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Mar 15

Hope for breast cancer survivors as scientists develop a test that predicts if their disease will return in the next 20 years

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Breast cancer survivors may soon know exactly how likely their cancer is to come back.

A new test offers women peace of mind through predicting their risk of getting breast cancer again in the next 20 years.

Scientists have examined tumours to find there are 11 different types of breast cancer, all with separate risks of relapsing.

They can now identify those women who do not need to worry because they are in a group mostly likely to be cured after five years.

Simply by looking at genes in breast cancer tumours, they can also break the news to some women that their cancer has a 62 per cent chance of coming back in 20 years.

Experts believe that people relapsing after this type of cancer do so because they do not respond well to radiotherapy, chemotherapy and drugs designed to eradicate cancer cells from the body. 

These can come 'back to life' many years later, causing someone to get cancer again.

The researchers also worked out relapse rates for women with HER2-positive breast cancer, but say these are out of date because the patients in the study did not have access to a relatively new drug called Herceptin.

The test gives women their chance of breast cancer coming back after 10, 15 or 20 years and their chances of dying from breast cancer or another cause.

The results, published in the journal Nature, also reveal triple-negative breast cancer is more likely to spread to the brain, while oestrogen receptor-positive, HER2-negative cancer more often spreads to the bone.

Next researchers will investigate different treatment options for the 11 breast cancer groups they have found.

Professor Karen Vousden, chief scientist for Cancer Research UK, said: 'One in seven women will get breast cancer in their lifetime in the UK, and we hope that research like this will mean that if faced with the disease, even more of our daughters and granddaughters will survive.' 

© Provided by Associated Newspapers Limited A new test offers women peace of mind

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  • I want you to imagine for a moment a mother, sister, wife or girlfriend going for a routine physical and are told that a lump was found in one of their breasts. Urgently a mammogram is scheduled and within 10 minutes a doctor tells them they have breast cancer. The feeling has been described as being in a windstorm or being taken underwater. One woman who Pawsitively 4 Pink helped said, “ hearing those words was like my lungs filling with water and I can see people around me to help, but they don’t understand that I am drowning”. Shock, fear and concern set in about the grade, stage and severity of the cancer Tests, blood work, surgeries, radiation and chemotherapy become a way of life, while never getting a firm grip on all of the ways in which breast cancer will affect her life. Instead of work, picking the kids up from school, making dinner, and a little relaxation at the end of the day. Anxiety, nausea, and perseverating thoughts about what the day will look like and how you will muddle through become the norm. Because of the toll that treatment takes on your body, you are unable to work. You have enough sick time for a week or so, and then there will be no money coming in to meet the financial obligations. What was once about managing the grueling process of treatment now has become about managing the fundamental needs of life; Food, water, shelter, safety and security. What if this same woman was YOUR mother, sister, wife, or girlfriend? Pawsitively 4 Pink financially supports low-income underserved women who been diagnosed with breast cancer. We try to relieve some of the compounding stressors along the journey of this diagnosis. PLEASE DONATE, EVERY DOLLAR COUNTS.
  • If you stumbled upon this article because your world is off-kilter after a breast cancer diagnosis, know that what you’re feeling is completely valid. While the entire experience of having breast cancer is more difficult than anyone deserves, after speaking with people who have been in this position, we realized that the time right after diagnosis can be particularly vulnerable and challenging. It’s understandable if you’re thrown for such a loop that you’re not sure how to begin moving forward. Although learning to cope after a breast cancer diagnosis is a really individual process, experts and survivors we spoke with emphasized that there are a few ways you might be able to make the experience even a little bit easier. Here are their suggestion 1. Let yourself feel everything you're feeling. It’s totally normal to experience a flood of emotions after a breast cancer diagnosis. “[You] may feel angry, numb, scared, overwhelmed, or as if the universe is an unjust and hateful place to exist,” Kimberly Vandegeest-Wallace , Ph.D., a clinical psychologist with the University of Kansas Health System, tells SELF. Also totally normal: You may have the urge to suppress these reactions when dealing with breast cancer. Honestly, whatever you’re feeling is valid, and ultimately you should do whatever you need to do in order to get through the experience. For some, letting your emotions come through without judgement can be particularly helpful. “Regardless of the emotional response, one of the most nurturing things we can do is to normalize and make room for it,” says Vandegeest-Wallace. “If you are mad, don’t deny it. Just be mad for a minute. It is an emotion. It won’t last forever.” As she explains, “Emotions are wonderfully fluid.”After being diagnosed with stage 2 breast cancer in 2018, Colandra M., 36, found that creating space for her feelings was essential. “If I did not allow myself to feel the reality of what was happening to me, I would not have been able to cope,” Colandra tells SELF. “[It helped] me to overcome ... my fear of the unknown.” For Chelsea M., 30, the anger and sadness didn’t hit until after she finished treatment for early stage triple negative breast cancer in December 2018. Prior to that, she’d been in what she describes as “survival mode,” just trying to get through it all as quickly as possible without exploring her emotions. “Once I was done with [treatment] and went back to ‘normal’ life, I cried every day,” Chelsea tells SELF. “I thought something was wrong with me, but hearing from my doctor that this is very common really helped me feel better. I had to allow myself to just let it happen 2. Know that you're not alone, even if it feels like you are Being diagnosed with breast cancer might make you feel completely alone, but it’s critical to understand that you’re not, Brigid Killelea , M.D., M.P.H., chief of breast surgery for Yale Medicine and a Yale Cancer Center surgical oncologist, tells SELF. Breast cancer is unfortunately common, which is frustrating and devastating but also means that there are other people out there who know exactly what you're going through. You don't need to join a support group right now if that doesn't feel right to you. But even reminding yourself that there are people you can connect with who might be able to help with things like handling loved ones’ reaction to the news can be really powerful. If you do decide you’d like to take it a step further, you can find local breast cancer support groups through organizations like the American Cancer Society , or you can Google for resources in your area. There are virtual support communities available, too, which might be an easier way to get used to the whole thing. Philecia L ., 32, was diagnosed with stage 4 breast cancer in 2018. The online breast cancer community became a lifeline, she says. “It really helps to relate to someone online without the expectation of meeting up in person,” she tells SELF. “It’s so nice to send a message and talk about something we can both relate to.” Philecia says the friends she’s made through Instagram and other online channels jump to support her “without a second thought 3. Try to ask for—and accept—help. After a breast cancer diagnosis, you might be feeling compelled to isolate yourself at a time when support from those you love matters even more than usual, Jessy Warner-Cohen , Ph.D., M.P.H., a health psychologist at Long Island Jewish Medical Center, tells SELF. It totally makes sense if you need some time to process by yourself. But one thing that other patients mentioned is the importance of eventually accepting help from their support system. CJ C., 68, who has been living with metastatic breast cancer for 13 years, acknowledges that wanting to be alone is understandable. However, she tells SELF, life with breast cancer would have been too big a challenge for her to handle on her own. It’s been especially invaluable for CJ to have a loved one be a second set of eyes and ears at doctors’ appointments when she’s experiencing “ chemo brain ,” or the cognitive effects that can happen with chemotherapy, she explains. Vandegeest-Wallace suggests trying to get comfortable with delegating chores or anything else that’s simply too demanding. Let your best friend walk your dog. Accept your neighbor’s meals. “As someone hands over lasagna ... the newly diagnosed cancer patient may be thinking, ‘My life is clearly a hot mess if someone is bringing me cheesy pasta.’ But cheesy pasta is a symbol of love and friendship, so receive it as such,” Vandegeest-Wallace says. You might feel like asking for help makes you a burden or positions you as weak, but it only means that you’re a human going through a challenging experience. Needing support at this time makes sense. "Maintaining a strong support system is essential during and after treatment,” Anna Belcheva , M.D., an oncologist with Houston Methodist Cancer Center, tells SELF. “Family, friends, fellow cancer patients, nurse navigators, and patient advocates can all be a part of that system 4. Schedule “you” time each week. Elaine F ., 35, was immediately struck with terror after being diagnosed with stage 2 breast cancer at 34, she tells SELF. Elaine frequently lost herself in thoughts of her illness, which took her to a dark mental and emotional space. Between that and all the logistics that come with navigating breast cancer, she had little time to enjoy as much of life as she could. “I realized that I hadn’t set aside much time for me to do the things I wanted to do for myself,” Elaine tells SELF. “[I started] setting aside time to do things that would bring me joy,” including hiking , going to comedy shows, getting massages, and reading new books, she says. Devoting her time and energy to something besides thinking about breast cancer gave her a much-needed reprieve. Dana D., 37, had a similar experience after being diagnosed with stage 1 breast cancer in 2010. As the founder of AnaOno Intimates , a lingerie company for people with breast cancer, Dana often felt like the illness was overwhelming her life from both personal and professional angles. She was constantly juggling doctor’s visits, working to pay medical bills, helping others dealing with breast cancer through her company, and trying to sleep enough due to the understandable fatigue. It was a lot to handle, so Dana learned to treat herself to pedicures, massages, and facials. In addition to the relaxation, this allowed Dana to feel looked after for reasons that had nothing to do with her cancer, she explains. 5. Whenever you can, remember that you are more than your diagnosis. Receiving a breast cancer diagnosis can completely change how you view parts of (or your entire) identity. After undergoing chemotherapy and a double mastectomy , Colandra felt “less like a woman,” she tells SELF. To counter that feeling, she started taking frequent trips with female friends. “After returning home from being away with the girls, I was much lighter in spirit and kept a happy disposition,” she says. “It is so necessary to change things up from the seemingly endless trips back and forth to the doctor.” Allie B ., 30, experienced a different type of identity shift after diving into aggressive treatment when she was diagnosed with triple negative breast cancer and a BRCA1 genetic mutation at 28. “Taking care of my physical health was my top priority,” she tells SELF. “Don't get an infection. Remember your medicine. Take care of your open wounds. But while fighting for my life, I lost myself.” Breast cancer, she says, felt like her new identity. She knew that wasn’t true, but she also knew she had to figure out who she was after such a transformative experience. So, Allie set out to discover who her new post-diagnosis and post-treatment self was. Sometimes she did this through seemingly small moves, like putting on bolder than usual hoop earrings to go along with her new buzz cut. Other days, it meant going against her naturally social instincts and saying no to dinners out with friends so she could recharge at home. It makes total sense if you don’t feel like you can focus on seeing much past your diagnosis right now. But at times when it seems as though “breast cancer patient” is all you are, finding small ways to remember that isn’t true might be helpful. 6. Process your feelings in therapy. If you feel as though your post-diagnosis emotions are too big to handle on your own, therapy may help you find your way. If you’re not already seeing a mental health professional, here are some tips for finding an affordable therapist . Allie sought out a therapist who helps her reflect on all that she’s been through. “[It] allows me to actually sit with my feelings,” she says. “There is a lot of power in saying your fears and worries out loud. Talking to her gives me the chance to release the thoughts that I used to let overwhelm me and spin around in my head.” As Allie explains, her therapist isn’t just a sounding board. While in treatment, Allie found a sense of freedom in talking to her therapist because she didn’t have to worry about sharing certain upsetting thoughts with loved ones who were already worried about her prognosis. Now, Allie and her therapist focus on self-care . “She reminds me to take time for myself and… engage in healthy practices like meditation and journaling.” 7. Wear something that makes you feel strong during treatment. Within six months of being diagnosed with triple negative breast cancer, LaTonya D ., 50, tragically lost her sister to metastatic breast cancer (which had claimed the life of her mother in the early 1990s) and gained custody of her sister's then-11-year-old son. Then, while undergoing chemotherapy , LaTonya’s hair, eyebrows, and eyelashes fell out. “I did not want my reflection in the mirror to look like cancer or remind me of my mother and sister,” she tells SELF. So, before each chemo treatment, LaTonya had a “mini-makeover” at Sephora. She wore fake eyelashes and wigs to get her infusions. Sometimes LaTonya even showed up to chemo dressed up as Wonder Woman, filling the otherwise grueling time with “fun and sunshine,” she says. Dressing up in a way that reminded LaTonya of her strength and perseverance made it a bit easier to get through treatment for both herself and her nephew, she says. 8. Go somewhere or do something with the sole purpose of recharging. Lauren O., 32, found travel to be transformative after being diagnosed with stage 2 triple negative breast cancer in 2017. “I made it a priority to reclaim my life as soon as I finished chemotherapy,” Lauren tells SELF. “That started with a beachside trip to Mexico with my partner. Connecting physically with the sand, ocean, and salty breeze rejuvenated me spiritually and otherwise.” This Mexican adventure was so excellent that it changed Lauren’s original plans to return to “regular” life after the trip. Instead, she renovated an RV that she and her partner have used to travel all over the country to tap into what she calls the revitalizing “power of travel.” While you may not be able to do exactly the same thing, finding a physical location that renews your spirit might help you cope with some of the difficult emotions a breast cancer diagnosis can cause. That could just mean going for a walk outside, having a sleepover with a friend or family member, or taking a quick trip somewhere cheap. Bottom line: Whatever you may be feeling after a breast cancer diagnosis is fair. Experimenting with what helps you cope best is valid, too. As Dr. Killelea explains, “[People] deal with breast cancer differently, and there is no right or wrong way to handle it.”
  • Kathy Kaufield has an important message she wants every woman to hear: know your breast density . What are dense breasts? They’re breasts that have more fibrous connective tissue as opposed to fatty tissue. About 40 percent of women between the ages of 40 and 70 have dense breasts. But mammograms are effective at finding cancerous tissue in dense breasts only 50 percent of the time. These are important statistics to know, and ones that Kaufield didn’t when she was diagnosed with breast cancer. Years prior to her diagnosis, the New Brunswick, CA, survivor found a lump “ that turned out to be nothing, ” Kaufield told Anna Maria Tremonti from The Current at CBC Radio. After that, she had regular check-ups so her doctor could monitor her and be on the lookout for anything else suspicious. Yet, she was not told she had dense breasts. And therefore, did not know that her risk of breast cancer had increased. The problem is that dense tissue will show up white on a mammogram — and so will cancerous tissue. This makes it easier to miss a concerning issue because the cancer is camouflaged. “If you’re looking for a tumor, it’s like finding a snowball in a snowstorm,” Kaufield told CBC Radio . And, though doctors don’t know why, having dense breasts also makes a woman 6 times more likely to develop cancer than a woman with fatty breasts, according to Breastcancer.org . In June of 2015, Kaufield had a mammogram, and was given the all-clear. Several months later, she was showering at a hotel and didn’t have her shower puff, or loofah, from home, so she washed her body with her hands. It was then that she felt a golf-ball-sized lump. Six months after her clear mammogram result, she was diagnosed with breast cancer. After going through breast cancer surgery , 16 rounds of chemo, 6 weeks of radiation, and hormone therapy, Kaufield knows firsthand how cancer can ravage you, and is so thankful she caught it when she did It seems like a no-brainer to tell women their breast density, yet it’s not always required. In Canada, doctors may not even get a breast density report, and even if they do, they may not even tell their patient. It depends on which province or territory they live in. In the United States, only 35 out of 50 states require doctors to tell their patients about breast density (as of September 2018). However, that could mean telling them about breast density in general, not the woman’s own breast density. Kaufield is working alongside Dense Breasts Canada to urge the Canadian government to require doctors in all provinces to tell their patients about their breast density. Breast density is not something you can tell by feel alone; a radiologist will need to look at your results on a mammogram. Yet a 2016 study showed that there were significant discrepancies on what radiologists actually qualified as dense breasts. Not only were radiologists all over the board when it came to deciding what denoted a high breast density, the reports were written at a reading level that is often difficult for patients to understand. In addition to helping spread the word with Dense Breasts Canada, Kaufield is spreading the word through her own campaign #TellMe (in English) or #DisMoi (in French), and has her own website Tell Me My Breast Density . Although Kaufield is now a freelance writer and communications consultant, she’s a former political reporter — and so has used those connections to get the ball rolling in New Brunswick and elsewhere in Canada. She is on a mission, and she won’t be stopping anytime soon. BY C. DIXON