Join our expressive writing workshops designed for breast cancer patients and survivors. Reduce stress, process emotions, and find healing through the power of writing. RSVP for our upcoming virtual and in-person sessions. Expressive Writing for Breast Cancer Support & Healing Discover the power of words. Learn More What is Expressive Writing Expressive writing is a proven technique that helps people process emotions, reduce stress, and promote healing. At SurvivingBreastCancer.org, we offer expressive writing sessions tailored specifically for those navigating a breast cancer diagnosis, treatment, or survivorship. Why Expressive Writing Works Reduce anxiety and depression through storytelling Process complex emotions around diagnosis and survivorship Connect with others in a safe, supportive environment Improve overall emotional well-being and clarity Multiple Dates Expressive Writing with Thomas Dooley Mon, Jun 08 Online Event Sign Up RSVP Multiple Dates Reflective Writing for Metastatic Breast Cancer Fri, Jun 12 Online Event Sign Up RSVP "Expressive writing has been my outlet during treatment. I’ve never felt so seen and supported." Multiple Dates Expressive Writing with Thomas Dooley Mon, Jun 08 Online Event RSVP Multiple Dates Reflective Writing for Metastatic Breast Cancer Fri, Jun 12 Online Event RSVP Backed by Research Expressive writing isn't just therapeutic—it’s backed by science. For decades, researchers have studied the emotional and physical health benefits of expressive writing, particularly for people coping with chronic illness and trauma. For those impacted by breast cancer, the act of writing can be a profound tool for reflection, resilience, and renewal. Improves Emotional Well-being: According to Dr. James Pennebaker, a pioneer in expressive writing research, writing about emotional experiences can lead to significant improvements in mental health, including reduced stress, anxiety, and depression [1]. Supports Immune Function: A landmark study showed that expressive writing may even improve immune system functioning and decrease the number of visits to the doctor [2]. Helps Process Trauma and Grief: A meta-analysis published in the journal Health Psychology found that expressive writing can be particularly helpful in reducing symptoms of PTSD and supporting emotional recovery after trauma, including illness-related trauma. Enhances Meaning-Making: Writing helps individuals make sense of their experiences, identify patterns, and find meaning—even during difficult health journeys. This sense of meaning has been linked to improved psychological resilience in cancer patients [4] as well as allowing individual to process complex emotions associated with one's diagnosis [5]. Multiple Dates Expressive Writing with Thomas Dooley Mon, Jun 08 Online Event RSVP Multiple Dates Reflective Writing for Metastatic Breast Cancer Fri, Jun 12 Online Event RSVP Read the Incredible Poems Coming Out Of Our SBC POETRY LAB Looking for more ways to support your well-being? View Programs References: [1]. Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95(3), 274–281. [2]. Pennebaker, J.W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162–166. [3]. Frisina, P. G., Borod, J. C., & Lepore, S. J. (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. Health Psychology, 23(6), 763–771. [4]. Stanton, A. L., et al. (2002). Randomized, controlled trial of written emotional expression and benefit finding in reast cancer patients. Journal of Clinical Oncology, 20(20), 4160–4168. [5]. Patient Education and Counseling. (2022). Using expressive writing to improve cancer caregiver and patient outcomes: A systematic review.

Meditation for Breast Cancer (On Demand) Visit our official YouTube meditation playlist! Live Classes: Multiple Dates Meditation Reflection The 8 Steps of Buddhism - A Path to Healing May 25, 2026, 10:00 AM – 11:00 AM EDT Online Event Each month, join us for a guided meditation exploring one of the Eightfold Path principles. Together, we’ll cultivate mindfulness, compassion, and resilience, one step at a time. Free and open to all. RSVP On Demand: Multiple Dates Meditation Reflection The 8 Steps of Buddhism - A Path to Healing Mon, May 25 Online Event More info RSVP Multiple Dates Reiki Circle of Care Mon, May 25 Online Event More info RSVP Multiple Dates SBC Well-Being Book Club: Finding Peace on the Buddha’s Eightfold Path Tue, May 26 Online Event More info RSVP Multiple Dates SBC Well-Being Club: Finding Peace on the Buddha’s Eightfold Path Tue, Jun 02 Online Event More info RSVP Multiple Dates Meditation Tuesday for Self-Care Tue, Jun 02 Online Event More info RSVP Multiple Dates Guided Hypnosis for Breast Cancer Thrivers & Caregivers Wed, Jun 03 Online Event More info RSVP Multiple Dates Forest Bathing: Mindful Nature Connection & Healing Wed, Jun 17 Virtual Event More info RSVP Multiple Dates Meditation Reflection The 8 Steps of Buddhism - A Path to Healing Mon, Oct 19 Online Event More info RSVP Looking for more ways to support your healing journey? View Programs REIKI Reiki is a gentle energy healing technique that reduces stress, eases pain, and supports emotional well-being—perfect for those on a healing journey. Watch Now Experience Healing Anytime 💫 We invite you to explore our prerecorded Reiki sessions—designed to promote relaxation, reduce stress, and support your healing journey. Whether you're managing breast cancer or simply need a moment of peace, these gentle energy practices are here for you, anytime, anywhere.

Looking for a distraction from treatment? Join our Breast Cancer Book Club for great reads and greater support from other breast cancer patients and survivors. Breast Cancer Book Club Where we read books that have nothing to do with cancer! What we are reading this month: Piranesi by Susanna Clarke The Breast Cancer Book Club™ is a monthly virtual book club for breast cancer patients and survivors. Unlike the traditional support group, where breast cancer is the usual topic of discussion, this book club is designed to take our minds OFF of cancer, while still providing opportunities for support and connection! When do we meet? The Book Club meets the first Sunday of every month at 11 am ET. You are welcome to join each month or pick and choose your month based on your availability and the book we are reading. How do I know what book to read? During our Sunday virtual Book Club, we will announce the next book the group will be reading. Once announced, the information will be published on our website. You can purchase the book and join the discussion the following month. If you want to plan ahead you can access the list of upcoming books. Membership Membership is free! Those who join the Breast Cancer Book Club™ are encouraged to follow our Instagram Account as well as get involved in the weekly discussions through our private online group. How do I sign up ? It's easy! Each month, we will have that month's book club published on our Event's Page . Just RSVP and you will receive the zoom link to attend the meeting. Join Us the First Sunday of Each Month 11:00 a.m. Eastern Multiple Dates Breast Cancer Book Club – A Monthly Escape Into Stories, Connection, and Joy Sun, Jun 07 Zoom Meetings +3 more RSVP Looking Ahead At each gathering, we reveal the next book selection for the upcoming month to create a sense of surprise and anticipation. However, we also understand that reserving books from the library on short notice can be challenging. If you’d like to plan ahead, you can view the list of upcoming book selections below. Explore Looking Back Curious about the books we've read before? You can check out our list of past books below! Explore Support Our Book Club! Your donation enables us to provide books to those diagnosed with breast cancer at no cost to the patient. We firmly believe in access to services and resources and breaking down those financial barriers. thank you for your support. DONATE TO THE BOOK CLUB Frequently Asked Questions: Join the Breast Cancer Book Club Community~ Membership FREE Come Join Us The First Sunday of Every Month at 11 AM ET

After a breast cancer diagnosis, diet and nutrition play crucial roles during and after treatment. Discover the best dietary habits for breast cancer patients. Food as medicine Eat Right, Feel Amazing Health and nutrition is such an important part of the fitness equation. The right compliments of foods allow you to achieve optimal performance and feel your best! "Let food be thy medicine and medicine be thy food" Lifestyle & Wellness Resources Programs Content Library Podcast Download the App Subscribe to the Newsletter Make a Gift More Breast Cancer Diet & Nutrition Guide A Partial Guideline for Nutrition and Exercise For Breast Cancer Patients, Survivors, & Thrivers A healthy diet is only one of several factors that can affect the immune system; exercise and stress management are equally as important in improving one’s overall health and well-being. Following the initial diagnosis of breast cancer, most women tend to re-think their nutrition and health practices. It’s only natural to question what caused this cancer to occur and what lifestyle changes one should be making. Most women believe they must make significant dietary changes to ensure good outcomes following breast cancer treatment. We found several studies to be most helpful when coming to terms with Nutrition and Exercise post diagnosis. What follows is directly pulled from the John Hopkins study : There are no food or dietary supplements that will act as “magic bullets” to prevent breast cancer from returning. National Cancer Institute guidelines for cancer prevention can be used to decrease the chance of a breast cancer recurrence. These guidelines include: Increase intake of fruits, vegetables and whole grains Decrease fat intake to less than 30 percent of calories Minimize intake of cured, pickled and smoked foods Achieve and maintain a healthy weight Alcohol consumption should be done in moderation, if at all This second study from Dana Farber addresses diet and exercise suggestions http://www.dana-farber.org/health-library/articles/healthy-diet-and-exercise-tips-for-breast-cancer-patients/ Exercise Exercise Exercise during all stages of life is important, but it can be particularly important for breast cancer survivors because it can help you feel better after treatment and promote survivorship. Studies show that walking 3-5 hours per week at a pace of 2 to 3 miles per hour can lower the chances of breast cancer recurrence and death by up to 40 percent. Walking can help you fight fatigue, depression, and anxiety as well as improve heart and bone health. Engaging your children in physical activity can be a great way to incorporate exercise into your daily life schedule. Remember to talk to your doctor before beginning an exercise program. Plant-based diet Plant-based diets, which include fruits, vegetables, whole grains and lean proteins, are all highly recommended components of a balanced diet for breast cancer survivorship. Research has found that eating 5 or more daily servings of fruits and vegetables a day in addition to the equivalent of walking 30 minutes, 6 days per week is associated with significant survival advantage. Eating a well-balanced diet with lean protein, including plant sources, such as lentils, beans, nuts, nut butters, whole grains, fruits, vegetables and healthy fats like avocado and olive oil, in amounts to maintain a healthy weight, along with exercise is the best thing you can do for optimal health. Meal Planning and Phytonutrients Raw vs. cooked vegetables? Vegetables are an important part of a healthy diet. Eating a variety of different types of vegetables, whether cooked or raw, provides the body with various vitamins, minerals, and phytonutrients. Raw and cooked vegetables provide different nutrients. For example, cooked tomatoes are rich in lycopene, a nutrient that's not as available in raw tomatoes. In turn, raw tomatoes are rich in potassium and vitamin C, nutrients that decrease with cooking. In all methods of preparation, and whether you buy them frozen or fresh, be sure to include plenty of vegetables in your daily diet. What are the best ways to cook vegetables? The healthiest ways to cook vegetables include steaming, stir-frying, sautéing, baking and grilling. These methods prevent the overcooking of vegetables that would disintegrate the valuable nutrients. Which are healthier: fruits and vegetables that are fresh or frozen? They are equal. No matter how they are stored, the nutritional value of fruits and vegetables varies only slightly whether they are fresh or frozen. Buy them and enjoy them often; that's the healthiest way to eat fruits and vegetables. Choosing locally grown produce is another option for maximizing the nutrient levels in produce. What about canned fruits and vegetables? Buy fruit canned in water or light/natural juice. When buying canned vegetables, check the label for the sodium content and choose the low-sodium version. Canned fruits and vegetables can be easy to digest, and therefore are good choices for persons with diarrhea due to cancer treatment or recent surgery. Should I choose organic fruits and vegetables? The scientific research on organic verses conventional foods and cancer risk is not conclusive enough for specific guidelines to be determined. Therefore, the decision to choose organic or conventional produce is ultimately a personal health choice. When consuming produce, remember these points: Always wash all produce (organic or conventional), even if the package is labeled "pre-washed" If you decide to choose organic produce and cost is a concern, choose organic produce that has been found to contain the highest levels of pesticide residues when grown conventionally. The following lists may be useful for making wise choices. The USDA, Consumer Reports, and the Environmental Working group have investigated the amounts of pesticide residues found on commonly consumed produce and created the following tables. Produce was washed before pesticide levels were tested. Produce with highest levels of pesticide residue: Apples Bell Peppers (Green and Red) Celery Cherries (U.S.) Grapes (Chile) Lettuce Nectarines Peaches Pears Potatoes (U.S.) Spinach Strawberries Produce with lowest levels of pesticide residues: Asparagus Avocados Bananas Broccoli Sweet Corn Cabbage Eggplant Kiwi Mango Onions Pineapples Peas (frozen) The bottom line: The benefits of eating fresh fruits and vegetables far outweigh the risks associated with pesticide residue. Phytonutrients found in fruits and vegetables (organic or conventional) promote immune support and detoxification in the body and are excellent sources of disease-fighting nutrients. Read Articles Events & Programs Our events and programs are designed to offer healing, support, and friendship. Whether you attend a weekly meetup, a meditation class, or an art therapy session or expressive writing workshop, our programs promote well-being while offering a safe and nurturing space for you to just be you! 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Breast cancer risk factors are essential knowledge for all women considering getting tested. 1 in 8 women develops breast cancer in their lifetime. Breast Cancer Risk Factors Breast Cancer Risk and Risk Factors You may be familiar with the statistic that says 1 in 8 women will develop invasive breast cancer. Many people misinterpret this to mean that, on any given day, they and the women they know have a 1-in-8 risk of developing the disease. That’s simply not true. In reality, about 1 in 8 women in the United States — 12%, or about 12 out of every 100 — can expect to develop breast cancer over the course of an entire lifetime. In the U.S., an average lifetime is about 80 years. So, it’s more accurate to say that 1 in 8 women in the U.S. who reach the age of 80 can expect to develop breast cancer. In each decade of life, the risk of getting breast cancer is actually lower than 12% for most women. People tend to have very different ways of viewing risk. For you, a 1-in-8 lifetime risk may seem like a high likelihood of getting breast cancer. Or you may turn this around and reason that there is a 7-in-8, or 87.5%, chance you will never get breast cancer, even if you live to age 80. How you view risk often depends on your individual situation — for example, whether you or many women you know have had breast cancer, or you have reason to believe you are at higher-than-normal risk for the disease — and your usual way of looking at the world. Even though studies have found that women have a 12% lifetime risk of developing breast cancer, your individual risk may be higher or lower than that. Individual risk is affected by many different factors, such as family history, reproductive history, lifestyle, environment, and others. Breast Cancer Risk Factors A “risk factor” is anything that increases your risk of developing breast cancer. Many of the most important risk factors for breast cancer are beyond your control, such as age, family history, and medical history. However, there are some risk factors you can control, such as weight, physical activity, and alcohol consumption. Be sure to talk with your doctor about all of your possible risk factors for breast cancer. There may be steps you can take to lower your risk of breast cancer, and your doctor can help you come up with a plan. Your doctor also needs to be aware of any other risk factors beyond your control, so that he or she has an accurate understanding of your level of breast cancer risk. This can influence recommendations about breast cancer screening — what tests to have and when to start having them. Risk Factors You Can Control Weight . Being overweight is associated with increased risk of breast cancer, especially for women after menopause. Fat tissue is the body’s main source of estrogen after menopause, when the ovaries stop producing the hormone. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk. Diet . Studies are looking at the relationship between diet and breast cancer risk and the risk of recurrence. The Women's Health Initiative Trial suggested that a diet very low in fat may reduce the risk of breast cancer. More research is needed in this important area for women who are interested in eating well to reduce their risk of ever getting breast cancer. In the meantime, here's what dietitians suggest: • Keep your body weight in a healthy range for your height and frame. Body mass index , though not a perfect measurement, can help you estimate your healthy weight. • Eat plenty of vegetables and fruit (more than 5 cups a day). • Try to limit your saturated fat intake to less than 10% of your total calories per day and limit your fat intake to about 30 grams per day. • Eat foods high in omega-3 fatty acids . • Avoid trans fats, processed meats, and charred or smoked foods. You'll find that processed foods generally don't fit in this type of diet as well as fresh foods do. For more information, visit our page on healthy eating to reduce risk of breast cancer in the Nutrition section. Exercise . Evidence is growing that exercise can reduce breast cancer risk. The American Cancer Society recommends engaging in 45-60 minutes of physical exercise 5 or more days a week. (See our Fitness Guide) Alcohol consumption. Studies have shown that breast cancer risk increases with the amount of alcohol a woman drinks. Alcohol can limit your liver’s ability to control blood levels of the hormone estrogen, which in turn can increase risk. Smoking. Smoking is associated with a small increase in breast cancer risk. Exposure to estrogen. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Some of these risk factors are under your control, such as: • taking combined hormone replacement therapy (estrogen and progesterone; HRT) for several years or more, or taking estrogen alone for more than 10 years • being overweight • regularly drinking alcohol Recent oral contraceptive use. Using oral contraceptives (birth control pills) appears to slightly increase a woman’s risk for breast cancer, but only for a limited period of time. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk. Stress and anxiety. There is no clear proof that stress and anxiety can increase breast cancer risk. However, anything you can do to reduce your stress and to enhance your comfort, joy, and satisfaction can have a major effect on your quality of life. So-called “mindful measures” (such as meditation, yoga, visualization exercises, and prayer) may be valuable additions to your daily or weekly routine. Some research suggests that these practices can strengthen the immune system. (See our resources on Positive Thinking, Meditation and Affirmations ) Risk Factors You Cannot Control Gender. Being a woman is the most significant risk factor for developing breast cancer. Although men can get breast cancer, too, women’s breast cells are constantly changing and growing, mainly due to the activity of the female hormones estrogen and progesterone. This activity puts them at much greater risk for breast cancer. Age. Simply growing older is the second biggest risk factor for breast cancer. From age 30 to 39, the risk is 1 in 228, or .44%. That jumps to 1 in 29, or just under 3.5%, by the time you are in your 60s. Family history of breast cancer. If you have a first-degree relative (mother, daughter, sister) who has had breast cancer, or you have multiple relatives affected by breast or ovarian cancer (especially before they turned age 50), you could be at higher risk of getting breast cancer. Personal history of breast cancer. If you have already been diagnosed with breast cancer, your risk of developing it again, either in the same breast or the other breast, is higher than if you never had the disease. Race. White women are slightly more likely to develop breast cancer than are African American women. Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer. Radiation therapy to the chest. Having radiation therapy to the chest area as a child or young adult as treatment for another cancer significantly increases breast cancer risk. The increase in risk seems to be highest if the radiation was given while the breasts were still developing (during the teen years). Breast cellular changes. Unusual changes in breast cells found during a breast biopsy (removal of suspicious tissue for examination under a microscope) can be a risk factor for developing breast cancer. These changes include overgrowth of cells (called hyperplasia) or abnormal (atypical) appearance. Exposure to estrogen. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Some of these risk factors are not under your control, such as: • starting menstruation (monthly periods) at a young age (before age 12) • going through menopause (end of monthly cycles) at a late age (after 55) • exposure to estrogens in the environment (such as hormones in meat or pesticides such as DDT, which produce estrogen-like substances when broken down by the body) Pregnancy and breastfeeding. Pregnancy and breastfeeding reduce the overall number of menstrual cycles in a woman’s lifetime, and this appears to reduce future breast cancer risk. Women who have never had a full-term pregnancy, or had their first full-term pregnancy after age 30, have an increased risk of breast cancer. For women who do have children, breastfeeding may slightly lower their breast cancer risk, especially if they continue breastfeeding for 1 1/2 to 2 years. For many women, however, breastfeeding for this long is neither possible nor practical. DES exposure. Women who took a medication called diethylstilbestrol (DES), used to prevent miscarriage from the 1940s through the 1960s, have a slightly increased risk of breast cancer. Women whose mothers took DES during pregnancy may have a higher risk of breast cancer as well. > What's the Difference between Diet and Nutrition? On Breast Cancer Conversations, the Podcast Listen Now

Creative Expression Art, Writing, Stitch & Crochet Join us Weekly, Monthly, and On Demand! Creative Expression Multiple Dates Wed, May 27 Stitch & Share: A Mindful Crochet Gathering / Online Event RSVP May 27, 2026, 6:00 PM – 7:00 PM EDT Online Event Crocheting and knitting have been shown to reduce stress, ease anxiety, and promote mindfulness, helping survivors and caregivers find calm and connection during challenging times. See All Multiple Dates Mon, Jun 01 Artistic Expression: Emotional Wellness & Self-Discovery / Online Event RSVP Jun 01, 2026, 6:00 PM – 7:30 PM EDT Online Event Unlock the transformative power of creativity with our Artistic Expression sessions—an immersive experience designed to nurture emotional balance, support healing, and inspire self-discovery. +1 more Multiple Dates Mon, Jun 08 Expressive Writing with Thomas Dooley / Online Event RSVP Jun 08, 2026, 6:00 PM – 7:30 PM EDT Online Event How can we quiet the constant noise of daily life and truly hear the story unfolding within us? Reflect and Recharge is a powerful, interactive writing workshop designed specifically for breast cancer thrivers seeking emotional healing, connection, and clarity through the art of expressive writing. +3 more Multiple Dates Fri, Jun 12 Reflective Writing for Metastatic Breast Cancer / Online Event RSVP Jun 12, 2026, 10:00 AM – 11:00 AM EDT Online Event Join us for special session for those living with MBC who would like to take some time to reflect with others in the community, participate in a few journaling exercises, and share their thoughts and feelings in a confidential and supportive setting. +5 more

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

Learn about the latest advances in breast cancer treatment, including life-saving developments in pharmaceuticals and detection. Advances in Breast Cancer Treatments

For women in the U.S., breast cancer death rates are higher than those for any other cancer, besides lung cancer. Besides skin cancer, breast cancer is the most commonly diagnosed cancer among American women. In 2019, it's estimated that about 30% of newly diagnosed cancers in women will be br Know the Stats Get the Facts Understand your risk. Understandng Breast Cancer Breast Cancer Statistics Breast Cancer Symptoms Risk Factors Genetic Testing Breast Density About 1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime. In 2021, an estimated 281,550 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 49,290 new cases of non-invasive (in situ) breast cancer. About 2,650 new cases of invasive breast cancer are expected to be diagnosed in men in 2021. A man’s lifetime risk of breast cancer is about 1 in 833. About 43,600 women in the U.S. are expected to die in 2021 from breast cancer. Death rates have been steady in women under 50 since 2007, but have continued to drop in women over 50. The overall death rate from breast cancer decreased by 1% per year from 2013 to 2018. These decreases are thought to be the result of treatment advances and earlier detection through screening. For women in the U.S., breast cancer death rates are higher than those for any other cancer, besides lung cancer. As of January 2021, there are more than 3.8 million women with a history of breast cancer in the U.S. This includes women currently being treated and women who have finished treatment. Breast cancer is the most commonly diagnosed cancer among American women. In 2021, it's estimated that about 30% of newly diagnosed cancers in women will be breast cancers. Breast cancer became the most common cancer globally as of 2021, accounting for 12% of all new annual cancer cases worldwide, according to the World Health Organization. In women under 45, breast cancer is more common in Black women than white women. Overall, Black women are more likely to die of breast cancer. For Asian, Hispanic, and Native-American women, the risk of developing and dying from breast cancer is lower. Ashkenazi Jewish women have a higher risk of breast cancer because of a higher rate of BRCA mutations. Breast cancer incidence rates in the U.S. began decreasing in the year 2000, after increasing for the previous two decades. They dropped by 7% from 2002 to 2003 alone. One theory is that this decrease was partially due to the reduced use of hormone replacement therapy (HRT) by women after the results of a large study called the Women’s Health Initiative were published in 2002. These results suggested a connection between HRT and increased breast cancer risk. In recent years, incidence rates have increased slightly by 0.5% per year. A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. Less than 15% of women who get breast cancer have a family member diagnosed with it. About 5-10% of breast cancers can be linked to known gene mutations inherited from one’s mother or father. Mutations in the BRCA1 and BRCA2 genes are the most common. On average, women with a BRCA1 mutation have up to a 72% lifetime risk of developing breast cancer. For women with a BRCA2 mutation, the risk is 69%. Breast cancer that is positive for the BRCA1 or BRCA2 mutations tends to develop more often in younger women. An increased ovarian cancer risk is also associated with these genetic mutations. In men, BRCA2 mutations are associated with a lifetime breast cancer risk of about 6.8%; BRCA1 mutations are a less frequent cause of breast cancer in men. About 85% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations. The most significant risk factors for breast cancer are sex (being a woman) and age (growing older). References American Cancer Society. How Common Is Breast Cancer? Jan. 2021. Available at: https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html . American Cancer Society. Key Statistics for Breast Cancer in Men. Jan. 2021. Available at: https://www.cancer.org/cancer/breast-cancer-in-men/about/key-statistics.html . American Cancer Society. Cancer Facts & Figures 2021. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf . Reuters. Breast cancer overtakes lung as most common cancer-WHO. Feb. 2021. Available at: https://www.reuters.com/article/health-cancer-int/breast-cancer-overtakes-lung-as-most-common-cancer-who-idUSKBN2A219B . National Cancer Institute. BRCA Gene Mutations: Cancer Risk and Genetic Testing. Nov. 2020. Available at: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet . American Cancer Society. Breast Cancer Risk Factors You Cannot Change. Sept. 2019. Available at: http://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html . Breast Cancer Conversations A WEEKLY PODCAST Where we talk about all things breast cancer. Hear from medical experts, learn about the latest treatments, listen to stories from those diagnosed with breast cancer and be inspired by visionary #cancerpreneurs , advocates, and more! Privacy Policy © 2022, Registered 501(c)(3). EIN 82-2953427 Contact us info@survivingbreastcancer.org 5 Cedar Street, Boston, MA 02119 Never miss a beat. 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Breast Cancer is hard enough so why not gift yourself or someone you love essential items to enjoy! Shop Survivingbreastcancer.org's brand, cloths, and lifestyle products and feel the love! Quick View 5x7 IBC Flyers (50) Price $25.00 Excluding Sales Tax Quick View Event Flyer (English and Spanish) Price $25.00 Excluding Sales Tax Quick View Tri-Fold Brochures (English and Spanish) Price $25.00 Excluding Sales Tax Quick View Variety Pack Price $45.00 Excluding Sales Tax Quick View 5x7 MBC Flyers (50) Price $25.00 Excluding Sales Tax Quick View 5x7 Book Club Flyers (50) Price $25.00 Excluding Sales Tax Quick View 5x7 Expressive Writing and Meditation (50) Price $25.00 Excluding Sales Tax Quick View 5x7 Art Therapy Flyer (50) Price $25.00 Excluding Sales Tax Products Designed With You & Your Patients In Mind All Proceeds from our sales go directly back into SBC to support our programs and services. Thank you for shopping for a cause!

Reiki Circle of Care Reiki is a gentle, hands-on energy healing practice that promotes relaxation, reduces stress, and supports overall well-being. Especially helpful for those navigating breast cancer, Reiki can ease pain, anxiety, and fatigue while restoring balance to the body and mind. Experience the calming benefits of Reiki as part of your healing journey. Multiple Dates Reiki Circle of Care Mon, May 25 Online Event More info RSVP

A new metastatic breast cancer diagnosis can disrupt anyone's life in a major way. Learn about your next steps to fight back with innovative treatments. Newly Diagnosed with Metastatic Breast Cancer. Now What? What brings you to this website is most likely a metastatic breast cancer (MBC) diagnosis. Perhaps you experienced a recurrence from early stage breast cancer (stages 0,I, II, or III) to advanced or late stage breast cancer (stage IV, MBC). In some cases you may have been diagnosed de-Novo meaning that you never experienced an early stage of breast cancer and based on diagnostic tests were diagnosed with metastatic breast cancer as your initial diagnosis. Whatever the reason, I want you to know that you will be supported and that our Surviving Breast Cancer (SBC) community is here for you! We are here to help! A metastatic breast cancer diagnosis is different than an early stage diagnosis in the way in which it disrupts our lives and throws us into a whirlwind of continual doctors appointments, follow ups, tests, scans, and the like. Each and every one of us have unique experiences, and what our SBC platform and community provides is education, support, and resources for you as a complement to your medical care. We are not medical professionals, nor provide medical advice. But what we do offer is content, stories, and community when you need it most! What I mean by that is you are welcome to dive in to absolutely everything we offer today, or, you can take bite size approaches to get the information and support when you feel ready for it. We've listed a few links and resources to help get you started and to hopefully make things a bit less overwhelming. Download. Questions to Ask Your Surgeon Download PDF Questions to Ask Your Radiologist Downlod PDF Questions to Ask Your Oncologist Coming Soon Events & Programs Multiple Dates Metastatic Breast Cancer (MBC) Support Group with Nancy Gaulin, PsyD Thu, May 21 Zoom Join us for our Thursday Night Thrivers MBC Support Group, a warm and uplifting space created specifically for the Metastatic Breast Cancer community. This free, online support group is facilitated by the exceptional psychologist Nancy L. Gaulin, PsyD, MBA a specialist in cancer-related support +37 more RSVP Multiple Dates MBC Peer to Peer Support | Thursday Night Thrivers Meetup Thu, Jun 04 Virtual Join our MBC Peer to Peer Support group during Thursday Night Thrivers. A monthly breakout space for the metastatic breast cancer community to connect, share, and find support. See All RSVP Multiple Dates Reflective Writing for Metastatic Breast Cancer Fri, Jun 12 Online Event Join us for special session for those living with MBC who would like to take some time to reflect with others in the community, participate in a few journaling exercises, and share their thoughts and feelings in a confidential and supportive setting. +5 more RSVP Recent Articles

Surviving Breast Cancer offers guidance on sex after breast cancer, helping survivors navigate intimacy, relationships, and emotional healing. Breast Cancer & Intimacy Sex After Breast Cancer In a previous blog and podcast we opined on the difficulties of maintaining relationships with loved ones, family, spouses, partners, etc. following a breast cancer diagnosis. Now we look at the adversarial effects of breast cancer towards sexual intimacy. Many, although not all, women find that breast cancer treatment, I.e. surgery, radiation, chemotherapy, estrogen eliminating hormonal therapy, severely hampers intimate sexual relations. Poor self image, physical exhaustion, painful treatment, and emotional distress all tend to weigh in negatively regarding sex drive. But overall recovery from breast cancer is partially dependent on overcoming the above referenced issues and participating in warm loving sexual acts. Sex can thus play a pivotal role. As we have mentioned in previous posts, single women who have been diagnosed worry how breast cancer will affect their relationship prospects, and also about how and when to tell those prospective lovers about their condition. The most uncomfortable stuff to talk about is probably your sex life and the changes that have taken place with your illness. You may not know what needs fixing or how to fix it, but you know things are different. Many women report having less sex than before their illness, for several reasons: • The breast cancer experience slows down your body. It takes longer to do lots of things, including getting interested in and starting and finishing sexual intercourse. • Sex may be uncomfortable or even painful if you've been thrown into sudden onset menopause. No surprise that you tend to have less sex, for now. Many women may have had little or no sex from the time of diagnosis through treatment. Most people have wild ideas about what goes on in other people's bedrooms. Give yourself a break: The carefully researched book Sex in America (by Michael, Gagnon, Laumann, and Kolata) tells us that Americans have a lot less sex than the movies, television, and the guys in the locker room would have you believe. The averages reported in that book are: • seven times a month between ages 30 and 40 • six times a month between ages 40 and 50 • five times a month between ages 50 and 60 For people over 60, the numbers continue to decline. But although you may assume that no one in their 70s and 80s has a sex life, that's just not so. Don't let the myths about other people's sex lives get in the way of what's happening in yours. And remember that there are exceptions to every pattern. If your sex life is not working the way you want it to, your doctor or nurse may be able to referee these issues with your partner and you. You can cue your doctor in advance, since he or she has most likely already touched on delicate issues with you. Maybe he or she can be the tour guide for the two of you. If your partner is there when you talk with the doctor who's managing your care, you and your partner both get a chance to air and dispel fears, and replace myths and false information with facts. Help from a pro Not all doctors and nurses are comfortable discussing sexual issues and practices. Most doctors don't routinely ask about your sex life. And patients don't usually begin to discuss their love life with a doctor who hasn't mentioned it. Nobody's talking! Someone has to break the pattern. A trained social worker, sex therapist, psychologist, or psychiatrist can help you open up communication with your partner and get around to talking about intimacy and sex issues. A support group may be more helpful than you might realize. Women in these groups often share advice that extends to the bedroom, including ways to increase sexual pleasure that are explicit and specific for women who've had breast cancer. Meeting needs in other ways Most marriages have problems that don't get fixed. Marriage is a package deal, and in marriages that work, the good things outweigh the bad. But as a survivor, you may find that breast cancer highlights the problems in your marriage. Can you live with those problems? Can you enjoy your marriage even as you contemplate what's missing? Can you capture the missing pieces in other ways? Give serious thought to your needs and how to meet them. Other ways to meet your needs: • Fantasy can enrich your life. Countless women read to fill the vacuum (romance novels are enormously popular). • Join a book club, a church or synagogue, or a group that meets to discuss investments, movies, or local politics. • Do more with individual friends, like walking, shopping ("retail therapy"), or travel. • Make a bigger deal of birthdays and anniversaries. • Expand your involvement in community or spiritual activities. • Get politically active in the breast cancer movement: camaraderie for a cause close to your heart. Having a serious illness almost always takes some kind of toll on your sex life. But breast cancer can bring all thoughts of intimacy and sexuality to a screeching halt. Treatments can bring on temporary -- and sometimes permanent -- premature menopause, making intercourse painful. Chemotherapy and radiation often lead to crushing fatigue. You may want to stay in bed, but you don’t want to use it for anything but sleep. The medications you take, as well as the emotional effects of the disease, can lead to depression. And of course, from the changes wrought by surgery to the hair loss and puffiness of chemotherapy, breast cancer can have a devastating effect on your body image and your ability to feel sexy. The sexual side effects of breast cancer can linger long after treatment stops. A 2007 follow-up report on young breast cancer survivors, conducted by researchers at the University of California-Berkeley, found that some women reported persistent sexual difficulties five years after their treatment had ended. And according to the National Cancer Institute, about one out of every two women who’ve undergone breast cancer treatment experiences long-term sexual dysfunction. That’s the bad news. But the good news is there is sex after breast cancer! > Sex and self-image Breast cancer changes the way you see your body. “Women sometimes feel very disconnected from their bodies when they go through this,” says Jean Carter, PhD. Carter is a licensed psychologist and the sexual health counselor for the sexual health program at Memorial Sloan-Kettering Cancer Center. “Your body’s been through so much and it’s worked to get well,” she says. ”But there have been sacrifices.” One thing you need to know early on is that your partner still finds you attractive and desirable. That’s rough on the days when you look in the mirror and can’t imagine ever feeling sexy again, much less looking sexy to someone else. It’s important to prepare yourself and your partner for what you’ll see. If you haven’t yet had surgery, ask your breast center if they have photographs of women after the kind of surgery you’ll undergo. Look at them with your partner and talk about what to expect. There's no denying that the sexual side effects of breast cancer can linger long after treatment is over, but there is sex after breast cancer. Lumpectomies, Mastectomies, Breast Reconstructions and Thoughts on Body Image. It was created by women in a cancer survivors’ group at Penn State. “The way your partner looks at your incision for the first time,” says Lillie Shockney, RN, “you’ll remember that forever.” Shockney is administrative director of the Johns Hopkins Breast Center and a breast cancer survivor herself. “If he has no clue what to expect and has a puzzled look on his face, the woman may interpret it as ‘He thinks I’m ugly, he thinks this is awful.’ Showing photographs can take the surprise away.” Communication is important. Talk with your partner about what you’re comfortable with, and what you’re not. “Both partners may be waiting for the other one to make the first move,” says Shockney. “She’s waiting for him to tell her he wants sex, and he’s waiting for her to touch him.” Your partner may be afraid of hurting you, or afraid that you’ll think he’s pushing you to have sex when you’re not ready simply by asking about it. If your breasts were major erogenous zones for you before surgery, you may be feeling particularly bereft after a mastectomy or even a lumpectomy . Shockney suggests taking the pressure off by exploring and discovering other areas of your body, rather than trying to “force it” in areas where you still have performance or body image issues. “For some women, the diminished arousal in areas of a newly constructed breast or scar tissue might serve as a painful reminder that their sex life has changed,” Shockney says. Instead, think of areas like shoulders, ears, and knees as new hot spots for intimate touch. If you’re still not comfortable with your new body, that’s what lingerie is for! There’s nothing wrong with getting a little help. A soft, satin nightie can be sexy and arousing. At the same time, it can help to conceal areas you’re still shy about. Or you can get even more creative. “I asked a patient to try using a feather boa to help her feel sexy, and at the same time keep her scars from being so evident. She loves it!” says Shockney. “It’s all about finding what you’re comfortable with.” Coping with changes But even as you get comfortable with the “new you” in the mirror, other parts of your body may be causing you problems in the bedroom. You may go through temporary menopause because of chemotherapy. Or if you have estrogen-receptor positive breast cancer, you may be taking hormonal therapy that can leave you in a menopausal state for years. The resulting vaginal dryness and other symptoms may make it painful to even think about having sex. “A lot of women I see are afraid to have sex,” Carter tells WebMD. “They’re really struggling. And it’s a shame, because there are wonderful, simple strategies to improve your sexual experience that, taken together, can work wonders.” Vaginal moisturizers. These aren’t lubricants, which are meant to be used during sex. Instead, they’re like the moisturizers you use on your face and hands, to benefit the tissues themselves. “They’re introduced as a suppository into the vagina adding moisture back into the vaginal space and giving it that natural elasticity,” says Carter. “It’s meant to be absorbed, and it helps the vagina to have more health and moisture for several days.” Lubricants. You definitely still want a lubricant for use during intercourse, says Carter. But lubricants should be combined with regular, ongoing use of vaginal moisturizers for best results. “If you’re feeling a rubbing or burning sensation during intercourse,” Carter says, “you don’t have enough lubrication. If it’s a stretching , painful sensation like the skin is going to split, you don’t have enough moisture.” Exercises. The classic Kegel exercises -- tightening and releasing the sphincter muscle as you do when you urinate -- that so many women use during pregnancy are also great for making intercourse easier. “If intercourse has been painful,” Carter says, “you may tighten up in anticipation of the pain. If you do Kegels right before intimacy , you fatigue the vaginal muscles and it is more open.” Vaginal dilators. A sex therapist, like Dr. Carter, can teach you how to use these dilators, which help gently stretch the vaginal tissue. Over and over again,” Carter says, “I’ve seen women who are completely hormonally deprived be able to have comfortable, enjoyable intimacy by using these strategies. A lot of the time, it’s so easy to fix. It astonishes me how often women come into my office and ask, ‘Why didn’t anyone tell me this? Shockney advises her patients to shake up their previous sexual habits. She tells them they may have been a silent player in bed before. But now she wants them to speak up. She tells them, “Say, ‘This feels good. This doesn’t feel good.’ Don’t rely on grunting for him to figure it out. That’s not the best way to communicate.” She also tells her patients, “If you’ve never watched an x-rated movie, try one -- just one. It may jump-start things, and you’ll be amazed at how active you’ll become. Or try various sex toys. So what if you never did these things before. You never had breast cancer before, either! I’ve had women come to me and say ‘I thought my sex life was great before, and then I thought I was going to lose it. But now it’s better than ever. TOPICS COVERED IN THIS EPISODE -People who refuse aspects of therapy including radiation. -What to expect when going in for radiation-Planning appointment -What is radiation and why would I need it? -Radiation and skin care -Proton Beam Radiation (the science behind protons; a number of clinical trials exploring proton beam radiation in the breast cancer community to minimize cardiac toxicity). -Risks association with radiation, but we still sign the consent. As a young breast cancer survivor, I ask Dr. Jimenez to explain the 10, 20 and 50 year plan for women who go through treatment. HEALTH RISKS -Cardiac toxicity -Field of cardio oncology partners and have mapped out the ideal -Herceptin and anthracyclines. After 5 years of survivorship, you should have a cardiac stress test. -Getting a baseline with an ultrasound of the heart so if there are changes, doctors can track them. -Our job (in Radiation Oncology) in follow up is to open up and make sure that referrals are made. How is your nutrition? Are you exercising? Did you schedule your next mammogram? QUOTES: "Your providers are your providers for life". "You are never a bother, it is our job and privilege to take care of you! " What's the Difference between Diet and Nutrition? On Breast Cancer Conversations, the Podcast Listen Now Looking for more ways to support your healing journey? View Programs

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Our breast cancer poetry lab is a space for patients and survivors to express their emotional journeys. Read from others' works and share yours! Breast Cancer Poetry Writing is a great form of therapy and healing. Enjoy the original compositions from our Survivingbreastcancer.org Community! Be Inspired. Submit Your Poem Expressive Writing How can we dial down the noise in our daily lives to listen to the story emerging within ourselves? In this interactive session, we will come together to reflect on the personal narratives that give shape and meaning to our lives and find community in the experiences we share. Multiple Dates Expressive Writing with Thomas Dooley Mon, Jun 08 Online Event More info RSVP Multiple Dates Reflective Writing for Metastatic Breast Cancer Fri, Jun 12 Online Event More info RSVP 1 2 3 4 5 Welcome to the Poetry Lab Welcome to the Poetry Lab Welcome to the Poetry Lab Welcome to the Poetry Lab Dream Dream Dream Dream Create Create Create Create Express Express Express Express Multiple Dates Expressive Writing with Thomas Dooley Mon, Jun 08 Online Event More info RSVP Multiple Dates Reflective Writing for Metastatic Breast Cancer Fri, Jun 12 Online Event More info RSVP

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

Privacy Policy This document was last updated on February 21, 2020, Privacy Policy: Survivingbreastcancer.org is committed to maintaining privacy protections for its users. This Privacy Policy governs the manner in which www.survivingbreastcancer.org (the “Organization”) collects, uses, maintains and discloses information collected from users (each, a "User") of the http://www.survivingbreastcancer.org website ("Site"). For purposes of this agreement, “Service” refers to the Organization’s service which can be accessed via our website at www.survivingbreastcancer.org in which users can find educational resources. The terms “we,” “us,” and “our” refer to the Organization. “You” refers to you, as a user of Service. By accepting our Privacy Policy and Terms of Use, you consent to our collection, storage, use and disclosure of your personal information as described in this Privacy Policy. Personal identification information We may collect personal identification information from Users in a variety of ways, including, but not limited to, when Users visit our site, place an order, fill out a form, respond to a survey, and in connection with other activities, services, features or resources we make available on our Site. Users may be asked for as appropriate, but not limited to the following: name, email address, mailing address, phone number. Users may, however, visit our Site anonymously. We will collect personal identification information from Users only if they voluntarily submit such information to us. Users can always refuse to supply personally identification information, except that it may prevent them from engaging in certain Site related activities. Non-personal identification information We may collect non-personal identification information about Users whenever they interact with our Site. Non-personal identification information may include the browser name, the type of computer and technical information about Users means of connection to our Site, such as the operating system and the Internet service providers utilized and other similar information. Web browser cookies Our Site may use "cookies" to enhance User experience. User's web browser places cookies on their hard drive for record-keeping purposes and sometimes to track information about them. User may choose to set their web browser to refuse cookies, or to alert you when cookies are being sent. If they do so, note that some parts of the Site may not function properly. We use cookies to personalize content and ads, to provide social media features and to analyze our traffic and visitor behavior. We use cookies that are strictly necessary, support performance, enable functionality and provide you with a personalized experience. We also share information about your use of our site with our social media, advertising and analytics partners as necessary. How we use collected information www.survivingbreastcancer.org may collect and use Users personal information for the following purposes: To run and operate our Site We may need your information display content on the Site correctly. To improve customer service Information you provide helps us respond to your customer service requests and support needs more efficiently. To personalize user experience We may use information in the aggregate to understand how our Users as a group use the services and resources provided on our Site. To improve our Site We may use feedback you provide to improve our products and services. To run a promotion, contest, survey or other Site feature To send Users information they agreed to receive about topics we think will be of interest to them. To send periodic emails We may use the email address to send User information and updates pertaining to their order, announcements, blog posts, events and educational information. It may also be used to respond to their inquiries, questions, and/or other requests. How we protect your information We adopt appropriate data collection, storage and processing practices and security measures to protect against unauthorized access, alteration, disclosure or destruction of your personal information, username, password, transaction information and data stored on our Site. However, these measures do not guarantee that your information will not be accessed, disclosed, altered or destroyed by breach of such firewalls and secure server software. By using our Service, you acknowledge that you understand and agree to assume these risks. Links to other websites As part of the Service, we provide links to or compatibility with other websites or applications. However, we are not responsible for the privacy practices employed by those websites or the information or content they contain. This Privacy Policy applies solely to information collected by us through the Site and the Service. Therefore, this Privacy Policy does not apply to your use of a third party website accessed by selecting a link on our Site or via our Service. To the extent that you access or use the Service through or on another website or application, then the privacy policy of that other website or application will apply to your access or use of that site or application. We encourage our users to read the privacy statements of other websites before proceeding to use them. Sharing your personal information We may share or sell information with third parties for marketing or other purposes. We may use third party service providers to help us operate our business and the Site or administer activities on our behalf, such as sending out newsletters or surveys. We may share your information with these third parties for those limited purposes provided that you have given us your permission. Electronic newsletters If User decides to opt-in to our mailing list, they will receive emails that may include the Organization news, updates, related product or service information, etc. If at any time the User would like to unsubscribe from receiving future emails, we include detailed unsubscribe instructions at the bottom of each email or User may contact us via our Site. Third party websites Users may find advertising or other content on our Site that link to the sites and services of our partners, suppliers, advertisers, sponsors, licensors and other third parties. We do not control the content or links that appear on these sites and are not responsible for the practices employed by websites linked to or from our Site. In addition, these sites or services, including their content and links, may be constantly changing. These sites and services may have their own privacy policies and customer service policies. Browsing and interaction on any other website, including websites which have a link to our Site, is subject to that website's own terms and policies. Advertising Ads appearing on our site may be delivered to Users by advertising partners, who may set cookies. These cookies allow the ad server to recognize your computer each time they send you an online advertisement to compile non personal identification information about you or others who use your computer. This information allows ad networks to, among other things, deliver targeted advertisements that they believe will be of most interest to you. This privacy policy does not cover the use of cookies by any advertisers. You may learn more about opting out of major ad networks at https://websitebuilders.com/tools/advertiser-opt-out/ . Google Adsense Some of the ads may be served by Google. Google's use of the DART cookie enables it to serve ads to Users based on their visit to our Site and other sites on the Internet. DART uses "non personally identifiable information" and does NOT track personal information about you, such as your name, email address, physical address, etc. You may opt out of the use of the DART cookie by visiting the Google ad and content network privacy policy at http://www.google.com/privacy_ads.html Compliance with children's online privacy protection act Protecting the privacy of the very young is especially important. For that reason, we never collect or maintain information at our Site from those we actually know are under 13, and no part of our website is structured to attract anyone under 13. Changes to this privacy policy www.survivingbreastcancer.org has the discretion to update this privacy policy at any time. When we do, we will post a notification on the main page of our Site. We encourage Users to frequently check this page for any changes to stay informed about how we are helping to protect the personal information we collect. You acknowledge and agree that it is your responsibility to review this privacy policy periodically and become aware of modifications. Your acceptance of these terms By using this Site, you signify your acceptance of this policy. If you do not agree to this policy, please do not use our Site. Your continued use of the Site following the posting of changes to this policy will be deemed your acceptance of those changes. Contacting us If you have any questions about this Privacy Policy, the practices of this site, or your dealings with this site, please contact us. Our Website Host: WIX Our website is hosted on Wix.com Ltd. They provide us with the online platform that allows us to sell our products and provide services to you. Your data is stored through Wix’s data storage, databases and the general Wix application. They store your data on a secure server behind a firewall. Payment with WIX If you choose a direct payment gateway to complete your purchase, then Wix stores your credit card data. It is encrypted through the Payment Card Industry Data Security Standard (PCI-DSS). Your purchase transaction data is stored only as long as is necessary to complete your purchase transaction. After that is complete, your purchase transaction information is deleted. All direct payment gateways adhere to the standards set by PCI-DSS as managed by the PCI Security Standards Council, which is a joint effort of brands like Visa, MasterCard, American Express and Discover. PCI-DSS requirements help ensure the secure handling of credit card information by our store and its service providers. For more insight, you may also want to read Wix’s Terms of Service http://www.wix.com/about/terms-of-use or Privacy Statement http://www.wix.com/about/privacy THIRD-PARTY SERVICES WITH WIX Wix has partnered with a number of selected service providers, whose services and solutions complement, facilitate, and enhance our own. These include hosting and server co-location services, communications and content delivery networks (CDNs), data and cyber security services, billing and payment processing services, domain name registrars, fraud detection and prevention services, web analytics, e-mail distribution and monitoring services, session recording and remote access services, performance measurement and Such Third Party Services may receive or otherwise have access to our Visitors’ and Users’ Personal Information and/or Users-of-Users’ Personal Information, in its entirety or in part – depending on each of their particular roles and purposes in facilitating and enhancing our Services, and may only use it for such purposes. Note that while our Services may contain links to other websites or services, we are not responsible for such websites’ or services’ privacy practices, and encourage you to be aware when you leave our Services and read the privacy statements of each and every website and service you visit. This Privacy Policy does not apply to such linked third-party websites and services. Wix is accountable for personal data that it receives under the Privacy Shield and subsequently transfers to a third party as described in the Privacy Shield Principles. In particular, Wix remains responsible and liable under the Privacy Shield Principles if third-party agents that it engages to process the personal data on its behalf do so in a manner inconsistent with the Principles, unless Wix proves that it is not responsible for the event giving rise to the damage. SECURITY WITH WIX Wix has implemented security measures designed to protect the Personal Information you share with us, including physical, electronic, and procedural measures. Among other things, we offer HTTPS secure access to most areas of our Services; the transmission of sensitive payment information (such as a credit card number) through our designated purchase forms is protected by an industry-standard SSL/TLS encrypted connection; and we regularly maintain a PCI DSS (Payment Card Industry Data Security Standards) certification. We also regularly monitor our systems for possible vulnerabilities and attacks, and regularly seek new ways and Third Party Services for further enhancing the security of our Services and protection of our Visitors’ and Users’ privacy. However – regardless of the measures and efforts taken by Wix, we cannot and do not guarantee the absolute protection and security of your Personal Information, your Users-of-Users’ Information, or any other User Content you upload, publish, or otherwise share with Wix or anyone else. We, therefore, encourage you to set strong passwords for your User Account and User Website and avoid providing us with any sensitive information that you believe its disclosure could cause you substantial or irreparable harm. Furthermore, because certain areas of our Services are less secure than others (for example, if you set your Support forum ticket to be “Public” instead of “Private”, or if you browse to a non-SSL page), and since e-mail and instant messaging are not recognized as secure forms of communications, we request and encourage you not to share any Personal Information on any of these areas or via any of these methods. California Online Privacy Protection Act CalOPPA is the first state law in the nation to require commercial websites and online services to post a privacy policy. The law's reach stretches well beyond California to require a person or company in the United States (and conceivably the world) that operates websites collecting personally identifiable information from California consumers to post a conspicuous privacy policy on its website stating exactly the information being collected and those individuals with whom it is being shared, and to comply with this policy. - See more at: http://consumercal.org/california-online-privacy-protection-act-caloppa/#sthash.0FdRbT51.dpuf According to CalOPPA we agree to the following: Users can visit our site anonymously Once this privacy policy is created, we will add a link to it on our home page, or as a minimum on the first significant page after entering our website. Our Privacy Policy link includes the word 'Privacy', and can be easily be found on the page specified above. Users will be notified of any privacy policy changes: • On our Privacy Policy Page Users are able to change their personal information: • By emailing us COPPA (Children Online Privacy Protection Act) When it comes to the collection of personal information from children under 13, the Children's Online Privacy Protection Act (COPPA) puts parents in control. The Federal Trade Commission, the nation's consumer protection agency, enforces the COPPA Rule, which spells out what operators of websites and online services must do to protect children's privacy and safety online. We do not specifically market to children under 13. Fair Information Practices The Fair Information Practices Principles form the backbone of privacy law in the United States and the concepts they include have played a significant role in the development of data protection laws around the globe. Understanding the Fair Information Practice Principles and how they should be implemented is critical to comply with the various privacy laws that protect personal information. In order to be in line with Fair Information Practices we will take the following responsive action, should a data breach occur: We will notify the users via email • Within 7 business days We will notify the users via in site notification • Within 7 business days CAN SPAM Act The CAN-SPAM Act is a law that sets the rules for commercial email, establishes requirements for commercial messages, gives recipients the right to have emails stopped from being sent to them, and spells out tough penalties for violations. We collect your email address If at any time you would like to unsubscribe from receiving future emails, you can email us and we will promptly remove you from all correspondence.

Learn about Metastatic breast cancer, also called stage IV breast cancer, and the innovative treatments that are changing the story for patients. Living with Metastatic Breast Cancer Resources & Support So You Can Keep Living Life! Created in partnership with Abigail Johnston and the Grieving Together Project. In honor of the late Alyson Tischler. What is Metastatic Breast Cancer? Metastatic breast cancer—also called stage IV breast cancer—means that the cancer has spread beyond the breast and nearby lymph nodes to other parts of the body. Common sites of metastasis include the bones, liver, lungs, and brain. When breast cancer cells travel through the blood or lymphatic system to other organs, they can grow and form new tumors. Read More Advanced Treatment Options If you’ve recently been diagnosed with metastatic breast cancer (MBC), it can feel like you’re suddenly thrust into a new world filled with acronyms, treatment decisions, and unfamiliar terminology. We take a deeper look at four innovative categories of treatment that are changing the landscape of metastatic breast cancer care: CDK4/6 inhibitors, Antibody-drug conjugates , Immunotherapies, & PARP inhibitors Read More Understanding Survivor's Guilt Why Am I Still Here When Others Are Gone? If you’ve ever felt this way, you’re not alone. Many people living with metastatic breast cancer (MBC), or have no evidence of disease/ active disease, after treatment experience a complex emotional weight known as survivor’s guilt. Read More What is Metastatic Breast Cancer? Newly Diagnosed with MBC? Start Here Explore a wide variety of programs, virtual meet-ups, webinars, blogs, & podcasts curated specifically for those living with Metastatic Breast Cancer. Monthly Metastatic Breast Cancer Webinars Explore the Series Attend Upcoming Events &Programs Multiple Dates Metastatic Breast Cancer (MBC) Support Group with Nancy Gaulin, PsyD Thu, May 21 Zoom +37 more RSVP Multiple Dates MBC Peer to Peer Support | Thursday Night Thrivers Meetup Thu, Jun 04 Virtual See All RSVP Multiple Dates Reflective Writing for Metastatic Breast Cancer Fri, Jun 12 Online Event +5 more RSVP No events at the moment See The Full Calendar Enhance your Advocacy Get involved and volunteer with SBC Today! Contact Us Handy Resouces File Name Description Download SBC MBC Legacy Workshop Handout Ideas, inspiration, and resources for leaving your legacy Estate Planning for the Terminally Ill A practical guide to the logistics and administration of estate planning. Financial Literacy & Breast Cancer Definition of terms, budget sheets, and financial considerations to help you navigate MBC MBC Resources (Recap from SABCS 2022) Breast Cancer Advocates, Stephanie Walker and Christine Hodgdon share a PDF with MBC resources. Read the Blog Join Our Mailing List and Receive Weekly Newsletters and Announcements Subscribe to Our Mailing List Join Thanks for subscribing!

Your generosity gives hope. Find out how you can get involved and make an impactful and meaningful difference. Donate to breast cancer and make a difference. Lifestyle & Wellness Resources Programs Content Library Podcast Download the App Subscribe to the Newsletter Make a Gift More Make a Difference Through Asset Based Giving & Charitable Bequests Donating assets and making charitable bequests to SurvivingBreastCancer.org holds significant value and contributes immensely to our mission of providing comprehensive support, resources, and advocacy for those battling breast cancer. Below are several key points highlighting the importance and advantages of asset-based donations: $50 $100 $250 Making a Meaningful Difference: Your asset donations directly contribute to providing essential services, financial aid, emotional support, and educational resources to breast cancer patients, survivors, and their families. Each donation helps in fostering a community of hope and resilience. Tax Advantages and Financial Benefits: Because we are a federally recognized 501(c)(3) non profit donating appreciated assets, such as stocks, real estate, automobiles or other investments, may offer substantial tax advantages. It can result in tax deductions for the fair market value of the donated assets, potentially reducing capital gains taxes and providing significant financial benefits to the donor. Supporting Ongoing Programs and Initiatives: Asset-based donations contribute to sustaining and expanding SurvivingBreastCancer.org's programs, including support groups, awareness campaigns, research initiatives, and access to vital resources for underserved communities. Creating Lasting Legacies that live on: A legacy gift is a deeply personal way to ensure that your values, compassion, and commitment to community continue to make an impact—today and for generations to come. By including SurvivingBreastCancer.org (SBC) in your estate plans or making a legacy gift during your lifetime, you help ensure that no one faces breast cancer alone. Your generosity sustains free education, community connection, and integrative oncology–inspired programs for individuals and families navigating breast cancer at every stage. Encouraging Others to Give: Your donations serve as an inspiring example, encouraging others within our community and beyond to contribute, fostering a culture of generosity and philanthropy. The people in this community are so warm and welcoming. The conversations transcend beyond breast cancer stories, thus creating even stronger connections. I finally found my tribe! Your donation transforms lives How to Donate I encourage you to consider the significant impact of donating assets to SurvivingBreastCancer.org. Your contributions, whether large or small, play a pivotal role in our collective efforts to support and uplift those affected by breast cancer. Together, let's continue our mission of bringing hope, support, and strength to individuals and families facing the challenges of breast cancer. Or contact William at 603.361.7018 Email William Today Contact William directly to discuss the endless possibilities and to set up your donation. More Ways to Give If you would like to schedule an appointment and discuss legacy donations or endowments, please contact SBC. We are happy to partner with you! Donate by Check Survivingbreastcancer.org 5 Cedar Street, Suite 1 Roxbury, MA 02119 Checks can be made out to "Survivingbreastcancer.org" Donate by Venmo @Survivingbreastcancerorg Donate Securities Contact SBC Donate Now English Español

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

Your generosity gives hope. Donate to make a real difference in the breast cancer community, including through DAF and stock-based giving options. Lifestyle & Wellness Resources Programs Content Library Podcast Download the App Subscribe to the Newsletter Make a Gift More Community Our support groups provide a virtual community setting to allow those diagnosed to share personal experiences, ask questions, and foster connection. Our programs are tailored to early-stage breast cancer, those living with metastatic breast cancer, as well as inflammatory breast cancer which impacts less than 5% of those diagnosed. Your donation also enables us to provide complementary programs to help breast cancer survivors make sense of the trauma a breast cancer diagnosis brings through professionally led programs. Donate now Podcast, webinars & more! Knowledge is Power! Support accurate and trustworthy educational content in the form of blogs, articles, and research, to weekly podcast episodes and webinars where we interview the experts. Help us ensure that we are getting the information into the hands (eyes and ears) of those diagnosed who need it most! Donate now Trustworthy Information A breast cancer diagnosis at any stage is emotionally overwhelming, and it also comes with a lot of new information to absorb. At SurvivingBreastCancer.org, we've gathered resources to help new cancer patients and their families navigate this sea of information. We stay up to date with the latest clinical trials and curate content from trusted partners and providers so our community members can make informed decisions based on reputable sources. Donate now Hearing From The Experts Our travel grant program enables breast cancer patient advocates to attend important conferences and events such as the San Antonio Breast Cancer Symposium, the American Society of Clinical Oncology, Living Beyond Breast Cancer, and may others. Your generosity helps off set the cost of travel, registration, hotels, and meals so those diagnosed with breast can attend conferences, gain valuable information, and connect with survivors, thrivers, and patient advocates! Donate now In-Person Support Your contribution to our in-person breast cancer retreats provides those diagnosed with breast cancer to experience a much-deserved and needed respite for a long weekend. Participants on our SBC Retreats receive an all-inclusive weekend get-a-way to connect with others diagnosed with breast cancer, customized programming, delicious and nutritious meals, and opportunities to be in nature and make lasting connections. Donate now Donate to SurvivingBreastCancer.org At SurvivingBreastCancer.org (SBC), we believe everyone deserves free, compassionate support from the moment of diagnosis and beyond. Every day, people log on to connect with our global community of patients, survivors, thrivers, and caregivers who understand what it means to live with breast cancer. Your gift ensures this vital support is always within reach. Because of donors like you, SBC offers more than 400 free virtual programs every year to support mental, emotional, and physical health, from weekly meditation sessions to support group meet-ups and educational webinars. Our on-demand library of 600+ videos, podcasts, and resources empowers survivors and caregivers to find strength, information, and hope at any time, from anywhere. Donor-Advised Funds (DAF) Giving SurvivingBreastCancer.org now supports DAF contributions through Funraise! If you'd like to donate stock through your DAF account, the process is simpler than ever. Just click the DAFpay button to get started. We appreciate all types of contributions helping to support the breast cancer community! Securities & Stocks Donor Advisor Fund (DAF) Direct Donation By Check or Venmo Donate to Programs Your generosity funds life-saving support programs, innovative research, and empowers survivors to thrive beyond breast cancer. You can: Donate to the program of your choice Automate monthly, quarterly or yearly donations Let us know who you are honoring with your donation Donate Now Donate by Check Survivingbreastcancer.org 5 Cedar Street, Suite 1Roxbury, MA 02119 Checks can be made out to "Survivingbreastcancer.org" Donate by Venmo @Survivingbreastcancerorg Make a one-time or schedule a recurring donation to SurvivingBreastCancer.Org whether it is a personal donation or on behalf of a company. Donate Now Donate Stock or other Securities Legacy Donations or Endowments Public Traded Securities Asset-based Donations Donor-Advised Funds Please contact us to schedule an appointment. We are happy to partner with you! Contact us Donor Advisor Fund (DAF) A Donor-Advised Fund (DAF) is one of the most flexible and tax-efficient ways to support SurvivingBreastCancer.org. How to Make a DAF Gift Contact your DAF provider and recommend a grant to: SurvivingBreastCancer.org EIN: 82-2953427 Address: 5 Cedar Street Unit 1, Roxbury MA, 02119 Use our legal name: SurvivingBreastCancer.org, Inc. Notify us so we can thank you and ensure your gift supports the programs you care about most. Please contact us to schedule an appointment. We are happy to partner with you! Your Tax-Deductible Donation Makes a Difference! By donating, you’re ensuring we can continue to offer life-changing programs and services. All contributions are tax-deductible, and every dollar goes directly toward our cause! Community Education Resources Travel Grants Retreats Support Groups Our support groups provide a virtual community setting to allow those diagnosed to share personal experiences, ask questions, and foster connection. Our programs are tailored to early-stage breast cancer, those living with metastatic breast cancer, as well as inflammatory breast cancer which impacts less than 5% of those diagnosed. Your generous donation also enables us to provide essential complementary programs to help breast cancer survivors make sense of the trauma a breast cancer diagnosis brings through professionally led programs in art therapy and expressive writing. These modalities foster healing beyond just the physical. They touch upon the mental and emotional well-being of breast cancer survivors. Donate Now Podcasts, webinars & more! Knowledge is Power! Support accurate and trustworthy educational content in the form of blogs, articles, and research, to weekly podcast episodes and webinars where we interview the experts. Help us ensure that we are getting the information into the hands (eyes and ears) of those diagnosed who need it most! Donate now Trustworthy information A breast cancer diagnosis at any stage is emotionally overwhelming, and it also comes with a lot of new information to absorb. At SurvivingBreastCancer.org, we've gathered resources to help new cancer patients and their families navigate this sea of information. We stay up to date with the latest clinical trials and curate content from trusted partners and providers so our community members can make informed decisions based on reputable sources Donate Now Hearing From The Experts Our travel grant program enables breast cancer patient advocates to attend important conferences and events such as the San Antonio Breast Cancer Symposium, the American Society of Clinical Oncology, Living Beyond Breast Cancer, and may others. Your generosity helps off set the cost of travel, registration, hotels, and meals so those diagnosed with breast can attend conferences, gain valuable information, and connect with survivors, thrivers, and patient advocates! Donate Now In-Person Support Your contribution to our in-person breast cancer retreats provides those diagnosed with breast cancer to experience a much-deserved and needed respite for a long weekend. Participants on our SBC Retreats receive an all-inclusive weekend get-a-way to connect with others diagnosed with breast cancer, customized programming, delicious and nutritious meals, and opportunities to be in nature and make lasting connections. Consider giving a life-changing experience to those in our breast cancer community. Donate Now Like Meet our Founders Meet our Founders Meet our Founders Meet our Founders DONATE TODAY DONATE TODAY DONATE TODAY Testimonials Testimonials Testimonials Testimonials Help us provide crucial resources and support for breast cancer survivors, thrivers and their families. Every donation makes a difference. Donate Today Breast cancer is a significant health issue, impacting the lives of millions. According to the American Cancer Society, approximately 1 in 8 women in the United States will be diagnosed with invasive breast cancer during their lifetime, which translates to an estimated 297,790 new cases expected in 2024 alone . Your generosity funds life-saving support programs, innovative research, and empowers survivors to thrive beyond breast cancer. You can: Donate to the program of your choice Automate monthly, quarterly or yearly donations Let us know who you are honoring with your donation Get started Mental & Emotional Support Your generous donation enables us to provide essential complementary programs to help breast cancer survivors make sense of the trauma a breast cancer diagnosis brings through professionally led programs in art therapy and expressive writing. These modalities foster healing beyond just the physical. They touch upon the mental and emotional well-being of breast cancer survivors. Donate Now Donate $50 Donate $100 Donate $250 Support Groups Our support groups provide a virtual community setting to allow those diagnosed to share personal experiences, ask questions, and foster connection. Our programs are tailored to early-stage breast cancer, those living with metastatic breast cancer, as well as inflammatory breast cancer which impacts less than 5% of those diagnosed. Now those diagnosed with Inflammatory breast cancer finally have a community they can call their own! The online experience enables us to reach rural communities, health centers, and patients who may not have access to support programs otherwise. Your contribution makes our weekly support groups truly THRIVE! Donate Now Donate $50 Donate $100 Donate $250 Wellness Programs Give the gift of wellness. SBC offers many wellness programs tailored for those diagnosed with breast cancer. We offer weekly online classes such as Yoga, Meditation, Qi Gong, Pilates, Mindfulness, Movement Classes, and more! Donate Now Donate $50 Donate $100 Donate $250 Educational Content to Empower Knowledge is Power! Support accurate and trustworthy educational content in the form of blogs, articles, and research, to weekly podcast episodes and ask the experts webinars. Help us ensure that we are getting the information into the hands (eyes and ears) of those diagnosed who need it most! Donate Now Donate $50 Donate $100 Donate $250 Educational Travel Grants Our travel grant program enables breast cancer patient advocates to attend important conferences and events such as the San Antonio Breast Cancer Symposium, the American Society of Clinical Oncology, Living Beyond Breast Cancer, and may others. Your generosity helps off set the cost of travel, registration, hotels, and meals so those diagnosed with breast can attend conferences, gain valuable information, and connect with survivors, thrivers, and patient advocates! Donate Now Donate $50 Donate $100 Donate $250 SBC RETREATS Bringing People Together to Share Connection, Forge Friendships, and Create Lasting Memories $100 $50 $250 More Ways to Give Your Tax-Deductible Donation Makes a Difference! By donating, you’re ensuring we can continue to offer life-changing programs and services. All contributions are tax-deductible, and every dollar goes directly toward our cause! Donate by Check Survivingbreastcancer.org 5 Cedar Street, Suite 1Roxbury, MA 02119 Checks can be made out to "Survivingbreastcancer.org" Donate by Venmo @Survivingbreastcancerorg To: Donate Stock or other Securities Legacy Donations or Endowments Public Traded Securities Asset-based Donations Donor-Advised Funds Please contact us schedule an appointment . We are happy to partner with you!

A breast cancer diagnosis is life-changing for patients and their families. The SBC community will support you through every step of your treatment journey. Lifestyle & Wellness Resources Programs Content Library Podcast Download the App Subscribe to the Newsletter Make a Gift More Newly Diagnosed with Breast Cancer. Now What? What brings you to this website is most likely a breast cancer diagnosis. Perhaps you found a lump, noticed swelling or experienced pain; maybe you are awaiting test results; or you just heard the words that you've been diagnosed with breast cancer; or perhaps you are experiencing a recurrence. Whatever the reason, I want you to know that you will be supported and that our Surviving Breast Cancer (SBC) community is here for you! We are here to help! A breast cancer diagnosis disrupts our lives and throws us into a whirlwind of doctors appointments, follow ups, tests, scans, and the like. Each and every one of us have unique experiences, and what our SBC platform and community provides is education, support, and resources for you as a complement to your medical care. We are not medical professionals, nor provide medical advice. But what we do offer is content, stories, and community when you need it most! What I mean by that is you are welcome to dive in to absolutely everything we offer today, or, you can take bite size approaches to get the information and support when you feel ready for it. We've listed a few links and resources to help get you started and to hopefully make things a bit less overwhelming. Download. Questions to Ask Your Surgeon Download PDF Questions to Ask Your Radiologist Downlod PDF Questions to Ask Your Oncologist Download PDF Burning Questions Latest News Who Should I Tell? Learning that you have been diagnosed with breast cancer can set you into a whirlind of uncertainty and that is to be expected. There is probably a lot of information you do not yet know. At this time, you may want to start thinking about who you should tell. While this can also be difficult for loved ones, family, and friends to hear, you are actually in the process of cultivating your support team! Remember, you do not need to tell everyone all at once. Perhaps starting with close family, let friends know how they can help support you during this time. It is a personal decision on how private or public you want to be and completely your choice in how much information you choose to share. You may want to have seperate conversations with your children depending on their ages. We also recommend speaking with your medical team about your treatment options and getting a plan in place for when you may need to take time off from work or be out of the office. Should I Get A Second Opinion? You may consider receiving a second opinion from another medical oncologist or breast surgeon. In some cases, people get multiple opinions before making any decisions on their care and medical treatment plan. Women in our Breast Cancer Support Group often share that it is important for them to feel comfortable with your doctors; that there is a rapport and trust. After all, your medical team is going to be your primary caregiver throughout treatment so it is important you feel comfortable with the person, able to ask questions, and feel confident in your plan of action. Your Medical Care Team may consist of one or several of the following: Breast Oncologist Breast Surgeon Breast Plastic Surgeon Radiation Oncologist Social Worker Psychologist What Treatment Options Do I Have? Thanks to continued research taking place in Breast Cancer, people diagnosed today have a variety of treatment options and are able to live long healthy lives. Treatment options will be tailored to your specific diagnosis and dependent on the stage of your breast cancer (1-4) and it's characteristics. For example, is it HER2 positive or negative, is it triple negative meaning it is estrogen receptor negative, progesterone receptor negative and HER2 negative. Your oncologist will also take into consideration how advance the cancer is. During this phase you may be getting more tests and scans. During this phase, you may also consider genetic testing. Genetic testing is helpful for a multitude of reasons including helping to make surgery decisions. If you end of testing positive for a genetic pre-disposition to developing breast cancer, your surgeon may recommend a full double mastectomy. Traditional standard of care includes: Surgery (not always required if you are diagnosed with metastatic stage IV breast cancer, that is, your cancer has spread beyond your breast to your bones, lungs, liver, or brain) Radiation (not always required) Chemotherapy (not always required) Hormonal Therapy (not always required) Oftentimes people will also consider integrative therapies as a complement to the standard treatments which also has been shown to reduce some of the side effects of treatment: Acupuncture Yoga Meditation Additionally speak to your oncologist about Clinical Trials and if you would be a candidate. Will I Need Chemotherapy? Not everyone diagnosed with breast cancer will need chemotherapy. There are several factors that go into this determination and should be a conversation you have with your oncologist. For example, your doctor will take into consideration the stage of cancer that you have (i.e., stage 1, 2, 3, 4) and the characteristics of your tumor, (i.e., if it is hormonal positive or negative) etc. In some instances, chemotherapy will be an option for people prior to surgery. This is called neo-adjuvant chemo. Other times, chemotherapy may be prescribed after surgery which is referred to as adjuvant chemotherapy. . Join our community SBC offers a safe space to build community. We provide reliable information and offer what you most need during the diagnosis: understanding. English Español