise is important in diseases and breast cancer is no exception. In an observational trial, exercise reduced breast cancer risk in postmenopausal women significantly (6). These women exercised moderately; they walked four hours a week over a four-year period. If they exercised previously, but not recently, five to nine years ago, no benefit was seen. The researchers stressed that it is never too late to begin exercise.

Only about one-third of women get the recommended level of exercise every week: 30 minutes for five days a week. Once diagnosed with breast cancer, women tend to exercise less, not more. We need to expend as much energy and resources emphasizing exercise as a prevention method as we do screenings.

Soy intake

Contrary to popular belief, soy may be beneficial in reducing breast cancer risk. In a meta-analysis (a group of eight observational studies), those who consumed more soy saw a significant reduction in breast cancer compared to those who consumed less (7). There was a dose-response curve among three groups: high intake of >20 mg per day, moderate intake of 10 mg and low intake of <5 mg.

Those in the highest group had a 29 percent reduced risk, and those in the moderate group had a 12 percent reduced risk when compared to those who consumed the least. In addition, higher soy intake has been associated with reduced recurrence and increased survival for those previously diagnosed with breast cancer (8). Why have we not seen this in U.S. trials? The level of soy used in U.S. trials is a fraction of what is used in Asian trials. The benefit from soy is thought to come from isoflavones, plant-rich nutrients.

Western vs. Mediterranean diets

A Mediterranean diet may decrease the risk of breast cancer significantly.

In an observational study, results showed that, while the Western diet increases breast cancer risk by 46 percent, the Spanish Mediterranean diet has the inverse effect, decreasing risk by 44 percent (9). The effect of the Mediterranean diet was even more powerful in triple-negative tumors, which tend to be difficult to treat. The authors concluded that diets rich in fruits, vegetables, beans, nuts and oily fish were potentially beneficial.

Hooray for Breast Cancer Awareness Month stressing the importance of mammography and breast self-exams. However, we need to give significantly more attention to prevention of breast cancer and its recurrence. Through potentially more soy intake, as well as a Mediterranean diet and modest exercise, we may be able to accelerate the trend toward a lower breast cancer incidence.

References:

(1)breastcancer.org.(2)uspreventiveservicestaskforce.org. (3) acog.org. (4) JAMA Inter Med online. 2014 Aug. 11. (5) Clin Epidemiol. 2019; 11: 593–603. (6) Cancer Epidemiol Biomarkers Prev online. 2014 Aug. 11. (7) Br J Cancer. 2008;98:9-14. (8) JAMA. 2009 Dec 9; 302(22): 2437–2443. (9) Br J Cancer. 2014;111:1454-1462.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.

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Patients arriving at the Fortunato Breast Health Center use sanitizing gel before being given a mask and having their temperature taken.

Early detection is crucial in diagnosing and treating breast cancer. But screenings in the time of the COVID-19 pandemic have become more complicated, with many screening centers closing for a time and patients fearful to come into a hospital or clinic setting. Mather Hospital’s Fortunato Breast Health Center has responded with strict safety protocols designed to protect patients and staff.

Above, patients are socially distanced from Fortunato Breast Health Center staff when checking in for a screening.

“As always with breast cancer and other cancers, your best bet is to have an early diagnosis,” said Breast Center Co-Medical Director Michelle Price, MD. “The importance of early detection cannot be overstated. Therefore, we have adapted protocols so that we can continue to provide expert care in the setting of the COVID-19 pandemic.”

The Breast Center recommends that women receive their first screening mammography at age 40 and continue annual screening every year thereafter. Many professional societies involved with the diagnosis and treatment of breast cancer also continue to recommend annual screening mammography starting at age 40, including the Society for Breast Imaging, American College of Radiology and National Comprehensive Cancer Network. In some high-risk situations, screening may begin even earlier.

Strict safety protocols have been implemented at the Breast Center in response to the COVID-19 pandemic. Dr. Price said this includes all staff and patients wearing masks at all times, everyone undergoing temperature checks when they arrive at the Breast Center, patients completing a COVID screening questionnaire about possible exposure to the virus, and the use of sanitizing gel.

“We no longer routinely have patients use waiting rooms, to minimize personal interactions,” said Dr. Price. “When patients arrive, they first call from their car, and are brought in one at a time for a streamlined experience.”

Where patients once routinely filled out a medical history form to provide information, the technologist now interviews the patient and records the pertinent data. This change eliminates the need for patients to handle a pen and paper.

Fortunato Breast Health Center Co-Medical Directors Michelle Price, MD, and Joseph Carrucciu, MD, with a 3D mammography unit in a photo taken prior to the COVID-19 pandemic.

“We have a socially distant protocol where the patient has very limited contact with anyone else, providing maximal safety. The technologist brings the patient to the mammography room, where she is provided a gown to change in to privately. When ready, the technologist enters the room and performs the mammogram. When the study is complete, the patient is again given privacy to get dressed, and she is escorted out of the department by the technologist. As has always been the case, the imaging equipment is thoroughly disinfected between patients. People seem very satisfied with what we have done from the point of safety protocols. It’s a similar setup they’ve experienced at other doctors’ offices,” said Dr. Price who stressed the importance of continuing with annual mammograms despite the pandemic.

“Early in the pandemic, non-urgent medical care was postponed, but now the situation has changed,” she said. “The current consensus is that screening should continue if it can be done safely. We have implemented protocols to maximize safety for patients and staff alike. Early detection of breast cancer offers us the best chance for successful treatment.”

The Fortunato Breast Center uses advanced 3D mammography that is designed to make screening more comfortable. The 3D mammography also offers sharper, clearer images for improved diagnostic accuracy all while providing the lowest radiation dose of all FDA approved mammography systems.

Fortunato Breast Center radiologists are specialists who only read breast imaging studies and look back as far as possible at a patient’s history of breast images for any subtle changes or abnormalities in order to provide the most accurate reading.

Should a patient have a breast cancer diagnosis, the Breast Center’s compassionate nurse navigators provide personal guidance with scheduling appointments for tests and follow-up procedures, getting prescriptions, insurance questions, and any other help patients may need. The Breast Center’s nurse navigators provide support throughout every step of the patients’ journey to recovery.

The Breast Center offers no cost or discounted mammography screenings for those individuals with low income and no health insurance. For more information, visit www. matherhospital.org/breasthealth or call 631-476-2771.

All photos courtesy of Mather Hospital

Above, employees at Mather Hospital taking part in last year's Wear Pink Day. Photo from Mather Hospital

And then there was light. Paint Port Pink, Mather Hospital’s annual breast cancer awareness campaign will kick off today, Oct.1, with the lighting of pink lights throughout the Village of Port Jefferson and in Port Jefferson Station. The month-long breast health outreach by Mather’s Fortunato Breast Health Center raises awareness, provides educational information and fosters solidarity in the community.

This year’s campaign, sponsored by New York Cancer & Blood Specialists, will join with its annual fundraising event Families Walk for Hope, which supports the Fortunato Breast Health Center. The Walk, a five-mile breast cancer fundraiser held the first Saturday in May, was postponed due to the COVID-19 pandemic and is now taking place virtually through the end of October. The Walk this year will benefit the Fortunato Breast Health Center and Mather’s COVID-19 Emergency Fund. As a thank you and a reminder to wear a mask, anyone donating $10 or more to the Walk will receive a handmade mask. Register at www.familieswalkforhope.org

New this year is a Virtual Paint Night, hosted by Mather’s 2 South oncology and medical/surgical unit. Register at www.matherhospital.org/paintnight Also new is a “Mask-querade” mask decorating contest. Participants are asked to “pink” their masks and send photos to [email protected] by Oct. 20, as well as  posting on social media with the #paintportpink. The winner will be selected on Oct. 21 and receive a $100 gift card.

The hospital’s HealthyU webinar series will present four webinars on breast cancer each Tuesday in October from noon to 1 p.m. The series will look at diagnosis, treatment, surgery and breast reconstruction. Register for these webinars at www.matherhopsital.org/healthyu.

Returning this year is the Pink Your Pumpkin contest. Photos of “pinked” pumpkins can also be emailed to [email protected] by Oct. 20 and posted on social media with #paintportpink. The winner will be chosen on Oct. 21 and will receive a $100 gift card.

Paint your pumpkins pink for breast cancer awareness month.

Wear Pink Day takes place virtually on Friday, Oct. 16. Community members are urged to dress in pink in support of breast cancer awareness and post selfies on social media with #paintportpink. Photos can also be mailed to [email protected] to be included in a collage on Mather’s Facebook page. Don’t have anything pink to wear? Register for the Families Walk for Hope and receive an official pink t-shirt that can be used for your selfie.

The Port Jefferson Free Library celebrates Paint Port Pink with a Cherry Blossom Lantern workshop on Thursday, October 15, from 3 to 4 p.m. Participants will be guided step by step to paint their own lantern in a beautiful cherry blossom pattern. Register at https://tinyurl.com/cherryblossomlanterns.

A calendar of events and a list of Paint Port Pink community partners offering promotions to benefit the Fortunato Breast Health Center’s Fund for Uninsured is at www.matherhospital.org/pink. Register for the Families Walk for Hope at www.familieswalkforhope.org Call 631-476-2723 for more information.

Many businesses in the area will decorate their windows in support like the Cutting Hut in Port Jefferson Station.

Paint Port Pink, Mather Hospital’s annual breast cancer awareness campaign, returns this year with a full calendar of events. The month-long breast health outreach by Mather’s Fortunato Breast Health Center raises awareness, provides educational information and fosters solidarity in the community.

Paint Port Pink begins Tuesday, Oct. 1 with a Turn on Your Lights event for local community partners and residents, who turn on pink lights that were distributed by the hospital along with flags and information on breast health. Many community partners decorate their display windows with a pink theme and Mather recognizes the best efforts through their annual window decorating contest.

Mather Hospital employees dressed in pink during last year’s event.

New this year is Ladies Night Out at Comsewogue Public Library on Wednesday, Oct. 2, designed to celebrate women’s health by combining fun activities with wellness information. Participants can attend a mini-paint night, make their own body scrubs and get a back and neck massage by Mather-affiliated chiropractors. They can also learn about breast health from the Fortunato Breast Health Center’s Co-Medical Director Dr. Michelle Price, participate in a Reiki circle and get information on good nutrition for women from a Mather registered dietitian and sample healthy smoothies.

The Pink Your Pumpkin contest also returns this year. The contest asks participants to visit a local farm stand or craft store and find the perfect pumpkin, use their imagination to decorate it, and then submit a photo to [email protected] before Oct. 20. The top three winners will be selected by employee leaders at Mather Hospital on Oct. 21, and the results will be posted on Mather’s Facebook page.

Wear Pink Day is Oct. 18 – which is World Mammography Day – when Mather employees and community residents are encouraged to dress in pink and post their photos at #paintportpink.

Paint Port Pink community partners will again offer special promotions and fundraisers for the Fortunato Breast Health Center’s Fund for Uninsured, which offers no-cost or discounted mammography screenings to those with little or no insurance. These include Kilwin’s, Panera Bread, Chick-fil-A, Amazing Olive and Ethan Allen Furniture, Setauket.

The fall semester of HealthyU, Mather’s seminar series and exhibit fair, is on Saturday, Oct. 26. The day will feature many informative seminars including Women and Heart Health, the Brittle Bones of Osteoporosis, a Checklist for Health after 60, Tax Tips for Seniors and Staying Young Forever. Register for this free event at https://www.matherhospital.org/healthyu-registration/.

For more information about Paint Port Pink, please call 631-476-2723 or visit www.matherhospital.org/pink.

Photos from Mather Hospital