1. Margin Call – A Better Read on Breast Cancer

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    from Lee Memorial Health System / Added

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    A new device that uses radio-frequency to search for remnants of breast cancer is sending shock waves through the treatment community. “Once we have the specimen out, the device touches against the specimen and shoots a radio-frequency beam into the specimen. And depending on how that reflects back, can tell us whether or not there’s cancer at the edge of the specimen,” says Dr. David Rock, who is a breast surgeon on the medical staff of Lee Memorial Health System. The Regional Cancer Center hopes to be first in the state to get their hands on the ‘Marginprobe’. It’s a hand held device approved by the FDA for use in the operating room, to examine tissue removed during a lumpectomy. “Normal tissue reflects the waves back at a different frequency, and so that’s a very accurate way to determine whether there’s cancer on the edge which is an indicator that maybe you left some cancer behind,” says Dr. Rock. The breast-preserving lumpectomy has virtually the same small recurrence rate as a mastectomy. Based on getting clear margins during surgery. Up to now, it took days to know for sure. “If you see cancer at the edge you would usually have to go back about three days later, reopen the incision and take a little bit more tissue from that spot and re-close,” says Dr. Rock. About 1 in 4 women have to go back for additional surgery because traces of cancer are left behind. Getting a better read on tissue at the time of surgery reduces subsequent trips back to the operating room. “That’s nice because women feel more confident that if they go in for a lumpectomy- they’re only going to have one procedure and we’re going to get all the cancer on the first try,” says Dr. Rock. The added precision is freeing women up to get the treatment they need without sacrificing life or breast. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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    • Anstett and Galligan #breastcancer Kickstarter out-take http://kck.st/1yKVvKO

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      from kathleen Galligan / Added

      18 Plays / / 0 Comments

      Midway through producing a book on surgical and non-surgical breast cancer choices with award-winning journalist Pat Anstett-guess who is diagnosed? Me. This is just an out-take for our Kickstarter to raise funds for travel to complete our reporting. Sometimes you just have to laugh. Want to help? http://kck.st/1yKVvKO

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      • Breast Cancer and Genetics: Why Personalized Care Is Key

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        from Patient Power / Added

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        Some women may have a family history of breast cancer and possibly even had a positive BRCA test for the breast cancer gene. To explain, Dr. Kristine Calhoun, a dedicated breast specialist and associate director of Seattle Cancer Care Alliance's Breast Health Center, joined Patient Power and shared her expertise about the connection between genetics and breast cancer. Dr. Calhoun stresses the importance of a personalized discussion with your doctor regarding your specific situation related to the prevention and treatment of breast cancer.

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        • Who Are Double Mastecomies Right For?

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          from Patient Power / Added

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          When a woman is diagnosed with breast cancer, it can be terrifying. Concerns begin to arise, such as how do you treat the cancer and what surgical approach is right for you? Dr. Kristine Calhoun, a dedicated breast specialist and associate director of Seattle Cancer Care Alliance's Breast Health Center, joined Patient Power to discuss the controversy surrounding double mastectomy and the important factors to consider when choosing what treatment is best for your specific situation.

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          • The Surgical Segment of Breast Cancer

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            from Lee Memorial Health System / Added

            35 Plays / / 0 Comments

            For most breast cancer patients, surgery is the first leg of treatment. “Because not only does it treat the primary cancer, meaning to remove the tumors, but it also gives us answer by looking at the lymph nodes,” says Dr. Rie Aihara, surgical oncologist on medical staff at Lee Memorial Health System. “And some of the answers we get from surgery actually dictate what kind of therapy would come next.” Once the path becomes clear, the baton is passed to a medical oncologist, radiation oncologist, or both. In best circumstances they work as a team, as is the case within the Regional Cancer Center’s multi-disciplinary breast cancer clinic. “We’re looking at the same things. We’re able to discuss, really ask all the questions, really bring our thoughts together. So not only is it faster, but I think the quality is much better,” says Dr. Aihara. Women are empowered with choices when it comes to surgery. Based on the nature of their cancer and personal preference, they may opt to remove a portion of breast, one breast or both if they have genetic risk. “We do see a lot of women who choose a double mastectomy, especially in the younger population because they have so many years to think about recurrences and things like that. And we always emphasize if there’s only cancer in one area, certainly if it’s treatable by lumpectomy. That’s what we would advise.” Surgery is often the end of the treatment road. A majority of women chose to undergo reconstruction. Many times it starts during a mastectomy using tissue expanders and is completed once they reach the finish line. “A lot of people come in with this horrible image of a mastectomy that they used to do years ago and once we sit down with them, show them pictures, a lot of people are extremely relieved and really have a positive attitude going forth,” Dr. Aihara says. For these reasons, the surgical segment is often the anchor in this relay for life. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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            • Patient Centered Cancer Care

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              from Lee Memorial Health System / Added

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              The world of cancer is a world of change, maybe not the collective diseases, but the way health professionals approach it. The move is towards patient centered care. “It’s an era of individualized therapy. One treatment may be suitable for you, while it may not be for another person,” says Dr. Rie Aihara, surgical oncologist with the medical staff of Lee Memorial Health System. The Regional Cancer Center relies on a multidisciplinary approach. One usually not found outside of academic medical centers. It assembles teams of specialists to evaluate patients together. “And the beauty of that is all of us can get together, in one setting, not just the treating specialist but also the radiologist, the pathologist, the nurse health navigators, genetic counselors. So every ancillary service this building has to offer can meet in one place, discuss the patient all in one setting, view the same pathology slides, the radiology, and then come up with a conclusion or a recommendation at the end of that session,” says Dr. Aihara. Patients then meet with each care provider on the same day. “The feedback that we get from patients is wonderful,” says Tammy Zinn, RN, with Lee Memorial Health System. Tammy Zinn is a nurse navigator- she troubleshoots problems that may affect a patient’s health or wellbeing, from working through financial hardships to preparing for a mastectomy. “The breast health navigator meets with the patient initially and does education about her diagnosis and then navigates them through the whole health system,” says Zinn. Studies show this is truly good medicine. Cancer patients with larger support groups handle the process better. The team approach is better at personalizing treatment and also equalizes access to quality care. “Fifty to sixty years ago, everybody with a diagnosis of cancer had surgery. It was a sort of kitchen sink therapy with chemotherapy. But now that they have so many options, whether it be a surgical option, lumpectomy vs. mastectomy, choices in radiation, individualized therapy meaning whether woman’s tumors are responsive to hormones or not. All of these factor into what the treatment is going to be,” says Dr. Aihara. Being patient centered puts a team of professionals to work on a single purpose. “I always tell our patients, it’s teamwork,” says Dr. Aihara. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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              • The DCIS Dilemma

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                from Lee Memorial Health System / Added

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                Cancer experts are increasingly being forced to draw the line. Distinguishing what is and isn’t cancer. When it comes to breast cancer, more women are getting the diagnosis of DCIS, or non-invasive breast cancer. “Basically ductal carcinoma in situ means that it’s cancerous cells that are still within the milk ducts. Once they go beyond the milk ducts into surrounding tissue then its called invasive cancer,” says Dr. Gail Santucci, diagnostic radiologist with Lee Memorial Health System. Many women find it difficult to distinguish between pre-invasive and invasive and often overestimate the implications. In fact it involves a spectrum, ranging from low grade to high grade - each carry a different risk. Currently most experts believe DCIS merits intervention. “The approach right now is try to do a minimally invasive type treatment of the cancer where you have a lumpectomy which is local excision rather then the whole breast being removed and then radiation therapy to prevent the spread of more cancer into the remaining breast tissue,” says Dr. Santucci. New research is raising concern about labeling. When women get a DCIS diagnosis they often focus on the term ‘carcinoma’ or only hear ‘cancer’ which affects their views on treatment. Some believe surveillance is a feasible option, as many men do with early stage prostate cancer. The challenge is in making sure people who need treatment get it. “When you hear in the news occasionally ‘well, breast cancer is over-treated’ a lot of these pre-cancers turn into a problematic cancer that would kill the patient. And it might; you don’t know for sure,” says Dr. Santucci. More than 50,000 women a year in the U.S. are diagnosed with DCIS. It’s rising rate coinciding with more widespread use of mammography. A difficult dilemma with many unknowns and so much at stake. “It’s not fully sorted out, yet I think everyone agrees that high grade ductal carcinoma in situ definitely needs to be treated,” says Dr. Santucci. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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                • BREAST CANCER: Intraoperative radiotherapy is as effective as whole breast irradiation with fewer non-cancer deaths

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                  from Audio Medica / Added

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                  LONDON— Intraoperative radiotherapy given at the time of lumpectomy was found to be ‘non-inferior’ to the use of conventional post-operative whole breast external beam radiotherapy and had equivalent breast cancer specific mortality but fewer non-cancer deaths. This is according to findings from the TARGIT-A study by researchers in the United Kingdom, Germany and Australia with five-year follow up data published in the Lancet. The authors give reassurance that with a ‘risk adapted’ strategy — in which patients receiving intra-operative therapy were given supplementary external beam radiation if the operation revealed they were at high risk — is a safe and effective alternative to the conventional approach and could not only benefit patients but also reduce costs. Investigators Professor Jayant S Vaidya PhD and Professor Michael Baum MB ChB FRCS describe their findings and discuss the clinical implications. REFERENCE: www.thelancet.com Vol 382 Published online November 11, 2013 http://dx.doi.org/10.1016/S0140-6736(13)61950-9 TITLE: Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial Jayant S Vaidya, Frederik Wenz, Max Bulsara, Jeffrey S Tobias, David J Joseph, Mohammed Keshtgar, Henrik L Flyger, Samuele Massarut, Michael Alvarado, Christobel Saunders, Wolfgang Eiermann, Marinos Metaxas, Elena Sperk, Marc Sütterlin, Douglas Brown, Laura Esserman, Mario Roncadin, Alastair Thompson, John A Dewar, Helle M R Holtveg, Steffi Pigorsch, Mary Falzon, Eleanor Harris, April Matthews,
Chris Brew-Graves, Ingrid Potyka, Tammy Corica, Norman R Williams, Michael Baum, on behalf of the TARGIT trialists’ group Breast cancer, breast surgery, whole breast radiotherapy, intraoperative radiotherapy, lumpectomy, Michael Baum, Jayant Vaidya

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                  • Breast Conservation & Recurrence Risk

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                    from Lee Memorial Health System / Added

                    52 Plays / / 0 Comments

                    To save or not to save, a major decision women face with early breast cancer. Whether to have mastectomy or lumpectomy, a breast conserving surgery. “If you have a breast cancer, you don’t necessarily have to lose your breast to treat the breast cancer. About 70% of the patients that I treat preserve their breasts,” says Dr. Lea Blackwell, surgical breast oncologist on Lee Memorial Health System’s medical staff. Also called partial mastectomy, lumpectomy removes only the tumor and surrounding tissue. It’s considered an effective treatment when used with radiation. But comes with a slightly higher risk of relapse. “There is a slightly increased risk of recurrence if you leave the breast intact. But there’s no difference in survival. If they have a recurrence after their partial mastectomy, then they would have to have a mastectomy for optimum treatment,” says Dr. Blackwell. Several factors may impact the return rate. “If you’re a young individual, if you have lymphoid involvement you know, then you are at elevated risk or reoccurrence,” says Dr. Blackwell. A local recurrence is most common in the first five years after diagnosis. While many of the risk factors are beyond control, researchers believe lifestyle choices are also in play. “Any tobacco use is detrimental and one thing has been linked to risk of reoccurrence is alcohol intake. Alcohol intake in individuals that have had breast cancer is linked to a higher rate of reoccurrence,” says Dr. Blackwell. Weight is also proving to be a heavy-hitter among risk factors. “They’ve noticed in people that were obese, they had a higher rate of breast cancer reoccurrence then people that were a normal weight. So there’s been a push to try to maintain a healthy lifestyle after their breast cancer because that should reduce their risk of reoccurrence,” says Dr. Black. When it comes to keeping breast cancer at bay, patients have to consider the choice of treatment, and the choice of habit. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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                    • MarginProbe Receives FDA Approval

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                      from MultiVu Video / Added

                      43 Plays / / 0 Comments

                      Dune Medical Devices, Inc., announced today that its breakthrough intra-operative tissue assessment tool for early-stage breast cancer surgery, the MarginProbe System, has received Premarket Approval (PMA) by the United States Food and Drug Administration. The technology significantly improves surgeons’ ability to intra-operatively identify "cancer on the margin” and significantly reduce pathologically positive margins following a patient’s initial lumpectomy surgery. To view Multimedia News Release, go to http://www.multivu.com/mnr/58891-dune-medical-devices-fda-approval-marginprobe-system-breast-cancer-surgery

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