Personalized Cancer Treatment Strategies 101 We all know that the standard of care is simply not enough and if the cancer is not contained early on and actively managed, then it will most likely recur and progress. Below are a few examples of personalized options that often lead to better treatment results and longer time in remission: Newly Diagnosed Patients Chemo Sensitivity Testing Oncologists typically have to choose between a handful of standard chemotherapeutic agents to start from. This decision is often based on little knowledge about the tumor. BUT chemotherapy has toxic side effects, which weaken the body and decrease its ability to fight cancer. If the right chemo isn't chosen (which is often the case), the patient experiences toxicity with no benefit. Chemo-sensitivity testing tests and determines the most effective drug or combination for the patient. It is not routinely done because it requires viable tumor tissue and because it is an out-of-pocket expense. Pursuing this test upfront will set the patient up on the right treatment course from day one. Personalized Cancer Vaccine Surgery is followed by chemo, and chemo is followed by a passive monitoring period (scans, MRI, etc). This period is referred to as a “wait-and-see”, and reactions are only made when the problem recurs. BUT there are experimental tools to activate the immune system to fight cancer proactively. A personalized cancer vaccine is a type of immunotherapy that directs the patient's own immune system to recognize unique markers on the tumor and then awaken it to actively fight cancer cells, helping to reduce the chances of recurrence. In a perfect world, every patient should get vaccinated, but we are not there yet. This treatment is not routinely done because it requires viable tumor tissue and because it requires a complex infrastructure to prepare and administer. It is also experimental (but tested at various academic institutions), and has little or no side effects (good quality of life). Pursuing a personalized vaccine is a proactive way of fighting cancer, can extend time in remission, and reduce the chances of recurrence. Recurrence or Advanced Patients Genetic Sequencing Targeted drugs are different from chemotherapeutic agents. Chemo kills good and bad cells, while targeted drugs are designed to kill the bad cells. A genetic sequencing test (also referred to as a molecular profiling test) identifies unique markers on your tumor, and matches those to drugs designed to target mutations expressed on the tumor. While this often reveals treatment options beyond the current standard of care (because some of the drugs are experimental), this diagnostic does not test whether the drug actually works on that tumor or not. It narrows down a list of about 100+ targeted drugs to about 10, thus giving the oncologist direction. This test is almost routinely ordered in the USA, sometimes covered by insurance, and requires paraffin (dead) tumor tissue. Pursuing this test upfront will identify targeted drugs your oncologist can use to treat your cancer. Drug Screening Test This test screens for the widest range of chemotherapeutic agents, targeted drugs, and experimental drugs (not designed to target a specific mutation). It tests the various options and combinations on the tumor itself and prioritizes the best one that works (so it is not theoretical). This test is not routinely done because it requires viable tumor tissue and because it is an out-of-pocket expense. Pursuing this test upfront will help you identify a chemo, a targeted drug, or an experimental drug from a wider range of options, and confirm that the drug works before wasting a lot of time and effort pursuing a treatment that does not work. Mouse Xenograft Models This is a deeper version of the drug screening test. The idea is to grow the patient’s tumor in mice so when screening drugs, one does not only have the cancer cells, but the entire tumor environment to test on. This helps explore advanced, experimental, and combinational drugs that might work (or drugs that have previously worked on other indications) rather than experimenting on the patient’s body. This is helpful when you have a rare disease or very limited treatment options left. This test is not routinely done because it requires viable tumor tissue and because it is an out-of-pocket expense. Pursuing this test upfront will help you identify a chemo, a targeted drug, an experimental drug, or a combination of them, and also confirm that the drug works before wasting a lot of time and effort pursuing a treatment that does not work. Personalized T-Cell Therapy Also referred to as TILs (Tumor Infiltrating Lymphocytes) is a form of Immunotherapy, and often complements vaccines. Vaccines recruit more soldiers to the battle by educating the part of the immune system that does not recognize the cancer. T-cell therapy also recruits more soldiers to the battle, but by cloning and multiplying the part of the immune system that recognizes the cancer, thus giving your own immune system a better chance to fight the cancer cells with little or no side effects. Ideally, every patient should get T-cell therapy, but this is not yet feasible. T-cell therapy is not routinely performed because it requires viable tumor tissue, is experimental, and requires a complex infrastructure to prepare and administer. Pursuing T-cell therapy boosts the immune system to fight cancer in parallel to other treatments you are on, can extend time in remission, and reduce the chances of recurrence. Bottom Line No two tumors are alike, and each contains important information critical to the treatment, BUT tumors are NOT preserved alive by the hospitals and are routinely discarded. Personalized treatments start with having access to the viable tumor, Store My Tumor. For more information: www.storemytumor.com Team StoreMyTumor +1.267.702.5501 cs@storemytumor.com www.StoreMyTumor.com Return to the Blog

By Rachael Curry What is IDC? Invasive ductal carcinoma (IDC) is the most common type of breast cancer, accounting for 80% of all breast cancers in women and 90% in men. Yes, you read that correctly – 1% of men are diagnosed with breast cancer . Also called infiltrating ductal carcinoma, it refers to a type of cancer that has spread beyond the ducts, which carry milk from the breast lobules to the nipple. “Invasive” refers to this spread of the cancerous cells, while “ductal” refers to the origination of the cancer in the milk ducts, and “carcinoma” refers to a type of cancer that begins in the skin or protective tissues such as breast tissue. While IDC is most common in older women, especially those over the age of 55, it can also affect younger women and men. Like many forms of breast cancer, IDC often has no symptoms at first. However, signs sometimes include: A lump in the breast or underarm Skin irritation or pain Redness or scaly texture on the breast and nipple Unusual discharge from the nipple Nipple turning inwards IDC is usually detected as a lump in a screening mammogram, which takes an X-ray picture of the breast. This leads to a biopsy and other testing procedures to assess the size and spread of the tumor. Potential tests include CT scans (using multiple angles of X-rays to create cross-sectional imaging), PET scans (using imaging to visualize metabolic processing within the organs and tissues), MRI (using a magnetic field to create images of organs and tissues), bone scans (using nuclear imaging to detect the presence of metastatic cancer in bones), and chest X-rays. Invasive Ductal Carcinoma Prognosis Is invasive ductal carcinoma “curable”? The linguistics of the word “curable” are not black and white. In this case, we will assume that “curable” means that there is no remaining evidence of disease. The short answer is that IDC can be curable with the correct treatment methods. Treatment will be determined based on the stage of IDC, which classifies the size and location of the cancerous cells. The provider will analyze the growth and spread of the lump throughout the body to determine this. IDC consists of four stages. Stage 1 means that the tumor is smaller than 2 centimeters in diameter and the breast cancer is contained to just the breast. Stage 2 is a smaller lump that has only spread to a few lymph nodes in the underarm area, while Stages 3-4 refer to a larger lump that has spread to multiple lymph nodes or other organs. The 5-year survival rate of Localized IDC is 99% while Regional IDC is 86% and Distant IDC is 27%. With IDC, there are usually strong positive prognoses, although, as with any medical procedure, it is impossible to guarantee a 100% success rate. How is IDC Treated? Treatments are classified as either local, meaning they only target one area of the body, or systemic, meaning they target the entire body, likely for a cancer that has spread and progressed to a further along stage. Local Treatments Local treatments include surgery and radiation therapy. Surgery is used to remove the breast tumor, which is sufficient if the cancer has not spread to the lymph nodes. Either a lumpectomy will remove the lump and a bit of surrounding tissue, or a mastectomy will remove part or all of the breast tissue. Radiation therapy directs rays of high energy at the breast to destroy any remaining cancerous cells after surgery. Systemic Treatments Systemic treatments include chemotherapy, hormonal therapy, and targeted therapy. Chemotherapy utilizes powerful medicine to destroy cancerous cells in the body by traveling throughout the bloodstream. Side effects are frequent since this also weakens healthy cells within the body. Hormonal therapy, also called anti-estrogen or endocrine therapy, is used to lower the amount of estrogen in the body. Because the hormone estrogen signals the growth of cancerous cells, this form of therapy can either destroy or block the hormonal receptors that create this signal. Targeted therapy similarly targets certain parts of cancerous cells to inhibit their growth. Conclusion The treatment method for IDC will be determined between you and your provider. Regardless of the treatment selected for your personal circumstances, there is a largely positive outlook. Routine mammogram screenings are important to detect potential invasive ductal carcinoma early on, when there may be no symptoms, and lead to prompt treatment initiation. Read more about breast cancer risk factors . https://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/invasive_ductal_carcinoma.html https://www.breastcancer.org/symptoms/types/idc https://www.webmd.com/breast-cancer/ductal-carcinoma-invasive-in-situ About the Author I am a 2019 graduate of the University of Michigan with a BA in Gender and Health, and a current MPH candidate at Boston University focusing in Healthcare Management. I am interested in the intersection of social identity and women’s reproductive health. In the future, I hope to help create a more accessible and equitable healthcare system for all women. During my free time, I enjoy painting, drawing, running, and hiking.

By Rachael Curry Did you know that the Food and Drug Administration (FDA) does not require safety tests for makeup products before they're released to unaware consumers? Yes...you read that right. There are only 11 ingredients and color additives that the FDA has actually prohibited. This might be shocking until you attempt to read the ingredient names on the back of your bottle of foundation. If you can't pronounce any of them, you're not the only one! Our skin is our largest organ. What we put on our face can penetrate into the deeper levels of our skin and be absorbed into our bloodstream. While it is not as literal as dabbing lavender essential oil on our wrist and wondering if it will show up the next time we have our bloodwork taken, there is some truth in knowing what we lather, rub, spray and pencil onto our faces can enter into our bodies.  So, what exactly are we putting on our skin? Are our makeup products filled with toxic ingredients? Why is "clean beauty" (defined as beauty products composed only of ethical and proven ingredients) so important?  In the EU, cosmetics ingredients must be assessed for safety before entering the market. Those that are linked to harm are restricted. Unfortunately, this level of oversight does not exist in the US, thus enabling cosmetic companies to prey on the unwitting US consumer as a test subject, which is both unethical and dangerous! I am not saying you must immediately toss out all of your makeup products, shampoos, and cleansers, but I would argue that we should make the transition to conscious beauty. If we want to be healthy, not just in terms of diet and nutrition, but lifestyle, then let’s also start to make the shift in terms of how we are taking care of our bodies on the outside! Let’s start with the basics as we make this transition to being more aware of toxins in our everyday products. Here are my top 5 to look for when searching for cosmetics and self-care products: 1. Parabens According to the Environmental Working Group, (EWG), parabens can act like the hormone estrogen in the body and disrupt normal hormonal function. There is concern that exposure to environmental estrogens may contribute to the risk of breast cancer in women by changing the gene expression and accelerating the growth of breast cancer cells (Wróbel 2014, Okubo 2001).  Long-Chain Parabens Long-chain parabens, like propylparaben and butylparaben , have been linked to increased levels of estrogen activity. Most recently, the European Chemicals Agency   has listed butylparaben as a substance of high concern and will be phasing out products that contain this hazardous chemical. 2. Phthalates Phthalates are another endocrine disruptor to watch out for. They are typically found in self-care products like deodorant and nail polishes, which add to the plasticity of the product.   3. Ethylene Oxide According to cancer.gov , this carcinogen can be linked to breast cancer. It is commonly found in Formaldehyde. Ethylene oxide is on the list of what I call the “Unknown 7”. That is because there are 7 ingredients that US manufacturers do not need to disclose. While Canada and the EU are required to disclose the information, there is currently no legislation on the regulation of this toxic, cancer-causing substance within the US. Ethylene oxide is found in common products such as nail polish and eyelash glue, as well as baby soaps and shampoos. Since this is one of the “hidden” ingredients, the only way to avoid this carcinogen is by looking for ingredients that enable the slow release of formaldehyde, including: Diazolidinyl Urea DMDM Hydantoin Imidazolidinyl urea Quaternium-15 Tosylamide/Formaldehyde Resin Sodium hydroxymethylglycinate 2-bromo-2-nitropropane-1,3-diol (bronopol) Polyoxymethylene Urea 5-Bromo-5-Nitro-1,3 Dioxane Methenamine Glyoxal Benzylhemiformal 4. Petroleum Distillates These ingredients are often produced in the same location as the cancer-causing chemicals found in gas and oil. It is most commonly found in mascara, and besides the harmful chemicals, it can cause skin irritation and dermatitis. 5. Fragrances Fragrances as a whole might seem like quite a large category. However, fragrances can be potentially harmful as the US does not require manufacturers to list the chemicals that their fragrances are actually composed of. So, when you see “fragrance” listed as an ingredient, it could be referring to a number of different chemicals. For those with sensitive skin, fragrances can be extremely irritating, and in others, can even cause potential allergic reactions. And because the actual chemicals are not disclosed, fragrances can sometimes be cancer-causing. All of this information may seem overwhelming at first! It is hard to be conscious of what’s inside every product we purchase — from food and cleaning supplies to makeup and more. It is also okay if you do not have the energy or resources to completely transform your beauty products. Perhaps there is just one type of product you’d like to think more consciously about, and that is a great place to start! If clean beauty interests you, many brands in the US focus on creating safe and ethical cosmetics. Thrive Causemetics is one clean beauty brand that sells products free of parabens, phthalates, sulfates, and fragrances. Additionally, a percentage of their profits are donated to partners, several of which are breast cancer organizations including ours, survivingbreastcancer.org! Follain is another brand that has a laundry list of restricted chemicals for their products. They also use safety reviews and performance reviews to ensure that their cosmetics are both safe and good quality before entering the market. (Follain also has two storefronts in Boston, located in Beacon Hill and the South End!) They have also expanded to TX, WA, and MD as well! Some major makeup retailers, such as Sephora, will even allow you to filter their products in order to view only the clean beauty products. One easy way to make the transition to clean beauty might be to replace old products as you run out - such as purchasing a “clean” eyeliner when you run out of your old eyeliner. If you are someone who prefers to buy makeup at the drugstore, you might just look for products that have smaller lists of ingredients or lower concentrations of the ingredients above. There is never a bad place to start! If you are interested in learning more about clean beauty, hear from reps at Follain , Ecothriver Cultivate Cleaner and Amy Ferraro Whitset, who is an Independent Consultant for Beautycounter on the podcast, Breast Cancer Conversations.

What questions should you ask your breast cancer surgeon? Preparing for your first appointment with your breast surgeon is an exciting moment. It allows you to meet the surgeon who will be removing your tumor! It also should be an opportunity for you to ask questions, get more information on what options are available to you, and in some cases, you may even leave your appointment with your surgery date scheduled. Once the surgery date is scheduled, you may even feel a sense of calmness and relief knowing that the process is moving along and there is a concrete date you can focus on. For many, the day of surgery is celebratory because it is the day they are removing the cancer! However, leading up to that first appointment can be overwhelming, anxiety-driven, and perhaps even numbing as you are grappling with your recent breast cancer diagnosis. With appointments ranging from meeting with oncologists and your medical care team to showing up for bloodwork, tests, and waiting for results, we understand that a breast cancer diagnosis is like a crash course in a foreign language. How are you supposed to know what questions to ask when you don't yet know what you don't know! Don't worry, that is where Surviving Breast Cancer comes in! Having reviewed numerous reputable sources and speaking with breast surgeons, our breast cancer survivors, and thrivers, we've compiled a list of the most burning questions. Pick and choose from the list below, or ask your surgeon about all of them! The choice is yours, and your doctors will make the time to answer all of your questions, define terms you don't know, and explain surgical procedures so that you have a solid understanding of ALL of your choices, as well as your rights as a patient to make informed decisions and consent. After all, this is your body and your choice! Download a printable PDF version. QUESTIONS TO ASK YOUR BREAST SURGEON ***Note: None of the information provided on this sheet constitutes medical or legal advice. Always consult with your medical care team. This compilation of questions is not comprehensive and is only meant for educational purposes. The questions below have been compiled from online resources such as cancer.net, breastcancer.org, and from those diagnosed with breast cancer in our survivingbreastcancer.org community. If you would like to add to this list, please contact info@survivingbreastcancer.org . Questions About Your Surgeon Are you board-certified? Do you specialize in this type of surgery? How many operations like the one I am considering have you performed? Questions To Ask Before Surgery Do I need any other tests before this surgery? Am I a candidate for a lumpectomy? Am I a candidate for nipple sparing surgery? If I have a choice between a lumpectomy and a mastectomy, what are the pros and cons of each option in my case? What is the best possible outcome from my surgery? What is the worst-case scenario from this type of surgery? Questions To Ask Your Surgeon About Lymph Nodes Do the lymph nodes in my underarm need to be removed? What is a sentinel lymph node biopsy? What are the benefits and risks? Would you recommend it for me? What is the risk of lymphedema with a sentinel lymph node biopsy? What is the risk of lymphedema with axillary lymph node dissection? What should I know about taking care of my arm after a lymph node dissection? What is the benefit of having more lymph nodes removed? What are the side effects of these procedures? Can they be prevented or minimized? Questions To Ask Your Surgeon About Your Breast Cancer Treatment Plan Should I consider chemotherapy before surgery? Will radiation after surgery affect my reconstruction options? Will radiation affect the aesthetic outcome of my surgery? (i.e., will my breast change size?) Questions To Ask About Surgery Options When do I need to decide on surgery? What are the risks if I decide not to have this surgery? Will my tumor be saved? Where will it be stored? For how long? How can it be accessed in the future? If I need a mastectomy, is reconstruction (plastic surgery) an option for me? What are the advantages and disadvantages? What types of breast reconstruction surgery am I eligible for? Fat Grafting/ Autologous Fat Transfer vs Implants vs. opting for Going Flat and no reconstruction (aesthetically flat closure) If I choose to have implants, are there different types of implants to choose from? How do I decide which implant is best for me? What are the potential risks and side effects of this operation? Do I need to consult a plastic surgeon about reconstruction options? Can you help me arrange that? How many surgeries will be involved? Will I need expanders? Can you explain to me what they are and for how long I will have them? Am I eligible to have one surgery where you remove the tumor and can go directly to implant? What are the pros and cons? If I have a mastectomy without reconstruction, where can I get a prosthesis? Is this covered by my insurance? Will there be permanent effects from the surgery? Should I get a second opinion? How do I go about doing that? Questions About the Surgery Itself How long is the procedure? How long will I stay in the hospital? What type of anesthesia will I need for this operation? What medications and supplements should I stop taking? Should I stop taking hormone replacement therapy? What about birth control pills? What are the possible complications for this type of surgery? How would I know if there is a problem? Will my medical insurance cover all charges from you and the hospital? Questions About Recovery How long will it take me to recover after the surgery? What should I expect the first day, first week, first month? (check out our blog featuring our favorite pillows, recovery hacks, and bras we love!) What kind of pain will I be in afterwards? How do you help me manage my pain? What risks or side effects of this surgery do I need to know about? i.e., pain, tenderness, bruising, scarring, numbness? Which ones do I need to report to you? Will any of the side effects be long-term? Is there anything I can do to reduce side effects? When should I call your office if I experience any side effects? Will the hospital provide a home nurse to help change my bandages? How will this be arranged? Will I have stitches, staples, and/or bandages? Will I need to have surgical drains? How do I clean the drains? How long will the surgical drains be in? What kind of care will my incision need after surgery? Is there anything I can do before surgery to help the healing process after surgery? When can I shower or bathe? Where will the scar be, and what will it look like? Can you draw me a picture so I can better understand? What will my breasts look and feel like after surgery? What type of clothes should I bring to go home in? Will I need a special type of bra? When will I need to return for a follow-up appointment? When will I find out the results of the surgery? Who will discuss the pathology report with me? Will it be in person or by phone? Will my arm be affected by surgery? For how long? Will I need physical therapy for my arm? Are there physical therapy exercises I should do after surgery? When can I start exercising again? Are there any activities I should avoid and for how long? When can I start to treat my scar on my own? Do you recommend special creams or lotions? When can I return to work and other daily activities? Questions To Ask About Your Surgery Day What should I do to get ready for the operation? Do you have recommendations on how to help me relax before surgery? What can I expect as part of the pre-op? Does that happen the same day of the surgery or prior? Questions To Ask Your Breast Surgeon After Your First Surgery What is the size of the tumor? What is the grade and stage of this disease? What are my biomarkers? What do these mean? What are the chances that the breast cancer will return? Will I need chemotherapy? Am I eligible for the Oncotype DX or Mammoprint? Can you explain my pathology report (laboratory test results) to me? Can I get a copy of my pathology report? Was all of the cancer removed during the surgery? Do I have clear margins? How many lymph nodes were removed? Has the cancer spread to any of the lymph nodes? If so, how many? Has the cancer spread anywhere else in my body? Do I need additional surgery? Are there additional tests you recommend? How often do you and I meet for follow-ups?

By Candace Bloomstrand Metaplastic Breast Cancer is a very rare form of breast cancer that originates in the milk duct of the breast before spreading to the tissue surrounding the duct. Metaplastic breast cancer accounts for less than 1% of all breast cancers, but it can also behave more aggressively. Metaplastic tumors look and behave differently from other types of breast cancer tumors. Metaplastic tumors are often, but not always, “triple-negative,” meaning that they test negative for estrogen and progesterone receptors and the HER2 protein. The tumors often contain types of tissue not normally found in the breast, such as squamous cells or osseous cells. Metaplastic tumors are also often larger at diagnosis than other breast cancer tumors and more likely to metastasize. (Listen Now) To access our podcast with Jessica Duemig, author of Warrior, Challenge Accepted , please click on the image to the right to hear more about her experience with Metaplastic Breast Cancer . Because Metaplastic tumors are quite rare and often “triple-negative,” treatment options are limited and vary depending on the size and location of the tumor, whether the cancer has metastasized, and the patient’s overall health and age at diagnosis. Surgery, either via a lumpectomy or a mastectomy, and radiation therapy are often recommended. Metaplastic breast cancer is also more likely than other breast cancers to recur after treatment, so your doctor may recommend systemic therapy as well. The prognosis for Metaplastic Breast Cancer greatly depends on the stage and grade of the tumor, as well as the patient's age and overall health. Five-year survival rates range from 49% to 68%. (Click here and here to read more about Triple Negative Breast Cancer). Although the survival rate is lower than other forms of breast cancer, science is rapidly evolving, and every day we learn more and more about this form of breast cancer and new ways to effectively treat it. Metaplastic Breast Cancer Metaplastic carcinoma of the breast is a subtype of invasive breast cancer. Metaplastic breast cancer is a very rare form of breast cancer, accounting for less than 1% of cases. Since it is invasive, it has grown through the wall of the milk duct into other breast tissues or beyond the breast. Doctors call it metaplastic because of the way the cells look under a microscope. Instead of looking like ductal cells, metaplastic tumor cells look very abnormal. In fact, they look more like other tissues in the breast, such as connective tissue. This has lead scientists to believe the ductal cells went through some kind of unexplained change—or metaplasia. Metaplastic Breast Cancer Global Alliance: Who Are We? This grass-roots patient organization was started by a team of women, all diagnosed with metaplastic breast cancer, who are dedicated to helping to improve the outcome for all women in this community. We envision a time in the not-so-distant future when women diagnosed with early stage MpBC can be told by their doctors that the protocol they are being treated with is known to produce good results for that specific type of cancer, and that the future is not so grim. We strive to bring hope to the horizon for women diagnosed with MpBC and their families. Breast Cancer Survivor Makes Every Step Count For Shalena Prude, life is not something to face sitting down. Grounded in strong friendships and family ties, Shalena has built a successful career and kept a close watch on her health. But a breast cancer diagnosis 2 years ago showed her just how strong she needed to be to stay standing. The diagnosis was stage 2A metaplastic triple-negative breast cancer, a very rare and aggressive form of cancer. About 10%-20% of breast cancers are triple negative, and fewer than 2% are metaplastic. These cancers are more difficult to treat and have a poorer prognosis. But Shalena is ready to share her story and to let others see her cancer not as a weakness but as a brave chapter in her journey.

The short answer is yes. What Is Toxic Positivity? The Psychology Group defines toxic positivity as “the excessive and ineffective overgeneralization of a happy, optimistic state across all situations. The process of toxic positivity results in the denial, minimization, and invalidation of the authentic human emotional experience.” (See their Toxic Positivity table below and feel free to share it). Although we at survivingbreastcancer.org strongly believe in the power of positivity , we do recognize that positivity can have negative effects when used to mask or silence natural human experiences. By denying the existence of critical thoughts, feelings, and emotions, you may set yourself up to fall into a negative state of repression, which can be a tipping point leading towards depression. Humans are flawed and subject to negative emotions. We suffer the ignominy of jealousy, anger, resentment, worthlessness, inadequacy, and greed. Everyone must accept that life can be overwhelming, painful, and insufficient. Let’s not pretend that life is composed exclusively of positive experiences and emotions. Why Is Toxic Positivity Harmful? Toxic positivity takes positive thinking to an extreme by only putting optimism on a pedestal, denying authentic human emotion. It can become a form of shaming, as it sends a signal that our feelings are wrong. It can also cause guilt that somehow we are "broken" and need to "fix" how we are feeling. Subtle signs of true emotional states can appear when friends, family, and colleagues expect you to "get over" something, brush off problems, and leave your personal matters at the door. People can expect you to put on a smile and muscle through. Are You Suffering From Toxic Positivity? There are many telltale signs that one is approaching Toxic Positivity, including: Feeling guilty for your emotional state Shaming others for their positivity Denying how you are truly feeling Minimizing the experience Hiding behind the veil of perspective How to Overcome Toxic Positivity There are workarounds to escape Toxic Positivity. Trust that your emotions play a critical role in your life and or recovery. Accepting difficult emotions serves as a coping mechanism, decreasing the intensity of those feelings. Recognize acceptance when you talk about how hard your day was, or how you are having difficulty with your medical treatment, with your caregiver, partner, parent, friends, or family. It’s important to relieve yourself, to get things off your chest, especially negative emotions. It’s like lifting a weight from your shoulders, even if it’s more difficult than pretending everything is fine. Emotions are not all positive or all negative. Instead, think of them as guardrails; they help us make sense of life and respond accordingly to its ebbs and flows. If you’re sad about leaving your primary care team, it probably means that experience was meaningful, successful, and reassuring. If you feel anxiety about entering the post active treatment stage, it probably means you are concerned about recurrence and or how you are perceived by others. Feelings are not only a way for our mind to clue us into what’s happening; they also help communicate information to those around us. If we are sad, it may attract comfort. If we convey guilt, it helps the call for forgiveness. While it may be beneficial to try to look on the bright side of things and find the silver lining in life’s myriad experiences, it’s important to also acknowledge and listen to our emotions when they aren’t as pleasant. No one can be a ray of sunshine all the time; as humans, we just don’t work that way. In fact, paying attention and processing your emotions as they come and go may help you better understand yourself, and enable those around you to help you even more.

We at SBC wanted to touch on a pressing issue pertinent to the LGBTQIA+ community. Although the value of equal protection in the eyes of the law has been underlined by several legal precedents over the years, it is still challenged far too often. Insurance, in particular, is one aspect in which regulation has lagged behind the progressivism of the new age. It is crucial to bring attention to the discriminatory practices of insurance companies, 365 days of the year. After someone has transitioned, there is a lot of transition-related care that may be medically necessary. Still, not all insurance companies take this into consideration and do not always cover these costly necessities. This type of transition-related care cannot be explicitly excluded , according to 24 states and the District of Columbia. This consensus is based on a broad-but-controversial interpretation of the Americans with Disabilities Act and Title VII of the Civil Rights Act. Still, this means over half of states allow transgender exclusions in health care coverage for health insurance plans. Insurance companies may attempt to word these exclusions in many different ways, but in almost all cases, these exclusions are considered discrimination in the eyes of the law. Some examples of discriminatory wording include categorical exclusions and limits for transition-related care or a transition-related procedure. Also, they cannot change one’s rates or cancel their coverage due to one’s transgender status . The final and arguably most frequent discriminatory practice engaged in by insurance companies is denying coverage for care that is typically associated with a specific gender. For example, a transgender woman could be recommended for anything from gynecological care to a prostate exam, and neither one should be denied by her insurance company on the basis of gender . Ultimately, she is entitled to whatever care her provider deems medically appropriate . Luckily, healthcare plans on the Health Insurance Marketplace from www.healthcare.gov are required to cover all sex-specific preventive services deemed medically appropriate. This means that for those who struggle to find coverage that matches their needs, the Health Insurance Marketplace may be one of the many options to consider! Resources: “Health Care.” Know Your Rights , National Center for Transgender Equality, www.transequality.org/know-your-rights/health-care . Landman, Keren. “Fresh Challenges To State Exclusions On Transgender Health Coverage.” NPR, 12 Mar. 2019, www.npr.org/sections/health-shots/2019/03/12/701510605/fresh-chall enges-to-state-exclusions-on-transgender-health-coverage . “Transgender Health Care Coverage.” HealthCare.gov, www.healthcare.gov/transgender-health-care/ . “Which States Prohibit Transgender Exclusions?” Out2Enroll, www.out2enroll.org/which-states-prohibit-transgender-exclusions/ .

Metastatic breast cancer (MBC), also referred to as Stage IV or advanced stage breast cancer, occurs when cancer cells have spread through the lymphatic system or bloodstream to other parts of the body, such as bones, brain, lungs, or liver. De Novo is a term that refers to a metastatic diagnosis at the time of initial diagnosis and staging. A de novo metastatic breast cancer diagnosis accounts for approximately 6-10% of breast cancer diagnoses. Distant Recurrence is a term that is used when the cancer has returned after an initial early-stage diagnosis (i.e., Stage 0, II, III) and treatment, and has spread beyond the breast to other parts of the body. The likelihood of recurrence depends on a number of factors, including: Tumor characteristics Genetic predisposition Current cancer stage Age at the time of diagnosis Lymph node involvement Typically, oncologists will closely monitor patients for the first five years, as cancer recurrence is highest during this period. According to the Cleveland Clinic, symptoms depend on where the cancer returns. For example, people may experience bone pain if the cancer has metastasized to the bones. Other symptoms may include chronic dry cough, dizziness, extreme fatigue, chest pain, or difficulty swallowing. It is important after treatment to maintain a healthy diet, exercise, and to keep up with your medical follow up appointments. In addition to the whole month of October being recognized broadly as breast cancer awareness month, you may not know that October 13th specifically marks metastatic breast cancer awareness day . Whereas MBC refers to the original breast cancer spreading to other parts of the body, a second primary cancer (SPC) refers to an additional, separate cancer diagnosis. “A second primary cancer may occur in the same tissue or organ as the first cancer, or in another region of the body. These second cancers may be related to a genetic predisposition , common risk factors, treatments for the original cancer, or simply occur sporadically as cancer often does.” ( verywellhealth.com ) For breast cancer survivors, this means a second primary diagnosis could be a new breast cancer diagnosis after original treatment, or a separate cancer in other tissues of the body. The incidence rate of all SPC has been rising, mainly because of improved survival rates of cancer patients after their original diagnosis. In the articles below, we share research being done on MBC and SPC, as well as support resources for those experiencing either. From SurvivingBreastCancer.org Living With Metastatic Breast Cancer - Resources & Support 116. Living With Metastatic Breast Cancer & Our MBC Life While breast cancer may unite us, there are many nuances, even within the metastatic community to bring to light. These women share their unique and powerful stories with us. They are advocates and supporters, and they are here to educate, share in our community and create space for our MBC breast cancer community. Listen Now. #110. Losing Someone You Love to MBC: Meet The Husbands In this episode, we talk with three men who have lost their wives to metastatic breast cancer -- Jimmy, Andrew, and Christian -- as they take us through their journeys through cancer with their wives and share with us the wonderful memories of these truly impactful women. They reveal the emotions they experienced with the initial diagnosis, the ways they grappled with supporting their wives while maintaining perspective, and share advice for couples who maybe embarking on their own cancer journeys together. Listen Now. #122. Cancer Recurrence and the Power of Twitter In this episode we speak with Silke. Diagnosed with stage II breast cancer only to find out it had spread to her bones 6 years later. Silke shares with us the intimate emotions as she navigates the successes of a surgery, a low onco-type score, and not needing radiation. After being on three lines of treatment she is now seeing positive responses from a clinical trial. Listen Now. Thursday Night Thrivers: Thursday October 14th, 7 PM EST In addition to our ongoing weekly Thursday Night Thrivers meetups, beginning October 14th the second Thursday of each month will include a special breakout room for the MBC community to connect. RSVP Here. Content Across The Web Family History and Risk of Second Primary Breast Cancer after In Situ Breast Carcinoma ( Cancer Epidemiology, Biomarkers, and Prevention ) This research, published in 2018, aimed to examine why some women develop second primary breast cancer after in situ breast cancer. They found that first-degree family history of breast cancer was associated with about a 33% increased risk of developing a second primary breast cancer among women with a previous in situ breast cancer and those with two or more affected first-degree relatives had an even higher risk, about 94% more likely. Those whose relative was diagnosed at less than 50 years old were about 78% more likely to develop a second primary breast cancer. No difference in risks associated with the number or age of affected relatives was observed by menopausal status. If your family history puts you at an increased risk, it is important to know this and share it with your doctor so that they can be proactive about monitoring for a second primary cancer. Read More. Risk of Second Primary Cancers Among Long-Term Survivors of Breast Cancer ( Frontiers Oncology ) A 2020 study out of China used data on second primary diagnoses among long-term breast cancer survivors to create a clinically predictive model of patients’ likelihood to develop an SPC. The researchers found that cumulative incidence of SPC increased over time. Radiotherapy was associated with increased risk of any SPC, while chemotherapy was significantly associated with decreased risk of any SPC. These findings can help identify patients at increased risk of SPC. Read More. #LightUpMBC ( METAvivor.org ) METAvivor is an organization dedicated specifically to supporting the MBC community. For Metastatic Breast Cancer Awareness Day on October 13th, they’ve created the #LightUpMBC campaign to promote the necessity of devoting more funds to MBC research. Currently only 5% of all breast cancer research funding goes toward MBC research. To help spread this message, on October 13th, 200 landmarks worldwide will be lit in pink, teal, and green, the colors of the metastatic breast cancer ribbon. Visit their site and find if any landmarks in your area will be participating this year. Read More. Metastatic Breast Cancer ( Cleveland Clinic ) Symptoms of MBC can vary depending on where it has spread to, but can include bone pain, bones that fracture or break more easily, nausea, worsening headaches, visual disturbances, jaundice, and unexplained weight loss. While some symptoms of MBC are similar to side effects of some medications you may be on, if these are new symptoms, it’s important to let your doctor know. Most treatment for MBC is systemic, meaning the treatment targets the whole body. Treatments can include a combination of chemotherapy, hormonal therapy, immunotherapy, and targeted therapy. Your exact treatment plan will depend on what parts of the body the cancer has spread to, past breast cancer treatments, symptoms, and tumor biology (how the cells look and behave). Read More.

By Whitney Wharton I had an abnormal routine mammogram in August 2024, which resulted in an ultrasound, then a biopsy, which confirmed breast cancer . Author Whitney (right) and her wife, Rebecca I had a double mastectomy in late November with immediate silicone implant reconstruction. My surgery was about 2.5 hours, and I went home the same day and went back to work 2 weeks later. I then had radiation. I take oral therapy, CDK4/6 inhibitor Kisqali, as well as an aromatase inhibitor and an estrogen blocker, because I was premenopausal and still producing estrogen. Author Whitney (left) and her wife, Rebecca The following are tips from other women that significantly helped me, and lessons learned that I wished I had done differently. I also sprinkle in humor because that personally helps me, but I am not making light of cancer and understand that this is not a laughing matter. According to the American Cancer Society , about forty thousand women die of breast cancer each year in the United States. I also understand that I had excellent care as an insured person who works at the same institution where I receive care, and that is a privilege.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Be your own healthcare advocate.   Ask your care team all your questions . Take your time. If you don’t understand the answer, ask them to explain it in a different way. Don’t feel like you have to rush. The physicians work for YOU. This is probably controversial, but in my opinion, liking/disliking your surgeon is not as important as their skill.  We had a terrible first meeting with my surgical oncologist. She is an angry elf. I thought my calm and collected Queen (my wife, Rebecca) was going to come over the table at her (which was super sexy in retrospect). I am so thankful that my wife was there because I was totally taken aback and speechless, and she took control when I couldn’t, and handled the situation. However, my surgeon is the best in the business, and I’d have her remove Thelma and Louise again. (The new silicone sisters are Kourtney and Kim.) I would, however, recommend finding a medical oncologist that is both skilled and has a good bedside manner , because you will be working with them long term . Insist on a care TEAM. Get a medical oncologist before surgery. Ask each physician every question you have, even if it’s not their specialty.  Some of the most helpful feedback I received came from asking my doctors this question: “What would you hope your daughter would choose in this situation?”  A few times, their answer did not match what the clinical recommendation was, and that continues to guide my care decisions. In my experience, I was asked to make decisions from a menu of options  that worked for me as a human, my family, and my comfort level. I wasn’t quite prepared for this level of involvement, but it was both scary and appreciated. Cancer is not an exact science. Take someone with you to your appointments. You will be on information overload , and may have to make quick decisions. Also, write down your questions . I found it helpful to have shared notes on my phone that my Queen/sister/mom could also add to. Waiting is the worst. And there is a lot of it. Ask your doctor about Oncotype DX tests, genetic counseling, etc.  before surgery. Someone I love would have opted for mastectomy vs. lumpectomy had she known her genetic information  and Oncotype DX scores before surgery. Information from Oncotype DX and genetic counseling can help with decisions about postop treatment (like chemo) and navigating recurrence risk. Author Whitney (left) and her wife, Rebecca Over-prepare for surgery.  I probably did this to the extreme, but it made me feel better. Fill all your prescriptions beforehand. Have your bed/recliner all set up and ensure you are as comfy as possible. I also gave close contacts my wife’s phone number so she could respond in case I was unable or heavily medicated, and people wanted updates. Ask if your surgeon administers a nerve block . I’m not sure if this is why my pain never exceeded 3/10 and why I didn’t need hard pain meds, or if I just got lucky. Probably both. But consider getting a nerve block. Assemble your   home care team . I was SO lucky to have my Queen, my sister and my mom. My wife was my constant and helped with my drains, showers and basically everything. My sister came to help run errands and help with my dogs and my mom came a few days after my sister left. And be patient with your home care team. They are just as (if not more) scared than you are. Fiber supplements/bars  to help with constipation. I recommend starting them as soon as possible. Trust me. Keep a log of your meds/drain output.  I had a “cancer table” with my cards and flowers and my meds all in one place. A place where I could easily access and find things was helpful. If you have to wear a compression cancer corset (bra) after surgery , make sure you get one that fits properly. I have man shoulders and am 5’11’’, and I felt much better when my home care team ordered new ones for me. One size does NOT fit all, and you should be comfortable. There will likely be details and information that you won’t know until after surgery.  I didn’t know if they would be able to save my nipples until surgery. It was a blood flow thing. My plastic surgeon told me that if he wasn’t able to save my nipples that they could sew them to my leg and replace later, to which I responded, “What in the Stephen King are you even talking about?!” Luckily they were able to save mine, but if not, I opted to just let them go. They are just nipples, after all. On the topic of nipples (these are a few of my favorite things), there are many options if you are not able to have nipple-sparing surgery. My besties are mainly men, and I put this to a vote. Top three votes were 1) getting three boobs like the woman alien in the movie Total Recall  starring Arnold Schwarzenegger, 2) tattoos of waffles, or 3) having buttons sewn on... for texture. Helpful gifts:  Soft pajama shirts that zip in the front. Cash for tips for valet parking at doc visits. Meal trains might feel overwhelming – especially if you have a tiny fridge like we do and don’t want to eat the same thing for days in a row. I’d suggest Instead of Flowers meal delivery, or DoorDash/Uber Eats gift cards are awesome. Bookstore gift cards (my favorite). OK that’s all I’ve got. I hope some of this is helpful for at least one person. Someone also please Google the freezing point of silicone so I know if I am safe to venture outside during the polar vortex with Kourtney and Kim. Love to you all and for anyone who needs an ear, a shoulder or support during their own journey, I’m always here. Thanks for reading. Whitney, Kourtney and Kim Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. About the author:  Whitney Wharton, PhD Associate Professor Cognitive Neuroscientist  Emory University I am a research scientist at Emory University in Atlanta and am doing a story on cuts to breast cancer research. I testified at the U.S. Senate on the impacts of these cuts to patients and scientists. You can watch it on YouTube: https://www.youtube.com/live/JofqSdWmhbM   Research cuts story featuring Whitney: Emory University breast cancer study one of thousands losing grants amid budget cuts Read More: Treatment Tips & Questions to Ask Your Medical Oncology Team Understanding Genetic Testing for BRCA1 and BRCA2 Mutations Empowering Yourself: Questions to Ask Your Doctor After a Breast Cancer Diagnosis Breast Cancer in Young Women: Common Questions Answered Why a Second Opinion Matters for Breast Cancer On the Podcast: Breast Cancer Conversations Breast Reconstruction and Plastic Surgery Explained: Expert Insights from Dr. Thomas Francel Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Tricia Hammack Dear Me, I see you—standing in front of the mirror, trying to recognize the woman staring back . Your body is tired, worn from the fight you never asked for. Your chest bears the scars of survival, and yet you wonder if that survival has cost you your worth. You ache not just from the treatments, but from the silence, the emotional abandonment, the sharp loneliness that crept in where love was supposed to live.  You were raising two boys, pouring out everything you had while barely holding yourself together. And through it all, the one who promised to be your partner, your comfort, made you feel ugly, unwanted—less than. He made you question your beauty, your value, your enough-ness.  But I’m here now. And I need you to know something he couldn’t show you—something even you struggled to believe: you are not what he made you feel .  Scars do not diminish you. They are proof of what you endured, and how deeply you loved your children, your life, yourself—even when it didn’t feel like love. Every inch of you carries a story of grit, grace, and unshakable strength.  Ten years later, I’ve walked through the wreckage and found something sacred: peace. No longer tied to the weight of someone else’s inability to love me , I have learned to love myself. Truly. Fiercely.  I may never find romantic love again—and I’m okay with that. Because the love I’ve found within myself  is enough. I am enough. And you always were.  So to the woman I once was—scared, hurting, brave beyond measure—I hold your face in my hands and whisper, you made it. You did not lose yourself. You were becoming.  With love and deep gratitude,  Me Read More: No Less of a Woman: Standing Tall Through Hardships Navigating Relationships After a Breast Cancer Diagnosis The Impact of Breast Cancer on Self-Image JOY OF FALLING On the Podcast: Breast Cancer Conversations Rebuilding Intimacy Post-Diagnosis: A Conversation on Sexual Health and Relationships with Tiffini Sharifi Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

While COVID-19 continues to concern immunocompromised individuals, the regular cold and flu season also deserves careful attention. This season typically begins in October and peaks between December and March. While colds and the flu are simply an unpleasant nuisance to most, those who are immunocompromised, such as those with breast cancer, are at a higher risk of complications. Luckily, many of the same precautions people grew accustomed to during the pandemic can also help protect you from and limit the spread of colds and the flu. These precautions include: Wearing a face mask Staying home when you feel sick Regular hand washing Getting an annual flu shot if your recommended by your doctor Explore the resources below for more information on the importance of vigilance and viral protection for breast cancer patients during cold and flu season, plus advice for if you do get sick. From SurvivingBreastCancer.org Nutrition Guide For Breast Cancer The right nutrition and exercise can help support your immune system to avoid colds and the flu. Read more for suggestions of foods that can boost your immunity. Read More. From Around The Web Cancer Patients and the Flu: What You Should Know ( MD Anderson Cancer Center ) “The biggest concern [around the flu] is that cancer patients are at a higher risk of developing serious complications if they do get the flu. So if you have cancer and start experiencing symptoms like a fever, runny nose, sore throat or coughing — especially if you have a compromised immune system — see a doctor right away. There’s a good treatment for the flu, but it has to be administered early, within 48 to 72 hours of the onset of symptoms. If you suspect you might have the flu, you should also be checked for other viruses.” Oseltamivir, sold under the brand name Tamiflu, is safe for everyone who has tested positive for the flu, including cancer patients. Additionally, it’s safe for patients with any type of cancer to get the flu vaccine. However, the vaccine doesn’t work as well among cancer patients as it does in those without cancer, particularly those on active treatment. “It’s also important for cancer patients to get the shot, as opposed to the nasal mist, because the mist is a live-attenuated vaccine and may actually cause the flu in immunocompromised patients and not be as effective as the shot.” Read More. The Common Cold ( CancerConnect ) “Why is the common cold important for cancer patients? The body’s primary defense against the common cold is the white blood cells that make up the immune system. Not everyone gets every cold. If you have a strong immune system, you are less likely to contract a cold virus, even if you are exposed to it. Cancer patients have weakened immune systems. Specifically, cancer patients may have abnormally low levels of neutrophils in the circulating blood, a condition called neutropenia. Neutrophils are a kind of white blood cell that helps prevent and fight infections. The most common reason that cancer patients experience neutropenia is as a side effect of chemotherapy. Chemotherapy-induced neutropenia increases a patient’s risk of infection and disrupts cancer treatment.” Read More. What If You Get a Cold During Chemo? ( Very Well Health ) “Chemotherapy weakens the immune system, making people who are undergoing treatment more susceptible to colds, the flu, or other infections. ... Infections, including a cold, the flu, and COVID, can be life-threatening for people with weak immune systems. If you have symptoms of an infection while you are receiving chemotherapy, call your doctor as soon as you start feeling unwell. ... The treatment that you receive for an infection while you're undergoing chemotherapy will depend on the cause of the infection and how severe your symptoms are. ... If you develop a cold or the flu during chemotherapy, your treatment might be delayed while your doctors focus on treating the infection. Patient safety is important during chemotherapy, and doctors do not want to risk making the infection worse by continuing a treatment that further weakens your immune system.” Read More. Cancer and Flu ( CDC.gov ) Cancer patients and survivors should get the flu vaccine, as should their caregivers and others 6 months and older who live with them to avoid spreading the flu. “You may need a pneumococcal shot, too. Having the flu increases a person’s risk for pneumococcal disease. Pneumococcal pneumonia is a serious flu-related complication that can cause death. People with cancer or other diseases that compromise the immune system should ask their doctor about pneumococcal shots. ” “Plan in advance with your doctor about what to do if you get sick. ... If you have flu symptoms — Stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone without the use of a fever-reducing medicine. Keep away from others as much as possible to avoid making them sick. It’s important for people with cancer to call their doctor immediately if they get a fever. If you get a fever during your chemotherapy treatment, it’s a medical emergency.” Read More.

Clean living. It sounds simple enough. However, understanding what clean living means, what it entails, why it matters, and how to practice it is not quite as simple as the name might imply. It can be challenging to identify a solid definition of clean living, also known as green living, because it carries various meanings. For example, some people focus only on the dietary aspect by striving to eat organic and natural foods. For others, clean living encompasses an entire lifestyle that includes everything from diet to household products to reducing their carbon footprint. The world is full of harmful and toxic chemicals. They can be found in the foods we eat, personal hygiene products, cookware and food storage containers, cleaning products, and even in clothing. Although it’s impossible to entirely eliminate contact with chemicals, many people choose to embark on a clean living lifestyle to improve their health, well-being, and the planet’s future. What Is Clean Living? Clean living encompasses multiple aspects of life, including intentional, healthy choices in diet, lifestyle, and household products. Mindfulness is a key component, with the products you choose with the cleanest ingredients promoting a healthier life. Additionally, clean living can extend beyond individual lifestyle changes, encompassing an environmentally friendly philosophy in everyday life. These practices include eliminating single-use plastic, patronizing businesses that demonstrate a commitment to the environment, holding organizations accountable for their sustainable practices, and minimizing waste as much as possible. The Link Between Clean Living and Health The health benefits of a clean-living lifestyle offer positive results for many, particularly those with chronic health conditions. Unfortunately, your home may be a source of many potentially harmful chemicals, including flame retardants in furniture or carpets, non-stick compounds in cookware, and toxins in plastic storage containers. Consequently, the scents you breathe in your own home may include chemicals known or suspected to cause serious health issues, including cancer. Some chemicals specifically influence your risk of getting breast cancer. Clean Eating Clean eating nourishes your body with healthy and nutrient-dense foods containing vitamins, minerals, high-quality protein, and healthy fats. Some of the main benefits of eating clean include improved heart and brain health, a more robust immune system, and increased energy levels. Rather than a specific diet, clean eating is about making deliberate decisions to choose whole foods—vegetables, fruits, whole grains, pulses (beans, lentils, and peas), dairy, nuts, seeds, and plant proteins—instead of more processed foods. Processed foods can contain many harmful chemicals and toxins, including the pesticides used on traditional fruit and vegetables and the hormones found in meat, eggs, and dairy. There are varying degrees of clean eating models. Some clean-eating advocates strive to avoid all traces of added sugar, high-fructose corn syrup, preservatives, artificial colors and flavors, and other additives. While admirable, this rigid diet is difficult for most to adhere to long-term. Clean Environment Research shows that the air inside most homes, workplaces, and other indoor places is often more polluted than the air outside . Many factors contribute to this unhealthy atmosphere, but chemicals in cleaners, detergents, air fresheners, and candles can be the culprits. Keeping homes, schools, and workplaces clean is vital to stop the spread of germs, viruses , and bacteria that put those with compromised immune systems, including cancer patients, at risk of serious illness. Unfortunately, many household and cleaning products often include harmful chemicals. Even so-called “green” or “natural” products may contain ingredients that can cause health problems. Fortunately, you can limit your exposure to these potentially damaging elements, but doing so requires close monitoring of ingredients. Federal and state laws don’t require companies to list the ingredients in cleaning products, making it challenging to determine whether a product contains chemicals linked to cancer or other chronic health conditions. Many cleaning products contain industrial chemicals with ingredients linked to breast cancer . In addition, several ingredients used in cleaning products may include, or be contaminated with, chemicals linked to breast cancer. Clean Personal Hygiene Many grooming and beauty products—shampoos and hair care products, shower gel, face creams, and makeup —contain Endocrine Disrupting Chemicals (EDCs), which can affect your hormone system. These chemicals are often used to prolong shelf life and as fragrance solvents. While many chemicals and contaminants in cosmetics and personal care products pose little risk to consumers, some have been linked to severe health problems, including cancer. In fact, nearly 600 cosmetics manufacturers have reported using 88 chemicals in multiple products that have been linked to cancer, congenital disabilities, or reproductive harm since 2009. How To Get Started With Clean Living ​​Transitioning to a clean-living lifestyle is a process that takes time and patience. While you could make sweeping changes to modify your entire lifestyle, this strategy is not attainable for most. Instead, try making incremental life changes, learn as you go, and build on your successes. To get started, prioritize what’s most important to you. Is your diet your biggest concern? Are your cleaning products making you sick? Are you experiencing constant skin breakouts from personal care products? Take small steps to tackle the issues affecting your life the most. A useful skill to develop is learning to read and understand labels. Warning: the ingredients you find on labels will probably shock you. If you don’t know what the chemicals and other ingredients are (and most of us don’t), look them up at Environmental Working Group (EWG ) or ThinkDirty to learn more. 5 Simple Clean Living Tips #1 Clean Eating While there are several definitions for clean eating , most people agree that clean eating consists of eating whole, unprocessed, nutrient-rich foods when possible. Rather than trying to revamp your eating habits and meal plans overnight, you can begin by working toward the goal of including more of these types of foods more often. The following tips can help you get started: Avoid processed foods and artificial ingredients as much as possible. Incorporate more whole fruits and vegetables into every meal. Buy organic food whenever possible. Avoid highly processed foods with long lists of ingredients. If purchasing packaged foods, choose items that have five ingredients or fewer, especially with ingredients you can recognize and pronounce. #2 Choose Safe Cookware It’s counterproductive to embark on a clean eating program if your cookware isn’t safe. Non-stick cookware, such as Teflon , promised convenience and the ability to save consumers time and money, but it also includes harmful chemicals. Instead, cook with any of the following safe cookware options: Cast-iron cookware Ceramic cookware Stoneware Corningware and glass cookware Stainless steel cookware #3 Avoid Plastic Food Storage & Food in Tin Cans Don’t spoil the benefits of clean eating by making unhealthy food storage choices. For example, BPA (bisphenol A) contains hormone-disrupting chemicals that can mimic estrogen in the body, potentially affecting brain development, disrupting hormones, and negatively impacting fertility. You should avoid any plastic containers and food that comes in packaging containing BPA. Unfortunately, research has shown that BPA alternatives can be just as harmful or even worse for your health! It’s especially important never to microwave food in plastic containers since heating plastic expedites the release of harmful chemicals. You can ease into this change by starting with one replacement, such as swapping plastic food storage containers with glass alternatives. #4 Swap Household Cleaners Another way to avoid harmful ingredients is to swap out commercial household cleaners for more natural and eco-friendly options. Amazingly, there are no government regulations in the US that require companies to disclose their complete ingredient list due to proprietary trade secrets. However, there are still ways to avoid bringing toxic chemicals into your home , including the following methods: Switch to microfiber for an easy, safe, and non-toxic way to clean your home without any chemicals at all. You can save time and money while also cutting down on waste since microfiber cloths last for years while replacing cleaning solutions and paper towels. ​​Utilize natural cleaning solutions for more stubborn stains and situations. One effective and safe option is to use vinegar, baking soda, lemon juice, and fragrance-free liquid soap. In addition to eliminating harsh chemicals, DIY cleaning products can be a big money saver. #5 Review Personal Care Products According to the EWG , the average woman uses 12 products containing 168 unique ingredients every day. Skin is the body's largest organ, and the products used on your skin can be absorbed into your bloodstream. Therefore, the risk of health harm is greater when you use more products. To minimize negative effects from personal care products, reduce the number of products you put on your body, including makeup, body lotion, soap, body wash, and shower gel. Avoid all products with fragrance, which is a blend of ingredients that can contain up to 4,000 undisclosed ingredients, including harmful toxins such as phthalates. Additionally, many of the chemicals used to make fragrances can cause endocrine disruption, asthma, and even cancer, and should be avoided altogether. Count on us to keep you informed as science uncovers information on how clean living can help you be as healthy as possible. In the meantime, explore our guidelines for a healthy diet , and become part of our empowering community, including our Breast Cancer Survivor & Friends Meet and Greets . We’re always here for you! SurvivingBreastCancer.org Resources & Support: Our Podcast Our Weekly MeetUp Online Support Groups Free, Weekly Events

Today, there’s a wealth of information available about breast cancer symptoms—e.g., a lump in your breast being foremost, breast skin irritation, dimpling, a new lump under your arm, redness, etc. Women are now being encouraged to know what their breasts look and feel like, using monthly self-exams and regular check-ups with their healthcare provider, so that they can identify any changes. However, inflammatory breast cancer (IBC) rarely appears as a painless, hard lump in the breast or underarm. Unlike other types of breast cancer, with inflammatory breast cancer—a rare, but the most aggressive form of breast cancer—there is no lump to detect during a self-examination or a mammogram. The Look and Feel of Inflammatory Breast Cancer IBC can manifest in the form of several abnormal symptoms, including: Sudden swelling of a breast, which may look red, or feel itchy or warm Ridges or raised or pitted marks (like the appearance of an orange peel) on breast skin Nipple retraction or discharge Swollen lymph nodes in the underarm or above the collarbone What Makes IBC Different? IBC accounts for only a tiny fraction of breast cancers but can spread more quickly than other types of breast cancer. IBC also tends to show up in women younger than other breast cancers and is more common in women of African descent . With IBC, cancer cells form in the breast, blocking the lymph vessels in the skin and causing infection-like symptoms instead of one solid lump, so it’s often diagnosed as an infection rather than breast cancer. In addition, because IBC isn't found by mammography or ultrasound, it’s often in an advanced stage, with approximately one-third of inflammatory breast cancer patients diagnosed at stage 4. Diagnosing IBC Diagnosing inflammatory breast cancer can be challenging and is often misdiagnosed as a skin infection of the breast. Multiple tests are used to diagnose IBC, including: Digital Mammogram Including 3D Digital Breast Tomosynthesis (DBT) uses X-rays to create a 3D rendering of the breast, allowing it to be viewed in layers or “slices.” Breast MRI uses radio waves and strong magnets—rather than X-rays—to create detailed breast images. These images can locate and diagnose breast tumors. Breast Ultrasound uses high-frequency sound waves to detect abnormalities in soft-tissue organs like the breast. Diagnostic Surgery or Biopsy removes a small portion of the breast tumor to be analyzed for hormonal markers or genetic mutation. PET or CT Scan , a positron emission tomography (PET), or computed tomography (CT) scan may be used if cancer is suspected of spreading to other parts of the body, like the lungs, brain, or bones. There is still no diagnostic code for inflammatory breast cancer. Treating IBC Inflammatory breast cancer is considered locally-advanced breast cancer. It is typically treated with several types of treatment, including: Chemotherapy: Drug treatment uses powerful chemicals to kill fast-growing cancer cells in the body. For people with IBC, chemotherapy is usually used before surgery (when known as “neoadjuvant” chemotherapy) to reduce the size of tumors. But chemotherapy may also be necessary after surgery (when it is known as “adjuvant” chemotherapy) to eliminate any remaining cancer cells. Surgery: Removes cancerous breast tissue is usually the next stage of treatment for patients whose tumors respond well to neoadjuvant chemotherapy. Typically, this involves a mastectomy—the surgical removal of the entire breast and the lymph nodes under the adjacent armpit. Once treatment is complete, patients may wish to undergo breast reconstruction surgery. Radiation Therapy: Also known as radiotherapy, uses high doses of radiation to kill cancer cells and shrink tumors. It is typically used following surgery to eradicate any remaining cancer cells. If a patient’s IBC does not respond well to neoadjuvant chemotherapy, radiation therapy may be used before surgery to reduce the size of the tumor. Hormone Therapy: Such as an aromatase inhibitor or Tamoxifen, is usually used after surgery in breast cancer cells that may be hormone receptor-positive (HR-positive). Hormone therapy medications can target HR-positive cancer cells either by reducing the body’s production of the relevant hormones or by blocking the hormone receptors on cancer cells. Targeted therapies: Used to slow or stop breast cancer cells’ growth with high levels of human epidermal growth factor 2 (HER2), a protein that helps HER2-positive cancer cells grow. Immunotherapy: Also called biologic therapy, uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. Hope Is on the Horizon IBC is rare—accounting for only one to five percent of all breast cancers —however, it remains one of the deadliest cancers, accounting for 10 percent of all breast cancer deaths or 4,200 people each year. However, women with IBC now live about twice as long after diagnosis as their counterparts did in the mid-to-late 1970s. As a result, researchers are working diligently on new drugs and treatment therapies. For example, at NIH in Bethesda, MD, Dr. Sandra Swain is researching the experimental anti-VEGF antibody (Avastin) effect on advanced breast cancer. Additionally, research is being conducted to distinguish the molecular fingerprint of IBC to understand better why IBC is biologically different from other cancers. For example, figuring out the differences in gene expression patterns between normal and IBC cancer cells may reveal what sets IBC apart from other cancers. Unlike other breast cancers, IBC is not inherited, so discovering IBC genes will not necessarily help predict who is more likely to get the disease. However, finding specific genetic markers in the tumors of a woman newly diagnosed with IBC could be a valuable tool for designing treatment plans. Researchers at Duke University are experimenting with the use of heat therapy (hyperthermia) to deliver chemotherapy drugs encapsulated in tiny fat bubbles (liposomes) to tumors in the fight against IBC. The heat also triggers the liposomes to release the drugs and settle inside the tumor. Since the drug is delivered only to the tumor, doctors can use higher doses of chemotherapy—30 times more—to kill cancer cells without poisoning other body tissues. You’re Not Alone A diagnosis of inflammatory breast cancer can be scary, overwhelming, and isolating. But, we’re here for you every step of the way, with educational resources , a caring online community, and anything else to give you strength and hope. You are never alone when you become part of our global community . Instead, you’re surrounded by others who have been touched by breast cancer. RSVP for our next IBC MeetUp here . SurvivingBreastCancer.org (SBC) is dedicated to supporting those affected by breast cancer and their families. SBC provides an educational and virtual community platform to help breast cancer patients, survivors, and their families navigate prevention, diagnosis, treatment, and beyond. Check out our resources or consider donating today! SurvivingBreastCancer.org Resources & Support: Our Podcast Our Weekly MeetUp Online Support Groups Free, Weekly Events

Dear Kristen, How do you deal with the stress of having metastatic breast cancer (MBC)? I am always anxious and some days are overwhelming. The unknown of scan results is too much for me! Dear Reader, Let me just say, from one woman with MBC to another, that Stage IV Metastatic Breast Cancer is a freaking scary diagnosis, and it’s no wonder you feel stressed and anxious. Staying calm, optimistic, and feeling safe now and then takes all the courage and resilience we can muster. It calls on our inner heroines, the parts of us who feel the fear but do what’s needed anyway. I believe what we are called to do is nothing short of heroic. So when you’re feeling scared or vulnerable or helpless in the face of diagnostic tests and cancer treatment, here are some ideas for things you can do. I have road-tested every one of them in the four years since my own diagnosis, and can tell you they work. Some days they’ll work better than others, and you might need to use a lot of them when “scanxiety” strikes, but I promise they helped me, and I hope they help you too. Invoke Your Inner Heroine Think of yourself as being the main character in the story of your life, and what a wonderful heroine you are! You have made it this far because of your inner strengths, your wits, and your ability to solve problems. Perhaps you’re like the mythological goddesses or Amazon warriors; maybe you possess the qualities of Amelia Earhart or Joan of Arc, who is reported to have said, “I am not afraid. I was born to do this.” You can do this too. Remind Yourself of Past Feats of Bravery We’ve all done some scary things in our lives, whether it was speaking in front of a group or cutting our hair short for the first time or fighting in Afghanistan. Look through your life and write down a few times when you were courageous and put the list somewhere you can refer to when fear strikes. Then straighten your posture, take a deep breath, and keep moving forward. Do New Feats of Bravery As a woman with MBC, you’re already doing brave things every single day, but you can increase how courageous you feel by doing scary things unrelated to cancer. Speak out about a cause you believe in; have a difficult conversation you’ve been avoiding; cut loose from a draining relationship. Doing so will remind you that you have personal power you can use whenever you need it. Outwit the Bad Guys Remember that fear is just chemicals in your body (the “bad guy” hormones like adrenaline and cortisol) triggered by thoughts in your head that result in bodily changes like shortness of breath, faster heart rate, an upset stomach, sweating, and/or chills. If you can change your thoughts, you will change what’s happening to you physically, easing these uncomfortable conditions. You don’t need to shift all the way to thinking, “I’m not afraid,” though – your body would know you were lying to yourself. But if you can think a different kind of thought – thinking of something you’re grateful for or of being loved, for example – your survival brain will relax, your breathing will deepen, and your pulse will slow. Functional MRI (fMRI) images have shown that it is almost impossible to hold anxious thoughts and gratitude in your head at the same time; they originate in completely different parts of your brain. Another trick you can use to outwit the bad guys is to go meta with your thinking. When you find yourself spinning into anxiety, imagine floating above your body and seeing yourself suffering from those scary thoughts. Offer yourself compassion for what you’re experiencing, and your stress level is likely to drop. Get the Good Guys On Your Side Fortunately, your body also produces four “happy hormones” (dopamine, serotonin, oxytocin, and endorphins) that you can trigger by doing a bunch of enjoyable things. They include: Laughing – watch a funny sitcom or videos on YouTube, TikTok, Instagram; talk to a funny friend Listening to music that makes you want to sing along or dance Playing binaural beats through headphones – these are sounds designed to alter your brainwaves so that they are calming instead of frantic; you can find a sample here Meditating for as little as five minutes – imagine your thoughts as bubbles floating up and away from you. SBC actually has a whole library available with on-demand meditations. Spending time with a loving pet Spending time with a loving human Spending time in nature Getting enough restful sleep by establishing a calming bedtime routine, going to bed at the same time each night, turning off your phone, and darkening your room as much as possible Getting a massage Breathing relaxing fragrances like lavender or whatever scent you love Getting some exercise – even a short walk will help boost your mood and happy hormones Taking certain natural supplements – with your doctor’s permission, try tyrosine to increase dopamine, green tea extract to bump dopamine and serotonin, and tryptophan for more serotonin Taking prescription medications – if all else fails, talk to your doctor about medications to help you sleep or to relieve overwhelming anxiety and depression Join a Band of Other Heroines Being in a state of fear can make you feel like you’re alone in your struggle, but in fact, there are any number of communities you can join where the women will know exactly what you’re going through. There is a wonderful virtual community open to you through Surviving Breast Cancer (SBC), from the Thursday Night Thrivers Zoom group (with breakout sessions specifically for the MBC community), to a book club, Zumba classes, art therapy, and so much more. There are even special online activities just for us MBC’ers. To stay up to date on all that’s available, just read the weekly SBC newsletter or go to the website . There are a number of Facebook groups specifically for women with MBC as well as groups for those on different chemotherapies. Your oncologist’s office may also have information on in-person groups that could offer a local MBC community. ~ ~ ~ We don’t get to choose what happens to us, but we get to choose how we write ourselves into our stories. Why not choose to be the heroine who sees the truth, acknowledges the hard path ahead, and rises to travel it with grace and courage and a band of supportive women at her side? Wishing you all the strength in the world, and hope to see you in the SBC community. Kristen xo

Cryotherapy , or cold therapy, is any kind of treatment that uses near-freezing or freezing temperatures. It works by constricting blood vessels, which in turn can reduce blood flow to a particular area. While it may seem counterintuitive to want to reduce blood flow, by doing so to an area of the body with inflammation, it can help reduce associated swelling and discomfort. Cryotherapy can also help improve pain by reducing nerve activity. Cryotherapy can be especially helpful for issues such as neuropathy , where the peripheral nervous system (any neurons outside of the brain and spinal cord) is malfunctioning. Common symptoms include tingling or numbness, pain, sensation changes such as an increased or decreased ability to feel things, loss of coordination, or muscle weakness. While neuropathy is most common with diabetes, those with breast cancer are at risk, given that some chemotherapies or radiation treatments can cause nerve damage . Up to 30 or 40% of people undergoing chemotherapy develop neuropathy to some degree, so cryotherapy is a simple, effective way that many breast cancer patients and those in survivorship can help manage the potential symptoms, both during and after treatments. Concurrent administration of cryotherapy to hands and feet during specific chemotherapy treatments has been shown to help inhibit future neuropathy development by limiting the ability of the drug to attack sensitive nerves in the limbs. Specific chemotherapies that have been considered with cold therapy for breast cancer are taxanes such as paclitaxel (Taxol) or docetaxel (Taxotere), which are commonly given to those with metastatic breast cancer. The more you take certain chemotherapies, the higher your risk for peripheral neuropathy: increasing dosage, frequency of treatment, or using a combination therapy can put you at a greater risk of nerve damage. By using cold therapy at the time of treatment, you may be able to more effectively mitigate the onset of future neuropathy. Cold therapy is also something that you can use at home to help with neuropathy symptoms. Using cold therapy can look as simple as using an ice pack on an inflamed area or using an ice bath to help with generalized body pain. Or, if you want something stronger and have the resources for it, it’s also possible to get professional cryotherapy equipment for your home, including liquid nitrogen-chilled cryofans for specific body area treatments or whole-body cryosaunas. Cryotherapy is a newer therapy in cancer care, and because it can reduce blood flow, there are risks that need to be considered. It’s not recommended for people with other medical conditions, such as diabetes, where your ability to detect potential tissue damage is already reduced. If used for too long, cryotherapy can potentially result in skin burns or irritation, hypothermia, or the exacerbation of cardiovascular issues such as high blood pressure. It’s best to consult a healthcare provider if you’re unsure if cryotherapy is right for you. If you're interested in trying out cryotherapy for yourself, check out some of the many products that our partners at NatraCure have to offer:

By Eric Minghella with the Disability Benefits Center If you have been diagnosed with breast cancer and can no longer work, you can file a claim for Social Security Disability Insurance (SSDI). SSDI is funded by payroll taxes and offers monthly financial compensation to disabled individuals who, at one point, could work but are no longer able to work. As long as you have worked in the past and expect that you won’t be able to work for at least a year because of breast cancer, you may be able to qualify for SSDI benefits. Qualifying For Social Security Disability Benefits Many people assume that having cancer automatically qualifies them for disability benefits. Some cancer types do automatically make someone eligible for disability benefits in the U.S., but not all cancers qualify for this automatic designation. The medical conditions that qualify someone to be approved for disability benefits are all listed in the Social Security Administration’s Blue Book along with the requirements that you must meet to qualify for benefits because of that condition. You will have to submit medical evidence that you meet the requirements in the listings. To qualify for disability benefits because of breast cancer, your cancer must meet one of these conditions: An advanced breast cancer that has extended to the chest, skin, or internal mammary nodes. A carcinoma (cancer starts in the cells of the skin or tissue lining organs) that has spread above or below the collarbone, has spread to 10+ nearby nodes, or has spread to distant regions of the chest. A carcinoma that returns after anticancer therapy. Small-cell (oat cell) carcinoma. You will have to submit a biopsy, mammogram, MRI scans, or any other medical documentation of your cancer that you have to the SSA when you are sending in your application. When you are applying, the SSA will let you know what paperwork to include with your application. Medical Vocational Allowance What happens if your breast cancer is early stage or doesn’t meet the listing requirements above, but the treatment makes it impossible for you to work? Many individuals find themselves in this position. You may still be able to qualify for disability benefits with a Medical Vocational Allowance. To qualify in this regard, you need to have your doctor fill out a Residual Functional Capacity (RFC) evaluation. This is a sheet where your doctor can write in detail about your symptoms, your treatment, and why you can’t work. The SSA will look at the RFC form , your work history, your skill set, and other factors to determine if there is any kind of work that you can do with the limitations that you have. If they can’t find any jobs that you can do with the skills you have and the work limitations from breast cancer, then they may declare you eligible for disability benefits. Filing A Claim Don’t wait to file a claim for disability benefits. You can apply easily online . If you need help filing for disability , you can make an appointment to apply in person at an SSA office location. Make sure you have copies of all your medical documentation, and you can submit your claim packet for disability benefits online. ---- Resources: https://www.cdc.gov/cancer/breast/young_women/bringyourbrave/breast_cancer_young_women/index.htm https://www.ssa.gov/disability/professionals/bluebook/13.00-NeoplasticDiseases-Malignant-Adult.htm - 13_10 https://secure.ssa.gov/apps10/poms/images/SSA4/G-SSA-4734-U8-1.pdf https://www.disabilitybenefitscenter.org/how-to/how-to-file-the-residual-functional-capacity-rfc-form https://www.disabilitybenefitscenter.org/blog/help-apply-for-benefits https://secure.ssa.gov/iClaim/dib

By Kelly Hsu Exercise has numerous positive effects on physical and mental health. Many people are familiar with the relationship between exercise and diseases such as heart disease and diabetes. However, what is the relationship between exercise and breast cancer? Different exercise regimens may work for people at different points of their disease trajectory. A vast body of research has shown the beneficial effects of exercise for patients at all different points of their illnesses. Exercise During Treatment Can Improve Symptoms While chemotherapy can typically cause decreased cardiovascular fitness, a study showed that patients who completed a 12-week supervised exercise program during neoadjuvant chemotherapy had no change in cardiovascular fitness by the end of the program [ 1 ]. One study showed that mobilization stretching exercises improved chest flexibility for patients after breast surgery [ 2 ]. A study demonstrated that breast cancer survivors receiving adjuvant chemotherapy benefited from supervised heavy-load resistance exercise, with no increased risk of lymphedema [ 3 ]. A randomized trial of a resistance exercise intervention in patients starting adjuvant chemotherapy led to decreased physical fatigue and improved quality of life [ 4 ]. Exercise Can Have Beneficial Effects On Cancer Outcomes A study showed that patients who underwent a year-long diet and exercise intervention during neoadjuvant chemotherapy had improved pathological complete response (a prognostic factor associated with longer survival after treatment) than those who received usual care [ 5 ]. Research shows that aerobic and stretching exercises improved quality of life and also reduced depression severity for patients after completing treatment [ 6 ]. A review evaluating various studies looking at diet, exercise, and combined diet and exercise interventions found that fat loss was consistently associated with decreased risk of cancer recurrence [ 7 ]. Reviews across different studies have found that increased physical activity is associated with decreased incidence of breast cancer-related death [ 8 , 9 ]. For cancer survivors, the American Cancer Society recommends starting slowly and building up to “150-300 minutes of moderate intensity (or 75-150 minutes of vigorous intensity) activity each week [ 9 ].” Examples of moderate intensity exercises include but are not limited to brisk walking, tennis, gardening, dance, yoga, or pushing a lawn mower. Vigorous intensity exercises may include jogging, running, hiking, or shoveling. Getting into a regular exercise routine is hard, and even harder after a cancer diagnosis. All exercise plans should be tailored to the individual at their unique stage and recovery progress. If you are at the beginning of treatment, the key is to start gently and do what is appropriate for your body without overexerting yourself. Even light walks can go a long way in improving physical health and mood. Keep in mind that it is always important to consult your clinician prior to starting any new exercise programs. Exercise can be done alone, but evidence also shows that group exercise can have a tremendous impact on improving mental wellness in addition to physical wellness. If you are looking for a place to start or supplement your current exercise regimen, 2Unstoppable is a non-profit offering a multitude of oncology fitness resources, including the option to be connected to an in-person or virtual fitness partner. “It is well known that a fitness buddy or exercise community motivates us to get up and move … moreover, with a group or buddy, we are likely to exercise harder, more consistently, and for the longer term. The magic is that it is actually a reciprocal relationship. Motivation and accountability from others helps get us moving, but physical activity also opens us up to connect further with other women, helping us to find the emotional support women with breast cancer really need. In her book The Joy of Movement , Kelly McGonigal posits that ‘regular exercise may lower your threshold for feeling connected to others – allowing for more spontaneous feelings of closeness, companionship, and belonging.’ Further, ‘the link between physical activity and social connections offers a compelling reason to be active. It also serves as an important reminder that we humans need one another to thrive.’ 2Unstoppable leverages that important link to help more women improve their own outcomes. 2Unstoppable offers the unique combination of oncology exercise, coupled with social support, offered on the virtual platform, and designed specifically for women with cancer. 2Unstoppable offers education, oncology exercise classes, monthly challenges, resources, and a free online fitness buddy matching program – all to inspire and support women with a cancer diagnosis to get moving and improve their own outcomes.” - Michelle Stravitz, CEO & Co-Founder of 2Unstoppable Check out SBC’s upcoming events for free virtual movement programs! Learn More: The Benefits of Exercise The Healing Power of Movement I Know That I Am Not Alone In This Experience Exercise is Good for Everybody No Matter Your Weight, Shape, or Size, You Matter. References: Teplinsky, E., Podolski, A., Bessada, K., Rutledge, J., Burke, B., Christoudias, M., Klein, L., & Abbate, K. (December 2022). Breast Cancer Patients Undergoing Chemotherapy: Results from the STRENGTH Trial. Poster presented at the San Antonio Breast Cancer Symposium, San Antonio, TX. Wilson D. J. (2017). Exercise for the Patient after Breast Cancer Surgery. Seminars in oncology nursing , 33 (1), 98–105. Bloomquist, K., Adamsen, L., Hayes, S. C., Lillelund, C., Andersen, C., Christensen, K. B., Oturai, P., Ejlertsen, B., Tuxen, M. K., & Møller, T. (2019). Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphedema: a randomized trial. Acta oncologica (Stockholm, Sweden) , 58 (12), 1667–1675. Schmidt, M. E., Wiskemann, J., Armbrust, P., Schneeweiss, A., Ulrich, C. M., & Steindorf, K. (2015). Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: A randomized controlled trial. International journal of cancer , 137 (2), 471–480. Ferrucci, L., Sanft, T. B., Harrigan, M., Cartmel, B., Li, F., Zupa, M., McGowan, C., Puklin, L., Nguyen, T. H., Tanasijevic, A. M., Neuhouser, M. L., Hershman, D., Basen-Engquist, K., Jones, B., Knobf, T., Chagpar, A. B., Silber, A. L. M., Ligibel, J. A., & Irwin, M. L. (December 2022). Randomized trial of exercise and nutrition on pathological complete response among women with breast cancer receiving neoadjuvant chemotherapy: the Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer) Study. Poster presented at the San Antonio Breast Cancer Symposium, San Antonio, TX. Aydin, M., Kose, E., Odabas, I., Bindul, B. M., Demirci, D., & Aydin Z. (2021). The Effect of Exercise on Life Quality and Depression Levels of Breast Cancer Patients. Asian pacific journal of cancer prevention, 22(3) , 725-732. Dieli-Conwright, C.M., Lee, K. & Kiwata, J.L. Reducing the Risk of Breast Cancer Recurrence: an Evaluation of the Effects and Mechanisms of Diet and Exercise. Curr Breast Cancer Rep 8, 139–150 (2016). Lahart, I. M., Metsios, G. S., Nevill, A. M., & Carmichael, A. R. (2015). Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta oncologica (Stockholm, Sweden), 54(5), 635–654. Spei, M. E., Samoli, E., Bravi, F., La Vecchia, C., Bamia, C., & Benetou, V. (2019). Physical activity in breast cancer survivors: A systematic review and meta-analysis on overall and breast cancer survival. Breast (Edinburgh, Scotland), 44, 144–152. American Cancer Society. (2020 June 9). Physical Activity and the Person With Cancer. https://www.cancer.org/healthy/eat-healthy-get-active/acs-guidelines-nutrition-physical-activity-cancer-prevention/guidelines.html Author bio: Kelly Hsu I am a recent graduate of Wellesley College (Class of ‘21), where I studied neuroscience. I am currently working as a Clinical Research Coordinator at the Massachusetts General Hospital Cancer Center on several patient-centered outcomes research studies. Through my experiences, I have developed passions for health education, psychosocial oncology, and palliative care. I plan to attend medical school next fall, where I hope to keep pursuing these interests. SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Boston, MA — September 4, 2025  – SurvivingBreastCancer.org (SBC) is pleased to announce a new collaboration with Tonya Orchard, PhD, MS, RD, Professor of Human Nutrition, Director, Didactic Program in Dietetics, The Ohio State University, and Maryam Lustberg, MD, MPH, Director, Center for Breast Cancer; Chief, Breast Medical Oncology, Yale Cancer Center, on the Food for Thought  study. This innovative research explores the connection between nutrition and cognitive health in women undergoing treatment for triple-negative breast cancer (TNBC). The Food for Thought  study is a fully remote clinical trial designed to understand how personalized nutrition counseling may impact brain health during and after cancer treatment. Eligible participants—women ages 40–65 who have recently been diagnosed with stage II–III TNBC—will be randomly assigned to receive either a 12-week personalized nutrition intervention with a registered dietitian or a general healthy lifestyle program. Both groups will participate in virtual visits, receive support, and complete follow-up assessments over a nine-month period. “Cancer care is not just about treating the disease—it’s about supporting the whole person,” said Laura Carfang , Founder and Executive Director of SurvivingBreastCancer.org . “We know cancer can have lasting effects on cognitive ability, and nutrition is a powerful tool in protecting and improving brain health. This study aligns with our mission to provide holistic, patient-centered support that improves quality of life.” Participants will benefit from: Free nutrition counseling by a registered dietitian-nutritionist Free select foods during the intervention A Fitbit to support healthy lifestyle changes The convenience of a fully remote study (no travel required) SBC is proud to support this study as part of its ongoing commitment to addressing the long-term effects of breast cancer and survivorship. By investing in research at the intersection of nutrition, cognition, and cancer care, SBC continues to advance innovative approaches that empower patients and caregivers throughout the cancer journey. About SurvivingBreastCancer.org SurvivingBreastCancer.org is a national nonprofit dedicated to providing free, accessible, and supportive programs for individuals diagnosed with breast cancer and their families. Through educational resources, weekly support groups, expressive arts programs, and a library of on-demand podcasts and videos, SBC serves thousands of patients annually, helping them navigate treatment and survivorship with confidence, compassion, and community. Media Contact Name:  Laura Carfang Title:  Founder & Executive Director, SurvivingBreastCancer.org Email:   laura@survivingbreastcancer.org Website:   www.SurvivingBreastCancer.org

By Ashley Bell Read Ashley’s metastatic breast cancer story: My De Novo MBC Story: I’m Not Going to Give Up on My Diagnosis Ashley Bell at SABCS 2024 The San Antonio Breast Cancer Symposium (SABCS) is one of the largest breast cancer conferences in the world. 2024 marked the 47th year of the conference, which attracts academics, clinicians and researchers involved in breast cancer in medical, surgical, gynaecological and radiation oncology, as well as patient advocates and other health care professionals. I attended SABCS with SurvivingBreastCancer.org as a 2024 SBC Educational Scholarship recipient. The symposium reflects significant input from advocates who have left their impression on the event over the last half-century. What was started as solely a scientific conference focused on the distribution of information on the biology, cause, prevention, diagnosis, and therapy of breast cancer and premalignant breast disease has evolved to include input from the people who live with it. Patient advocacy has evolved from a handful of grassroots organizations to highly organized networks of knowledgeable, trained, passionate champions for advancement in the understanding and treatment of breast cancer . They have evolved around special interests based on cancer type, domestic situation, ethnicity, gender, location, etc. All share a common enemy — breast cancer. Thousands of advocates attend SABCS , both in person and virtually. They participate, learn, advocate, and educate, all to advance breast cancer care, therapies, and treatment for those who are paying the physical and emotional costs of living with this disease. Here’s a recap of my week: Tuesday: I attended a few networking events. One of them was put on by Lyndsay Levingston, founder of SurviveHER. I was also introduced to a new technology in breast cancer screening called Bexa. Breast exams with Bexa are an inexpensive form of early detection that can be brought into every community. The process is highly adopted by all women, and can be delivered from safe, accessible sites in the community like churches, or from small, simple sites in rural communities. Bexa has the ability to overcome the challenges that today leave women without an option, or without an option they will choose. Wednesday-Friday: I represented SBC at our booth in the patient pavilion of the exhibition hall. I introduced people to the organization, made some connections, and some lifelong friends. Ashley Bell, SBC Educational Scholarship recipient, with SBC Director of Programs & Events Elisa Herrera and SBC Early Stage Leadership Team volunteer Julie Cottrill at SABCS 2024 SBC was well represented throughout SABCS. I was glad to attend the symposium alongside another patient advocate through the SBC Educational Scholarship Program . Breast cancer is a complex group of diseases that occur in a complex world. SurvivingBreastCancer.org never shies away from asking critical questions about how issues of screening, treatment, and diagnosis impact people living with and at risk of the disease. SurvivingBreastCancer.org’s work is evidence-based and social justice-focused. SBC sees past the hype and calls for more effective, less toxic treatments that truly make a difference in the lives of people who need them. The organization strives to reveal the ways in which inequities, barriers to healthcare, and environmental exposures produced by larger systems drive the breast cancer crisis AND disparities in diagnosis, treatment, and mortality. SurvivingBreastCancer.org representation at SABCS 2024 Read More: My De Novo MBC Story: I’m Not Going to Give Up on My Diagnosis Understanding Advanced Treatment Options for Metastatic Breast Cancer Questions to Ask Your Doctor After a Breast Cancer Diagnosis Addressing the Unique Challenges of Breast Cancer in People Under 40 On the Podcast: Breast Cancer Conversations Patient Advocate Tips for Attending SABCS Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

What is Immunotherapy? Immunotherapy is a type of cancer treatment that seeks to harness the power of the body’s immune system to fight cancer. It works by stimulating or “training” the body’s own natural defense system to recognize and attack cancer cells, essentially giving it the ability to seek out and eliminate tumor cells on its own. Immunotherapy has recently been used in the treatment of metastatic breast cancer (MBC). Examples of breast cancer immunotherapy include monoclonal antibodies, checkpoint inhibitors, cytokine therapy, and adoptive cell therapies. Monoclonal Antibodie s Monoclonal antibodies are proteins produced in the laboratory that are designed to recognize specific targets on or within cancer cells. They then attach to these targets and either mark the cancer cells for destruction by other parts of the immune system or directly block signals used by the cancer cells to survive and grow. Checkpoint Inhibitors Checkpoint inhibitors are drugs that target proteins on T-cells (a type of white blood cell), which prevent them from recognizing and attacking cancer cells. By blocking these proteins, checkpoint inhibitors can help enhance an immune response against breast cancer. Cytokine Therapy Cytokine therapy is a type of treatment that uses naturally occurring substances in the body called cytokines. Cytokines can be injected into the body to help stimulate an immune response against breast cancer cells and promote tumor regression. Adoptive Cell Therapies Adoptive cell therapies involve taking T-cells from a patient, modifying them in the laboratory to make them recognize and attach to cancer cells, then infusing them back into the patient. Adoptive cell therapies can help boost an immune response against breast cancer cells and may be useful for treating metastatic disease. Immunotherapy has emerged as a promising treatment option for many types of cancer, including metastatic breast cancer. However, not all patients respond to immunotherapy, and it can be difficult to monitor the response in those who do receive treatment. How Do You Know If Your Immunotherapy Treatment is Working? One way to monitor response to immunotherapy in metastatic breast cancer is through imaging studies such as computed tomography (CT) scans or magnetic resonance imaging (MRI). These imaging studies can provide information on tumor size and whether the tumor is shrinking, stable, or growing. However, changes in tumor size may not always be a reliable indicator of response to immunotherapy, as some patients may experience immune-related adverse events that can cause inflammation and swelling around the tumor, leading to an increase in tumor size even if the tumor is responding to treatment. Another way to monitor response to immunotherapy is through biomarker analysis. Biomarkers are molecular or genetic signatures that can be measured in blood or tissue samples. In the context of immunotherapy, biomarkers such as tumor mutational burden (TMB), programmed death-ligand 1 (PD-L1) expression, and immune cell infiltration can be used to predict response to immunotherapy and monitor response over time. TMB is a measure of the number of mutations present in a tumor, and tumors with high TMB are more likely to respond to immunotherapy. PD-L1 expression is a marker of immune evasion, and tumors that express high levels of PD-L1 may be more responsive to immunotherapy. Immune cell infiltration, as measured by the density of T cells or other immune cells within the tumor, can also be used to predict response to immunotherapy. In addition to imaging and biomarker analysis, clinical assessment of symptoms and quality of life can also be used to monitor response to immunotherapy in metastatic breast cancer patients. Patients who are responding to immunotherapy may experience improvements in symptoms such as pain, fatigue, and difficulty breathing, as well as improvements in overall quality of life . Overall, monitoring response to immunotherapy in the metastatic breast cancer setting requires a multifaceted approach that incorporates imaging studies, biomarker analysis, and clinical assessment of symptoms and quality of life. By using a combination of these methods, clinicians can more accurately assess response to treatment and tailor treatment strategies to individual patients. What is Signatera? Recently, a new technology called Signatera has been developed to look for circulating tumor DNA (ctDNA) in the blood of breast cancer patients. CtDNA is a form of genetic material that is shed from cancer cells into the bloodstream and can be used to monitor response to immunotherapy. Signatera uses next-generation sequencing technology to look for mutations in ctDNA that are unique to that patient’s tumor. This technology can be used to detect the presence of ctDNA and track changes in ctDNA over time, which can provide valuable information on response to immunotherapy. Signatera is an exciting new tool that has the potential to revolutionize the way we monitor response to immunotherapy in breast cancer patients. By providing a more accurate assessment of patient response, Signatera could improve clinical outcomes and lead to better treatment decisions for breast cancer patients receiving immunotherapy. How Does Signatera Work? Signatera is a molecular test that uses ctDNA to monitor response to cancer therapy and detect residual disease in MBC patients undergoing immunotherapy. This technology allows for real-time tracking of the tumor’s genetic signature, allowing clinicians to make decisions about treatment more quickly and accurately than ever before. Signatera can also be used to measure minimal residual disease (MRD), which can predict recurrence or metastasis in MBC patients receiving immunotherapy. By monitoring ctDNA levels, Signatera has the potential to increase accuracy in treatment evaluation, improve patient outcomes, and reduce healthcare costs associated with ineffective treatments. Conclusion Overall, breast cancer immunotherapy offers an exciting new approach to treating this disease, and there are many different treatments available. We also understand that the uncertainty of a breast cancer diagnosis and the anxiety of wanting to know if your treatment plan is working is real. Talk to your healthcare provider about which options might be right for you. Learn more about Signatera You Might Also Like: Addressing Breast Cancer Recurrence in High-Risk Patients Breast Cancer Recurrence: Second Primary versus Metastasis Reducing the Risk of Breast Cancer Recurrence Navigating Cancer Treatment: Top Tips from an Oncology Pharmacist Unlocking the Power of Emotional Intelligence SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

After the numbing tidal wave of emotion following a breast cancer diagnosi s —the fear, anxiety, shock, anger, and disbelief—it’s hard to comprehend the enormity of what lies ahead. It may take time to adjust to your new reality as someone with breast cancer. Despite the overwhelming emotions, you must navigate the labyrinth of treatment options. It’s a lot to grasp, requiring careful consideration, and probably includes a crash course about the pros and cons of treatment and possible breast reconstruction surgery. Once diagnosed, many women undergo a mastectomy or lumpectomy to remove the affected breast tissue. Following this, they often face a decision about whether to have breast reconstruction surgery . While reconstruction can help restore the breast’s appearance, there are advantages and disadvantages to consider when deciding if it is right for you. The choice to have breast reconstruction surgery is highly personal ; however, understanding the pros and cons can help you make an informed decision. The Basics of Breast Reconstruction Surgery Breast reconstruction surgery is a procedure often performed to restore the shape, size, and appearance of a person’s breast after a mastectomy or lumpectomy . The surgery can be performed at the same time as the mastectomy (immediate reconstruction) or a later date (delayed reconstruction). In some cases, doctors recommend waiting if follow-up treatments like radiation are needed, as they may damage reconstruction results. The two main types are implant reconstruction , which uses silicone or saline breast implants, and autologous, or “flap” reconstruction , which uses tissue from another part of the patient’s body. The American Cancer Society provides an excellent, detailed guide on the basics of these procedures. Pro: Restoration of Body Image and Self-Esteem One of the most significant benefits of breast reconstruction is the potential to restore body image and self-esteem after breast cancer. Many women report feeling more confident and comfortable with their bodies post-reconstruction . Breast reconstruction aims to achieve symmetry between the two breasts, which can be especially helpful for those with a unilateral (one-sided) mastectomy. Con: Potential Complications and Risks Like any surgery, breast reconstruction has potential risks and complications . These can include infection, bleeding, pain, and complications relating to anesthesia. Additionally, there can be complications specific to the type of reconstruction, like an implant rupture or flap failure . Pro: Choice and Control Breast reconstruction offers women a degree of choice and control over their bodies post-cancer. It allows them to choose how they wish to appear after a mastectomy or lumpectomy, providing a sense of agency when many aspects of life may feel out of control. Con: Additional Surgeries and Recovery Time Breast reconstruction often requires multiple surgeries, particularly in the case of flap reconstruction. It can mean more time in the hospital , more recovery time, and more time away from work or other responsibilities. Pro: Improved Clothing Fit Many women report that clothes fit better after breast reconstruction. It can make shopping and dressing more enjoyable and less stressful, aiding recovery and improving quality of life . Con: May Delay Return to Normal Activities The recovery period following breast reconstruction surgery can be lengthy, potentially delaying your return to normal activities, work, or exercise . Each person’s recovery timeline will be different, and it’s crucial to consider personal circumstances when thinking about this surgery. Pro: Eliminate the Need for External Prostheses Some people choose between using a prosthesis or breast reconstruction surgery. Women who choose reconstruction surgery won’t need to use and maintain external prostheses. Surgery can be convenient for those who are active or find prostheses uncomfortable. Making an Informed Decision Deciding on reconstructive breast surgery is a personal choice that depends on each individual’s unique situation . Consulting with your cancer treatment team and plastic surgeon can help you weigh your specific pros and cons. While reconstruction has benefits, it also carries risks that need careful consideration. Count On Us for Information, Resources, and Support Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, etc., and podcasts that feature professionals, advocates, and caregivers who share valuable information. Your donations enable SurvivingBreastCancer.org to offer resources and support every day, every month, and every year. Note: This article is designed to provide general information and is not meant to replace professional medical advice. Always discuss your options with your healthcare provider. Learn more: Newly Diagnosed. Now What? Surgery Options The Choice to Go Flat DIEP Flap Results On the Podcast: Breast Cancer Conversations The Importance of Physical Therapy in Breast Cancer Recovery with Expert Derly Munoz DIEP Flap Reconstruction: What you need to know about Changes in Insurance Codes Mastectomy Recovery Tips: What I wish I had known SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Stacey Devine, MD Many women gain weight or experience an increase in body fat percentage after a breast cancer diagnosis. These metabolic changes increase the risk of recurrence and other complications like diabetes and heart disease. Understanding why this happens can help you make lifestyle changes to support your health. Continue reading to learn about various factors that can contribute to weight gain during and after breast cancer treatment, and what you can do to address them. How Does Breast Cancer Treatment Cause Weight Gain? Breast cancer treatments themselves may contribute to weight gain and changes in body composition. Women who receive chemotherapy have an increased risk of weight gain and metabolic dysfunction. Studies on weight gain from hormone-blocking medications like tamoxifen and aromatase inhibitors are mixed. However, a recent study found that women who have more side effects from these medications are at an increased risk of weight gain. Joint pain from aromatase inhibitors can make exercise more difficult. Many cancer treatments are believed to negatively impact the gut microbiome, which can also increase weight gain. How Treatment Side Effects Can Impact Your Weight Side effects during treatment can impact weight gain and metabolic changes, and therefore need to be addressed more fully. Fatigue makes participating in physical activities more challenging. Sleep-disrupting hot flashes and insomnia are common in breast cancer survivors. Poor sleep can impact hormones like leptin and ghrelin , which impact food cravings and hunger cues. Sleep issues and chronic stress from a cancer diagnosis can also increase cortisol levels . Cortisol can increase insulin, decrease metabolism, and increase the storage of visceral fat in the belly. What Can You Do About These Changes? Breast cancer survivors need to understand the risk of these metabolic changes for their health. They also need support to adopt a proactive approach and maintain their overall well-being. Below are a few practical tips to help you manage weight gain and a healthier lifestyle throughout survivorship. Engage in Regular Physical Activity Even if you are in active treatment, try to move your body daily. You may need to lower your intensity or do shorter sessions, but even some movement is beneficial. Patients who exercise regularly typically tolerate their treatments better. Stay Hydrated Drink plenty of water throughout the day. Our bodies can confuse thirst with hunger, and staying well hydrated can reduce cravings and support your metabolism. Avoid sugary drinks, as these can easily add hundreds of calories a day to your diet and have no nutritional value. Incorporate Balanced Meals Include a mix of protein, healthy fats, whole grains, and an abundance of vegetables and fruits. Try to get the majority of your diet from whole food sources to make sure you are getting plenty of essential nutrients. Prioritize Quality Sleep Set yourself up for success with a relaxing bedtime routine to promote better sleep habits. Keep your bedroom dark, cool, and quiet to facilitate deep sleep. Manage Stress Techniques like meditation , breathing exercises , journaling , and spending time in nature can all help reduce stress and stress hormones. If side effects from your treatments are not relieved by lifestyle measures and are negatively impacting your quality of life, consider an integrative oncology consultation. Integrative oncology providers are trained to help patients with cancer reduce side effects from their treatments and improve their quality of life. Many of the factors contributing to weight gain may be outside of your control. However, you have the power to take control of your well-being and make positive changes to support your health journey. By focusing on what you can control and your lifestyle choices, you can build a strong foundation for a healthier life after breast cancer treatment. Learn more: Exercise and Breast Cancer Reducing the Risk of Recurrence No Matter Your Weight, Shape, or Size, You Matter. On the Podcast: Breast Cancer Conversations Diet, Exercise, and a Breast Cancer Vaccine, Oh My! With Judith Fitzgerald Metabolic Health and Breast Cancer Brings Clinical Trials for TNBC and MBC Patients What You Need To Know About Your Metabolic Health and Breast Cancer SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events Submit Your Writing: SBC Blog Submissions

By Kiara Ford The MBC ribbon is green, pink, and teal. Most people, even those who have never experienced cancer, are familiar with the concept of stages used to classify the extent of the disease. It is through this awareness that much of the public has come to hold a deep fear of the highest classification, stage IV. This stage of breast cancer is also known as metastatic breast cancer, or MBC. Stage IV breast cancer has no cure. Because metastatic breast cancer is a life-threatening terminal diagnosis, it often carries associations that can make it difficult or uncomfortable to discuss. Nevertheless, it is estimated that over 168,000 people in the United States alone are living with metastatic breast cancer . Those living with MBC must be included in conversations about breast cancer, including treatments, quality of life, and clinical trials. The unique experience of advanced breast cancer must be understood within the community. While October is recognized as Breast Cancer Awareness Month (BCAM) and October 13 has been designated Metastatic Breast Cancer Awareness Day , there is more we can do to foster a greater comprehension of stage IV breast cancer. People living with this terminal diagnosis need to be heard and seen. Metastatic breast cancer needs to have a seat and a voice at the table. Continue reading to learn more about what metastatic breast cancer is and how it is diagnosed and treated. What is Metastatic Breast Cancer? Metastatic breast cancer is the term used to describe when cancer that was originally located in the breast spreads, or metastasizes, to other distant parts of the body. Cancer cells can spread in many different (sometimes concurrent) ways, such as traveling through the body via lymph nodes or the circulatory system, invading healthy cells or capillaries, and forming tumors in new locations in the body. Metastatic breast cancer is most often found in the bones, lungs, liver, and brain . Symptoms of metastatic breast cancer can vary based on where the disease has metastasized. What are the Symptoms of Metastatic Breast Cancer? General symptoms of metastatic breast cancer can include loss of energy or appetite, in addition to more specific symptoms varying based on where the cancer has spread. People with metastasis to the bones may experience swelling, bone pain, and be more susceptible to fractures. Metastasis to the liver may cause jaundice, rash or skin irritation, abdominal pain, vomiting or nausea, and high liver enzyme counts in the blood. Metastasis to the lung can cause chronic cough, difficulty breathing, chest pain, and abnormal chest X-ray images. Metastasis to the brain can cause vomiting or nausea, behavioral changes, seizures, persistent and worsening headaches, and difficulty with vision, speech, and memory. It is important to notify a doctor as soon as these symptoms emerge, particularly if you have already been diagnosed with breast cancer or have a family history of breast cancer. While these are general symptoms, it is important to know that symptoms do not always present. Therefore, it is important to stay up-to-date with your mammograms, breast screenings, doctors’ appointments, and follow-ups. How is Metastatic Breast Cancer Diagnosed? The diagnosis process for metastatic breast cancer often resembles that of other cancer types. It begins with a conversation with a doctor to analyze family history and current symptoms. This is followed by tests , the nature of which vary based on the symptoms experienced. Doctors may recommend genetic testing, imaging, blood tests, or biopsies. Those diagnosed with metastatic breast cancer have often already been diagnosed and treated for breast cancer in the past, and are experiencing recurrence. Only about 6-10% of people receive metastatic breast cancer as their initial diagnosis, referred to as de novo metastatic breast cancer . How is Metastatic Breast Cancer Treated? Treatment of metastatic breast cancer will vary based on the individual patient. Factors such as where the cancer has metastasized, genetic predisposition , biomarkers discovered through biopsy, and personal goals will shape individual treatment plans. If the cancer is recurrent, doctors will also factor in previous treatments when deciding on the best course of action. Typically, surgery and radiation therapy are more difficult in cases where the cancer is widespread, but they may be useful in some circumstances, particularly in managing symptoms caused by the cancer. Most often, treatment for hormone-positive metastatic breast cancer consists of hormonal therapies and chemotherapy to shrink or slow the growth of cancer cells. Treatment will also aim to manage the symptoms caused by the cancer, in order to focus on not just quantity, but quality of life. Clinical trials aim to develop new treatments for metastatic breast cancer, and can provide additional treatment options for those living with MBC. Learn more in the Clinical Trials section of our website and on the Breast Cancer Conversations podcast. There is currently no cure for metastatic breast cancer. Ongoing MBC research is dedicated to understanding causes and risk factors, creating new treatment options, and improving the comfort of those living with metastatic breast cancer. SurvivingBreastCancer.org offers meetups and programs tailored specifically for those living with metastatic breast cancer. Join us at Thursday Night Thrivers or an upcoming installment of our MBC Webinar Series ! MBC Resources: Join Our Thursday Night MBC Meetup Newly Diagnosed with MBC Living With MBC MBC Stories: Chapter Three of My Breast Cancer Journey My De Novo MBC Story: I’m Not Going to Give Up on My Diagnosis HOPE is my Favorite Four-Letter Word On the Podcast: Breast Cancer Conversations Finding Strength and Joy in Parenting with Metastatic Breast Cancer A bout the Author: Kiara Ford is a recent graduate of Emerson College, where she majored in communication studies and minored in health and society. She is currently a community health worker trainee with the non-profit organization Asian Women for Health. She is passionate about patient advocacy and health equity, and hopes to raise awareness and increase understanding of patients’ rights through her work. From the Same Author: Breast Cancer and Healthcare Access Within the Hispanic Community Inflammatory Breast Cancer: Breaking Down the Basics

Breast cancer is a global concern, touching the lives of countless women. What if we could better understand its roots, specifically the role of our hormones ? Continue reading as we unravel the intimate dance between hormones and breast cancer. We’ll review what hormones are commonly associated with breast cancer and differentiate between types of breast cancer  and treatment based on hormone status. What Are Hormones? Hormones are chemical messengers produced by the endocrine glands in our body. They travel through the bloodstream to tissues and organs, influencing many bodily processes, including growth, metabolism, and reproductive functions. Among the many hormones, estrogen, progesterone, and testosterone are particularly relevant when it comes to breast cancer. Hormonal Influence on Breast Cancer According to the National Cancer Institute , breast cancer’s growth can sometimes be fueled by the body’s natural female hormones, particularly estrogen and progesterone. These cancer cells possess receptors on their surface that can bind to hormones circulating in the body. As a result, hormone receptors—proteins that pick up hormone signals—are routinely tested during a breast cancer diagnosis . Understanding the hormone sensitivity of your breast cancer assists your doctor in determining the most effective treatment strategy or in preventing recurrence. Hormone Receptor-Positive Breast Cancer When breast cancer cells have receptors for estrogen and progesterone, they are termed ER-positive or PR-positive, respectively. They rely on these hormones to grow. Hormone Receptor-Negative Breast Cancer If breast cancer cells lack these receptors, termed ER-negative or PR-negative, they don’t rely on hormones for growth and usually require different treatment approaches. Estrogen and Breast Cancer Estrogen is an important hormone involved in the normal development of breast tissue. It promotes cell growth and division in the breasts and other areas of the body. However, prolonged exposure to high estrogen levels  over time increases the risk of developing breast cancer . Several factors can lead to excessive cumulative estrogen exposure: Early onset of menstruation (before age 12) Late onset of menopause (after age 55) Obesity Hormone replacement therapy Alcohol consumption Approximately  60% to 70% of all breast cancers are estrogen receptor (ER)-positive, meaning the cancer cells have estrogen receptors and depend on estrogen for growth. For those with ER-positive breast cancer, standard treatment involves blocking estrogen’s effects or reducing estrogen levels.  Progesterone and Breast Cancer Progesterone is another hormone that controls breast development and growth. Excessive exposure to progesterone over time may also contribute to breast cancer risk . Research shows that progesterone receptors (PR) are present in about 60% of breast cancers. Of the different hormone receptor statuses, breast cancer that is both ER-positive and PR-positive tends to have a more favorable prognosis and more successful treatment outcomes. However, some breast cancers are ER-positive and PR-negative. These cancers tend to be more aggressive and have lower survival rates than ER/PR double-positive breast cancers. ER/PR Negative, Triple-Negative, and Triple-Positive Breast Cancer Hormone receptor-negative breast cancer cells lack receptors for estrogen (ER) and progesterone (PR), meaning these cancer cells do not increase in response to hormonal influences. Approximately 25-30% of all breast cancer cases are represented by this type of breast cancer . In triple-positive breast cancer , the proliferation of tumor cells is primarily influenced by the presence of estrogen receptors, progesterone receptors, and the human epidermal growth factor receptor 2 (HER2), a protein commonly found in breast cells. Triple-negative breast cancer (TNBC) cells are characterized by the absence of estrogen and progesterone receptors and do not overexpress the HER2 protein. This type of cancer is more prevalent in women under 40 years old, particularly among Black women or those with a mutation in the BRCA1 gene. Testosterone, Androgens, and Breast Cancer Both men and women produce testosterone and other androgens. In men, androgens are responsible for male sex characteristics. However, higher levels of circulating androgens originating from the adrenal glands are linked to increased breast cancer risk in postmenopausal women. Testosterone and other androgens may directly stimulate breast cell growth or be converted in fat tissue to estrogen, which can then spur cancer development and progression. Obesity is a risk factor for breast cancer and is associated with higher androgen levels. While much more research is still needed, targeting androgen activity is an emerging area of interest for specific breast cancer treatments. Hormone Therapy and Breast Cancer Treatment Hormone therapies, like tamoxifen and aromatase inhibitors , are designed to block the effects of hormones or reduce their levels in the body. They are especially beneficial for hormone receptor-positive breast cancers, and the following hormone therapies serve estrogen-related purposes: Tamoxifen: Blocks estrogen’s effect on breast cancer cells Aromatase Inhibitors:  Lower the amount of estrogen produced in postmenopausal women Ovarian Suppression:  Premenopausal women might receive treatments to stop the ovaries from producing estrogen Although they are considered effective, hormone therapies can have side effects. Discuss potential risks and benefits with your healthcare professional. Count On Us for Information, Resources, and Support  Estrogen, progesterone, testosterone, and other hormones play significant and complex roles in the origins and behavior of breast cancer. Understanding these relationships has led to improved risk assessment, screening, prevention, and treatment approaches that consider hormone receptor status and other factors. Continued research on hormone-related mechanisms will help further advance breast cancer care and outcomes. Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, etc., and podcasts  that feature professionals, advocates, and caregivers who share valuable information. Your donations  enable SurvivingBreastCancer.org to offer resources and support every day, every month, and every year.  Note: This article is designed to provide general information and not replace professional medical advice. Always discuss your options with your healthcare provider. Learn more: Excess Estrogen, Gene Testing, and Beyond The Promise of the Triple Negative Breast Cancer Vaccine Newly Diagnosed Different Types of Breast Cancer Understanding Your Pathology Report On the Podcast: Breast Cancer Conversations Triple Positive Breast Cancer Under 30 SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

In this article, we debunk common myths and provide factual insights into the use of herbal remedies and supplements in breast cancer. We emphasize the importance of informed decisions and consultation with healthcare providers when considering complementary therapies in the breast cancer journey. Navigating breast cancer treatment often leads individuals to explore various complementary therapies, including herbal remedies and supplements. While these options may promise benefits, understanding the myths and facts surrounding their efficacy and safety is crucial for individuals seeking complementary support. Myth #1 : Herbal Remedies Alone Can Cure Breast Cancer While early-stage breast cancer is treatable, if not curable, there is no known cure for metastatic breast cancer (also known as Stage IV breast cancer). Herbal remedies and supplements are not standalone treatments for breast cancer. They are complementary and should not replace conventional medical treatments such as surgery, chemotherapy, or radiation therapy. There is insufficient scientific evidence to support claims that herbs or supplements cure cancer. You should always speak with your medical team about any herbal supplements you are considering, as some supplements may interfere with your current treatments.  Myth #2: All Herbal Remedies are Safe Not all herbal remedies and supplements are safe, and some may interfere with cancer treatments or pose risks. For instance, consider some of the following possible herbal interactions: St. John's Wort: Can interfere with chemotherapy drugs and reduce their effectiveness Soy Supplements: Contain phytoestrogens that may affect hormone-sensitive breast cancer treatments Green Tea Extract: May interfere with certain medications or exacerbate side effects Myth #3 : "Natural" Means Safe Natural does not always equate to safe. In fact, several products have started utilizing the term “natural” in their branding and marketing, as consumers equate “natural” with health. Herbal remedies and supplements can have potent active ingredients that may interact with medications or cause adverse effects. Don’t be fooled by labels! Always consult with healthcare providers before incorporating new remedies into your treatment plan. Myth #4: All Herbal Products are Regulated and Standardized Herbal supplements are not rigorously regulated like prescription medications. They may vary in quality, purity, and potency, making it challenging to ensure consistency or safety across different brands or products. Ask your healthcare provider about the efficacy of incorporating specific herbal supplements into your breast cancer treatment. Myth #5: Herbal Remedies Have No Side Effects Herbal remedies and supplements can have side effects or interactions with medications. For example, consider the following negative interactions between supplements and cancer treatment: Echinacea: May cause allergic reactions or interact with immunosuppressant medications Garlic Supplements: Can thin the blood and increase the risk of bleeding, particularly during surgery In some cases, herbal remedies and supplements have been linked to liver damage, kidney problems, or other adverse effects. Inform healthcare providers about any supplements you're taking to avoid potential complications. Conclusion: Make Informed Choices While herbal remedies and supplements may offer potential benefits, it's crucial to approach them cautiously. Consult with healthcare providers before incorporating any supplements into your breast cancer treatment plan. Emphasize open communication to ensure the safe integration of complementary therapies alongside conventional treatments.