Meet the Team Medical Advisory Board Laura Carfang, M.A., Ed.D. Chief Executive Officer, Co-Founder, Board Member Laura@survivingbreastcancer.org William Laferriere, MBA Chief Visionary Officer & VP Business Development Co-Founder, Board Member William@survivingbreastcancer.org Kathleen Boyle, Ph.D. Board Member Abigail Johnston, J.D. Board Member Abigail@survivingbreastcancer.org Board of Directors Meghann Sweeney, J.D. Board Member Tony Carfang, MBA Board Member Dr. Amy Commander, MD Medical Director, Mass General Cancer Center-Waltham Director, Breast Oncology Program at Newton-Wellesley Hospital Director, Lifestyle Medicine Dr. Rachel Jimenez, MD Dr. Rachel Jimenz,, MD Associate Program Director, Harvard Radiation Oncology Residency Program Dr. Jandie Posner Surgical Oncology Dr. Sandra Naaman Endocrinology, Hypertension Specialist, Women’s Health, Breast Cancer Survivorship University of Chicago Medicine Brenda Coronado CPIM Director of Community Engagement & Hispanic Outreach Brenda@survivingbreastcancer.org Lourdes Heras MPH Director of Community Engagement & Hispanic Outreach Lourdes@survivingbreastcancer.org Meghan McCallum Executive Assistant for SBC Meghan@survivingbreastcancer.org Elisa Herrera Director of Programs and Events Elisa@survivingbreastcancer.org Ana Quintero Marketing and PR Specialist Ana@survivingbreastcancer.org Meet the SBC Team

You're Going To Be On The Podcast! What's Next? How To Prep for Your Podcast We are delighted to have you participate in our Webinar, Livestream Broadcast, and/or our podcast, Breast Cancer Conversations. A place where we talk about all things Breast Cancer. We highlight the personal experiences of those diagnosed with breast cancer. We share educational content and resources from experts in the field. Physicians provide in depth insights into the science and critical advances taking place in the industry. Now let's help you get prepped for the big day! ​ +++++++++++++++++++++++++++++++++++++ ​ Audio is everything. You have an amazing story to tell. Speaking through your computer won’t have great sound quality, so please make sure you have good headphones/mic set up prior to our interview. (I use my apple headphone/mic, but any brand will do. Basically, we want to avoid feedback coming from computer speakers). ​ We also recommend finding a quite room that has carpeting. Sound tends to bounce off of tile floors and large open concept rooms. It's best to find a smaller room with lots of rugs, carpeting and sofas that can help absorb any audio feedback. ​ ​ Please ensure no interruptions and distractions and allow 1 hour of uninterrupted time for our call. ​ We will be using Zoom or Streamyard for our call and pulling in audio to our master soundboard. A link will be emailed to you in advance. Please note: By participating in the Webinar, Livestream Broadcast and/or the Breast Cancer Conversations podcast with Survivingbreastcancer.org, you agree to allow us and anyone on the Survivingbreastcancer.org team, to record, distribute, and disseminate the contents in any manner. You also agree to allow Laura Carfang to retain rights to the produced media for potential future use in speeches, books, marketing, and in all other public distribution. In order to reach a broader audience, we also video record our podcasts so that it can be distributed on our YouTube channel. If you would prefer not to be video recorded, please let us know. Get ready to add value to so many lives! ​ ​ Tell Us About Yourself First Name Last Name Email Phone Submit Thanks for submitting! Upload Your Bio Upload Your Bio Upload Your Headshot Upload Your Headshot Please Link to your Twitter Profile Please link to your Instagram Profile I want to subscribe to the newsletter. Podcast Intake Form By submitting the below form you hereby give full consent to survivingbreastcancer.org to use all content and photographs for, but not limited to, our social media, advertising, newsletters, website use, printed materials, and public relations, and without limitation, reservation, or compensation. Survivingbreastcancer.org reserves the right to edit content. Please share your social media handles if you would like us to tag you when the Podcast is shared on our social media.

Resources for your clinics and your patients! Patient Referral Form Thusday Night Thrivers Read More A weekly meetup for your patients (all stages, all subtypes) held entirely online so anyone can join from anywhere. These weekly support groups are peer-to-peer facilitated by SBC trained volunteers Inflammatory Breast Cancer Support Read More Our support group is professionally moderated and provides a safe and welcoming space for patients to feel supported and make connections with others diagnosed with IBC. Metastatic Support Gorups Read More Every other week our MBC community gathers online to support each other and talk about their concerns and offer support. The 1st Thursday of the month the group is peer-to-peer facilitated by trained SBC volunteers and on the 3rd Thursday of the month, the group is professionally moderated Lobular Support Groups Read More Our monthly support group provides a safe and welcoming space for patients to feel supported and make connections with others diagnosed with Lobular Breast Cancer. These support groups are peer-to-peer facilitated by trained SBC volunteers Professionally Moderated Support in Spanish Read More Our Support Group offered on the 1st and 3rd Monday of the month is professionally moderated by a psychologist offering a safe and inclusive space for the Hispanic community. Support Groups Hosted in Spanish Read More Our Support Group offered on the 2nd and 4th Tuesday of the month is peer-to-peer moderated by trained volunteers of the SBC community offering a safe and inclusive space for the Hispanic community. Weekly & Monthly Support Groups Download the Flyers (5x7) Download the Flyers (8x10) We all want what is best for our patients. Let us be your partners in providing support when patients need it the most! Download the Flyers (5x7) Download the Flyers (8x10) Free Programs in English Download the Brochures From Art Therapy and Expressive Writing, to Yoga & Meditation SBC provides the complementary care your patients deserve Free Programs offered in Spanish Download the Flyer From virtual meet-ups to art therapy and webinars, our programs provide proven emotional support to assist your patients undergoing breast cancer treatment Free Educational Webinars Download the Flyer Offered in both English & Spanish, SBC provides educatoinal content through our livestreaming webinar series. Join Our Provider Mailing List The perfect way to stay up to date on our free programs, services, and hot topics. First name* Last name* Email* Company name Address Submit Classes, Webinars, LiveStreams, and More! Request SBC's Tri-Fold Brochures Available in English and in Spanish. Send us an email with your mailing address and we will happily ship brochures to you! Contact SBC For Your Office Perfect tri-fold brochures to include in any breast cancer packet for patients. All of our programs and services are 100% free. For Your Waiting Room Our brochures are a perfect addition to any office or waiting room area letting your patients know there is a community here to support them every step of the way. Refer Your Patients Let us bring hope and joy to the patients you serve. Looking to have a patient join one of our free online support groups, have them attend a workshop, or request a care package before your patient starts chemo or has surgery? SurvivingBreastCancer.org is here for you! Submit the Patient Referral Form below and we'll take it from there! Patient Referfal Fom Order Materials For Your Office Looking for bulk flyers and brochures to put in patient packets or distribute at upcoming health fairs? We have you covered. You can shop at our store and we kindly ask for a donation to help support the cost of printing and shipping. Order Now What Sets Us Apart Our Story

Surviving Breast Cancer provides breast cancer support, events, and webinars at no cost to you! Whether you are looking to gain more knowledge on a particular topic or meet up with other breast cancer survivors, we have something for everyone. Join our Support Group which meets every Thursday night. Attend one of our Sunday Metastatic Breast Cancer Series. Explore a live webinar featuring experts in the field. Move your body and mind with us every Monday. We even have a monthly Breast Cancer Book Club! Learn More and RSVP for Upcoming Events & Programs (Click here for Programs in Spanish) ​ Multiple Dates MBC Peer to Peer Support Thu, May 02 Virtual May 02, 2024, 7:00 PM – 8:00 PM EDT Virtual May 02, 2024, 7:00 PM – 8:00 PM EDT Virtual Join us for our signature Thursday Night Thrivers Meetup! On the first Thursday of every month, we will have a special breakout room for the MBC community. Share RSVP Multiple Dates Thursday Nights Thrivers Meetup Thu, May 02 Virtual May 02, 2024, 7:00 PM – 8:00 PM EDT Virtual May 02, 2024, 7:00 PM – 8:00 PM EDT Virtual This is your weekly breast cancer support group! It's a welcoming and inviting virtual space where you can come to meet others, ask questions, or just listen in. Our sessions are always confidential and a friendly space offering support as well a a bit of humor. Share RSVP Multiple Dates Breast Cancer Book Club Sun, May 05 Online May 05, 2024, 11:00 AM – 12:00 PM EDT Online May 05, 2024, 11:00 AM – 12:00 PM EDT Online Each month, the Breast Cancer Book Club chooses a book that has nothing to do with breast cancer. Share RSVP Multiple Dates Meditation Affirmations: Third Eye Chakra (Ajna) Mon, May 06 Online Event May 06, 2024, 10:00 AM – 11:00 AM EDT Online Event May 06, 2024, 10:00 AM – 11:00 AM EDT Online Event The process of focused meditation with attention and intention can provide answers to various questions we may have especially around limiting beliefs. This is an opportunity to anchor the chakra teachings and transform our consciousness around. Share RSVP Multiple Dates Artistic Expression: Our journey Mon, May 06 Online Event May 06, 2024, 6:00 PM – 7:00 PM EDT Online Event May 06, 2024, 6:00 PM – 7:00 PM EDT Online Event Unlock the transformative potential of creative expression with our immersive art exploration sessions. Delve into the healing energy of artistic endeavors as you discover the profound impact of mindfulness on emotional equilibrium. Share RSVP Multiple Dates Forest Bathing Tue, May 07 Virtual Event May 07, 2024, 6:00 PM – 7:00 PM EDT Virtual Event May 07, 2024, 6:00 PM – 7:00 PM EDT Virtual Event Join this Forest Bathing class and experience a deeper connection with nature, reduce stress, improve mental well-being, and increase feelings of calm and relaxation Share RSVP Multiple Dates Thursday Night Thrivers IBC Meetup Thu, May 09 Online Event May 09, 2024, 7:00 PM – 8:00 PM EDT Online Event May 09, 2024, 7:00 PM – 8:00 PM EDT Online Event Join the Inflammatory Breast Cancer SBC community, meet others diagnosed with IBC, and connect with those who truly understand the unique needs we all face. Share RSVP Multiple Dates Reflect and Recharge with Thomas Dooley Mon, May 13 Online Event May 13, 2024, 6:00 PM – 7:30 PM EDT Online Event May 13, 2024, 6:00 PM – 7:30 PM EDT Online Event How can we dial down the noise in our daily lives to listen to the story emerging within ourselves? In this interactive session, we will come together to reflect on the personal narratives that give shape and meaning to our lives and find community in the experiences we share. Share RSVP Multiple Dates Yoga Fitness with Chair Assist with Kim Tue, May 14 Online Event May 14, 2024, 11:30 AM – 12:30 PM EDT Online Event May 14, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided yoga fitness with chair assist. This is a WHOLE BODY practice with the intent to move and stimulate the body, mind and soul from head to toe. Share RSVP Multiple Dates Yoga Stretching for DIEP Flap Tue, May 14 Online Event May 14, 2024, 6:00 PM – 7:00 PM EDT Online Event May 14, 2024, 6:00 PM – 7:00 PM EDT Online Event Yoga stretching can be a helpful way to improve your range of motion and reduce pain after DIEP flap surgery. Share RSVP Multiple Dates MBC Support Group with Nancy Gaulin Thu, May 16 Virtual May 16, 2024, 7:00 PM – 8:30 PM EDT Virtual May 16, 2024, 7:00 PM – 8:30 PM EDT Virtual Join us for our signature Thursday Night Thrivers Meetup! On the third Thursday of every month, we will have a special meeting for the MBC community. This space will be hosted by the incredible Psychologist Nancy Gaulin. Share RSVP Multiple Dates Restorative Yoga with Kate: Unearthing Opportunities Mon, May 20 Online Event May 20, 2024, 5:30 PM – 6:30 PM EDT Online Event May 20, 2024, 5:30 PM – 6:30 PM EDT Online Event Did you know you have magical powers? We all can literally change our bodies through breath and movement. Experience this ancient practice and feel your own powers grow! Share RSVP In body Breathwork Tue, May 21 Virtual Event May 21, 2024, 6:00 PM – 7:00 PM EDT Virtual Event May 21, 2024, 6:00 PM – 7:00 PM EDT Virtual Event Breathwork is a powerful modality that combines conscious breathing techniques with mindfulness and meditation. Share RSVP Multiple Dates Thursday Night Thrivers-IBC 2.0 Thu, May 23 Online Event May 23, 2024, 7:00 PM – 8:30 PM EDT Online Event May 23, 2024, 7:00 PM – 8:30 PM EDT Online Event IBC 2.0 is a private support group for individuals who have graduated from our standing Thursday Night Thrivers-IBC. Our IBC 2.0 group dives into topics, questions, and concerns on a deeper level as members already know one another and have graduated from TNT-IBC. Share RSVP Multiple Dates Pilates with Nina: Breast Cancer Home Workouts Fri, May 24 Online Event May 24, 2024, 10:00 AM – 11:00 AM EDT Online Event May 24, 2024, 10:00 AM – 11:00 AM EDT Online Event You're invited to join our empowering online Pilates class set against the tranquil space of your home. Share RSVP Brain Spotting Mon, May 27 Virtual Event May 27, 2024, 6:00 PM – 7:00 PM EDT Virtual Event May 27, 2024, 6:00 PM – 7:00 PM EDT Virtual Event Brainspotting is a therapy technique used to address trauma and emotional distress. Share RSVP Multiple Dates Qi Gong with Kim Tue, May 28 Online Event May 28, 2024, 11:30 AM – 12:30 PM EDT Online Event May 28, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided Qi Gong class. A time-honored practice that utilizes breath, movement, and intention setting to promote health and equilibrium in the body. Share RSVP Meet the SBC Early Stage Team Tue, May 28 Livestream May 28, 2024, 7:00 PM – 8:00 PM EDT Livestream May 28, 2024, 7:00 PM – 8:00 PM EDT Livestream Join us for an introductory wwebinar wher you´ll get to meet our team! Share RSVP Load More Breast Cancer Support & Events Curated For You

Your loved one has just been diagnosed? Supporting Your Loved One Through Cancer prioritizing self-care to maintain your own well-being and be a source of strength for your loved one. A Caregiver's Guide to Breast Cancer Hear from the voices that inspire us to keep on going... ​ Are you a caregiver? Share your story William's Story Introduction In the middle of a lovely, sunny, late summer walk along the beaches of Boston, my partner, twelve months into treatment for breast cancer, looked up at me and opined: ​ “This has been the worst year of my life”. ​ My response was immediate: ​ “I must wholeheartedly disagree, I feel that this has been the best year of your life”. ​ She looked at me like I had two heads and inquired about my meaning. I elaborated with a thoughtful smile, “You have just beaten breast cancer”. This conversation aptly summed up my role as a breast cancer caregiver. ​ Closing - Managing Expectations ​ In closing I’d like to suggest that a caregiver remain focused on the job at hand and manage expectations. Don’t try to do to much. Recognize what you can do, perform your due diligence so that you can assist in the discussion and decision making. Remain positive and inspirational and as helpful as positive. But remember it’s a long haul and you, and your patient, will need to count on each other throughout the ordeal. Encourage Optimism, Avoid Negativity ​ A final anecdote: during the middle of a particularly depressing spell, I suggested that we go for a bicycle ride to get her out of her environment. As usual we went too far (40 miles total that day) and her depression was kicking in. So about thirty miles into our ride we stopped and took a break. After rehydrating and fueling we were able to get up and return the last 10 miles to our condo in Boston. Months later she asked how I was able to help her overcome her severe and scary depression on that particular ride. She told me her thoughts bordered on taking irrational actions. I told her that I remained focused on the positive and didn’t offer up any psychological rationale about dealing with her extreme sadness and potentially deleterious behavior. She then asked me “how did you know how to respond” and my answer was simply to reaffirm the healthful, positive aspects of our lives, which always returns us to our code during times of trouble - KGH (keep going hard). Characteristics of Caregiving There are many characteristics of life as a caregiver. The support that one provides to a cancer patient/survivor includes many of the following: emotional, physical, intellectual, financial, social, spiritual, nutritional, and motivational aspects to name just a few. But you are never alone. There is help and assistance everywhere. I found the following links to be quite helpful in coming to terms with my role as a caregiver. ​ https://www.cancercare.org/tagged/caregiving http://www.breastcancer.org/community/acknowledging/caregivers ​ From diagnosis and onward the responsibilities associated with caregiving kick in. There are meetings and discussions with your oncological and surgical teams. Options and alternative courses of action are proffered and weighted. Decisions have to be made in short order so it’s best to prepare yourself ahead of time by performing as much due diligence as you can. Do your research on the various options as spelled out by your care team. Once a course of action is agreed upon and plotted, take particular care to stay on top of developments, i.e. scheduled appointments, pain/emotional management, medications, coordinating and communicating information to the extended caregiving family, and helping with chores. ​ At all times, be aware that you are there to assist the patient. This isn’t about you. Involve yourself with the patient’s emotional issues. You do not need to be a medical professional. Common sense and responding through the lens of caregiving should provide you with enough tools to deal with the myriad emotions that arise, such as fear and depression/sadness. There are many support groups that you can reach out to, including hospital care groups, psychiatrists, social/media pages, https://www.survivingbreastcancer.org/ ​ #survivingbreastcancer The Social Perspective ​ Together we went out on a limb and informed all of our friends, both in person and through social media of the diagnosis. We also discussed it with our local area restaurant staff and work out circles at the YMCA, to eliminate any fears of considerations/communications from friends and associates regarding her cancer. Remember, the patient will be going through both emotional and physical changes, but still will want to resume enjoyable activities like date nights or walking on the treadmill as much as possible. We found that discussion opened many doors of kindness, friendship, and offers of help. Long Term ​ Breast cancer remediation and treatment is a long-term commitment. Be cognizant of the fact that you too, as a care giver, need help and support, and quality time as well. Don’t try to do it all. Involve others, either extended family, or friends, or even medical support groups. ​ Remain flexible. Due to the constant changing nature of recovery, from chemotherapy, to surgery, radiation, additional chemotherapy (if necessary) and follow up hormonal treatments, you may find yourself faced with multiple patient fronts. Side effects of the treatment are varied and include hair loss, water weight gain, physical breast alteration, depression, exhaustion, lymphedema, foot and mouth issues, to name several. Prepare yourself as best as you can to prevent the above from adversely affecting you in your role. It’s ok for the patient to be tired and sad. It’s also ok for the caregiver. I found comedy and music (movies, TV, radio) to be a great relief as it tends to change the narrative. Articles Supporting your loved one through cancer involves empathy, communication, and practical assistance. Read the following blogs to learn more about caregiving. Surviving Breast Cancer Apr 12 10 min The Last Thing I Told My Mom Was a Lie (Part 2) By Olivia Smith Content warning: death and dying Read part 1 of Olivia’s story: The Last Thing I Told My Mom Was a Lie (Part 1) My sister... 450 3 likes. Post not marked as liked 3 Surviving Breast Cancer Apr 5 6 min The Last Thing I Told My Mom Was a Lie (Part 1) By Olivia Smith Content warning: death and dying “I have some news to share with you girls. I went to the doctor because I have been... 1,514 9 likes. Post not marked as liked 9 Surviving Breast Cancer Jan 14 4 min Supporting Loved Ones with Breast Cancer: How to Offer Meaningful Help Emotional support is vital for someone facing breast cancer. Here are ways to provide meaningful emotional support 114 1 like. Post not marked as liked 1 Surviving Breast Cancer Jan 9 5 min Breaking the Silence on End-of-Life: What is a Death Doula? Talking about death is important. This statement may seem obvious to some, but it is a topic that is often avoided or treated as taboo in... 253 1 like. Post not marked as liked 1 Surviving Breast Cancer Dec 17, 2023 3 min Navigating Grief: Understanding the Stages of Loss and Healing Losing someone dear to breast cancer can be an immensely painful and emotional experience. As we grapple with the departure of our dear... 191 1 like. Post not marked as liked 1 Surviving Breast Cancer Mar 14, 2023 6 min No Coincidence By Donna Valentine, PA-C I have never had breast cancer, although it’s played a role in my daily life for over two decades. And I... 458 4 likes. Post not marked as liked 4 Surviving Breast Cancer Oct 16, 2022 3 min Cancer Caregivers: Contending with Change #FeatureFriday As difficult as it may be to grapple with breast cancer as a patient or a survivor, it’s important to remember that... 58 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min How To Be Helpful When A Loved One Is Sick By Nate Kolmodin My name is Nate Kolmodin. My mother was diagnosed with breast cancer in May 2004. After recently learning about her... 86 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 4 min Well-Being for Caregivers By Alexis Puthussery What is a caregiver? The American Cancer Society defines caregiver as “the person who most often helps the patient... 69 1 like. Post not marked as liked 1 Podcasts Discover podcasts on caregiving for insightful discussions, practical tips, and emotional support.Listen to experts and caregivers share experiences, strategies, and encouragement to navigate the challenges of caregiving with compassion and resilience. Caregiver & Patient Programs Are you caring for a loved one with breast cancer? We understand the challenges you face, and we want to support both of you on this journey. Join our tailored programs designed for breast cancer patients and their caregivers. Multiple Dates Yoga Fitness with Chair Assist with Kim Tue, May 14 Online Event May 14, 2024, 11:30 AM – 12:30 PM EDT Online Event May 14, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided yoga fitness with chair assist. This is a WHOLE BODY practice with the intent to move and stimulate the body, mind and soul from head to toe. Share RSVP Multiple Dates Yoga Stretching for DIEP Flap Tue, May 14 Online Event May 14, 2024, 6:00 PM – 7:00 PM EDT Online Event May 14, 2024, 6:00 PM – 7:00 PM EDT Online Event Yoga stretching can be a helpful way to improve your range of motion and reduce pain after DIEP flap surgery. Share RSVP Multiple Dates Restorative Yoga with Kate: Unearthing Opportunities Mon, May 20 Online Event May 20, 2024, 5:30 PM – 6:30 PM EDT Online Event May 20, 2024, 5:30 PM – 6:30 PM EDT Online Event Did you know you have magical powers? We all can literally change our bodies through breath and movement. Experience this ancient practice and feel your own powers grow! Share RSVP Multiple Dates Pilates with Nina: Breast Cancer Home Workouts Fri, May 24 Online Event May 24, 2024, 10:00 AM – 11:00 AM EDT Online Event May 24, 2024, 10:00 AM – 11:00 AM EDT Online Event You're invited to join our empowering online Pilates class set against the tranquil space of your home. Share RSVP Multiple Dates Qi Gong with Kim Tue, May 28 Online Event May 28, 2024, 11:30 AM – 12:30 PM EDT Online Event May 28, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided Qi Gong class. A time-honored practice that utilizes breath, movement, and intention setting to promote health and equilibrium in the body. Share RSVP

Download PDF Surgery Options Questions to ask your Surgeon What should I expect during a consultation for breast reconstruction? ​During your breast reconstruction consultation, be prepared to discuss: ​ Your surgical goals Medical conditions, drug allergies and medical treatments Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use Previous surgeries ​ Your plastic surgeon will also: Evaluate your general health status and any pre-existing health conditions or risk factors Examine your breasts and take measurements of their size and shape, skin quality and placement of nipples and areolae​ Take photographs Discuss your options and recommend a course of treatment Discuss likely outcomes of breast reconstruction and any risks or potential complications ​ Be sure to ask your plastic surgeon questions. It's very important to understand all aspects of your breast reconstruction. To help, we have prepared a checklist of questions to ask your breast reconstruction surgeon that you can take with you to your consultation. ​ It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with your plastic surgeon. ​ What options are available for breast reconstruction? If you've decided to have breast reconstruction, you'll still have many things to think about as you and your doctors talk about what type of reconstruction might be best for you. There are many different reconstruction techniques available. Take the time to learn about the breast reconstruction options and consider talking to others who have had that procedure before you make a decision. ​ Breast reconstruction with implants Implant-based breast reconstruction may be possible if the mastectomy or radiation therapy have left sufficient tissue on the chest wall to cover and support a breast implant. For patients with insufficient tissue on the chest wall, or for those who don't desire implants, breast reconstruction will require a flap technique (also known as autologous reconstruction). The most common method of tissue reconstruction uses lower abdominal skin and fat to create a breast shape. There are several techniques that can be used for implant-based breast reconstruction. Make sure to discuss with your plastic surgeon which is appropriate for you. ​ Immediate breast reconstruction above the pectoral muscle This procedure is performed in combination with the mastectomy and results in an immediate breast mound. After the mastectomy has been performed by the breast surgeon, the plastic surgeon will place the breast implant, wrapped in a biological mesh known as acellular dermal matrix (ADM), to help the implant maintain correct anatomic position, above the pectoralis muscle. ​ With this procedure, recuperation may be more rapid because the muscle in the chest has not been elevated. Further, the breast implant itself is not influenced by the contraction of the muscle. Complications, while rare, may include skin loss, excess bleeding, infection, malposition of the implant so that asymmetry occurs, wrinkling or rippling of the implant, possible fluid collection underneath the implant and/or unfavorable scarring. This procedure may also require secondary autologous fat transfer to eliminate upper pole wrinkling and rippling over time, which will occur over secondary procedures. ​ Immediate breast reconstruction under the pectoral muscle This procedure is also performed as a combination with the mastectomy and results in an immediate breast mound. The incision generally is performed through the mastectomy site. Once the mastectomy is completed, the plastic surgeon will elevate the pectoralis major muscle. This will allow the muscle to retract upward and allow a pocket to be developed underneath the muscle and at the bottom of the normal breast position. Delayed breast reconstruction utilizing tissue expander. ​The initial portion of this procedure entails the breast surgeon performing a standard mastectomy and possible axillary dissection. In many instances, a drain will be placed between the muscle and the skin of the mastectomy. ​ Once these procedures have been performed, the plastic surgeon will divide the lower pole of the chest wall muscle, elevate the chest wall muscle and the lateral chest muscle together upwards towards the collarbone. After that is done, the muscle and tissue below is elevated together to form the pocket for the breast expander at the base of the breast or the inframammary crease. The pocket is made large enough for the expander to be placed and the muscle closed. Occasionally, there is a need for placement of a small amount of acellular dermal matrix (ADM) to assist in the closure of the muscle. ​ There are two types of breast tissue expander ports. One, similar to a chemotherapy port, is placed separate from the tissue expander, usually along the rib cage. This will require a separate small incision for the port. The second type is a port that is contained within the expander itself. In both instances, the ports will be used to inflate the tissue expander over several visits with saline solution. The port is accessed with a small needle and saline is injected into the expander through the port site ​ Tissue expansion usually occurs weekly according to patient tolerance. The volume of the tissue expanders commonly exceeds the weight of the mastectomy tissue. Once the final tissue expansion, or stretching, is completed there will be a time of passive expansion where little to no volume is added to the tissue expanders. This allows the muscle and skin to stretch and relax. The length of time will vary from patient to patient. Once this is completed, a second outpatient procedure will be necessary to remove the tissue expander and place the permanent breast prosthesis. Complications, while rare, may include skin loss, exposure of the expander, excess bleeding, infection, malposition of the implant so that asymmetry occurs, wrinkling or rippling of the implant, possible fluid collection underneath the implant, pain at the injection site, muscle spasms with expansion and/or unfavorable scarring. Lymphedema 101 On Breast Cancer Conversations, the Podcast Listen Now A biodegradable acellular dermal matrix (ADM) will be placed at the bottom of the breast or inframammary crease and attached to the muscle. The breast implant will be placed under the ADM and your own muscle. This allows the breast implant to settle in a normal position, and the ADM stretches into a pleasing, rounded lower breast shape. It is not uncommon to have drains placed with this procedure. They may be removed anywhere from 48 hours to 2 weeks after surgery. This procedure is a one-staged procedure, which allows the desired shape to result without any further surgical intervention. The muscle on top of the implant will help prevent the development of upper pole wrinkling. Complications, while rare, may include skin loss, excess bleeding, infection, malposition of the breast implant so that asymmetry occurs, wrinkling or rippling of the implant, possible fluid collection underneath the implant and/or prosthesis deflation. Immediate breast tissue expander placement The surgical process for saline breast tissue expanders and breast expanders following mastectomy are the same. Expanders with saline have been used for decades but recently, a new type of expander using air, which allows for more patient control, have been introduced. Expanders have some of the same complication rates and risks as the other types of breast reconstruction, which include infection, seroma, hematoma, extrusion and/or expander deflation. The expander is placed into a submuscular or subcutaneous space with no external filling ability. The expander will fill with compressed air contained within the expander itself. The patient will do self-controlled expander fills utilizing an external automatic activation device at home and will achieve similar results to the standard saline filled tissue expansion devices. It will be necessary to monitor the incisions and progress on your own and contact the physician if you feel there is something wrong. The advantage of the expander it that it may decrease doctor visits and decrease total expansion time. ​ Immediate breast reconstruction utilizing latissimus dorsi muscle. ​ This procedure is performed as a secondary operation immediately during the mastectomy or delayed after radiation. The latissimus muscle is a very large vascular muscle in the back that is attached at the base of the arm, extends onto the chest from the arm past the shoulder blade and attaches close to the spinal column. The latissimus muscle stretches to the tip bone and hallway into the axilla or armpit area and is supplied mostly by artery in the axilla. The latissimus flap is frequently used when the amount of soft tissue is limited secondary to surgery, the pectoralis muscle is absent, partially removed or damaged secondary to radiation. It entails undermining the skin on the back and releasing some of the skin allowing it to remain attached to the muscle. The main muscle and artery is called pedicle flap. This flap is released from the back, passed through a tunnel that is made underneath the axilla and into the anterior chest to fill the mastectomy defect site. The muscle is placed and sutured to the chest wall. An implant is then placed behind this flap and in front of the chest. One can also use a tissue expander and gradually increase to breast size. The advantage to this expander is it can completely replace the amount of breast tissue that has been removed and protect the latissimus flap. A completely inflated implant or a postoperative adjustable expander/implant can be immediately placed. It is not uncommon to require a secondary revision procedure to gain more accurate symmetry of both breasts. The latissimus flap is recommended for patients who have already had mastectomy and radiation. The use of radiation frequently limits the amount of implant surgery that can be performed. The secondary advantage of this flap is that it brings new blood flow and healthy skin to the radiated field. It is also recommended for patients who are very thin and have limited options for flap reconstruction. ​ Complications, while rare, may include limited blood flow of the artery compromising the flap, skin loss, exposure of the expander, excess bleeding, infection, malposition of the implant so that asymmetry occurs, wrinkling or rippling of the implant, possible fluid collection underneath the implant, pain at the injection site, muscle spasms with expansion and/or unfavorable scarring. ​ Breast reconstruction with abdominal-based flaps Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. In these cases, breast reconstruction usually requires a flap technique (also known as autologous reconstruction). This is the most common method of tissue reconstruction, using lower abdominal skin and fat to create a breast shape. A woman may also choose not to have an implant for personal reasons. ​ The skin and fat used for this procedure is the tissue between your belly button and pubic bone that you can pinch. Once this tissue is taken to make a breast, you will typically have a scar from hip bone to hip bone and around your belly button. However, some women may not be candidates for abdominal-based flaps for various reasons: • Not enough donor tissue in the lower abdomen • Prior scars that may have damaged important blood vessels • Previous flaps that have failed and seeking an alternative ​ Specific flap options Several different flaps use the tissue from the lower abdomen. The difference between each of them is related to blood vessels that supply these flaps. These flaps include the Pedicled TRAM (traverse rectus myocutaneous) flap, the free TRAM flap, the DIEP (deep inferior epigastric artery perforator) flap and the SIEA (superficial epigastric artery) flap. ​ Pedicled TRAM flap A TRAM flap uses the muscle, fat and skin from your lower abdomen to reconstruct a breast. In order to survive on your chest in its new location, this tissue requires a blood supply. The blood supply to this tissue comes from the underlying rectus (six-pack) muscle. The flap remains attached to your rectus abdominis muscle and is tunneled up through the abdomen and chest to create the breast mound. Since your entire muscle is sacrificed, you may experience some abdominal weakness or have difficulty performing sit-ups. ​ Free TRAM flap Like the TRAM flap, the free TRAM flap is also based on the blood vessels coming through the rectus abdominis muscle. However, in this flap the muscle above and below the blood vessels is divided, so that only a portion of muscle is removed. The entire flap is then transplanted to the chest. The blood vessels from the muscle are connected to blood vessels in the chest using a microscope. ​ DIEP flap The DIEP flap utilizes the same lower abdominal skin and fat as the TRAM and free TRAM flap; however, it spares the rectus abdominis muscle and fascia. Rather than taking the entire muscle or a small portion of the muscle, the small blood vessels – an artery and a vein – that come through the muscle to the skin and fat are identified; these vessels are then dissected through the muscle prior to being divided. Once they are divided, the tissue is again transplanted to the chest and the vessels are connected to blood vessels in the chest. Since your muscle is preserved, there is a lower risk of abdominal weakness or hernias and less postoperative pain. ​ SIEA flap The SIEA flap also uses the lower abdominal skin and tissue, but the blood vessels that supply this flap do not go through the abdominal muscle. Rather, they only go through the fat. Advantages of this flap include preservation of the abdominal muscles, resulting in less postoperative pain and a speedier recovery. However, these blood vessels may not be present in all women; and even when present, may be too small to provide a reliable blood supply for a flap. For these reasons, the SIEA flap is not performed as frequently as the DIEP or free TRAM flaps. ​ Special notes regarding recovery Because the free TRAM, DIEP and SIEA flaps involve microsurgical tissue transfer, blood flow to the flap is closely monitored in a hospital setting after surgery. If there are concerns about the flap, a reoperation may be necessary to assess the blood flow. ​ Breast reconstruction with thigh-based flaps Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. In these cases, breast reconstruction usually requires a flap technique (also known as autologous reconstruction). ​ Thigh-based flaps may be a good option for women with small to medium volume breasts. To achieve a larger size, these flaps may be combined with an implant or another flap (called "stacked flaps," which are not widely available). All of these techniques require your plastic surgeon to have skill and training in microsurgery. ​ However, some women may not be candidates for thigh-based flaps for various reasons: • Not enough donor tissue in the upper thighs • Prior scars that may have damaged important blood vessels • Previous flaps have failed and they are seeking an alternative ​ Specific flap options Gracilis-based flaps are based on the gracilis muscle, located in the upper inner thigh. The gracilis muscle helps bring the leg toward the body, and its function will be lost after this type of surgery. During these procedures, a flap of skin, fat, muscle and blood vessels from the upper thigh is moved to the chest to rebuild the breast. Blood vessels are carefully reattached using microsurgery. ​ Different names are used to describe the orientation of the resulting donor site incision on the upper inner thigh: ​ • TUG flap: Transverse Upper Gracilis flap • VUG flap: Vertical Upper Gracilis flap • DUG flap: Diagonal Upper Gracilis flap The choice of incision depends on your unique thigh shape and your surgeon's experience. Most surgeons will try to conceal the scars in the crease at the top of the thigh, but the scar may end up a bit lower and be visible while wearing a bathing suit. These flaps result in a tighter inner thigh, similar to an inner thigh lift. ​ Similar to the gracilis-based flaps, a PAP flap uses skin and fat from the back of the upper thigh to reconstruct the breast using microsurgery. PAP stands for Profunda Artery Perforator, which is a blood vessel that supplies this area of the thigh. No muscle is used, so a PAP flap is considered muscle-sparing. PAP flap scars are usually hidden in the crease between the lower buttock and upper thigh. ​ Special notes regarding recovery Because these flaps involve microsurgical tissue transfer, blood flow to the flap is closely monitored in a hospital setting after surgery. If there are concerns about the flap, a reoperation may be necessary to assess the blood flow. ​ Thigh-based flaps do tend to have more healing problems at the donor site than abdominal-based flaps due to the location of the incision. Lower leg swelling may occur but usually resolves with time. ​ When one thigh-based flap is used to reconstruct one breast, asymmetry may result due to tightness and thinness of one thigh. Additional procedures may be recommended to improve symmetry between the thighs. ​

We all have a story. We are all here to share & Support. Diagnosed with breast cancer at 34 Health and fitness has always been a part of who I am. For decades I have practiced yoga, enjoyed running, hiking, biking, swimming and weight training. I followed a vegan diet and thought I was in the best shape of my life, that is, until I was diagnosed with breast cancer at the age of 34. "How could this happen to me?" ​ ​This shattering news became the catalyst for launching SurvivingBreastCancer.org. I have undergone both neoadjuvant and adjuvant chemotherapy, surgery, radiation, and hormonal therapies, and noticed that the real trauma from a cancer diagnosis came after I completed my active treatment. It was when I heard the good news that my next follow-up appointment would not be next week, but in 12 weeks, followed by 6 months, and then in a year. That's when it hit me. That's when I realized the important role Survivingbreastcancer.org plays in the breast cancer arena and why I have dedicated myself to building a breast cancer survivorship platform. ​ Understanding my own health and wellness not only became my top priority, but it became my full-time job. Managing one’s health isn’t something that you do 3 days a week. It is a commitment to one’s self and life-style choice. The Surviving Breast Cancer organization revolves around a positive mindset, and I want to share that mindset with you! Come take a look around and make yourself at home! ​ ​ Xo, -- Laura

Read Stories Surviving Breast Cancer Sep 14, 2022 1 min My Boys and My News By Jill Rackham I will never know what it was like for my children to receive such news about their mum, Telling my boys about my cancer... 113 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min How To Be Helpful When A Loved One Is Sick By Nate Kolmodin My name is Nate Kolmodin. My mother was diagnosed with breast cancer in May 2004. After recently learning about her... 86 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 2 min All the Things I Wish You Were Here For: I Lost My Mom to Breast Cancer By Kyla Thompson All the things I wish you were here for. All the things I wish you could tell me. All the things I struggle with because... 32 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 1 min Goodbyes Are Hard By Matilda Flanagan (11 years old) I cry as someone holds me Trying to calm me They rock me Just like my mom did Before she got sick I... 25 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 1 min It Will Be OK By Matilda Flanagan (11 years old) It will be OK She will be OK Hair isn’t everything It will grow back I can’t pretend everything is OK... 47 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 4 min Kyla’s Story This is a story about my mom. A story of love. A story changed by breast cancer, but not defined by it. My mom was my best friend. She... 32 Post not marked as liked 1 2 My name is Kyla Thompson, and I welcome you, kids, like me, to our space! My mom passed away of metastatic breast when I was 13. She was first diagnosed when I was two years old. I didn't know what breast cancer was then. 11years later, on October 21, 2014, a world that was filled with sports, homework, friends, and more shifted in a few seconds. My mom was gone. It was at a breast cancer walk just a few weeks later, with thousands of people, when I realized the need for #pinkkids. Of all the walkers, more than half were kids. I knew then I wasn’t alone. ​ I knew we needed to connect with each others and #pinkkids is the place for that connection. We are starting by sharing stories on the blog and through podcasts, as well as a private Group (link below). We’ll keep you up to date through SBC emails, as well as our Instagram (_pinkkids_). Looking forward to talking! Do you have a mom or dad who has been diagnosed with breast cancer? Or perhaps you have lost a parent to MBC? Connect with Kyla, share your story, post your why, or just let her know how you are doing today, we're all here to listen, support, and be a resource! ​ Email Kyla at pinkkids@survivingbreastcancer.org Breast Cancer 101 Lifestyle & Wellness Resources Programs Library Podcast About More Resources For Children & Adolescents Share your story. Share Your Why. Share A picture. Share. Email Kyla at pinkkids@survivingbreastcancer.org

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Newly Diagnosed with Metastatic Breast Cancer. Now What? What brings you to this website is most likely a metastatic breast cancer (MBC) diagnosis. Perhaps you experienced a recurrence from early stage breast cancer (stages 0,I, II, or III) to advanced or late stage breast cancer (stage IV, MBC). In some cases you may have been diagnosed de-Novo meaning that you never experienced an early stage of breast cancer and based on diagnostic tests were diagnosed with metastatic breast cancer as your initial diagnosis. Whatever the reason, I want you to know that you will be supported and that our Surviving Breast Cancer (SBC) community is here for you! ​ We are here to help! A metastatic breast cancer diagnosis is different than an early stage diagnosis in the way in which it disrupts our lives and throws us into a whirlwind of continual doctors appointments, follow ups, tests, scans, and the like. Each and every one of us have unique experiences, and what our SBC platform and community provides is education, support, and resources for you as a complement to your medical care. We are not medical professionals, nor provide medical advice. But what we do offer is content, stories, and community when you need it most! What I mean by that is you are welcome to dive in to absolutely everything we offer today, or, you can take bite size approaches to get the information and support when you feel ready for it. We've listed a few links and resources to help get you started and to hopefully make things a bit less overwhelming. Download. Questions to Ask Your Surgeon Download PDF Questions to Ask Your Radiologist Downlod PDF Questions to Ask Your Oncologist Coming Soon Burning Questions Latest News Who Should I Tell? ​ Click here to add your File description. Summarize the content of the file, why it is useful, and who should download it. Should I Get A Second Opinion? You may consider receiving a second (third, or fouth) opinion from another medical oncologist or breast surgeon. In some cases, people get multiple opinions before making any decisions on their care and medical treatment plan. ​ Women in our Breast Cancer Support Group often share that it is important for them to feel comfortable with your doctors; that there is a rapport and trust. After all, your medical team is going to be your primary caregiver so it is important you feel comfortable with the person, able to ask questions, and feel confident in your plan of action. As one woman in our MBC community mentioned, "the more smart people reviewing my specific cancer, the better!" ​ Your Medical Care Team may consist of one or several of the following: Breast Oncologist Breast Surgeon Breast Plastic Surgeon Radiation Oncologist Social Worker Psychologist Palliative Care team Natrapathic Doctor Nutritionist What Treatment Options Do I Have? Thanks to continued research taking place in Breast Cancer, people diagnosed with metastatic breast cancer have a variety of treatment options and are able to live long and fulfilling lives. Treatment options will be tailored to your specific diagnosis and dependent on where the cancer has metastasized (spread). For example, is it HER2 positive or negative, is it triple negative meaning it is estrogen receptor negative, progesterone receptor negative and HER2 negative. Additionally, though a series of diagnostics, your oncologist will also be able to tell if the cancer is in one area like the bones or the lungs, or if it is in multiple areas such as bones and other organs (liver, brain, etc.). ​ You may also consider genetic testing. The more information you have about you, your body, and your caner, the better! ​ Traditional standard of care includes: Surgery (not always required if you are diagnosed with metastatic stage IV breast cancer, that is, your cancer has spread beyond your breast to your bones, lungs, liver, or brain) Radiation (not always required but may be offered to target specific metastasis and/or allieveate pain as a form of palliative treatment) Chemotherapy Hormonal Therapy (not always required) ​ Oftentimes people will also consider integrative therapies as a complement to the standard treatments which also has been shown to reduce some of the side effects of treatment: Acupuncture Yoga Meditation ​ Additionally speak to your oncologist about Clinical Trials and if you would be a candidate. Will I Need Chemotherapy? It is most likely that if you are diagnosed with metastatic breast cancer you will be offer chemotherapy, immunotherapy, or targeted therapy. Treatment options can come in the form of oral chemotherapy or IV. ​ . Tue, Sep 10 Online 8 Week Program Encourage and Empower Program for the Newly Diagnosed Sep 10, 2024, 11:00 AM – 12:00 PM EDT Online 8 Week Program Join Gloria Shoon for a weekly gathering of encouragement and empowerment. In this 8 week program, designed specifically for those who are newly diagnosed, participants will explore tiny habits that build upon each other. Share RSVP

! Positive Thinking, Mindfulness & Meditation For Healing Meditation On Demand Meditation. Create your own private haven anytime and anywhere. We have a number of beautiful meditations in our library. Choose one and practice it for a week or two. If you practice every day at the same time, you’ll notice that your brain is trained to follow your meditation practice consistently. Live Classes Join us for virtual classes with instructors who understand the cancer experience and offer a warm and welcoming community setting. Meditation & Journaling Join our chakra meditation with Gloria every Monday. After the meditation, participants are invited to write about their experience during the meditation. If they feel called to do so, they can also share their writing with the class. This is a great way to realize how connected we truly are. What are chakras? In Sanskrit, the word “chakra” means “disk” or “wheel” and refers to the energy centers in your body. These wheels or disks of spinning energy each correspond to certain nerve bundles and major organs. To function at their best, your chakras need to stay open, or balanced. Connect with your inner self, your spirit, and being through exploring your chakras. Positive Thinking and the Power to Heal ​The power of positive thinking is so pervasive today that many doctors and nurses strongly recommend developing a positive mental attitude to prevent sickness, to help overcome medical setbacks like disease, and to assist in the recovery from surgery. ​ There is healing power in positive thinking. But can you heal yourself just by being positive, optimistic and focused? Yes! It is believed that positive thoughts are able to prompt physiological changes in your body that strengthen your immune system, decrease pain, and provide stress relief. The “Power of Positive Thinking”, a self-help book by Norman Vincent Peale , published in the last century, first proposed the method of "Positive Thinking ". It aimed to ensure that one could achieve a permanent fruitful and optimistic attitude through constant positive influence of his/her conscious thought. This was to be accomplished through affirmations/visualizations, thus allowing one to attain higher satisfaction and quality of life. Similarly, in the book, “The Secret” by Rhonda Byrne, the Law of Attraction is explored and suggests that whatever energy, thoughts, or visualizations you put out into the universe, you will receive. So, if you send out negative vibes, or think something negative will happen, it probably will. If you send out positive vibes, positive things will be returned. Read Inspiring Articles How to Develop Positive Beliefs Start by applying the right kind of positive thinking so that you direct your subconscious mind to help heal your body and improve your life. ​ Direct your conscious and subconscious mind to help you heal. ​ Don’t worry. "Worry only takes the joy out of your day". Find a way to focus on the positive. What are you grateful for? Start a mental list of the things and people in your life that you are thankful for.​ Be optimistic. Surviving Breast Cancer Mar 5 3 min Breast Cancer Stories Thoughts on October: Breast Cancer “All Too Aware” Month By Dania Francis Although most people know that October is Breast Cancer Awareness Month, many do not realize what a tough month it is.... Surviving Breast Cancer Feb 29 3 min Positive Mindset & Inspiration No Scars to Your Beautiful By Jayita Chatterjee [This one is for me, for my pink cancer friends that went through lumpectomy, mastectomy and/or reconstruction, and... Surviving Breast Cancer Feb 9 2 min Positive Mindset & Inspiration Remember You Are Not Alone By Lourdes D. Heras After a breast cancer diagnosis… My life, your life, our life changes and the lives of those around us are impacted.... Surviving Breast Cancer Jan 14 2 min Blog Emotional Well-being during Breast Cancer: Coping Strategies and Support Resources A breast cancer diagnosis can evoke a range of emotions—fear, anxiety, sadness, anger, uncertainty, and more. Emotional responses vary among Surviving Breast Cancer Jan 14 2 min Positive Mindset & Inspiration Holistic Approaches to Complement Breast Cancer Treatment: Benefits and Practices Understanding these holistic approaches, their benefits, and their integration with conventional treatments can be valuable for individuals. Surviving Breast Cancer Oct 11, 2023 1 min Poetry Inspire & Innovate By Gloria Shoon At the first light; With gratitude in my heart, I connect with self and all of the Universe... Love is always in season;... Surviving Breast Cancer Mar 28, 2023 2 min Blog New Meanings and Shifting Priorities By Kristen Carter If you want to know what’s most important in life, just ask a woman who’s been diagnosed with breast cancer. Facing her... Surviving Breast Cancer Mar 17, 2023 2 min Blog My Experience in the SBC Encourage & Empower Program By Carol Collins During my breast cancer treatment, I came across Survivingbreastcancer.org. I soon saw a sign up post for Encourage &... Surviving Breast Cancer Feb 25, 2023 4 min Blog Putting Yourself First By Kristen Carter When Dawn Oswald was diagnosed with early-stage breast cancer in 2008, her first impulse was to get on with treatment... Surviving Breast Cancer Feb 9, 2023 3 min Blog Self-Love Comes First By Kristen Carter Valentine’s Day can be a wonderful holiday if you’re in a relationship with someone you care for (and who cares for... 1 2 3 4 5 On Demand Meditation Cannot make a live class. No worries, we got you covered. You can access our on demand meditations anytime, anywhere! Let's Meditate Now Live Classes: What Your Chakras Are Telling You Chakra images courtesy of HopeSpring.ca Meditation testimonials Why and how meditation can help? "Meditation brings us into the now – the present and this helps us to eliminate our thoughts on the past and the future. Why this helps is because it is the past that can make us depressed and it is the future that can make us worry."

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What is Breast Cancer? What is Breast Cancer? ​ Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop. Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor. A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body. The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast. ​ Breast Anatomy. A breast is made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk. The ducts are tubes that carry milk to the nipple. The connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together. Most breast cancers begin in the ducts or lobules. Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor (see the Stages of breast cancer below for more information). Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. Instead, 85-90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general. ​ There are steps every person can take to help the body stay as healthy as possible, such as eating a balanced diet, maintaining a healthy weight, not smoking, limiting alcohol, and exercising regularly (learn what you can do to manage breast cancer risk factors ). While these may have some impact on your risk of getting breast cancer, they cannot eliminate the risk. Developing breast cancer is not your or anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive. ​ Stages of Breast Cancer Staging is a standard term used across the medical profession to communicate how widespread or advanced the cancer is in the breast tissue and possibly other parts of your body. If you are diagnosed with breast cancer, doctors and pathologists will examine biopsy and imaging results to determine the stage — also known as the progression — of the disease. The process is complicated but necessary to determine the best treatment plan for your particular type of cancer. The most common staging system is the TNM (Tumor, Node, Metastasis - more on this below), which focuses on tumor size, lymph node involvement and metastatic spread of the cancer. It also factors in details related to hormone receptors, the protein HER2 and growth rate of the cells. The staging of your tumor is utilized by doctors to explain the breadth and scope of the cancer and helps them determine how to move forward with treatment, including surgery, if needed. Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all the tests are finished. The stage of a breast cancer is determined by the cancer’s characteristics, such as how large it is and whether or not it has hormone receptors. The stage of the cancer helps you and your doctor: ​ • figure out your prognosis, the likely outcome of the disease • decide on the best treatment options for you • determine if certain clinical trials may be a good option for you Breast cancer stage is usually expressed as a number on a scale of 0 through IV — with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body. ​ Clinical vs. Pathological Staging Clinical staging is based on the results of tests done prior to surgery. If your biopsy comes back positive, your doctor may order additional tests to garner a better understanding if and where the cancerous cells have spread. This data gathering period may include physical examinations, mammogram, ultrasound, and MRI scans. In some cases your doctor may also order a bone or CT scans. Pathologic staging is based on what is found during surgery to remove breast tissue and lymph nodes. While a lot of the aforementioned tests can provide your oncological team with lots of information and data points, it is not until surgery is performed whereby the surgeons can remove the tumor and possible lymph nodes in order to confirm the size of the tumor, the number of lymph node involvement, and whether or not the cancer has metastasized. Early Stage Breast Cancer Early stage breast cancer refers to stages 0-III. Stage 0 Stage 0 cancers are called “carcinoma in situ.” Carcinoma means cancer and “in situ” means “in the original place.” Types of “in situ carcinoma” include • DCIS – Ductal carcinoma in situ • LCIS – Lobular carcinoma in situ • Paget disease of the nipple Stage I Stage I can be divided into Stage IA and Stage IB. The difference is determined by the size of the tumor and the lymph nodes with evidence of cancer. Stage II Stage II means the breast cancer is growing, but it is still contained in the breast or growth has only extended to nearby lymph nodes. This stage is divided into groups: Stage IIA and Stage IIB. The difference is determined by the size of the tumor and whether the breast cancer has spread to the lymph nodes. Stage III Stage III cancer means the breast cancer has extended beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles, but has not spread to distant organs. This stage is divided into three groups: Stage IIIA, Stage IIIB, and Stage IIIC. The difference is determined by the size of the tumor and whether cancer has spread to the lymph nodes and surrounding tissue. Stage IV In Stage IV, the cancer has spread to other organs and parts of the body beyond the breast. This stage is often referred to as metastatic breast cancer (MBC) and is more difficult to treat due to the impact on other organs. Stage IV cancer symptoms include visible swelling in the breast and armpit; dry, flaky skin; red, dimpled skin; nipple discharge; breast pain; fatigue; insomnia; loss of appetite; weight loss; shortness of breath and other symptoms related to the specific organs involved. Although Stage IV breast cancer is not curable, it is treatable to a certain extent and current advances in research and medical technology mean that more and more women are living longer by managing the disease as a chronic illness with a focus on quality of life as a primary goal. With excellent care and support, as well as personal motivation, Stage IV breast cancer may respond to a number of treatment options that can extend one’s life for several years. TNM Staging System Doctors use the TNM system to ensure that medical professionals are using the same language and system to describe the tumor. T refers to the size of the tumor measured in centimeters and where it is located. N refers to the number of lymph nodes which were positive for cancer. If no lymph nodes were involved, the pathology report would state N(0). M refers to whether or not the cancer has traveled to distant part of the body such as the bones or organs. If it has spread, it will state where and how much. As an example, stage IIB may read something like this: (T3, N0, M0) meaning the tumor is greater than 55mm and has not spread to the lymph nodes or other parts of the body. Updated Staging Guidelines The American Joint Committee on Cancer (AJCC) established the way cancer is communicated. Clinicians and the surveillance community count on the AJCC for the most comprehensive anatomic staging data available, I.e., the Cancer Staging Manual and Cancer Staging Atlas. In 2018 the AJCC updated the breast cancer staging guidelines to add other cancer characteristics to the T, N, M system to determine a cancer’s stage. In addition to knowing the stage of your cancer, breast cancer is also classified according to other characteristics. These include how sensitive it is to the hormones estrogen and progesterone as well as to the level of certain proteins that play a role in breast cancer growth, such as HER2. It is also classified by the cancer’s genetic makeup. • Tumor Grade: a measurement of how much the cancer cells look like normal cells • Estrogen- & Progesterone-Receptor Status: do the cancer cells have receptors for the hormones estrogen and progesterone? • HER2 status: are the cancer cells making too much of the HER2 protein? • Oncotype DX score, if the cancer is estrogen-receptor-positive, HER2-negative, and there is no cancer in the lymph nodes. The above amended guidelines have helped to create and reinforce ontological/surgical treatment advances. As you can imagine Staging is a complex undertaking and these latest AJCC guidelines allow for a more cohesive and universal diagnosis and treatment options. References and additional information on staging can be found on the resource links below: https://www.cancer.net/cancer-types/breast-cancer/stages https://www.breastcancer.org/symptoms/diagnosis/staging https://www.nationalbreastcancer.org/breast-cancer-stage-3 Breast Cancer Stages Early Stage Breast Early stage breast cancer refers to stages 0-III Late Stage or Advanced Stage Breast Cancer Late stage breast cancer refers to stage IV, or Metastatic Breast Cancer (MBC) Types of Breast Cancer Breast cancer is not just one disease — it can be classified into different types depending on how the cells in the breast look under a microscope. Different types of breast cancer include: ​ 1. Ductal Carcinoma In Situ (DCIS): DCIS is considered a non-invasive form of breast cancer, meaning it has not spread beyond the milk ducts into any surrounding normal tissue. Check out Jennifer's story being diagnosed with DCIS after a clear mammogram. 2. Invasive Ductal Carcinoma (IDC): This is the most common type of breast cancer, where cancer cells have invaded the surrounding tissue. 3. Inflammatory Breast Cancer: This type of breast cancer is considered aggressive and can often be hard to diagnose because it does not always form a lump. 4. Lobular Carcinoma In Situ (LCIS): LCIS is considered a non-invasive type of breast cancer which means that the cancer cells are contained within the lobules and have not spread to surrounding normal tissue. 5. Invasive Lobular Carcinoma (ILC): This type of cancer starts in the milk-producing lobules and can spread beyond them into other parts of the breast. 6. Mucinous Carcinoma: This type of breast cancer is slow growing and therefore often less aggressive. It starts in the main cells of mucus, called mucin. Although this type of cancer can develop anywhere, it's most common in your breast. 7. Metaplastic Breast Cancer: MpBC is an aggressive and invasive type of cancer, meaning that it multiplies quickly and can spread throughout the body. MpBC tends to spread or metastasize more than other breast cancers. ​ 8. Angiosarcoma: This type of cancer is very rare and can occur in any part of the body, but it is most commonly found in the breast tissue. 9. Phyllodes Tumor: This type of tumor is not considered cancer, but it can still be dangerous if not treated promptly. 10. Paget's Disease: This is a rare form of breast cancer that starts in the nipple and can spread to other parts of the breast if left untreated. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ > Questions to Ask Your Surgeorn Download PDF Understanding the Different Types of Breast Cancer Read On Connect with Others during our Weekly Virtual Meet-Up Learn More

Surviving Breast Cancer Mar 23, 2023 3 min Blog Men: Know Your Breast Cancer Risk By Rod Ritchie So very often, when it comes to getting timely treatment for a nagging symptom, or indeed other health matters, men can be... Surviving Breast Cancer Dec 18, 2022 7 min Resources & Tool Kits Different Types of Breast Cancer Different Types of Breast Cancer Breast cancer is not just one disease — it can be classified into different types of breast cancer... Surviving Breast Cancer Nov 27, 2022 3 min Male Breast Cancer Resources for Male Breast Cancer Patients By Rod Ritchie A guy is generally blindsided by a breast cancer diagnosis, whether it be early stage or Stage IV. After the initial shock... Surviving Breast Cancer Nov 4, 2022 3 min Male Breast Cancer Becoming a Patient Advocate By Rod Ritchie We all belong to the SurvivingBreastCancer.org community for different reasons. Many are variously curious and seek... Surviving Breast Cancer Oct 8, 2022 3 min Male Breast Cancer Pinktober: Raising Awareness or Just Pink Hoopla? By Rod Ritchie October is Breast Cancer Awareness Month (BCAM) and that’s when breast cancer charities go all out to raise funds.... Surviving Breast Cancer Sep 13, 2022 3 min Male Breast Cancer Genderless Breast Cancer Research By Rod Ritchie Most cancers are genderless, with the notable exceptions of ovarian, cervical, testicular, and prostate cancers. Why is... Surviving Breast Cancer Aug 16, 2022 3 min Male Breast Cancer The Stigma Surrounding Male Breast Cancer By Rod Ritchie I’ve written a lot about the stigma many men experience when they are given a breast cancer diagnosis. This truly is a big... Surviving Breast Cancer Aug 7, 2022 3 min Male Breast Cancer Male Breast Cancer: Treatment and The Pink Gown By Rod Ritchie Entering the world of breast cancer treatment can be a unique challenge for a guy. Be prepared to get around the scanning... Surviving Breast Cancer Aug 7, 2022 4 min Breast Cancer Stories 3-Time Male Breast Cancer Survivor By Vance Stacks My name is Vance Stacks, Jr. and I am a 3x male breast cancer survivor! I am also a son, a brother, a grandson, a nephew,... News, Articles, & Stories Share Your Story Men Get Breast Cancer Too You are not in this alone. ​ Breast Cancer In Men Breast cancer in men is a rare condition that affects men of all ages, though it is most commonly diagnosed in men over the age of 60. Male breast cancer makes up less than 1% of all breast cancers diagnosed each year. Male breast cancer usually starts in the milk ducts or lobules of the breast, and can metastasize (spread) male breast cancer is male breast cancer that has spread to the liver. Male breast cancer usually starts in the milk ducts or lobules of the breast, and can metastasize (spread) to other parts of the body, such as the lymph nodes, bones, brain, and liver. Early detection is key to successful treatment, so it is important for men to be aware of the signs and symptoms of male breast cancer. These include a lump or mass in the chest, discharge from the nipple, and changes in the appearance of the nipple or breast. If you experience any of these symptoms, be sure to see a doctor right away. With prompt treatment, male breast cancer can be successfully treated. Signs and symptoms of male breast cancer The most common symptom of male breast cancer is a lump or mass in the breast tissue. However, some men may also experience the following symptoms: -Pain or tenderness in the breast -Nipple discharge or changes in the nipple (such as redness, scaling, or inverted nipple) -Skin changes on the breast (such as dimpling or puckering) -Swelling of the breast -Lymph node enlargement (under the arm or around the collarbone) It is important to note that these symptoms can also be caused by benign conditions, such as gynecomastia (enlargement of male breasts due to hormonal changes). Therefore, it is important to see a doctor if you experience any of these symptoms. Only a doctor can properly diagnose the cause of these symptoms. ​ Risk factors for male breast cancer include: -Increasing age -Family history of breast cancer (male or female relatives) in which case you may consider genetic testing in order to understand your lifetime risk of developing breast cancer. -Exposure to certain chemicals, such as radiation or estrogenic compounds -Klinefelter syndrome (a genetic condition that affects males) -Liver disease -Obesity There is no sure way to prevent male breast cancer and having a family history of breast cancer does not mean you will get breast caner either. However, you may be able to reduce your risk by avoiding exposure to known risk factors, such as certain chemicals and radiation. You should also see a doctor regularly for check-ups, so that any cancerous growths can be detected early. Male breast cancer treatment The treatment of male breast cancer will depend on a number of factors, including the stage of the cancer, the size of the tumor, and the patient's overall health. Treatment options may include surgery, radiation therapy, chemoherapy, hormone therapy, or a combination of these methods. Surgery is the most common treatment for male breast cancer. The type of surgery will depend on the stage of the cancer. If you develop breast cancer a lumpectomy (removal of the tumor without removing the entire breast) may be an option. For more advanced cancers, a mastectomy (removal of the entire breast) may be necessary. Radiation therapy treatment uses high-energy beams to kill cancer cells. It can be used alone or in combination with surgery. Chemotherapy uses drugs to kill cancer cells. It is often used in combination with radiation therapy. Hormone therapy uses drugs to block the effects of hormones that can promote the growth of breast cancer cells. It is often used in combination with other treatments, such as surgery, radiation therapy, or chemotherapy. Examples of hormone therapy include tamoxifen or a class of drugs referred to as aromatase inhibitors. Prevention of male breast cancer There is no sure way to prevent male breast cancer. However, you may be able to reduce your risk by avoiding exposure to known risk factors, such as certain chemicals and radiation. You should also see a doctor regularly for checkups, so that any cancerous growths can be detected early. Living with male breast cancer A diagnosis of male breast cancer can be overwhelming. You may feel scared, alone, and unsure of what the future holds. However, it is important to remember that you are not alone. There are many resources available to help you through this difficult time. The most important thing you can if you have been diagnosed with male breast cancer do is to learn as much as you can about your cancer and your treatment options. This will help you make informed decisions about your care. You should also talk to your doctor about your concerns and ask any questions you have. There are also many support groups available for people with breast cancer. These groups can provide emotional support and practical advice. You may find it helpful to talk to other people who are going through similar experiences and living with a male breast cancer diagnosis. Understanding the subsets of breast cancer In order to make informed decisions about your care, it is important to understand the different types of male breast cancer. The two main types of male breast cancer are ductal carcinoma and lobular carcinoma. Infiltrating Ductal carcinoma is the most common type of male breast cancer. It begins in the milk ducts and typically spreads to the surrounding tissue. Lobular carcinoma is a less common type of male breast cancer. It begins in the milk lobules and may spread to other parts of the breast. In addition to these two main types of male breast cancer, there are several subtypes. The most common subtypes are invasive ductal carcinoma, invasive lobular carcinoma, and ductal carcinoma in situ. Invasive ductal carcinoma is the most aggressive form of male breast cancer. It typically spreads quickly and can be difficult to treat. Invasive lobular carcinoma is less aggressive than invasive ductal carcinoma, but it can still spread quickly. Ductal carcinoma in situ is a non-invasive form of male breast cancer. It means that the breast cancer cells are present in the ducts, but have not spread to the surrounding tissue. In addition to the different types of male breast cancer, there is also a subtype known as inflammatory breast cancer. This type of cancer is rare, but it is more aggressive than other types of male breast cancer. Inflammatory breast cancer typically spreads quickly and can be difficult to treat. This type of cancer is rare, but it is more aggressive than other types of male breast cancer. Inflammatory breast cancer typically spreads quickly and can be difficult to treat. ​ Symptoms of inflammatory breast cancer The most common symptom of inflammatory breast cancer is a change in the appearance of the breast. The breast may appear red, swollen, or have a rash. Other symptoms may include pain, nipple discharge, and changes in the size or shape of the breast. Treatment for inflammatory breast cancer There is no one-size-fits-all treatment for male breast cancer, as the best course of action will depend on the individual case. However, treatment typically includes a combination of surgery, radiation, and chemotherapy. In some cases, hormone therapy or targeted therapy may also be used. Inspiring stories of male breast cancer A diagnosis of male breast cancer can be devastating, but it is important to remember that there are many people who have been through similar experiences and gone on to lead happy and healthy lives. One inspiring story is that of Dale Oen, a world-champion swimmer from Norway. Oen was diagnosed with male breast cancer in 2011, but he continued to compete and went on to win a silver medal at the 2012 Olympics. He is now cancer-free and serves as an inspiration to other male breast cancer survivors. Another inspiring story is that of John Travolta, who was diagnosed with male breast cancer in 2010. Travolta underwent treatment and is now cancer-free. He has been very open about his experience with male breast cancer and has said that his main goal is to raise awareness about the disease. These stories show that a diagnosis of male breast cancer does not have to be a death sentence. With early detection and treatment, many people are able to lead long and healthy lives. Questions to ask your doctors about male breast cancer If you have been diagnosed with male breast cancer, you will probably have many questions for your doctors. Here are some important questions to ask: -What is the stage of my cancer? -What is the grade of my tumor? -What are my treatment options? -What are the side effects of each treatment option? -How likely is it that my cancer will come back after treatment? -What can I do to reduce my risk of recurrence? -What are the long-term side effects of my treatment? -How will my treatment affect my quality of life? -Is there anything I can do to improve my prognosis? Male Breast Cancer: Treatment Side Effects After a male breast cancer diagnosis, you will likely have many questions about your treatment options and the potential side effects. It is important to discuss these with your doctor so that you can make the best decision for your health. Some common side effects of male breast cancer treatment include fatigue, hair loss, nausea, and vomiting. These side effects can be difficult to deal with, but there are ways to manage them. Fatigue is a common side effect of male breast cancer treatment. It is important to get plenty of rest and to pace yourself. You may need to cut back on your activities or take a break from work. Hair loss is another common side effect of male breast cancer treatment. There are a number of ways to deal with hair loss, such as wearing a wig or using cold caps. Nausea and vomiting are other common side effects of male breast cancer treatment. There are medication that can help to control these symptoms. It is important to discuss the potential side effects of male breast cancer treatment with your doctor so that you can make the best decision for your health. BRCA1 and BRCA2: What You Need to Know The BRCA1 and BRCA2 genes are important in the development of male breast cancer. These genes are responsible for repairing damaged DNA. Mutations in the BRCA1 and BRCA2 genes can increase the risk of male breast cancer. Men with these mutations have a higher risk of developing male breast cancer, especially if they have a family history of the disease. There are a number of ways to test for the BRCA1 and BRCA2 mutations. A blood test can be used to look for the genetic mutation. If you have the BRCA1 or BRCA2 mutation, you may be able to take steps to reduce your risk of male breast cancer. For example, you may be able to take medication to lower your risk. You may also be able to have surgery to remove your breasts. If you are at high risk for male breast cancer, it is important to talk to your doctor about your options. You may be able to take steps to reduce your risk. Male Breast Cancer: Coping with a Diagnosis A male breast cancer diagnosis can be difficult to deal with. You may feel scared, overwhelmed, and alone. It is important to remember that you are not alone. Read Their Stories Every diagnosis is unique. Read their stories, hear their voices, feel inspired. Get the Facts Breast cancer in men is a rare condition that affects men of all ages Male breast cancer is a type of cancer that affects men. Though it is not as common as breast cancer in women, it can be just as deadly.

Attend an Event Multiple Dates Yoga Fitness with Chair Assist with Kim Tue, May 14 Online Event May 14, 2024, 11:30 AM – 12:30 PM EDT Online Event May 14, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided yoga fitness with chair assist. This is a WHOLE BODY practice with the intent to move and stimulate the body, mind and soul from head to toe. Share RSVP Multiple Dates Yoga Stretching for DIEP Flap Tue, May 14 Online Event May 14, 2024, 6:00 PM – 7:00 PM EDT Online Event May 14, 2024, 6:00 PM – 7:00 PM EDT Online Event Yoga stretching can be a helpful way to improve your range of motion and reduce pain after DIEP flap surgery. Share RSVP Multiple Dates Restorative Yoga with Kate: Unearthing Opportunities Mon, May 20 Online Event May 20, 2024, 5:30 PM – 6:30 PM EDT Online Event May 20, 2024, 5:30 PM – 6:30 PM EDT Online Event Did you know you have magical powers? We all can literally change our bodies through breath and movement. Experience this ancient practice and feel your own powers grow! Share RSVP Multiple Dates Pilates with Nina: Breast Cancer Home Workouts Fri, May 24 Online Event May 24, 2024, 10:00 AM – 11:00 AM EDT Online Event May 24, 2024, 10:00 AM – 11:00 AM EDT Online Event You're invited to join our empowering online Pilates class set against the tranquil space of your home. Share RSVP Multiple Dates Qi Gong with Kim Tue, May 28 Online Event May 28, 2024, 11:30 AM – 12:30 PM EDT Online Event May 28, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided Qi Gong class. A time-honored practice that utilizes breath, movement, and intention setting to promote health and equilibrium in the body. Share RSVP ​ Email dleroy@survivingbreastcancer.org with your background, interests, and class offerings. Interested in Becoming a Movement Monday Instructor? Pilates Heal & Move: Gentle Qigong for Breast Cancer Recovery This supportive class uses gentle movements & breathwork to promote healing, manage side effects, & find inner peace during breast cancer recovery. Suitable for all levels. DIEP flap Yoga Movement Days Creative and expressive movement, in the form of mind, body, and spirit exploration, holds the power to heal. Survivingbreastcancer.org offers free, monthly, online classes in restorative yoga, yoga for breast cancer, and Zumba. Enjoy weekly guided meditation, breathwork, and other mindfulness practices, as well as monthly expressive writing and art therapy workshops. All are welcome, including caregivers and supporters of those diagnosed. Move your body and mind with us every Monday! Restorative Yoga Articles Surviving Breast Cancer Feb 22 3 min The Importance of Physical Therapy During and After Cancer Treatment By Taylor McKnight Physical therapy is often the last thing on people’s minds when they receive a cancer diagnosis. However, it is an... 390 Post not marked as liked Surviving Breast Cancer Jan 14 2 min The Role of Exercise in Breast Cancer Recovery: Benefits and Recommendations Exercise plays a crucial role in the recovery journey for individuals diagnosed with breast cancer. Engaging in physical activity during and 116 Post not marked as liked Surviving Breast Cancer Jan 10 4 min The Healing Power of Pilates: Benefits for Breast Cancer Patients A breast cancer diagnosis can be a life-altering event, bringing with it a range of physical and emotional challenges. While medical... 225 Post not marked as liked 1 2 3 4 5 Multiple Dates Tue, May 14 Online Event Yoga Fitness with Chair Assist with Kim May 14, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided yoga fitness with chair assist. This is a WHOLE BODY practice with the intent to move and stimulate the body, mind and soul from head to toe. Share RSVP Multiple Dates Tue, May 14 Online Event Yoga Stretching for DIEP Flap May 14, 2024, 6:00 PM – 7:00 PM EDT Online Event Yoga stretching can be a helpful way to improve your range of motion and reduce pain after DIEP flap surgery. Share RSVP Multiple Dates Mon, May 20 Online Event Restorative Yoga with Kate: Unearthing Opportunities May 20, 2024, 5:30 PM – 6:30 PM EDT Online Event Did you know you have magical powers? We all can literally change our bodies through breath and movement. Experience this ancient practice and feel your own powers grow! Share RSVP Multiple Dates Fri, May 24 Online Event Pilates with Nina: Breast Cancer Home Workouts May 24, 2024, 10:00 AM – 11:00 AM EDT Online Event You're invited to join our empowering online Pilates class set against the tranquil space of your home. Share RSVP Multiple Dates Tue, May 28 Online Event Qi Gong with Kim May 28, 2024, 11:30 AM – 12:30 PM EDT Online Event Join Kim OBrien for guided Qi Gong class. A time-honored practice that utilizes breath, movement, and intention setting to promote health and equilibrium in the body. Share RSVP Breast Cancer Recovery Yoga: Gentle Poses with Chair Support (Improves Flexibility & Reduces Lymphedema) This restorative yoga class is designed specifically for breast cancer patients and survivors. Join certified instructor Kim O´Brien for a gentle sequence of poses using a chair for added comfort and support.

Breast Cancer Radiation Treatment Chemotherapy, Surgery, Radiation & Hormonal Therapy When you meet with your oncology team, it is always important to remember that this is a partnership; a partnership between you and your doctors. It is ok to ask questions, to ask for clarification and to ensure you are 100% comfortable with your treatment options. ​ Depending on the type of breast cancer you have (Triple Negative, Lobular, Inflammatory, etc. ), and the stage of your breast cancer, your treatment options will vary. In some cases people will start with chemotherapy, while others may have surgery first. In some cases, if your cancer has spread to the bones or organs, surgery may not be necessary. The point is, treatments very and if you read our breast cancer stories , you'll see the wide range of experiences our members share. What's the Difference between Diet and Nutrition? On Breast Cancer Conversations, the Podcast Listen Now Radiation Therapy Videos Coming Soon TOPICS COVERED IN THIS EPISODE -People who refuse aspects of therapy including radiation. -What to expect when going in for radiation-Planning appointment -What is radiation and why would I need it? -Radiation and skin care -Proton Beam Radiation (the science behind protons; a number of clinical trials exploring proton beam radiation in the breast cancer community to minimize cardiac toxicity). -Risks association with radiation, but we still sign the consent. As a young breast cancer survivor, I ask Dr. Jimenez to explain the 10, 20 and 50 year plan for women who go through treatment. HEALTH RISKS -Cardiac toxicity -Field of cardio oncology partners and have mapped out the ideal -Herceptin and anthracyclines. After 5 years of survivorship, you should have a cardiac stress test. -Getting a baseline with an ultrasound of the heart so if there are changes, doctors can track them. -Our job (in Radiation Oncology) in follow up is to open up and make sure that referrals are made. How is your nutrition? Are you exercising? Did you schedule your next mammogram? QUOTES: "Your providers are your providers for life". "You are never a bother, it is our job and privilege to take care of you! " Radiation Therapy: What Every Breast Cancer Patient Needs To Know | With Dr. Rachel Jimenez Listen Now Radiation Therapy for Metastatic Breast Cancer (MBC) with Dr. Rachel Jimenez and Dr. Kim Corbin. Listen Now Tales from the Radiology Tech Amy Ellen Parliman lives life by faith and enjoys spreading kindness. 26 years ago, she went to school to become a radiology technologist. She enjoys performing diagnostic imaging on her patients, she prides herself in safe and quality care. About 12 years ago she became a leader in her field and has moved into a leadership role in the Diagnostic Imaging Department. ​ She worked in mobile imaging for 13 years, she recently changed jobs to reenter the hospital scene. She enjoys sharing her skills in diagnostic imaging with newer technologist. Her thoughts are to create an environment that is warm and inviting for patients during some of the worse times of their lives. She lives by a code to treat all of her patients like she wants her parents treated. Her goal is a smile or maybe a laugh while caring for her patients. Over the years she has been able to learn from her patients and team. ​ On January 29, 2014 Amy became a Cancer patient. She underwent treatment for stage III breast cancer during 2014. She lived with NED until January 29, 2019 then she was told she had MBC. She is currently on her first line treatment. If the opportunity presents, she will share her various experiences of living after diagnosis. Listen Now Stories to Explore Tripple Negative Breast Cancer in your 20's and 30's >

Transforming Your Breast Cancer Care Clinical Trials are an excellent option. Watch Now on Breast Cancer Conversations, the podcast Meet the People Behind the Amelia Study! Clinical Trials 101 Breast cancer clinical trials offer hope to many women and men diagnosed with the disease. They provide access to cutting-edge treatments that are not yet available to the general public. Explore 1. Our Specialties You get a tailored curated list of clinical trials from experts who are doing cutting edge research and have partnered with SBC to bring these trials to you! 2. Featured Projects Relationships are key for any cancer care. We have taken the time to meet with the scientists, the researchers and the principle investigators engaging in the research and trials we bring to you, our SBC community members! 3. Resources We are not just highlighting trials, we are providing you with an in-depth look at the trial through interviews with the researchers, expert blogs and fireside chats with the scientists, and access to reliable opportunities. 4. The Latest Clinical trials provide you with access to the lastest resources and access to some of the best people in the world who are dedicating their lives to ending cancer. You don't just get the standard of care, you get above and beyond the standard! ARETHA-1 Study for Metastatic Triple Negative Breast Cancer A Phase II Study of Evexomostat plus Eribulin for People with Triple-Negative Breast Cancer Phase 2 Randomized Control Trial of Evexomostat (SDX-7320) in Combination with Eribulin for Patients with Metastatic Triple-Negative Breast Cancer and Metabolic Dysfunction: The ARETHA Study This study is being conducted at Memorial Sloan Kettering Cancer Center. Learn More Amelia 1 for HR+ (estrogen or progesterone), Her2-, metastatic breast cancer with a PIK3CA gene mutation and previously treated with a CDK 4/6 inhibitor (e.g., Ibrance®) in1st line setting ​ ​ The Amelia 1 clinical study is testing a new, experimental cancer treatment called Evexomostat to see if it prolongs patient treatment when combined with Piqray® and Faslodex® and if it helps control blood glucose spikes. Learn More PROTECT-BC (PROton Therapy to Eliminate Cardiac Toxicity for Breast Cancer) A study to assess the safety and effectiveness of a condensed course of radiation delivered daily over approximately 1-2 weeks instead of 5-6 weeks. ​ ​ Get In Touch Learn More Who We Work With Are you designing a clinical trial and are looking for a patient advocacy organization to partner with? Let's connect because we know that being you invite patient advocates to have a seat at the table, everybody wins. Get In Touch Our Clinical Trial Partners

Surviving Breast Cancer 3 hours ago 3 min I’d Rather Be Me Mandy shares her experience with self-advocacy when faced with fertility challenges, and later with breast cancer. Surviving Breast Cancer 1 day ago 1 min Uninvited A breast cancer poem from Jacqueline. Surviving Breast Cancer 2 days ago 4 min Why a Second Opinion Matters for Breast Cancer Read this article to learn about the importance of obtaining a second opinion regarding a breast cancer diagnosis. Surviving Breast Cancer 6 days ago 1 min VESSEL By Jerilyn Young My body is a vessel Navigating ocean waves Pushing Pulling Flowing sensations of unknown Preparing for rough seas ahead... Surviving Breast Cancer Apr 15 1 min The Now I thought I couldn’t bear any more Then I expand... Surviving Breast Cancer Apr 14 2 min The Waiting Room Dania shares her story from radiation treatment for triple negative breast cancer. Surviving Breast Cancer Apr 12 10 min The Last Thing I Told My Mom Was a Lie (Part 2) By Olivia Smith Content warning: death and dying Read part 1 of Olivia’s story: The Last Thing I Told My Mom Was a Lie (Part 1) My sister... Surviving Breast Cancer Apr 11 2 min Solitude No More By Lourdes D. Heras These six-letter dreadful words I hear In solitude’s embrace, in the shadow of darkness, I battle unseen, unheard.... Surviving Breast Cancer Apr 11 3 min Next Thing Next, Following Your Heart By Brookshire McDonald After the death of my husband in 1996, I waited the suggested year and moved from Mandeville, Louisiana to my... Surviving Breast Cancer Apr 10 1 min Knowing (my tiny love story) By Sara Kandler Unpacking the shopping bag from Marshalls, my husband sits a chrome cruet on our kitchen countertop....

Breast Cancer & Mental Health Surviving Breast Cancer Jan 14 2 min Holistic Approaches to Complement Breast Cancer Treatment: Benefits and Practices Understanding these holistic approaches, their benefits, and their integration with conventional treatments can be valuable for individuals. 126 Post not marked as liked Surviving Breast Cancer Sep 19, 2023 5 min The Psychological Impact of Breast Cancer: Strategies for Coping Breast cancer isn’t just a physical condition. For many, it’s an emotional and psychological experience that can profoundly affect your... 1,078 1 like. Post not marked as liked 1 Surviving Breast Cancer Jun 11, 2023 4 min Coping with Expectations After a Breast Cancer Diagnosis: The Realities and Challenges By Laura Carfang Receiving a breast cancer diagnosis can be an overwhelming experience that is followed by an array of emotions and... 369 6 likes. Post not marked as liked 6 Surviving Breast Cancer Nov 27, 2022 8 min Can Expressive Writing and Poetry Provide Emotional Healing? I know breast cancer can be an incredibly overwhelming and emotional experience. I'm preaching to the choir. It is common to feel scared,... 170 3 likes. Post not marked as liked 3 Surviving Breast Cancer Nov 19, 2022 8 min Mindfulness Tapping / Emotional Freedom Technique Introduction Mindfulness tapping, or emotional freedom technique (EFT), is a type of mindfulness meditation that uses your fingertips to... 6,106 Post not marked as liked Surviving Breast Cancer Oct 28, 2022 8 min Breast Cancer Screening and Disability: Not As Simple as it Seems #FeatureFriday According to the World Health Organization, breast cancer is the most common cancer among women, with an estimated 2.1... 203 Post not marked as liked Surviving Breast Cancer Oct 16, 2022 3 min The Alternative To Feeling Like A Victim By Kristen Carter It’s so easy when we have breast cancer and when we experience awful side effects to think of ourselves as victims of... 246 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min Expecting the Unexpected: Anticipatory Grief and Breast Cancer #FeatureFriday Have you ever felt preemptively depressed or anxious about something that hasn’t yet happened? Specifically, in regards to... 57 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min My Animal Companion Has Been With Me Throughout Breast Cancer By Kristen Carter Dear Kristen, I'm really struggling with intense sadness and loss since I had to say goodbye to my emotional support... 34 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 4 min Partner Abandonment and Cancer Receiving a breast cancer diagnosis and dealing with the subsequent treatments and issues is challenging. The news can ignite many... 476 1 like. Post not marked as liked 1 Surviving Breast Cancer Aug 7, 2022 4 min Tips for Managing Mood Swings and Breast Cancer By Kristen Carter Dear Kristen, Do you have any suggestions for dealing with moodiness? Between the stress of having breast cancer and... 115 1 like. Post not marked as liked 1 Surviving Breast Cancer Aug 7, 2022 4 min Managing the Emotional Stages of a Breast Cancer Diagnosis A breast cancer diagnosis can send you into a tailspin. The official pronouncement can stir emotions whether you’re newly diagnosed, face... 154 1 like. Post not marked as liked 1 Surviving Breast Cancer Aug 7, 2022 4 min Well-Being for Caregivers By Alexis Puthussery What is a caregiver? The American Cancer Society defines caregiver as “the person who most often helps the patient... 69 1 like. Post not marked as liked 1 Surviving Breast Cancer Aug 7, 2022 3 min Coping with Survivor's Guilt By Kristen Carter Dear Kristen, As someone living with MBC, it's hard not to go down rabbit holes, especially as we are seeing a lot of... 97 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 2 min Scanxiety I am trying to reduce the stress and anxiety when I hear I have to see another specialist or have more testing completed 57 1 like. Post not marked as liked 1 Surviving Breast Cancer Aug 7, 2022 3 min How Do I Find ME Again? It’s completely normal to feel disoriented and detached from our old lives and original selves after anything as life-altering as a breast c 97 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 4 min The Healing Power of Movement Most people are aware that some form of movement is beneficial. Whether exercising your muscles or your brain, moving every day can... 243 1 like. Post not marked as liked 1 Surviving Breast Cancer Aug 7, 2022 7 min Breast Cancer and the Holidays #FeatureFriday This year continues to fly by, and it’s hard to believe that, for those of us in the US, Thanksgiving is already upon us!... 106 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min Pet Companionship Offers Comfort for Breast Cancer Patients and Survivors Most people are familiar with the devastating physical effects of cancer. It's rare to find someone whose life hasn't been affected by it... 43 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min Lupron-Induced Mania By Robin K. Woodruff I was diagnosed with Stage IIa Invasive Lobular breast cancer in 2018. I already had pre-existing mental illness:... 305 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 5 min Healing Circles and the Cancer Experience By Ilene Kaminsky (Read part 1 here.) “The more you hide your feelings, the more they show. The more you deny your feelings, the more... 46 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 4 min The Framework of a Healing Circle By Ilene Kaminsky Something is missing. Where’s the deep emotional fallout that makes us wobble as we try our best to balance on that one... 23 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 7 min Breast Cancer Awareness Month Survival Guide #FeatureFriday To be frank, and at the risk of being cliché, Breast Cancer Awareness Month is the best of times and the worst of times.... 337 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 2 min Therapy and Breast Cancer #FeatureFriday As we reach the end of May, which marks Mental Health Awareness Month, it feels as appropriate a time as any to discuss... 73 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min Is There Such A Thing As Toxic Positivity? The short answer is yes. What Is Toxic Positivity? The Psychology Group defines toxic positivity as “the excessive and ineffective... 1,375 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 2 min PTSD and Breast Cancer Many breast cancer patients suffer from post-traumatic stress disorder (PTSD), an anxiety disorder typically brought on by a traumatic... 168 1 like. Post not marked as liked 1 Surviving Breast Cancer Aug 7, 2022 3 min Writing As A Therapeutic And Creative Outlet #FeatureFriday Writing can serve as a therapeutic and creative outlet. More specifically, journaling offers opportunities for expression... 390 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 9 min Choosing to Change By Courtney Proctor July 2012 – July 2013: A Year of Misdiagnosis I was 28 years old and otherwise healthy with no history of breast... 34 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 4 min How to Tell Friends and Coworkers You Have Breast Cancer You’ve just learned that you have breast cancer. You’re overwhelmed with emotions, questions, and fear. There’s so much to deal with, so... 333 Post not marked as liked Surviving Breast Cancer Aug 7, 2022 3 min Physician Burnout Physician (and Nurse) Burnout has been officially recognized for years and poses a significant existential threat to the safety of... 20 Post not marked as liked

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BREAST CANCER SUPPORT SERVICES​ Cancer Support In General Cancer Care Provides free counseling for cancer patients and their families, financial assistance, information and referrals, community and professional education, teleconference programs, and ongoing telephone and in-person support groups. ​ Voice: 1-800-813-4673 Cancer + Careers Nonprofit that empowers and educates people with cancer to thrive in their workplace, by providing expert advice, interactive tools and educational events. Its free services include a comprehensive website and library of publications in English and Spanish; legal and insurance information; career coaching; resume review, and much more. Email:cancerandcareers@cew.org Cancer Hope Network Provides one-on-one support to cancer patients and their families undergoing cancer treatment from trained volunteers who have survived cancer themselves. ​ Voice: 1-877-467-3638 Cancer Support Community Provides support, education, and hope through a global network to people affected by cancer. ​ E-mail: help@cancersupportcommunity.org Caring Bridge Offers personal, protected websites that can be used during a health journey to share updates with family and friends. Foundation 96 Provide a safe and supportive care community consisting of multidisciplinary service providers, for people and their care-givers who are transitioning from active cancer treatment to every-day life Cleaning For A Reason Offers free professional housecleaning and maid services to improve the lives of women undergoing treatment for any type of cancer. ​ Voice: 1-877-337-3348 Lobular Breast Cancer Alliance The Lobular Breast Cancer Alliance's (LBCA’) mission is to make all who are touched by ILC aware of its unique characteristics and the critical need for more ILC research; to be the go-to source for information on ILC studies, clinical trials and educational tools, and much more. Look Good…Feel Better Helps cancer patients improve their appearance during treatment. Free workshops across the country. ​ Voice: 1-800-227-2345 MD Anderson Cancer Center’s my Cancer Connection Matches cancer patients with others who have had the exact same diagnosis for support. ​ Voice: 1-800-345-6324 Paddle for the Cure Provides a special support organization for breast cancer survivors /supporters. They offer a unique survivorship program that uses recreational dragon boat paddling to manage side effects of treatment for breast cancer survivors and promotes a positive and healthy lifestyle. Patient Advocate Foundation Patient Advocate Foundation is a national non-profit charity that provides direct services to patients with chronic, life threatening and debilitating diseases to help access care and treatment recommended by their doctor. We offer free telephone-based case management services, educational materials, resource directories, financial aid funds, and have a co-pay relief program. ​ Voice: 1-800-532-5274 Patient Empowerment Network PEN is a nonprofit organization who’s mission is to fortify cancer patients and care partners with the knowledge and tools to boost their confidence, put them in control of their healthcare journey, and assist them in receiving the best, most personalized care available to ensure they have the best possible outcome. PEN helps enhance patient health literacy to enable shared decision-making and resources to empower patients and care partners at every step of their cancer journey Project Life A membership based virtual wellness house for those living with Metastatic Breast Cancer and their loved ones. R.A. Bloch Cancer Foundation BLOCH Cancer Hotline – Connects persons with cancer to home volunteers with same type of cancer. Provides free books about cancer. ​ Voice: 1-800-433-0464 Skarlette The Skarlette collection; attractive post-surgical lingerie, designed by flat women, for flat women. Email: hello@skarlette.co.uk Take Them a Meal Provides meal planning service for caregivers, friends, and family. Triage Cancer Triage Cancer provides education on legal and practical issues that may impact individuals diagnosed with cancer and their caregivers. Through free in-person and online educational events, materials, animated videos, and state-specific resources, Triage Cancer provides expert content on issues related to work, insurance, disability benefits, finances, estate planning, medical decision-making, and more. Twisted Pink Twisted Pink is a non-profit organization headquartered in Louisville, KY with a mission to provide hope and connection to people living with metastatic breast cancer by funding bold breakthroughs in research and awareness of the disease. We offer support, research and hope to people of all stages of breast cancer through our monthly Lunch & Learn programs, our Box of Hope program and our annual advocacy scholarships. Find out more at www.twistedpink.org Top of Page Cancer Support In General Cancer Support In Specific Insurance Assistance Financial Assistance Healthcare Assistance Prescription Drug Assistance Low-cost and Free Mammograms Lodging Assistance Child & Elder Care Assistance Transportation Assistance Cancer Support in Specific Asian Women for Health Asian Women for Health is a peer-led, community-based network dedicated to advancing Asian women’s health and wellness through education, advocacy, and support as well as through their 8-week Achieving Whole Health online wellness program. The goal is for Asian women to be well informed, have access to care that is of great quality and culturally appropriate so they are inspired to live happy, healthy lives. BrightSpot: The Bright Spot Network provides young cancer survivors who are parents of small children with a safe space for individual and familial healing, recovery, and reconnection His Breast Cancer HIS Breast Cancer Awareness nonprofit organization was founded in honor of all men who are at risk of, diagnosed and surviving with the Disease of Breast Cancer and to those who have died because of it. Our mission is to increase awareness and hence the early detection for all men and to help those who are at high risk due to genetics and other risk factors to gain access to regular screenings. Email: hisbreastcancer@gmail.com Indian Health Service If you are a member of a federally recognized tribe, you may be eligible for health services within the Indian Health Service. Male Breast Cancer Global Alliance Our mission is to advocate for all men diagnosed with breast cancer to ensure they receive equal access to support and treatment; to serve as a source of support and resources for the men, their caregivers, and their families; to ensure that men are appropriately represented in research and clinical trials, and to recruit volunteer “ambassadors” to increase awareness of breast cancer in men on a global scale. Men Against Breast Cancer Offers educational materials, online videos, workshops, and one-on-one networking with other men whose loved one has breast cancer. Conducts National Male Caregivers Conference and regional training workshops. ​ Voice: 1-866-547-6222 Sharsheret (Hebrew for “chain”) Supporting young women and their families, of all Jewish backgrounds, facing breast cancer. TigerLily Foundation Tigerlily Foundation’s mission is to educate, advocate for, empower, and support young women, before, during and after breast cancer. We envision a future where a breast cancer diagnosis doesn’t inspire fear, but ignites hope for a future. Through our programs, we seek to educate and empower women of all backgrounds, including those at heightened risk, those facing health disparities, and those with less access to care. National Native American Cancer Survivors’ Support Network An educational community-based research study created to help improve the quality of cancer care and the quality of life for all American Indian, Alaska Native, and First Nations cancer patients and their loved ones. ​ Voice: 1-800-537-8295 PEN - Digitally Empowered The program is a completely free, on demand, ten-module course that walks participants through the basics of technology as they learn how it can be effectively utilized to navigate their cancer journey. Pickles Pickles help support children affected by their parents or guardians cancer. Pickles Group creates thriving communities of kids supporting kids through and beyond their parent’s cancer journeys. Pickles kids strengthen resilience, have fun with friends who get them, and heal along the way. Young Survival Coalition Provides information and support for young women with breast cancer. The Missing Link Discover information, inspiration and innovation for health equity in breast care. More Life Magazine is a community-curated platform presented by The Missing Pink Breast Cancer Alliance . It is dedicated to sharing information, inspiration and innovation regarding efforts to advance health equity in breast care for communities of color. Navigating Cancer Care Decisions for Older Adults Learn how a cancer diagnosis may affect their senior living options. This resource also offers detailed information about how to find assisted living and nursing care facilities that provide cancer care to aging adults. Top of Page Cancer Support In General Cancer Support In Specific Insurance Assistance Financial Assistance Healthcare Assistance Prescription Drug Assistance Low-cost and Free Mammograms Lodging Assistance Child & Elder Care Assistance Transportation Assistance INSURANCE ASSISTANCE Affordable Care Act (U.S. Department of Health and Human Services) Find information on choosing a health insurance plan and the Affordable Care Act. A.M. Best Company Find insurance company ratings. American Association of Retired Persons (AARP) Find detailed information on Medicare and other health insurance programs for people over 50. ​ 888-OUR-AARP (888-687-2277) American Cancer Society – Understanding Financial and Legal Matters Find information on financial topics. ​ 800-ACS-2345 (800-227-2345) HealthWell Foundation The HealthWell Foundation is a national non-profit organization that provides financial assistance to insured Americans who struggle to meet their out-of-pocket costs for medical treatments. ​ Email: grants@healthwellfoundation.org Phone: (800) 675-8416 National Association of Insurance Commissioners Find your state's insurance commissioner. National Cancer Legal Services Network Find a directory of organizations that offer free legal help for people diagnosed with cancer and their families. National Coalition for Cancer Survivorship Find the booklets “Understanding Your Health Insurance” and "Your Employment Rights." ​ 877-NCCS-YES (877-622-7937) Patient Advocate Foundation Offers financial assistance information and legal and advocacy help if an insurance claim is denied. ​ 800-532-5274 Patient Advocate Foundation - National Underinsured Resource Directory Find local, state and national resources for people who have insurance but struggle to pay out-of-pocket costs of care. ​ 800-532-5274 The Catherine H. Tuck Foundation Offers financial assistance for personal expenses including rent, utilities and food, and transportation to and from cancer treatments. Triage Cancer Offers legal and practical materials in English and Spanish to help understand and compare your insurance options, what to do when you lose your insurance and work, and appeal denials of coverage. Top of Page Cancer Support In General Cancer Support In Specific Insurance Assistance Financial Assistance Healthcare Assistance Prescription Drug Assistance Low-cost and Free Mammograms Lodging Assistance Child & Elder Care Assistance Transportation Assistance A health care provider, such as your physician, nurse or social worker may have information on financial resources. Most hospitals and treatment centers have financial counselors. They can help you with the details of your insurance paperwork and give you an estimate of the cost of your treatment. ​ ​ Financial counselors can also help you work out a payment plan. If you are unable to pay, some places may be willing to reduce or waive some costs if you ask. ​ Hospital discharge planners, patient service offices, nurse navigators and patient navigators may also have information on resources and advice about financial matters. ​ Insurance questions For questions about your insurance policy, state insurance agencies and insurance companies can be helpful. Learn more about insurance. ​ ​​ No matter your income, you may qualify for financial aid from federal, state or local programs. A financial counselor at your hospital can help you learn about these programs. ​ Many organizations offer financial assistance and help with travel, lodging and medical items, including prescription drugs. Some are listed below. Information on insurance and other financial issues FINANCIAL ASSISTANCE Healthcare Assistance The Pink Fund Offers financial assistance for health insurance premiums. Sisters Network Inc. Offers financial assistance for breast prosthesis, medical bras and compression arm sleeves. Strings for a Cure Offers financial assistance for personal expenses including mortgage or rent, utilities, food and car payments. Social Security Administration Find your local social security office. Women’s Health and Cancer Rights Act (U.S. Department of Labor) Find information on federal laws requiring insurance coverage of breast reconstruction after mastectomy. Prescription Drug Assistance CancerCare – Co-payment Assistance Foundation Offers health insurance co-payment assistance for chemotherapy and targeted therapy drugs. ​ 866-55-COPAY (866-552-6729) Genetic testing Myriad Financial Assistance Program Offers financial assistance for genetic testing. Strings for a Cure Offers financial assistance for personal expenses including mortgage or rent, utilities, food and car payments. Patient Advocate Foundation Find an online directory of drug company assistance programs. Partnership for Prescription Assistance Offers low-cost and free prescription drug programs for people with limited income. ​ 888-4PPA-NOW (888-477-2669) Patient Advocate Foundation – Co-Pay Relief Program Offers financial assistance for prescription drug co-payments. ​ 866-512-3861 Quest Diagnostic's Patient Assistance Program Offers financial assistance for genetic testing. ​ 888-4PPA-NOW (888-477-2669) Rx Hope Find an online directory of prescription drug assistance programs. Strings for a Cure Offers financial assistance for prescription drugs co-payments. Top of Page Cancer Support In General Cancer Support In Specific Insurance Assistance Financial Assistance Healthcare Assistance Prescription Drug Assistance Low-cost and Free Mammograms Lodging Assistance Child & Elder Care Assistance Transportation Assistance Affordable Care Act Since September 2010, the Affordable Care Act has required all new health insurance plans to cover yearly mammograms with no co-payment (co-insurance) for women ages 40 and older. In many parts of the U.S., low-cost or free mammograms are also offered through national programs and community organizations. FDA Each October, during Breast Cancer Awareness Month, many imaging centers offer mammograms at reduced rates. To find a certified mammography center in your area, visit the FDA website. National Breast and Cervical Cancer Control Program Provides access to breast cancer screening to low-income, uninsured and underinsured women. Planned Parenthood Offers clinical breast exams and referrals for mammography (and any follow-up testing, such as breast ultrasound). Komen Affiliates fund Komen Affiliates fund breast cancer education and screening projects in their communities for those who need it most. Find an Affiliate in your area to learn what resources are available. ​ Komen also offers transportation services to and from cancer treatments, financial assistance for child care and elder care during treatment, and financial assistance for some medications , medical equipment, and lymphedema supplies. Call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) Monday through Friday from 9:00 a.m. to 10:00 p.m. ET and from 6:00 a.m. to 7:00 p.m. PT to help find low-cost options in your area. American Cancer Society – Hope Lodge and hotel lodging Offers lodging for families during cancer treatment. ​ 800-ACS-2345 (800-227-2345) Joe's House Find an online directory of free and discounted lodging for cancer patients and their families. LODGING ASSISTANCE If your hospital or treatment center is far from home, there may be times when you and your family need to find a place to stay overnight. Many hospitals and treatment centers can arrange a discount rate at a nearby hotel or motel. The American Cancer Society can also help. Child Care and Elder Care Assistance If children or elderly family members rely on you to take care of them, it can be hard to get to treatment. Family and friends may be able to help. (They often want to help, but don’t know how. This is one way they can help you.) The programs below also offer help. CancerCare – AVONCares Program Offers financial assistance for child care during treatment. ​ 800-813-HOPE (800-813-4673) American Cancer Society – Road to Recovery Offers local transportation to and from cancer treatments. ​ 800-ACS-2345 (800-227-2345) CancerCare – AVONCares Offers financial assistance for transportation to and from cancer treatments. ​ 800-813-HOPE (800-813-4673) Corporate Angel Network Uses empty seats on corporate planes to help cancer patients reach treatment centers. (Travel for caregivers is not covered.) ​ 866-328-1313 Lifeline Pilots Offers air travel to treatment centers for cancer patients and their caregivers. ​ 800-822-7972 Long-distance transportation - Air Charity Network Offers air travel to treatment centers for cancer patients and their caregivers. ​ 877-621-7177 Mercy Medical Airlift Offers air travel to treatment centers for cancer patients and their caregivers. ​ 800-296-1217 National Patient Travel Center Offers free or discounted air travel to treatment centers for cancer patients and their caregivers. ​ 800-296-1217 Top of Page Cancer Support In General Cancer Support In Specific Insurance Assistance Financial Assistance Healthcare Assistance Prescription Drug Assistance Low-cost and Free Mammograms Lodging Assistance Child & Elder Care Assistance Transportation Assistance TRANSPORTATION ASISISTANCE The social work and care coordination departments at your hospital may have information on local transportation programs. Some cancer organizations also have programs that can help. ​ City, county and state agencies can arrange for low-cost or free local transportation for people with disabilities. For more information on these services, contact your city, county or state transportation department. Low-cost and Free Mammograms Cancer Support In General Cancer Support in Specific Financial Assistance Insurance Assistance Healthcare Assistance Prescription Drug Assistance Transportation Assistant Lodging Assistant Child Care and Elder Care Assistance Low-cost and Free Mammograms

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Megatrends in Treasury, Money and Banking Megatrends in Treasury, Money and Banking Anthony J. Carfang, The Carfang Group Innovation, technology, regulation and geopolitics are intersecting and are about to change the face of treasury, money and banking as never before. Issues that appear small or incremental today could be seismic in the longer term. As markets, institutions and governments deal with these cross-currents, we could be witnessing the beginning of a transformation on a grand scale in finance. In this series, The Carfang Group presents eleven issues that will change the financial world. We call these the “Megatrends”. This article presents the eleven megatrends and invites your feedback and discussion. Subsequent articles will explore each of these in detail. These are the eleven Megatrends which we believe will reshape our financial world over the next decade. Central Bank roles are scaled back. Asset Managers overtake banks. Deposit Banking diminishes in importance. Deposit Insurance becomes universal. Private Liquidity Funds emerge as a major asset class. Technology disintermediates the intermediaries. Truly immediate payments eclipse “faster payments”. 20th century institutions and structures are realigned. Currency takes on a new role. Alternative currencies gain acceptance. Solutions for the underbanked take shape. ​ ​ About the author: Anthony J. Carfang is Managing Director of The Carfang Group and has a distinguished background in consulting, writing, speaking, thought leadership and advocacy in the area of treasury, payments and liquidity. He encourages you to provide feedback on this article or any other issues to tony_carfang@carfang.com . You can follow Tony at https://www.linkedin.com/in/carfang/ Central Bank roles are scaled back. ​ To receive a pdf version of this white paper, email tony_carfang@carfang.com ." ​ Central Bank roles are scaled back. ​ Without question, many central banks functioned superbly during the financial crisis in the dual roles of lender of last resort and payment guarantor of last resorts. They forcefully took on powers necessary to prevent a worldwide depression. Instead of reverting to their historical role after the crisis abated by 2011, they continued to function in crisis mode and now seem to have taken for themselves an entirely new mandate of economic support. We believe that this will come under close scrutiny over the next decade and the missions of central banks world-wide will be scaled back. Consider the following “last resort” moves that remain in place ten years post-crisis: ​ Central bank balance sheets remain at levels which make them THE dominant players, distorting the financial markets rather than merely facilitating those markets. Securities on their balance sheets now stand at $23 trillion, up from $4 trillion pre-crisis. The Federal Reserve began paying interest on bank excess reserves in a not so subtle effort to inject capital into banks and to fund its swollen balance sheet. Long after the crisis, it still pays market interest, thereby competing for private capital while quashing the intrabank Fed Funds market. Operation Twist was a specific program designed to lower long term rates relative to short term rates. Many of these OT securities remain on the Fed balance sheet, impacting the shape of the yield curve today. Quantitative Easing and Quantitative tightening are direct attempts by central banks to impact growth levels, still ongoing today, and are not a direct part of their mandate. Combined, these activities distort the important market signals that are necessary in robust markets. Central bank roles will come under close examination. The debate will be intense but healthy. Should central banks be limited to their "first principles" of currency stability and lender of last resort? Or should they proactively manage world economies? We expect a tilt back toward the former. Asset Managers overtake banks. Commercial banks have historically been the primary conduit through which depositors and borrowers clear the market. Most individuals and businesses maintain bank accounts to facilitate transactions and savings. Similarly, for individuals and all but the largest businesses, these banks are also the primary source of loans. Asset managers, on the other hand, provide investment management services primarily by deploying their investors’ capital via the secondary markets. That is abruptly changing in ways that are just beginning to emerge. We believe that over the next decade, asset managers will overtake banks as the primary financial institutions in both the retail and wholesale markets. Commercial banks, long the dominant market players, saw their competitive advantage sharply curtailed following the financial crisis. They became subject to SIFI supervision, Basel III’s liquidity requirements, tiered capital requirements and much more. Over the past ten years, total assets of the largest banks have been relatively flat. Asset managers not subject to these requirements, in particular the largest three companies, have grown enormously. The “Big 3” have nearly tripled in assets since the crisis and are now larger than the largest commercial banks. We expect that these supersized asset managers will be able to muscle into all aspects of the commercial banking franchise and radically alter the playing field. It is true that commercial banks enjoy the dual monopolies of deposit aggregation powers and payment settlement finality. However, technology will diminish those advantages (see below) to the point at which they cannot overcome their regulatory, capital and liquidity burdens. Deposit Banking diminishes in importance. The centuries-old deposit banking paradigm will not disappear anytime soon. But we believe it will radically change in the near future, creating significant winners and losers among financial and payments institutions. Deposits have long served two primary functions. They were a buffer to mitigate the uncertain clearing time for payments and they served as a repository for savings on the part of individuals who did not have direct access to the institutional markets. Rates paid on transaction deposits were negligible but that was part of the offset for transaction costs. Rates paid on savings were more competitive but slightly below market, given that banks provided the only way for retail savers to earn any return at all. Even today, banks aggressively compete for deposits across most wholesale and retail segments. Yet we believe this model is about to change as the cross currents of technology and regulation play out. ​ On the transaction front, with faster (instant) payments will come greater certainty, leading to what we refer to as “just-in-time money”. In this new world, the need for a buffer vanishes. Fintech solutions will fund these accounts as necessary and will deploy all excess funds into the money markets. On the savings front, technology is eliminating the friction and transaction costs that stood in the way of savers directly accessing the markets. On-line brokers and internet banks are just the tip of the iceberg. Further, traditional commercial banks are saddled with Basel III related capital, liquidity and stable funding requirements that further erode their competitiveness. Deposits were once the holy grail of banking. That is about the change. Deposit Insurance becomes universal. Government insurance for bank deposits is a common safety net worldwide. By insuring a set level of deposits, governments boost depositors’ faith in the banking system and encourage capital formation. Banks are assessed premiums by the insuring government agency. These premiums are generally passed along to depositors in the form of slightly lower rates or higher transaction costs. At the onset of the financial crisis, the U.S. Congress raised the coverage amount from $100,000 to $250,000 per depositor per institution, and that has not been rolled back during the recovery. Temporarily, the limit was removed altogether for non-interest-bearing accounts. Taking deposit insurance well beyond the safety net aspect, financial institutions and tech companies are partnering to expand coverage to all of a customer’s deposits. A depositor can place funds well above the $250,000 limit with a lead participant. A servicer will take that large deposit, break it into $250,000 units and place one unit each with other banks in their network. Some networks include over 1,000 banks, enabling a depositor to place up to $250 million in a single deposit and have the entire amount insured. While this might seem to be at odds with the spirit of deposit insurance, neither the FDIC nor Congress have taken steps to limit the rapid spread of these deposits that now exceed $1 trillion, one-eighth of the total insured deposit base. In fact, in 2018 Congress passed legislation that gave regulatory support to “reciprocal” deposits, a subset of these types of programs. Consider, then, the rapidly approaching scenario in which ALL deposits are insured and the resulting moral hazard. A thin layer of bank shareholder capital is the only source of market discipline. The government is on the hook for all losses. That asymmetry likely leads to outsized risk taking. Ultimately, the government will be forced to step in and de facto nationalize the banks. Bills have been introduced in Congress, most recently in 2018, to allow the US Postal Service to take deposits and make loans. This could be the logical conclusion of unlimited deposit insurance. If the government is bearing all the risks of the banking system, the logical conclusion is that it takes over the banking system. USPS banks could be the first step in that direction. Private Liquidity Funds emerge as a major asset class. Like private equity funds a few decades ago, which provided a way to circumvent public markets for long term capital, Private Liquidity Funds will circumvent the public markets to enable the efficient provision of liquidity to both investors and borrowers. Technology is enabling “just-in-time money” which will redefine “liquidity”. Sweep accounts are now available at low cost to most savers and investors. Funds can be fully invested right up to the day they are needed. Thanks to fintech advances, funds can be drawn down at precisely the time they are needed. At the same time, regulators in the U.S. and around the world have hamstrung money market funds that focus on private sector liquidity. In 2016, US regulators implemented regulations that reduced the viability of prime money market funds. Prime funds invested in commercial paper and other private sector debt instruments. Thus, both the providers and users of liquidity were penalized. The bulk of prime fund assets flowed into government and treasury funds and are no longer available to provide liquidity to businesses. Similar regulations are currently being implemented in Europe. Unfortunately, because of the dramatic scale-back of prime funds, the most efficient conduit between providers and users of liquidity has been significantly curtailed. The upshot will be an entirely new asset class. Some forward-thinking asset managers have already established the first funds of this breed. They are similar to the pre-regulation 2a-7 funds but are limited to institutional investors. However, we expect these to morph into an asset class that will ultimately look very different from the current funds (MMFs, SMAs and Ultra Short Bond Funds) and incorporate the redefined “liquidity” and facilitate just-in-time cash. Forty years ago, no one envisioned the current structure and transformative role of private equity funds. We believe a similar transformation is about to overtake the liquidity market. Technology disintermediates the intermediaries. Historically, banks and other financial intermediaries filled the information gap between suppliers of capital (depositors, investors) and users of capital. They also bridged the gap between risk takers and risk avoiders. Banks knew both sides of the trade and could comfortably stand between providers and users of capital who did not know each other. If a single bank did not know the counter party of a transaction, it could easily locate a correspondent bank that did. These intermediaries lowered the transaction costs and risks (friction) that separated borrowers from lenders. The result was the rapid global expansion of trade and commerce. Fintech is changing all that in five key ways: Technology is fast closing that information gap. It is putting more reliable and more up-to-date information in the hands of all the parties in any given transaction, reducing the need for an intermediary. Social networks such as LinkedIn and others allow buyers and sellers to connect and investigate each other directly. Peer-to-Peer networks and microfinance schemes bypass the financial intermediary entirely. Technology is powering broad based sweep programs that move excess funds out of even the smallest investor or depositor accounts, the intermediaries, and directly into the financial markets. Intelligent technologies, such as robo-advisors, use sophisticated algorithms to bypass the traditional channels. The upshot is that the intermediary role of financial institutions is being displaced. Truly immediate payments eclipse faster payments. Over the past several decades, payments have become faster, cheaper and more reliable. Checks used to take days in the mail and then days to clear once deposited. International funds transfers would pass through several banks, each taking a “lifting” fee as the funds slowly passed from originator to recipient. Fortunately, those days are over. Now, central banks, commercial banks and payment networks are all racing each other to make payments even speedier. This is all very good since timing delays in payments and the attendant information flows create risk and uncertainty as well as wreaking havoc with cash forecasts and liquidity cushions. In the US the Fed launched its Faster Payments task force with this statement: “The task force calls upon all stakeholders to seize this historic opportunity to realize the vision for a payment system in the United States that is faster, ubiquitous, broadly inclusive, safe, highly secure, and efficient by 2020.” Around the globe, the UK announced its Faster Payments Service in 2008. In 2017, the European Central Bank kicked off its TIPS program (TARGET Instant Payment Settlement) with the goal of “instant” payments 24/7 within the euro area. The Monetary Authority of Hong Kong launched the Faster Payments System initiative in 2018. No doubt, payments are becoming much faster, more secure and more universal. The benefits of these initiatives are immense. In faster payments, funds and information, however fast and efficient, must still flow between the originator, the originator’s payment processor and/or bank, a central bank, the recipient’s payment processor and/or bank before becoming settled funds in the recipients account with finality. Even the ECB, in its TIPS communique, defined instant payments as “a matter of seconds”. That is a huge improvement. However, as high-frequency traders and arbitrageurs know, “a matter of seconds” is an eternity in financial markets. We believe that there will be one more step beyond faster payments: truly immediate payments. These payments will settle instantly, anywhere, anytime. At present, it’s difficult to envision. Perhaps blockchain technology is providing us the first glimpse. This has the potential of eliminating the sequential process of moving money and information (however fast) among transactors, their intermediaries and their settlement network. Alternatively, the paradigm for instant payments might come from outside the industry. Consider this analogy with railroads. In the late 19th century, railroads competed with each other to provide faster, safer and cheaper options in moving both passengers and freight between two points. Yet, even in the heat of that competition, no one within the industry considered putting wings on rail cars. Ironically, most payment intermediaries today refer to their networks as “rails”. 20th century institutions and structures are realigned. Post-WWII, late 20th century institutions and structures are unraveling. But, because they are so ingrained in our psyche, these shifts seem incomprehensible. The magnitude and scope of their impact are difficult to assess. But we believe that this is a megatrend impacting Treasury, Money and Banking. Trade organizations and trade agreements are coming apart or are being realigned in material ways. To see just a few underway right now, look no farther than the Pacific trade agreements, NAFTA and the EU with Brexit. Countries are subtly shifting to bi-lateral rather than multi-lateral constructs. Structures are also giving way. SWIFT is caught in a tug of war between its nominal role as a funds transfer communication system and its externally imposed role of sanctions enforcer. LIBOR, the reference rate for several trillion dollars of actual debt and hundreds of trillions of dollars of derivatives is phasing out within the next two years. The financial world needs to be repapered! Government-Sponsored Enterprises (GSEs) are coming under scrutiny. Agencies such as Fannie Mae and Freddie Mac that provide government guarantees in order to meet a “social good” took shape following the early 20th century’s great depression. They have now grown into behemoths, and some lay the blame of the 2008 financial crisis at the doorstep of the housing GSEs. Although governments decried the size of these agencies and vowed to trim then, they have continued to grow since the crisis. Paradoxically, central banks need GSE to create the instruments that now sit on their swollen balance sheets. We believe that many of these agencies will be downsized over time. The 20th century financial and geopolitical world is changing, and all market participants must adapt. ​ Currency takes on a new role. This megatrend is counter-intuitive, but the data are clear. For decades, we’ve heard that we’re moving toward a cashless society. One with everything on a card or in a chip. Not so. The evidence is that, over the last decade, currency in circulation as a percentage of GDP has nearly doubled worldwide. In the US, currency increased from $800 billion in 2006 to $1.7 trillion in late 2018. That’s hardly a cashless society. (Scandinavia is an exception we need to explore.) Central banks and academia are beginning to study this phenomenon. Some key hypotheses about factors contributing to this are currently being formulated. They include: ​ Convenience – It’s easy to transact in cash. Low holding cost – In an ultra-low interest rate environment, cash is cheap. Privacy – Currency transactions (and barter) are the only types of economic activity that don’t inherently require a corresponding exchange of data. Historically, currency has defined the underground economy. We now see an emerging role for currency in the above-ground economy for market participants desiring and valuing privacy or anonymity. Store of Value – In negative interest rate environments we see in some parts of the world, there is actually an economic benefit to holding currency in order to retain value. More interestingly, in certain low interest rate environments, the low carrying costs, to many, seem like a small price to pay to hedge political or economic uncertainty. India is a fascinating case study in progress. In November 2016, India eliminated large denominated rupee notes that represented 86% of India’s currency. Citizens had the opportunity to exchange the notes for smaller denomination notes. The intent was to root out the underground economy and raise tax revenue. The ramifications were far reaching and still playing out. But Bloomberg offers one interesting conclusion: “Cash remains the most popular form of tender in India. Currency with the public has increased to 18.5 trillion rupees in August 2018 from 17.9 trillion rupees before demonetization.” That is a 3% increase in currency in spite of an 86% drop in large denominated notes! Again, economists at present are trying to understand the factors behind this trend. Obviously, however, this creates a nightmare for regulators and those managing monetary policy. The trend is both real and “Mega”. ​ Alternative currencies gain acceptance. This megatrend challenges the definition of money itself – the gaining acceptance of alternative currencies including crypto currencies. In ancient times, post-barter, precious commodities were the prevailing instrument of exchange and store of value. These commodities had intrinsic value that resulted in their reliability and acceptance. The middle ages saw the emergence of fiat currencies. They had value because a government said they had value. The problem with pre-modern fiat currencies is that they could be easily debased. A ruling body could simply turn on the printing press. Current fiat currencies such as the dollar, euro, pound, etc. are much more stable than their predecessors. That’s because they are issued and backed by the full faith and credit of sovereign governments. They are managed with a “goal” of price stability by central banks. The track record is far from perfect and debasement examples abound, but it is certainly improved. Crypto technologies are now enabling a new genre of fiat currency: crypto currencies like bitcoin and others. They are not the product of precious metals or scarce commodities. They are not issued by governments (yet). They are not “full faith and credit” instruments. They are not managed by central backs. Proponents insist that this litany of “they are nots” is actually a benefit, not a shortcoming. Following the Subjective Theory of Value, crypto currencies have value because buyers and sellers believe they have value. They are fiat currencies without governments or central banks. Adherents argue that frees them from manipulation by governments or central banks and creates a universal value. Air-BnB, Uber and Lyft offer instructive examples. After all, who would invite a total stranger to spend a night in their homes or jump into a stranger’s car. A key thing these companies provide to the gig economy is a decentralized mechanism of trust (in contrast to the trusted “central” bank). In doing so, they have transformed industries. This could be the trajectory of certain crypto currencies. We believe that some alternative currencies will become mainstream. While they might not be both a universal store of value and medium of exchange, some might take hold as settlement vehicles for specific types of payments. Others, because of their distributed processing security, could be liquidity vehicles. Still others, because of their global nature, could eliminate the need for foreign exchange in global trade. We’ll explore the profound implication in later megatrend articles. Solutions for the underbanked take shape. 30% of the world’s population do not have bank accounts. Many more do not have access to a basic set of banking services. They must either transact in cash, barter or use third party payment services, which tend to be very expensive. Check cashing services, payday lending, money orders, money transfer services, etc. provide the underbanked with some ability to make payments, but at a high cost. The economic impact is significant. In addition to the direct cost that the underbanked pay to access the financial system, there is an even greater cost in terms of lost economic activity. The inability to easily transact reduces the level of transactions and depresses commerce and trade. Fortunately, new technologies could provide economically viable solutions for the underbanked in the three most critical financial functions: ​ Payment system access – Currently, people and businesses need a bank account to initiate or receive payments. Solutions developed by payments intermediaries and enabled by blockchain will provide the underbanked with payment services, conceivably bypassing the banking system altogether. Store of value – Blockchain could become the system of record for certain types of financial assets. This promises to allow the underbanked to safely and securely accumulate financial assets without having bank accounts. Assets could even be denominated in traditional central bank currencies or in crypto currencies. Access to capital – Peer to peer lending and micro finance are already providing non-traditional access to capital for the underbanked. Technology will accelerate this trend and make these services available to a larger population. Bringing the underbanked into the mainstream of the world’s economies creates opportunities that are difficult to fully appreciate. Increased economic activity, improved standards of living, expansion of markets are just some of the benefits that await. ​ In Conclusion , this paper has presented eleven megatrends impacting treasury, money and banking on a global scale. Some of these trends are natural extensions of technological innovation, others are regulatory work-arounds or the result of geopolitical forces well beyond the control of any single jurisdiction. The Carfang Group believes that each of these megatrends, individually, are transformational and collectively point to a potential radical change to the financial system. Future articles will consider each of these megatrends in greater depth. We welcome your feedback as we embark of this exploration. ​ About the author: Anthony J. Carfang is Managing Director of The Carfang Group and has a distinguished background in consulting, writing, speaking, thought leadership and advocacy in the area of treasury, payments and liquidity. He encourages you to provide feedback on this article or any other issues to tony_carfang@carfang.com . You can follow Tony at https://www.linkedin.com/in/carfang/ ​ ​ ​ © 2019 The Carfang Group, LLC. All rights reserved.