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Article: Ultrasound-Guided Breast-Conserving Surgery May Reduce Need for Further Surgeries

Posted on April 30th, 2012

A new study shows using ultrasound to guide the surgical removal of tumors from women with palpable breast cancer is significantly better than the standard approach in ensuring that all cancerous tissue is removed while minimizing the removal of healthy tissue.

Dr. Krekel and her colleagues randomly assigned 124 patients with palpable early-stage breast cancer to either ultrasound-guided surgery or palpation-guided surgery. They found that only 3.3 percent of the margins in the ultrasound-guided surgery group contained cancer cells, compared with 16.4 percent in the palpation-guided surgery group. They also found that less healthy tissue was removed in the ultrasound-guided surgery group.

“If we get the same results in the United States, and these results can be incorporated into community practice, it will spare many women unnecessary re-excision surgery,” said Dr. Jo Anne Zujewski, head of Breast Cancer Therapeutics in NCI’s Division of Cancer Treatment and Diagnosis.

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Article: Drawbacks of Adding MRI to Mammography Plus Ultrasound May Outweigh Benefits

Posted on April 25th, 2012

Adding ultrasound or magnetic resonance imaging (MRI) to annual screening mammograms for women with an increased risk of breast cancer and dense breast tissue detects more new breast cancers than mammography alone but also results in more false-positive findings, according to results of a multicenter clinical trial.

Researchers found that adding ultrasound to mammography increased breast cancer detection by an average of 3.7 cases per 1,000 women screened after the second and third rounds of annual screening. The majority of cancers detected only by ultrasound were node-negative invasive cancers. Until now, it had been unclear whether continuing annual ultrasound screening would detect more cancers.

Although MRI was better at detecting cancer than mammography plus ultrasound, women found it less tolerable. “Despite its higher sensitivity, the addition of screening MRI rather than ultrasound to mammography in broader populations of women at intermediate risk with dense breasts may not be appropriate, particularly when the current high false-positive rates, cost, and reduced tolerability of MRI are considered,” the authors concluded.

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Life is a Journey not a Destination… Don’t Stop Believing!

Posted on August 18th, 2010

By Mary Jo Wolf, cancer survivor and Cancer Services client

My cancer journey began in November 2008, when I discovered a lump in my right breast. I didn’t panic and went about my evening as scheduled, but the thought of that strange mass lingered in my mind. I had been through an unwanted divorce in April, my family lived 6 hours away, and suddenly, I felt alone.

I went to my doctor on Monday. She examined me and immediately set an appointment for me at the Breast Diagnostic Center. On Tuesday, I had a mammogram, followed by an ultrasound. There was fluid around the mass that needed to be drained, but unfortunately, the radiologist couldn’t get it to drain. I had a total of five biopsies that day, and then made an appointment with a surgeon who would give me the biopsy results. I went to each of these appointments alone, hoping it was nothing. I didn’t believe that I might have cancer and I didn’t want to alarm anyone.

When I met with the surgeon for the biopsy results, my friend Becki came with me. She was diagnosed with breast cancer the previous year and knew I needed support. The diagnosis was DCIS (Ductile Carcinoma in Situ – noninvasive breast cancer). Becki started to cry and I was in shock. A million questions went through my mind. The surgeon recommended a lumpectomy. He would remove the lump and send it to the lab to get the exact diagnosis. He was fairly certain that no more treatment would be needed. My surgery was scheduled for Monday, November 24. My only child’s 21st birthday would be the next day. How was I going to tell her that I had cancer? Surgery went as scheduled and my wonderful daughter gave up her birthday celebration to take care of me.

Unfortunately, at my follow-up appointment , the surgeon reluctantly informed me that another surgery would be necessary because cancer cells were still present, and the mass tested positive for triple negative invasive breast cancer.

A week later, I had a second surgery, followed by complications. The incision would not heal; there was infection and a lot of pain. I met with my oncologist and she explained that I needed 20 weeks of chemo. Although my cancer didn’t spread to the lymph nodes, they had to treat it aggressively as if it did.

On a follow-up visit with the surgeon, he discovered another lump in the same breast. More ultrasounds and biopsies were done on the second lump, and the surgeon recommended a double mastectomy. After much research and discussion with family and friends, I concurred. My bilateral radical mastectomy was scheduled for Tuesday, January 20, 2009. I wanted the cancer out of me once and for all. Besides, new breasts at my age didn’t sound like such a bad idea. I always try to see the bright side. I met with the surgeon, oncologist, and plastic surgeon to discuss the plan for the next several weeks and months. It was surreal going over the surgery options with the plastic surgeon. The thought of having my breasts removed and reconstructed was overwhelming. My plastic surgeon talked with me as if he was talking to his own wife, mother, or sister. I trusted him and believed I was in good hands.
In early January, I took a tour of Cancer Services. It was so comforting to meet with my Client Advocate and find out how the organization could help me. Throughout my journey, Cancer Services was there – supplying tape and bandages and a hospital bed for when I returned home. They also offered much needed emotional support. Even today, as a cancer survivor, when I walk through the front door of Cancer Services to volunteer, I feel peace and comfort.
I had a double mastectomy and reconstruction on January 20, 2009. The morning of my surgery, my daughter laid in the hospital bed with me until they took me back to the operating room. As they rolled me down the hall, I could hear my daughter and my mom telling me they loved me. The next thing I knew, it was 10 ½ hours later and I was in intensive care. I had 8 drainage tubes, a pain pump in my stomach, and I was hooked up to a morphine machine for pain. Along with having my breasts removed, I had an incision from hip to hip. They used the fat, muscle, and tissue from my stomach to create my new breasts.

After my hospital stay, I returned home to find a hospital bed set up in my living room, supplied by Cancer Services. Because of the hip-to-hip incision, it was impossible for me to lie flat on my back. I believe the hospital bed helped my recovery immensely. When I was fairly well recovered from surgery, I began chemo. I was back at work and things were going as well as could be expected. After several treatments, I developed Hand and Foot Syndrome –a sometimes side effect of chemo. In April, my employer let me go because I couldn’t perform the duties of my job. I clung to hope, faith, and the thought that maybe what I had been through could help someone else some day. My dear friends had a benefit for me in May, and I was able to finish my treatment without worrying about how I was going to keep a roof over my head. I had my final chemo treatment in July of last year with reconstruction performed 2 weeks after my final treatment. After I regained my physical strength, I started to look for work, starting a new job in October of 2009.
I’m now a one-year breast cancer survivor. From April of 2008 to April of 2009, I went through a devastating divorce, cancer, and the loss of my job. Today, I’m a woman of great hope. I have a heart full of gratitude and look for ways to give back every day. Do I struggle at times? Yes. Am I sad at times because my body is scarred, my breasts have no sensation, and my life will never be the same because I had cancer? Yes. At the same time, the truth for me is this: what gives my life and the fact I had cancer meaning and purpose is being of service to others. Today, I’m a volunteer for Cancer Services. I can’t think of a better way to change the liability of having cancer into an asset. I believe that great good can come from great suffering. Most of all, I believe I was stripped of everything so I could have a new foundation on which to build a new life. Next year, my beautiful daughter will graduate from Purdue University and I will be 50 and fabulous! Here’s to my new life!

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