Making Advances against Breast Cancer


Encouraging News About Breast Cancer

The statistics are alarming. About one in eight women in the U.S. will develop invasive breast cancer. And 85% of breast cancers occur in women who have no family history of the disease. Advances in diagnosis and treatment have improved the survival rate for those who have been diagnosed with breast cancer. M. Michele Blackwood, MD, FACS, Chief of Breast Surgery, Rutgers Cancer Institute of New Jersey and Medical Director, Northern Regional Director of Breast Services for RWJBarnabas Health in partnership with Rutgers Cancer Institute of New Jersey, the state’s only National Cancer Institute-designated Comprehensive Cancer Center, explains why the news is encouraging.

What has changed in the diagnosis and treatment of breast cancer?

I refer to it as a generational change that began in the 1990s. Many women who were diagnosed with breast cancer then are still alive. Advanced imaging techniques, coupled with treatments that are tailored to each patient, were developed. 

How are MRIs used?

We use MRIs for patients who have breast cancer or who are at high risk. We have an MRI dedicated exclusively for this use. We have been able to shorten the time it takes to perform the MRI to eight to ten minutes. It’s conveniently located adjacent to where we perform mammograms.

How do you know if you are at high risk?

Family history puts a patient at a higher risk as does dense breast tissue. Some people don’t realize they’re at risk. There are several online tools to assess risk. Plug in your information and a calculation is done to assess it. The Gail Model is a risk prediction tool, and the IBIS Breast Cancer Risk Evaluation Tool is another. Women may want to discuss doing an assessment with their primary care physician.

Should men be concerned about breast cancer?

About 2,000 men a year are diagnosed with breast cancer. If two female relatives have breast cancer, or there is a history of men in the family with it, there is a greater likelihood of developing it.

 How has treatment improved?

 It is important to not over or under treat cancer. Treatment doesn’t automatically mean chemotherapy. With genomic sequencing we can drill down to different parts of the cancer. What makes it grow? How do we stop it from growing? It’s no longer a guessing game. We can treat cancer more like a chronic disease and extend life expectancy. There’s a deescalating approach to treatment, treating breast cancer with less invasive means and with more precision.

What is your recommendation for mammograms?

I advise an annual one every year after age 40.

To schedule a mammogram at The Breast Center at the Barnabas Health Ambulatory Care Center visit  rwjbh.org/mammo.

A Breast Cancer Survivor Shares Her Advice for Staying Positive During Treatment

 

Bedzaida Concorso, 55, of Belleville, has been through a lot. A breast cancer diagnosis. Chemotherapy. Surgery during the COVID-19 pandemic, when no one in her family was allowed to visit her in the hospital. More chemotherapy and radiation therapy that led to her skin blistering and peeling.

Throughout, she has fought to stay upbeat. “I love to dress cute. My doctor told me she loved how I came into the office so positive, with lipstick and earrings,” Bedzaida says. “A lot of people see a cancer diagnosis as a death sentence, but it really doesn’t have to be. You have to have the mindset of, ‘I’m gonna get up and fight every day.’

“I know that’s not easy, and no one with cancer can be positive all the time. But I hope what I’ve learned through my experience can help somebody else.”

 

Treatment Choices

Bedzaida first felt a lump in her left breast while on vacation in Puerto Rico in May of 2019. Because she was in the middle of a transition with her health insurance, she didn’t have a biopsy until August of that year. The test confirmed that the lump was stage 2 cancer.

“It was a shock, and it was hard for me to tell my parents and three adult children,” Bedzaida recalls. “I wasn’t sure what to do. I even asked the doctor, ‘What if I don’t do anything?’ She told me it was my choice to make.”

“Every breast cancer patient has a journey ahead that’s not going to be easy,” says Bedzaida’s doctor, Maria Kowzun, MD,FACS, director of breast surgery at Clara Maass Medical Center (CMMC). “In treatment of breast cancer, there is room for individual preferences to be accommodated, especially now, with so many more treatment options available. As doctors, we make our best recommendations, but at the end of the day, every decision is up to the patient.”

Bedzaida opted to go with Dr. Kowzun’s plan. Because the cancer was triple- negative and aggressive, Dr. Kowzun recommended neoadjuvant chemotherapy, a type of treatment in which chemotherapy medications are given before a decision is made about surgery.

“If the tumor responds, simpler surgery may be possible, and an extensive surgery like a mastectomy or a complete axillary dissection may not be necessary,” Dr. Kowzun explains. “If it doesn’t respond, surgery will give us a better idea of what kind of regimen she might respond to post-surgery to prevent the cancer’s recurrence.”

Bedzaida’s hair began to fall out from the chemotherapy, so she shaved it off. Unfortunately, the tumor did not shrink. Surgery was scheduled for March 16. “It turned out to be the first day that COVID-19 precautions said no visitors were allowed,” Bedzaida recalls. “My mom had flown in from Puerto Rico, my kids and my niece were all ready to stay with me, but they couldn’t. That was a heartbreak.”

 

Dr. Kowzun removed the tumor in a lumpectomy procedure and also removed 12 lymph nodes to which it had spread. Bedzaida was prescribed a course of radiation therapy through June. “The radiation oncology team was so nice and so good that they made things easier, even though my skin peeled and was raw,” she says. Bedzaida was also given an oral chemotherapy treatment, which will end in November.

“Bedzaida basically required everything possible in terms of treatment options,” says Dr. Kowzun. “But she never gave up hope.”

Moving Ahead

“It’s been an experience and it’s been mind- draining,” Bedzaida says, “but I had to shift my thought process because thinking negative wasn’t going to help me heal.”

As soon as she could, she went back to her job as a freight forwarder dealing with U.S. Customs. Because everyone else in her office was working at home, she could easily practice social distancing. “I’m not going to lie, it was hard, and I was so tired at night. But I love getting up in the morning, getting dressed, putting on lipstick and going to work,” she says. “This way, my home remains my sanctuary.”

Having breast cancer, Bedzaida says, has changed her thinking. “You don’t realize how precious life is until you think you might lose it,” she says. “Was it traumatic? Yes. Would I wish this experience on anybody? No. But it has opened my eyes. I’m going to embrace every single moment.” Bedzaida acknowledges that she’s gone through times of anger, fear and self pity. “That’s normal,” she says. “But I’ve always been a little tough, hardheaded.”

Her family, she says, has been her support group. “You need somebody you can call and cry to and say ‘I’m scared,’” Bedzaida says. “My sister has been my anchor and so have my mother and kids.”

She hopes that other cancer patients who hear her story are encouraged. “Keep your soul healthy as well as your body,” Bedzaida says. “And music—you’ve gotta have music!” For Bedzaida, that means staying tuned to her Spanish-language Christian music radio station.

“I’m determined to appreciate every single day I have on this earth, whether I’m sick or not,” Bedzaida says. “I’m never going to be the same—and I don’t want to be.”

A New Breast Center

The Center for Breast Health and Disease Management at Clara Maass Medical Center is now open at 36 Newark Ave., Suite 132, in Belleville. “We are located next door to a radiology treatment center and are providing coordinated care for our patients with the help of an oncology nurse navigator,” says Maria Kowzun, MD, surgical oncologist. We have created a multidisciplinary team and comprehensive program including a support group at Clara Maass Medical Center for our breast cancer patients.”

 

 

RWJBarnabas Health and Clara Maass Medical Center, in partnership with Rutgers Cancer Institute of New Jersey—the state’s only NCI-Designated Comprehensive Cancer Center—provide close-to-home access to the latest treatment options. For more information, call 844.CANCERNJ or visit www.rwjbh.org/beatcancer.

 

 

 

 

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