Breast Cancer Survivorship: Post-Diagnosis

2015KomenNCR-NBCAMGraphicFaceookCover-SurvivorshipBreast Reconstruction

Breast reconstruction can help restore the look and feel of the breast after a mastectomy. Performed by a plastic surgeon, breast reconstruction can be done at the same time as the mastectomy (“immediate”), or at a later date (“delayed”). Many women now get immediate breast reconstruction.

However, the timing depends on your situation and the treatment you will have after surgery. Not all women can have immediate reconstruction. It is important to discuss your options with your plastic surgeon, breast surgeon and oncologist (and your radiation oncologist if you are having radiation therapy).

There is no one best reconstruction method. There are pros and cons to each. For example, breast implants require less extensive surgery than procedures using your own body tissues, but the results may look and feel less natural. However, there are fairly few complications with any of the current techniques, especially when a woman is properly selected for a procedure.

Most breast reconstruction methods involve several steps. Both immediate and delayed reconstructions require a hospital stay for the first procedure. However, follow-up procedures may be done on an outpatient basis.

Screening/Re-diagnosis

Breast cancer survivors have an increased risk of getting a new breast cancer compared to those who have never had breast cancer. That is why it is important to get the follow-up care your doctor recommends. With proper follow-up, your doctor can keep track of how you are doing. This includes checking for and treating side effects. Follow-up care can also help ensure any recurrence of breast cancer can be found early when treatment is most effective.

The National Comprehensive Cancer Network offers these guidelines for follow-up of breast cancer treatment:

  1. Have a mammogram every 12 months. (For women treated with lumpectomy, have a mammogram six months after radiation therapy ends, then every 12 months.)
  1. Have a physical exam every three to six months for the first three years, every six to 12 months for years four and five, then every 12 months.
  1. Have a pelvic exam every 12 months if taking tamoxifen and have not had the uterus removed (have not had a hysterectomy).
  1. Have a bone health exam every one to two years, depending on a person’s risk factors.

Follow-up Tests

Depending on the symptoms, blood tests (including tumor marker tests) and imaging tests (including bone scans, CT scans, PET scans and chest X-rays) may be used to check for metastases. Using these tests to check for early metastases in people with no symptoms of metastases does not increase survival. For people with no symptoms of metastases, blood and imaging tests (other than mammography) are not a standard part of follow-up care.

Learn more about medical care after breast cancer treatment: http://ww5.komen.org/BreastCancer/MedicalCareAfterTreatment.html

We are celebrating National Breast Cancer Awareness Month. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

What Komen St. Louis Funding Can Do: Shereece’s Story

Late last year, when 52-year-old Shereece Gardner discovered a lump in her breast during a self- exam, she immediately contacted Susan G. Komen® St. Louis.

Shereece Gardner (photo by Elizabeth White)

Shereece Gardner (photo by Elizabeth White)

“I’ve participated in the Komen St. Louis Race for the Cure for the past 11 years,” recalls Shereece. “At that point, everything I knew about breast cancer, I knew because of Susan G. Komen. So, I assumed they had the resources to point me in the right direction.”

After hearing about Shereece’s situation, a Komen St. Louis staff member referred her to the Breast HealthCare Center (BHCC) at Missouri Baptist Medical Center. With Komen St. Louis funding, the BHCC provides increased access to breast screening services, as well as education, prevention and early detection of breast cancer by providing screening and diagnostic mammograms.

During her first appointment, Shereece met with Theresa Taylor, an outreach coordinator at the BHCC. “I informed Shereece about our grant program, ‘Reaching the Underserved,’ which I knew could really help her out financially,” says Theresa.

Funded by a Komen St. Louis grant for more than 12 years, the BHCC Reaching the Underserved program provides MBMC with the resources to support uninsured and underinsured women throughout the region. The program’s services are provided for at-risk women ages 40-64 at the BHCC and on its digital mobile mammography van. Follow-up services are provided at the BHCC for women with mammography abnormalities.

After meeting with Theresa, Shereece underwent a 3D mammogram (digital breast tomosynthesis), which provides more detailed, higher resolution images of the breasts, making it easier to detect smaller cancers. Unfortunately, the 3D mammogram revealed a suspicious tumor, and a subsequent biopsy confirmed Gardner’s suspicion: she had stage two breast cancer. Shereece then met with Paul Yazdi, MD, to discuss her diagnosis, treatment options and prognosis. He explained everything thoroughly and sympathetically, reassuring her that she was in good hands.

Shereece with Dr. Paul Yazi (photo by Elizabeth White)

Shereece with Dr. Paul Yazi (photo by Elizabeth White)

“I absolutely adore Dr. Yazdi,” says Shereece. “He makes me feel like I’m his only patient, and he is always incredibly generous with his time. That means so much when you’re battling cancer.”

In January 2014, Shereece underwent a lumpectomy and a sentinel node biopsy, which showed no signs of cancer in her lymph nodes. However, just to be safe, the medical team at the BHCC prescribed chemotherapy. Since February, Shereece has been coming to the hospital every three weeks to receive her chemo treatments during four-hour appointments.

“With breast cancer and chemo, there are good days and bad days, but I’m really thankful for the support of the medical team at MoBap’s Breast HealthCare Center,” says Shereece. “They have all been so wonderful and considerate. In fact, I get a call from someone on the team at least once or twice a month to check on me.”

Fortunately, all of Shereece’s breast cancer services — including the 3D mammogram, biopsies, lumpectomy and chemotherapy — are covered by the grant program. Without the support of the program, she wouldn’t be able to afford the cancer care she so desperately needs.

“I was honored to be part of the team that took care of Shereece. Being able to witness her courage and dignity in her fight against cancer is one of the most rewarding parts of my job,” says Dr. Yazdi. “I’m also happy to know that she was helped by the Komen grant program, which brings cancer care to many underserved women throughout the St. Louis community.”

Shereece’s last treatment is scheduled for June 18, four days after the Komen St. Louis Race for the Cure. She is planning to participate in this year’s Race — as one of the survivors.

“This year, the Race has taken on a whole new meaning,” says Shereece. “Thanks to Susan G. Komen and MoBap, I’m getting the help I need to win my battle with breast cancer.”

A Survivor’s Story: Faith, Family, Fitness

Guest Writer: Erica Griffin, Breast Cancer Survivor

“Breast cancer does not scare me.” These were the words I heard from my doctor in September 2008. Though my 30-year-old head was spinning with a diagnosis that came out of nowhere, her confident words stuck out to me like a neon sign at night.

Up until that point, my life had revolved around my husband, Jack, my high school sweetheart; our three children: Tyler, Zachary and Katie; and my love of running. Breast cancer had no place in my life. I was convinced that this was NOT my life. But it was. This was real. And the lump we had been watching for over a year – and had been assured that it was nothing – was indeed cancer. Shocking doesn’t even describe how I felt. I have no family history of breast cancer. I have maintained a healthy weight all my life by eating right and exercising. And I was only 30 years old.

So after hearing my doctor’s shocking words, I clung to the only things that I knew to be true: my faith, my family, and my fitness. I knew that my faith in God would carry me through and that He would take care of me. My family would be my source of love and unending support. And running would be my normalcy and my strength. We prepared for the fight all together.

Erica running as a survivor in her first Komen St. Louis Race for the Cure, 2009

Erica running as a survivor in her first Komen St. Louis Race for the Cure, 2009

I had a lumpectomy and all the lymph nodes removed from under my right arm. Five of ten of them were positive for cancer. Following surgery, I had six rounds of chemotherapy, six weeks of radiation, a full year of targeted drug treatment with Herceptin, and I still continue on hormone therapy. I had treatment every three weeks, and my doctors and treatment center are three hours away.

The roughest part of this was during radiation. We made the drive five times a week for six weeks. I would get up in the morning at 5 am, have some coffee and prayer time, go get on the treadmill for 45 minutes to an hour, then start waking up the kids for school. I would leave at 7:30 am, drop the boys off at school (Katie wasn’t old enough yet), and we would head to my radiation appointment, which was at 10:40 am every day. Afterwards, we would grab a quick lunch and drive home, making it home around 2:30 pm, in time to pick up the boys from school. Looking back, I can’t believe I did it. But with the support of my family and friends, who all took turns driving me and keeping me company, the time really flew by.

Erica running in the 2013 Komen St. Louis Race

Erica running in the 2013 Komen St. Louis Race

I read a quote from runner Monte Davis that says, “Running long and hard is an ideal antidepressant, since it’s hard to run and feel sorry for yourself at the same time.” I have lived this quote in my own life. Throughout it all, I continued running. The month that I had to take off after surgery felt like forever because running is a part of me. It is part of who I am. To me, it means more than health and fitness, it goes beyond that; it’s “me-time” and during this time of my life it meant normalcy and strength. I also knew that it would only do me good to keep physically active during treatments. And boy, did it! I sailed through my year of treatment strong. With every step I could hear my doctor’s words in my head: “Breast cancer does NOT scare me.”

Our family has actually benefited from my diagnosis with breast cancer. It seems strange, but it is so true. It has put our lives in very clear perspective. We realize what is truly important. No longer are things such as money, bills and the petty day-to-day things that used to concern us, nearly as important. We have learned to take the time to slow down and enjoy each other, and to thank God for every moment we are given together. It has strengthened our faith and made our family so much stronger. And I’m thankful for the lesson.

Winner! Erica was the first breast cancer survivor to cross the finish line at the 2013 Komen St. Louis Race for the Cure

Winner! Erica was the first breast cancer survivor to cross the finish line at the 2013 Komen St. Louis Race for the Cure

Since my last treatment in October 2009, I have had the opportunity to speak at several women’s events about my journey with breast cancer. I have such a desire to help others. I want to reach out to other young women who have had a diagnosis with breast cancer and tell them to be strong and believe you can WIN this fight! Be positive and put it in your mind that you WILL win. Even when you think you can’t wait one more minute for that test result, or that you can’t possibly take one more treatment, remember to rise up and stand strong…you have a whole army of fellow survivors standing behind you, living PROOF that YES YOU CAN.

A Survivor’s Story: Valeda Keys

Guest Writer: Valeda Keys, Breast Cancer Survivor

Everyone has a story to tell. No matter who you are, your life is worth talking about.

In 2007, my mother was diagnosed with breast cancer for the second time, 20 years after her first diagnosis. It was then that I had a vivid dream that I would have to go through this challenge as well.

I was advised to get mammograms starting at age 27 due to my family history of breast cancer. I have never missed a year getting my mammogram. On April 26, 2010, at 5:26 pm, I received a phone call and was told: “Mrs. Keys, you have Ductal Carcinoma in Situ.” I knew that meant CANCER. I was 37 years young at the time of diagnosis. With constant prayer, I knew I would get over this.

Valeda Keys (left) with her twin sister Vanessa Robinson

Valeda Keys (left) with her twin sister Vanessa Robinson

On May 13, 2010, a lumpectomy was performed on my left breast with some lymph nodes removed. After the lumpectomy, results from the genetic test I had taken revealed that I carried the BRCA-2 gene mutation. My identical twin sister also was tested and had the same result. During June and July 2010, I underwent radiation every weekday and began taking Tamoxifen.

On August 11, 2011, I was diagnosed with breast cancer again. This time the cancer had developed independently in my right breast. I was now 39 years young. My medical oncologist suggested I have a double mastectomy. I felt like my breasts were trying to kill me. I felt like I had no choice. I wanted my breasts, but I couldn’t have them.

On September 12, 2011, I had the double mastectomy. Part of the healing process included physical therapy and emotional therapy. Telling my story is healing.

During this time of recovery, I was ready to start giving back. It was put on my heart to have a breast cancer awareness conference entitled, “My Strength Is Your Strength.” This name came from everything I’ve been through and for women who may have to take this same journey.

The November 2012 conference was a great success. A second conference is planned for November 2, 2013. Susan G. Komen St. Louis has provided me with lots of materials to bring awareness to our community, family, friends and even strangers. I will continue to follow my passion, which is breast cancer awareness and sharing the story of my breast cancer journey with others.

As I continue to deal with the aftermath of breast cancer, I ran my first 5K at the 2013 Susan G. Komen St. Louis Race for the Cure. I remain hopeful in every area of my life.

Native St. Louisan Valeda Keys is a Licensed Practical Nurse and a two-time breast cancer survivor. She and her identical twin sister, Vanessa Robinson, trained for 10 weeks to run the 2012 Komen St. Louis Race 5K. Valeda was named the 2013 Honorary Team New Balance Member for the 15th Annual Komen St. Louis Race for the Cure®.

What Komen St. Louis Means to Me

Guest Writer: Kim Naumann, Komen St. Louis Volunteer

Komen St. Louis volunteer Kim Naumann (left) and her breast cancer survivor mother, Tommie Lewis

Komen St. Louis volunteer Kim Naumann (left) and her breast cancer survivor mother, Tommie Lewis

I began my Komen involvement by walking in the 2nd Annual Susan G. Komen St. Louis Race for the Cure. I knew I had personal family history with breast cancer. My maternal grandmother passed away due to breast cancer in her 80s, and both my maternal aunts were diagnosed in their 60s and are survivors.

In 2001, I discovered that a dear co-worker, Bonnie, was a breast cancer survivor and walked each year with friends, so I formed a Komen St. Louis Race team in her honor. It made me feel great to celebrate her survival and help raise money to give others a chance to survive. But I wanted to do more.

In 2006, I contacted the Komen St. Louis office and offered to help with the website. I became a volunteer on the Website Committee right away.

When I mentioned to people that I was volunteering for Komen St. Louis, they would open up about their own experiences. I found out that many friends, neighbors and co-workers had battled breast cancer. And then I lost some to the battle. This made me want to continue offering my skills, to help make sure the Race would go on and raise as much money as possible.

I was then personally touched by what Komen St. Louis grants can do.

One day, I received a call from my mother, who told me my sister, Karen, went to a well-woman exam where they found a lump in her breast. Karen had no insurance and did not know how she would pay for a mammogram. I immediately called the Komen St. Louis office, and within hours I had the name and number of a woman who set up an appointment for the next day for my sister to have her mammogram, fully funded by a Komen St. Louis grant. The lump turned out to be nothing to worry about. I was told if Karen had needed further treatment, her visits and care would have continued to be paid for with Komen St. Louis grant money.

I learned exactly where my donations had been going and I knew my Race team’s fundraising efforts helped pay for her mammogram! I had a great sense of satisfaction in what I was doing and a need to continue to help.

This past year, my mother called to tell me her mammogram showed an abnormality. There were ultrasounds, biopsies, and appointment after appointment. She opted for lumpectomy, followed by chemotherapy and radiation. Her chance of survival is more than 90 percent. I am my mother’s medical advisor, since my father had passed away a few months earlier, and I have been with her every step of the way. Now it is personal. My own risk has increased. It was horrible watching someone go through this process…all for a cancer that was the size of a pea.

I have always wanted to do something for my community. Contacting Komen St. Louis was the best idea I ever had. I don’t have a wealth of money to give, but I do have time and skills with software, web design and databases. I have met wonderful, caring people in all the Komen St. Louis activities in which I have had the privilege to participate. I will continue to give all I can to Komen St. Louis as long as I am needed!

My hope is that by the time my daughter is in her 40s, and her risk increases, we’ll have a cure. I know we will find the cures!