By Sara Kandler We roam our Brooklyn streets neighbors huddling all of us ghosts chat softly with our young son gaping construction site fat pigeon circling while tiny papery fragments fall from the bright September sky settling on our forearms We blow at them and wonder fibers of a love note? pencil shards? a fingernail? No choice but to inhale these ashes the nuclear fallout we’d only imagined Radio voices tell us this is not a war between East and West but we feel it so crushing clash of cultures sorrowful bequest How to stay close in this tsunami of distress? At night our toddler drifts off to sleep nothing to do but curl around him our backs arched into a bony heart a cage a brace a frame Nothing to say no words no lexicon no name for this disaster this massacre Leila saïda my husband whispers in Arabic good night kisses our son’s doughy forehead the quiet metronome of his breathing so soothing then movement below something shifting landforms drifting readjusting leila saïda a soft spoken promise draws the dunes of Fire Island toward those of El Jadida to form a modern day Pangea and we dream of another radiant morning the ground trembles then surges skyward tall towers of stone this time arcing bonding the continents finally, we’re home *This poem first appeared in the poetry journal ONE ART. Follow Sara on Medium: @sarakandler Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Ginger Guzman How I anxiously longed for your arrival when I was young Waiting impatiently for you to finally make your appearance But frightened and shy of you all the same, afraid of how it would be When you finally did make your debut I was so very proud of you You brought me to the portal of adulthood where I first caught a glimpse of the future me Your entrance made me feel that I was on my way To finally becoming a woman The furtive timid looks from boys The first shy explorations of what it meant to have you as a new elemental part of me As we both grew, you introduced me to sweet sensations and sensual play That heralded so many changes and exciting promises of corporal joys You would never grow so very big, but you became an essential feature Of who I was; from your advent there was no me without you I am ashamed now that I took you for granted for so many years Annoyed with you the times you caused me discomfort and pain Forgive my stupidity, I took you for granted and now I shed an ocean of tears For I never realized the day would come that we two could no longer together remain There must be more to you than just skin, tissue, veins, blood What happens to you after they cut you off? Where do you go? Do they just throw you out? Do you just disintegrate and fall apart in some trough? How do I know, really truly know, that I have no choice, how do I live with the doubt? But in my heart of hearts, in the secret place where I seldom go There lives a voice that tells me what I need to know And she tells me now that I must learn how to say goodbye The experts are right; I must acquiesce and comply In the best way I can and with all the love I am able to show But how I wish there was someone, some book or class, to teach me to let go, to teach me how You were the first definitive sign of my womanhood, In you lives my youth, my girlhood dreams, those sweet fumblings & breathtaking discoveries, All those years, all those dreams that I can longer dream, all I must keep locked in my heart I must let go of the bad and only retain the good Without you, I must find my way to a new start Your door must close, another opens now… Once again, you bring me to the very precipice of a new world where I am poised to jump I fear it won’t be as full of wonder and discovery As the one you first showed me But perhaps it may be filled with the wisdom I so desperately need And possibly lovely surprises may well await me where I go I pray that I have the courage to say goodbye and set you free Time is a commodity too precious to put in peril or squander, I mustn’t tarry any longer; I beg of you one more gift: please take this disease with you and leave me unbowed Take all the cells that won’t stop multiplying, take their malevolent intent with you on your way And leave me more courageous, smarter, braver, kinder, stronger Make all my fear, meanness, self-pity, despair, doubts depart, and I vow not to pass a day That I do not remember and do my best to make us both proud Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Gillian Pulford The spotlight shone as she stood De-robed-blindfolded Devoid of the familiar Guided to the table – she lay down, because they told her to Kind words deflected by an iron curtain of fear Bang they shot Bang, they shot again Transported to another world Was she dead? No, at least not yet But a different path in a parallel world lay ahead And there was no guide Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Rafia Nasir Food plays a vital role in our health. For those diagnosed with breast cancer, choosing the right diet can significantly support overall well-being and aid in the recovery process. It’s crucial to understand that good dietary choices may help improve symptoms and impact your overall quality of life. Breast cancer is unique to each individual, and there are various subtypes of the disease. Treatment plans can also differ from case to case. For these reasons, there is no one-size-fits-all diet for everyone. Rather, you can work with your healthcare team to determine the right food choices for your situation. As an oncology pharmacist, I’m sharing steps to consider when making food choices during your experience with breast cancer. While this information will help you understand a general approach for your nutrition, it’s strongly recommended that you consult a registered dietitian with oncology expertise for personalized advice. Here are some suggestions for how to get started: 1. Understand Your Unique Diagnosis: Determine your breast cancer subtype. Your subtype is typically included on pathology reports and other documents from your doctor. Confirm this by asking your doctor directly if you’re unsure. Breast cancer subtypes are different from one another and each subtype has unique dietary recommendations. Research the dietary guidelines relevant to your breast cancer subtype, and ask your dietician for their recommendations. 2. Consider Your Comorbidities: If you have pre-existing health conditions like hypertension, diabetes, obesity, or any others, it can influence the food choices you make during your breast cancer experience. This is because these conditions can interact with your dietary needs and considerations. Make sure your oncologist is informed when you make significant dietary changes. Provide your dietitian with information about any other conditions when creating your customized meal plan. 3. Understand Your Treatment Plan: Confirm your treatment plan with your oncology team: surgery, radiation, or medication-based approaches like chemotherapy, immunotherapy, targeted therapy, or hormonal treatment. Each treatment has dietary considerations and guidelines, indicating what’s suitable and what to avoid during treatment. It’s important to note that certain foods can have interactions with cancer medications, potentially affecting the medication’s effectiveness or exacerbating side effects. For example, you may have heard about grapefruit interacting with some medications. Or perhaps you’re wondering if you can safely enjoy small amounts of alcohol while you’re in treatment. Make sure to ask your oncology team, pharmacist, and dietician to confirm your understanding of any possible interactions. 4. Adapt for Your Side Effects: Your cancer treatment may cause a range of side effects, which can differ from patient to patient. As a result, your diet might require modifications to help alleviate these side effects and provide relief. Your doctor may advise managing your side effects at home through dietary changes or over-the-counter medications, or they may advise you to seek medical attention from your care team. Remember that cancer is a complex experience, and you’ll need to seek assistance from various oncology specialists as you navigate treatment. Your healthcare team can provide you with the guidance needed to navigate through the complexities of cancer treatment, including specific diet and food recommendations. Coupled with advice from a registered dietician, this support can help you make good nutrition choices for your unique situation. Learn more: Metabolic Changes After a Breast Cancer Diagnosis Diet and Breast Cancer Newly Diagnosed Different Types of Breast Cancer Understanding Your Pathology Report 11 Tips to Manage Chemotherapy Side Effects On the Breast Cancer Conversations Podcast: What’s the Difference Between Diet and Nutrition? From the same author: 10 Common Myths About Cancer Navigating Cancer Treatment: Top Tips from an Oncology Pharmacist Unlocking the Power of Emotional Intelligence Author bio: Rafia Nasir holds a Pharm-D degree and has extensive clinical and oncology experience. She worked for four years as a clinical pharmacist in medical oncology at an ISO-certified military hospital in Pakistan. Her experience as a clinical pharmacist helps her understand cancer treatment and the importance of individualized care. She currently works as a medical writer covering cancer treatment and research. By leveraging her clinical experience, she is able to translate complex medical information into patient-friendly language to help patients better understand their disease and treatment options. Through her work, she aims to bridge the gap between medical expertise and patient understanding. With a strong focus on patient education, she is committed to helping patients and their caregivers tackle cancer treatment complexities with confidence and hope. SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Dawn Oswald You’re worth it I’m worth it We are all worth it So get up and tell the whole world Do what you want And buy what you want Because you’re worth it Yell, kick and scream Tell them to listen to you Be that judge Hit your hammer Tell them eyes on me and listen This is what I want I want everyone to hear me Because I am worth every cent Spread the word I am in charge Keep listening I have more to say You can jump on my bandwagon Or jump off at the next stop Get a clue Not a hint or two Listen Hear me roar For I am worth it Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Jan Hillman My name is Jan and I’m three months into my third breast cancer journey. I was first diagnosed in 1986 at age 34 with stage two breast cancer in my right breast. I was treated with a lumpectomy. Eleven years later, another tumor appeared in the same breast. A PET scan revealed a second mass, both stage two, and I had a mastectomy and reconstruction. My life has been an amazingly positive journey, and this third chapter is a defining one. The new year of 2023 began positively. After years of volunteering for Breast Wishes Foundation (BWF), a Southwest Ohio-based non-profit organization granting wishes that bring joy to those with breast cancer, it was time for me to take the next step. That next step was answering the invitation to be the chair of the BWF Board. As Board members, we rolled up our sleeves. With a new 2023-25 Strategic Plan and vision to grant 500 wishes by the end of 2025 (as of this printing, 250 wishes have been granted), we grew our Board, raised more funds, and strategically marketed BWF. Early in the year, I was feeling fatigued and my joie de vivre had diminished. My primary care provider ordered blood work that revealed that I was anemic. She discussed this with me and recommended that I have a colonoscopy and an EDG, in which a gastroenterologist looks at the lining of the esophagus, stomach, and duodenum. I had both of these procedures and awaited the results. On a Wednesday evening in mid-May, I received a call and news from my gastroenterologist, Dr. Samuel, which was shocking, breathtaking and completely unexpected. He tried to soften the message by saying that he had bad news. Something about the hour and his tone of voice made that statement clear as glass. He continued to say, “Jan, you have metastatic breast cancer in your stomach.” Wait – what?! Dr. Samuel underscored the rarity of this finding, how it was surprising to him and the pathologist who had analyzed the biopsied stomach tissue. He told me that he had contacted an oncologist, Dr. Chamarthy, who would call me as soon as we said goodbye. My mind flew back to 1986 and 1997 when I was diagnosed with stage two breast cancer. All those old memories and treatments resurfaced, including the lumpectomy in 1986 and the mastectomy in 1997. Back to the present time… Dr. Chamarthy called me directly and we scheduled an appointment right away. My fiancé, Barry, accompanied me to my appointment and Dr. Chamarthy underscored the rarity of breast cancer metastasizing to the stomach. We discussed options for diagnosis and treatment and decided to proceed with additional diagnostic testing including PET scan, CT scan, brain MRI, bone biopsy, bone marrow biopsy, and breast MRI. Good news came from the breast MRI; there was no breast cancer found in my breasts. However, beyond my stomach, metastasis was discovered in my spine, rib, pelvis, sternum, bone marrow and skull (not brain). For my treatment, Dr. Chamarthy recommended chemotherapy in the form of intravenous paclitaxel and I had a port placed in my upper chest to ease chemotherapy administration and blood testing. By my choice, I am receiving 95% of my health care from Premier Health here in the greater Dayton, Ohio area, with most of that care at Upper Valley Medical Center (UVMC). I chose UVMC because it is close to home and, moreover, the compassionate, caring, skilled staff and their friendliness provide a comfortable feeling at every appointment, treatment and procedure there. My health care team is superb and every member including the nurses, physicians, technologists and all the other members have gone above and beyond to provide me with stellar care aimed at my healing. I am an equal opportunity healer and have continued to meditate and pray daily, keep up with my yoga and stretching practices, eat healthfully, walk, garden, and have weekly reiki and chiropractic treatments. The outpouring of love, prayers and support from friends, family and complete strangers has been astoundingly beautiful. It has been three months since I first learned of my metastatic third breast cancer. I’m living each day fully and that means keeping my life perspective in laser focus – forgiving, letting go and healing; not taking myself or my disease too seriously; having loving, memory making, and meaningful, thriving time with family and friends; and maximizing the power of positive change that comes with the most challenging life situation I’ve ever experienced. In real terms this also means devoting time, energy and strategy to raising funds and granting wishes for Breast Wishes Foundation. My approach is inviting people to learn about the power of bringing joy to those with breast cancer by granting wishes and requesting their consideration to give the gift of joy. Helping grant wishes that bring joy for others with breast cancer is bringing me immeasurable joy. Joy is truly the mother and father of hope. I commend the work of Surviving Breast Cancer! SBC’s mission to empower those diagnosed with breast cancer and their families from day one and beyond is powerful and uplifting, the core values are right on and the approach is strong. Bravo and kudos to Surviving Breast Cancer! Thank you for sharing your story, Jan. SBC loves you! Learn more: SBC Meditation Library New Meanings and Shifting Priorities The Alternative to Feeling Like a Victim On the Podcast: Breast Cancer Conversations How to Get a Grip: Coping Strategies for Complicated Times SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events Submit Your Writing: SBC Blog Submissions

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

By Julie Maley In life’s quiet tapestry, a storm did brew, Breast cancer’s shadow fell, my fears it drew. A wake-up call profound, it shook my core, From caregiving roles to seeking life’s grandeur. For years, my days were woven threads of care, Tending to others’ needs, burdens to bear. Preparing for the age of silvered grace, I tucked my dreams away, left no trace. But fate, relentless, knocked upon my door, Breast cancer’s specter, a truth to explore. It whispered of uncertainty, a twist of fate, The urgency to live, not hesitate. Fear coursed through veins like wildfire’s embrace, Yet in its grip, I found a newfound grace. The looming darkness carved a path of light, Guiding me to strength, igniting a fight. Strangers vanished, friends turned faces away, Yet in the darkness, love found a way. My husband, steadfast, stood by my side, A beacon of hope, in whom I could confide. For eighteen months, his love was my shield, As treatments waged war, together we healed. Others’ selfish whispers faded in the din, His care a testament, a love without sin. In vulnerability, I learned to be strong, In solitude’s embrace, I found where I belong. No longer just a caretaker in life’s grand play, I emerged as a warrior, seizing each day. Breast cancer’s grip, a catalyst so dire, Awakened my spirit, set my soul on fire. No longer defined by others’ whims and plans, I reclaimed my life, anew it began. So let the scars tell stories of battles won, A reminder of strength when darkness had won. Breast cancer’s shadow, it scared me to see, That life’s true gift is the chance to be free Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

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

By William Laferriere I’ve taken such great pleasure In watching a few of the latest Tour de France Bicycle race segments. I’m captivated and cannot help but draw Upon the many parallels of the peloton To our extensive breast cancer community. I dwell on it as a metaphorical gestalt: The peloton represents the community, The coaches, strategists and drivers Our myriad medical teams The spectators our friends, families, caregivers, & coworkers. For the peloton serves admirably as a collective body Depicting a united front and Represents our community writ large. The suffering, crashes, heat, crosswinds, Constant elbows, technical bike issues, losses, wins, Resemble our many successes, difficulties, setbacks, & colossal side effects, As we too seek to drive forward, To survive and prosper And to enjoy the road ahead of us. We observe the peloton as the bicyclist’s best weapon against The many provocative challenges, Mountains, weather, slick roads, Incalculable distances, Pedestrians clogging the pathway, And represents how We as a community Can best beat back our many tests Trials and travails. The peloton serves a familial duty In retrieving & returning the breakaway/lead riders, It also performs the admirable task Of recovering those that fall behind, & protects those Who have tumbled. The teammates and coaches within Constantly remind each other To take advantage of drafting techniques & of hydration and nutrition’s vast import For all recognize the significance Of appropriate fueling, output and rest. And so we too head towards The legacy of a finish line And know that our collective efforts Are most certainly appreciated, Respected, admired, and acclaimed. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Laura Carfang Edited by Meghan McCallum Breast cancer is a devastating disease that affects millions of people worldwide. According to the American Cancer Society, breast cancer is the second most common cancer in women, with approximately 2.3 million new cases diagnosed each year. Despite advances in treatment options, the risk of recurrence and the potential for metastasis remain significant concerns for breast cancer survivors. However, there is new hope on the horizon in the form of a breast cancer vaccine. A recent episode of the SurvivingBreastCancer.org podcast Breast Cancer Conversations, hosted by Laura Carfang, highlights the promising breakthrough of a breast cancer vaccine. The episode features Dr. Amit Kumar, the chairman and CEO of Anixa Biosciences, and Jennifer Davis, the first recipient of the triple negative breast cancer vaccine, which is currently in testing with Cleveland Clinic. Dr. Kumar, a trained scientist with extensive experience in the biotech industry, explains that Anixa Biosciences partnered with Cleveland Clinic in 2019 to bring this groundbreaking vaccine technology out of the laboratory and into human testing. The vaccine is designed to prevent the recurrence of breast cancer in survivors and potentially even prevent the onset of cancer in individuals who have never had breast cancer before. While the vaccine’s initial target is triple negative breast cancer, Dr. Kumar believes that this technology has the potential to prevent other types of breast cancer as well. Dr. Kumar emphasizes the significance of targeting triple negative breast cancer, which has not previously been achieved as it has for hormone receptor positive breast cancers. “If you have triple negative breast cancer, there’s really nothing out there in targeted therapy today. As a result, triple negative—which also happens to be the most lethal form of [breast] cancer and the most aggressive type of [breast] cancer that results in the most recurrences—really doesn’t have a lot of good therapies.” He notes that while there are specific treatment options for triple negative breast cancer, the treatment process is extremely challenging for those undergoing it. The hope with the vaccine, then, is to eliminate the need for this brutal treatment altogether by preventing the cancer from developing in the first place. Dr. Kumar collaborated with Cleveland Clinic to develop the vaccine. He met Dr. Vincent Tuohy, the immunologist at Cleveland Clinic who invented the technology behind the vaccine, and the two decided to commercialize and develop it for clinical use. Unfortunately, Dr. Tuohy passed away before seeing his vision come to fruition. The vaccine has since entered human testing and shows promise for the future. Dr. Kumar expresses deep gratitude for Dr. Tuohy’s work and the significant impacts it could have on the future of breast cancer prevention. Jenni Davis, a registered nurse, was diagnosed with triple negative breast cancer at the age of 41. She underwent chemotherapy, radiation, and a double mastectomy. As a patient at Cleveland Clinic, Jenni learned about the vaccine in development after finishing her treatment. Once it was available through the trial, her healthcare team advised her that she could be a good candidate for it. “I was so happy about it,” she says. Jenni was able to meet the trial criteria, and she received the first of three doses of the vaccine on October 19, 2021. The vaccine had been in research for over two decades at that point, Dr. Kumar notes, and Jenni was the first human to receive it. “I’m so very thankful to Anixa and Cleveland Clinic for coming together and rolling out this vaccine,” Jenni says. She is excited about the possibilities it holds for the future of breast cancer treatment and prevention. The vaccine is currently in early Phase 1 testing, and the initial data looks promising. If successful, this vaccine could be a game changer in the fight against breast cancer. It has the potential to significantly reduce the risk of recurrence and improve overall survival rates for those diagnosed with breast cancer. Additionally, it could offer hope to individuals who have never had breast cancer by providing a preventive measure against the disease. The podcast episode underscores the importance of early detection and regular screenings for breast cancer. It also emphasizes the significance of research and innovation in finding new and effective treatments. The collaboration between Anixa Biosciences and Cleveland Clinic is a testament to the power of partnerships in advancing medical breakthroughs. Listen to the episode: Good News for Triple Negative Breast Cancer: A Vaccine and Hope for the Future More information: Cleveland Clinic: Is a Preventive Breast Cancer Vaccine in Our Future? Cleveland Clinic Launches First-Of-Its-Kind Preventive Breast Cancer Vaccine Study Anixa Biosciences: Cancer Vaccines ClinicalTrials.gov: Adjuvant Therapy With an Alpha-lactalbumin Vaccine in Triple-Negative Breast Cancer

By Dawn Oswald Mask Why do we wear them? Is it to hide? To mask our pain? Is it for a party? To enjoy life? Mask, why do you wear them? I put on a mask for my brave face For my family Masks can be sad or happy They can be beautiful or ugly Masks can be worn throughout the day What would your mask look like? The mask can be changed at any time Just as people change their hats A mask for this A mask for that Wear it for whatever reason To be brave To just be sad for a moment To be glad To be powerful To help others Do you mask your pain so others don’t worry? Do you say I am good or say I am okay? Is it harder to lie or tell the truth? Is it a lie if you don’t want them to worry? Do you mask your quality of life? Do you do one day at a time like me? That’s what I tell people to do: “One day at a time.” Do you mask your sadness or depression? Do you ask for help? I wear multiple masks A mask to help you, to help me, to help everyone A mask of laughter, love, of concern, patience and of hope Masks can be of many colors The color of a rainbow It can be black or white A mask of different faces: sad, happy, grieving, or even scared It can be whatever you want it to be It is your mask You chose what mask you want to wear What mask do you have on today Wear it proud I am going to wear my mask of bravery, love, hope and caring for us all Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

You may have heard the term “genetic testing” from your doctor or a friend, but what is it? Genetic testing has revolutionized the medical landscape by providing crucial insights into the potential risk of developing certain diseases. The Mayo Clinic suggests that genetic testing for BRCA1 and BRCA2 mutations can offer valuable information about an individual’s cancer risk. However, the process can be confusing. Continue reading to learn about genetic testing for BRCA1 and BRCA2 mutations, the testing process, risks, benefits, and implications. What Are BRCA1 and BRCA2? BRCA1 and BRCA2 are human genes that produce proteins responsible for repairing damaged DNA and play a significant role in maintaining the stability of our cells’ genetic material. Everyone has the BRCA1 and BRCA2 genes – it’s the mutations to these genes that are a concern. When these genes are altered or mutated, they may not function properly, leading to the development of certain types of cancers, most notably breast and ovarian. What Is BRCA1 and BRCA2 Genetic Testing? According to the Cleveland Clinic, BRCA1 and BRCA2 genetic testing involve analyzing these genes for potential mutations. It’s typically performed with a blood test, although a saliva sample can also be used. The Importance of Genetic Testing for BRCA1 and BRCA2 Mutations Genetic testing for BRCA1 and BRCA2 mutations is vital as it helps individuals understand their risk of developing cancers, including breast and ovarian cancer. Knowing your genetic risk can lead to early detection or prevention measures. Who Should Consider Genetic Testing for BRCA1 and BRCA2 Mutations? Individuals with a strong family history of breast or ovarian cancer should consider testing. In addition, people with Eastern European (Ashkenazi) Jewish heritage have a higher prevalence of BRCA1 and BRCA2 mutations. Additionally, people diagnosed with breast cancer may be encouraged to take the test to learn about family members’ risk. However, it’s crucial to consult a healthcare provider or genetic counselor before taking the test. They can assist in understanding the potential risks, benefits, and limitations of genetic testing. What Can the Results From a BRCA1 and BRCA2 Test Reveal? Genetic test results can be positive, negative, or uncertain. A positive result means that a person has a mutation in BRCA1 or BRCA2 and, therefore, a higher risk of developing certain types of cancer. However, a positive test does not mean a cancer diagnosis is inevitable. Rather, it means that the risk is higher than the general population. A negative result can be more difficult to interpret because it depends on the individual’s family history of cancer. It can mean no mutation detection, but this doesn’t mean you have no risk of developing these cancers. It is essential to discuss your results with your healthcare provider or genetic counselor to understand what they mean for you. How to Manage a Positive BRCA Mutation Test Result If you have a positive BRCA mutation test result, several risk-reducing strategies are available, including more frequent screenings, medications, and preventive surgeries. A genetic counselor can provide detailed information based on your situation. What Are the Risks and Limitations of BRCA1 and BRCA2 Genetic Testing? While genetic testing can be useful, it also has potential limitations, including: Uncertain Results Sometimes, genetic tests identify a change in BRCA1 or BRCA2 that hasn’t been previously associated with cancer, called a variant of uncertain significance (VUS). Psychological Impact Learning about an increased risk of cancer can cause anxiety and stress. You may also have concerns about what this means for other biological family members. Test Limitations A negative test result doesn’t eliminate your risk of cancer. Understanding genetic testing for BRCA1 and BRCA2 mutations can empower individuals to make informed decisions about their health. Genetic testing is just one piece of the puzzle; other factors like lifestyle and environmental influences can also contribute to your risk. Genetic testing can provide valuable insights, but it’s not a crystal ball predicting your future health. Count On Us for Information, Resources, and Support Whether you’re newly diagnosed with breast cancer, are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms, testing, treatment options, surgery, etc., and podcasts that feature professionals, advocates, and caregivers that share valuable information. Your donations enable SurvivingBreastCancer.org to offer resources and support every day, every month, and every year. Note: This article is designed to provide general information and is not meant to replace professional medical advice. Always discuss your test results with your healthcare provider. Learn more: The Power of Knowledge (My BRCA Story) Genetic Testing for Cancer – What You Need to Know Reassurance for Genetic Testing Newly Diagnosed. Now What? You Might Also Like: Breast Cancer Conversations Podcast Episode 49: Understanding the Complexities of Genetic Testing SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Rafia Nasir Cancer is a complex and often misunderstood disease that affects millions of people across the globe. Unfortunately, misconceptions and myths about cancer can spread misinformation, fear, and confusion. Let’s dive into 10 common myths surrounding cancer and unravel the truth behind them. Myth 1: Cancer always leads to death One of the most common myths about cancer is that it is always fatal. It is true that cancer is a serious and potentially life-threatening disease. However, advances in early detection, treatment options, and supportive care have significantly improved survival rates. Many people are successfully treated and live full lives after being diagnosed with cancer. Myth 2: Superfoods or specific diets can cure cancer Although maintaining a healthy diet is important for overall health, there is no specific diet or food that can cure cancer. Some foods have beneficial properties or antioxidants that may support overall health, but they cannot replace medical treatment for cancer. It is very important to rely on evidence-based medical treatment provided by healthcare professionals. Myth 3: Only old people get cancer Cancer can affect people of all ages, including children and young adults. Although the risk of developing cancer increases with age, it is important to know that cancer can occur at any stage of life. The incidence of some types of cancer, such as leukemia and sarcoma, is higher in younger people. Myth 4: Mammograms cause breast cancer Mammograms, the X-ray imaging used to screen for breast cancer, do not cause breast cancer. The benefits of regular mammograms in detecting breast cancer early and increasing survival rates far outweigh any potential risks associated with the procedure. Myth 5: Hair color causes cancer There is no conclusive evidence linking the use of hair dyes to an increased risk of cancer. Although some studies have suggested a possible association, the overall risk is still considered minimal. Note: Some hair products such as straightening or smoothing treatments may contain formaldehyde or formaldehyde-releasing preservatives (DMDM hydantoin, imidazolidinyl urea, or quaternium-15, which can release formaldehyde over time). Prolonged inhalation or high levels of formaldehyde exposure have been associated with an increased risk of certain cancers, including nasopharyngeal cancer and leukemia. Regulatory agencies enforce restrictions on the concentration of formaldehyde in everyday consumer products to ensure safety. However, individuals with sensitivities or concerns may opt for alternatives that are formaldehyde free. It is advisable to carefully examine ingredient labels before using hair products and to follow safety instructions provided by manufacturers when using hair dyes. Myth 6: Cancer is only caused by genetics While genetic factors may contribute to an individual’s risk of cancer, lifestyle choices and environmental exposures also play a role. Tobacco use, unhealthy diet, physical inactivity, exposure to carcinogens, and other lifestyle factors can greatly increase the risk of cancer, even in individuals without a family history of the disease. Myth 7: Alternative therapies can cure cancer Alternative therapies and treatments can provide comfort and relief from symptoms, but should not be considered a cure for cancer. Effective management and treatment of cancer requires reliance on evidence-based medical treatments provided by healthcare professionals. Myth 8: Cancer is contagious Contrary to popular belief, cancer is not contagious. It cannot be transmitted from person to person like an infectious disease. Cancer is caused by genetic mutations or other factors in a person’s own cells, and is not caused by contact with or proximity to someone with the disease. Myth 9: Biopsies cause cancer to spread Biopsies, which involve removing a small sample of tissue for examination, do not cause cancer to spread. A biopsy is essential to accurately diagnose cancer, determine its characteristics, and guide appropriate treatment decisions. Myth 10: Sunscreen causes vitamin D deficiency Sunscreens are an essential tool for protecting the skin from harmful UV rays, reducing the risk of skin damage and skin cancer. But some people believe it can lead to vitamin D deficiency. Sunscreen does not completely block the skin’s ability to produce vitamin D. Even when wearing sunscreen, the skin can still absorb some UV radiation, allowing for adequate vitamin D synthesis. Additionally, there are other sources of vitamin D, such as certain foods and vitamin D supplements, which can help maintain optimal levels. Remember to seek reliable sources and consult with healthcare professionals for accurate information about cancer. It is important to dispel myths about cancer to promote understanding and make informed decisions. Feel free to share any other myths or questions you may have, and we’ll be glad to address them. Together, we can dispel misconceptions and promote awareness. Learn more: Diet and Breast Cancer Breast Cancer Risk Factors Reducing the Risk of Breast Cancer Recurrence 9 Essential Tips for Breast Cancer Survivors Cancer Etiquette: How to Talk with Loved Ones About Their Breast Cancer 10 Myths and Facts About Male Breast Cancer On the Breast Cancer Conversations Podcast: Diet, Exercise, and a Breast Cancer Vaccine, Oh My, with Judith Fitzgerald From the same author: Navigating Cancer Treatment: Top Tips from an Oncology Pharmacist Unlocking the Power of Emotional Intelligence Author bio: Rafia Nasir holds a Pharm-D degree and has extensive clinical and oncology experience. She worked for four years as a clinical pharmacist in medical oncology at an ISO-certified military hospital in Pakistan. Her experience as a clinical pharmacist helps her understand cancer treatment and the importance of individualized care. She currently works as a medical writer covering cancer treatment and research. By leveraging her clinical experience, she is able to translate complex medical information into patient-friendly language to help patients better understand their disease and treatment options. Through her work, she aims to bridge the gap between medical expertise and patient understanding. With a strong focus on patient education, she is committed to helping patients and their caregivers tackle cancer treatment complexities with confidence and hope. SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Shelley Caruso The morning always greets the horizon with color... The disappointment that sometimes enters our lives is just a period of reset. A reminder of how fragile all our tomorrows are, but at the same time how resilient the soul is. Adjusting your journey just for a time keeps us from becoming shipwrecked. Sometimes storms can take the wind out of your sail, but when the storm comes pull down your sails and weather the storm. I have been in a lack of energy. I have just realized I have been fighting to gain it back, which is actually more draining... My mind keeps racing to do this and do that and I am watching life speed past me. I’m so afraid I’m missing out on something when all the while I am, because my focus is just on that. It may take me a little time to get my groove back, but learning how to get there is part of the process. Today I choose to enjoy the sunrise with a grateful heart, knowing my time now is to continue to dance in the rain. Follow Shelley: @artofthebeholdershop Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Sara Kandler A trip up to the Cape in early July preposterous says Mom August is the time my dear to gaggle on Ballston haggle at the flea market pant up the cliff at Longnook But this trip feels different because it is forty years hence no low picket fence dissecting the dune buoys slung over the back rail outdoor shower bodies wet and naked stark tan lines We’re bringing you back as promised that’s why I whisper an inn a pilgrimage clandestine mission your wishes Pack tee shirts toiletries a talisman Nestle you together mounds of gray powder heavy as clay of clay We hike far enough find the spot immerse ourselves release you Dad sifts into the dashing waves reflecting the setting sun Mom swirls in the wind paintbrushes poised singing spirits free and what of us of me? Follow Sara Kandler: https://medium.com/@sarakandler Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Ann Fonfa Never again will I be able to serve dinner, lift up my top and be the topless waitress (with something on top). Never again will we walk arm in arm in the rain with his elbow bumping my breast (we talked of this in later years as one of our memorable moments). Never again will I wear a 34D bra. Good and bad. He remembers the first time he saw me without my blouse. He was stupefied. That memory lingers still. I was 19. Never again will I fill out my silk high neck blouses. Never again will crude men admire my “hangnail.” Never again will my breasts be crushed in a mammography machine. Never again will my breasts be crushed against my lover’s chest or breasts. Never again will my breasts ache before my period. That could have been changed by menopause if it had occurred first. Never again will I catch men addressing my chest instead of my face. They certainly used to. Never again will I be so relieved to remove my bra at the end of the day. I won’t have deep red marks on my shoulders anymore either. Never again will I fill out that black corset that Barbara bought for me at a tag sale for $0.50. It looked so good too. Never again. But then again, I’ll never be 25 again either. And life goes on its merry way. And my husband just called me gorgeous in that totally believable way he has. © Ann Fonfa 1997 Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

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

Breast cancer recurrence is the return of cancer after treatment, and it is a concern for many breast cancer survivors. High-risk patients, who have a higher chance of recurrence, require more proactive management strategies to address this concern. What makes someone high risk for breast cancer recurrence? While it is not always black or white, here are some of the general factors that may increase one’s risk for breast cancer recurrence: Advanced stage at diagnosis: The stage of breast cancer at diagnosis is one of the most important factors that determine the risk of recurrence. Patients with advanced-stage cancer, such as stage III or IV, have a higher risk of recurrence. Younger age at diagnosis: Women who are diagnosed with breast cancer at a younger age, especially before menopause, have a higher risk of recurrence. Hormone receptor status: Breast cancers that are estrogen receptor (ER) and/or progesterone receptor (PR) negative have a higher risk of recurrence. HER2 status: HER2-positive breast cancers have a higher risk of recurrence. Lymph node involvement: Breast cancers that have spread to the lymph nodes have a higher risk of recurrence. Tumor size: Larger tumors have a higher risk of recurrence. Disease remaining after treatment: If there are traces of cancer remaining in your body after surgery and/or other treatment like chemotherapy (called “molecular residual disease”), there is an increased risk of the cancer coming back. Previous history of breast cancer: Patients who have had breast cancer in the past have a higher risk of recurrence. It is important to note that while these factors increase the risk of recurrence, they do not necessarily mean that a patient will experience a recurrence. It is essential to discuss with your healthcare provider about your specific risk factors and create an individualized plan for surveillance and management. What proactive steps can you take now? Below are some proactive ways to address breast cancer recurrence if you are a high-risk patient: Adjuvant therapy: Adjuvant therapy includes chemotherapy, hormonal therapy, and targeted therapy, which are given after surgery to destroy any remaining cancer cells. High-risk patients are typically recommended to receive adjuvant therapy to lower the risk of recurrence. Lifestyle changes: Patients can lower their risk of recurrence by adopting a healthy lifestyle, which includes regular exercise, a balanced diet, maintaining a healthy weight, and avoiding alcohol and smoking. Regular follow-up care: Patients should have regular follow-up care with their healthcare provider to monitor for signs of recurrence. Follow-up care may include regular physical exams, mammograms, blood and other imaging tests as needed. There are also new tests that look for traces of cancer in the blood called circulating tumor DNA (ctDNA) that can provide an early alert that your breast cancer may be coming back. Talk to your doctor about whether this testing may be helpful for you. Genetic counseling and testing: High-risk patients may benefit from genetic counseling and testing to determine if they have an inherited genetic mutation that increases their risk of breast cancer. If they do, they can take steps to reduce their risk, such as prophylactic surgery or increased surveillance. Clinical trials: High-risk patients may be eligible to participate in clinical trials for new treatments or interventions that may reduce their risk of recurrence. In summary, addressing breast cancer recurrence in high-risk patients involves a combination of adjuvant therapy, lifestyle changes, regular follow-up care, genetic counseling and testing. You are your own best advocate! Don’t be afraid to ask questions and speak with your healthcare provider about your breast cancer and if you are at a higher risk of breast cancer recurrence. Being proactive is key! Learn more: Breast Cancer Recurrence: Second Primary versus Metastasis Reducing the Risk of Breast Cancer Recurrence Adolescents and Young Adults (AYA) with Breast Cancer Genetic Testing for Cancer: What You Need to Know Exercise and Breast Cancer You Might Also Like: Breast Cancer Conversations Podcast Episode 49: Understanding the Complexities of Genetic Testing SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Michelle LaFlamme You were in love Longing to covet One body part Fierce on the outside Unfixable cracks The inner core Was not nurtured Striving continued Both day and night To make the “perfect home” Three offspring To carry our names One beloved grandmother Carried to the grave Weeping cracks A broken foundation I jumped the wall I built a future Peter had other ideas Shame and doubt Became my friends And CANCER Came for a visit Now is the moment Let’s sell her home Almost, but not enough Shall I cheat? And try to get caught It will be enough There are no more Happy Pills 24 years, mostly bad You called down to me From your successes Happy anniversary! I went to bed Closed my eyes Waiting for just one Brave Moment Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

If you’ve had surgery or a biopsy, the biological sample from your procedure will be sent to a pathologist working in a laboratory. The pathologist will study your sample and create a pathology report providing important information about what was found in your sample. Your pathology report will be reviewed carefully by your oncology team, and you should discuss it with your doctors to ensure you understand your specific situation. Before you receive or review your pathology report, however, you may be looking for more information about what exactly this report is and what you can expect it to contain. You may feel some anxiety waiting for your pathology report, and deciphering the medical jargon and dense information can be daunting. Continue reading to understand the process and your pathology report in a simple, step-by-step format. What Is a Pathology Report? A pathology report is a document that contains the findings of a pathologist who has examined a patient’s biological samples under a microscope. The samples are usually obtained through biopsy, surgery, or a medical examination and can include findings from body tissues, fluids, or cells. Your pathology report provides valuable insight into the nature of your disease. It includes detailed information about the type, grade, and extent of your cancer, as well as the margins of the removed tissue. Pathologists play a critical role in diagnosing diseases like cancer, and their reports guide physicians in determining the appropriate course of treatment. Why Understanding Your Pathology Report Matters Understanding your pathology report empowers you to participate actively in your healthcare decisions with your oncology team. It helps you grasp the severity and nature of your condition and set expectations for your treatment. For more insights on why understanding your pathology report is crucial, refer to resources provided by The American Cancer Society. Understanding the Structure of Your Pathology Report A pathology report usually contains the following sections: Patient Information: Your name, patient ID, date of birth, and the name of the physician who requested the test. Specimen Information: The type and location of the sample, how and when pathology received it, and who provided it. It may include information about the margins — the edges of tissue that was removed during the biopsy or surgery. Since the goal of surgery is to remove all of the cancerous tissue, it’s vital to ensure that the margins are clear or negative (meaning that no cancer cells are detected on the edges). If any lymph nodes were removed during the procedure, the pathology report will also state whether cancer cells were found in them. Gross Description: What the pathologist observed with the naked eye, including the color, size, and weight of the sample. Microscopic Description: A description of what the pathologist observed under the microscope, including cell structures and abnormalities. Diagnosis: The pathologist’s interpretation of the findings and the final diagnosis. Reading Your Pathology Report Now that you know what a pathology report includes, here’s a guide to understanding your report: Verify Patient Information: Ensure that the patient details are correct. Mistakes, although rare, can happen. Understand the Specimen: Knowing what type of specimen was taken and where it was taken from can give context to the report. Gross Description: While this section can be technical, look for descriptors of size, shape and color, which can give you an idea of the sample’s normality. Microscopic Description: This section might be complex, containing detailed observations of cellular structures. Look for terms like benign, malignant, normal, abnormal, etc. to get a sense of what was found. Interpret the Diagnosis: Again, the final diagnosis as stated by the pathologist might be technical and challenging to understand. You can use reliable medical dictionaries like MedlinePlus to understand them. Remember, it’s essential to discuss these findings with your healthcare provider to fully understand your condition and to determine the next steps in your care. Count On Us for Information, Resources, and Support Understanding your pathology report is a critical step in managing your health. The knowledge contained in your report can help you better understand your diagnosis. This will empower you to navigate and make informed decisions about your treatment. Consult with your healthcare provider for clarifications and concerns. Please contact us if you have questions about speaking with your doctor regarding your pathology report! Whether you’re newly diagnosed with breast cancer, are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms, testing, treatment options, surgery, etc., and podcasts that feature professionals, advocates, and caregivers that share valuable information. Your donations enable SurvivingBreastCancer.org to offer resources and support every day, every month, and every year. SBC is here for you! Learn more: What is Breast Cancer? Breast Cancer Symptoms Newly Diagnosed. Now What? Note: This article is designed to provide general information and not meant to replace professional medical advice. Always discuss your pathology reports with your healthcare provider. SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By William Laferriere I’m sitting quietly, sipping, and enjoying An amazing, rich, dark cup of coffee, Colombia’s bitter, black gold elixir. The open door yields a lively, beautiful, early spring day, April’s showers have given way To a glorious, welcoming, body-warming sun, carefully addressing The blooms of azaleas, forsythias, and lilacs. The oaks and maples align with their new buds, As if slipping into something more joyful, A light, effervescent shade of green, Nature’s sweet renewal. My puppy sniffs once, twice and again, Before launching onto the stoop, Eyeing the shadows moving under the camouflaged canopy Of the neighboring preserve. He watches intently, wishing only That he could join the new coyote (Canis latrans) offspring As they playfully wrestle with each other Under the watchful eye of their alpha parents. Once they break into the sunshine I notice the pointed ears, slender muzzles, Grayish brown faces, reddish tinges at the ears, Silvery-gray coats adorning their backs, And a fine, drooping bushy tail, resembling my old German Shepherd, Zappa. Mother waddles around her pack, Still recovering from the birth of these same 7 puppies, Knowing they are safe within the confines of this fenced enclave, Both parents dutifully hunt breakfast, Nourish their offspring, and display a primal caregiving. At long last I’m left with the following rumination: There is order in the natural world, For every call a response, For every punch a counter, For every torn leaf, a new bud, For every death, a new life. To everything there is a purpose! Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Gloria Shoon Who are we? Whole, complete, innocent children of the Divine How do we express our Divine consciousness? By living life in the present to the fullest of our potential What does that mean? Getting to know yourself and your gifts; AND using them in service and support of others Why do that? To assist humanity's ascension to enjoy the Golden Age of love, joy, peace and abundance When? Now, today, this moment!!! by Gloria Shoon Friday August 13, 2010 Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Kelly Hsu What is DCIS? Ductal carcinoma in situ (DCIS) refers to when cells in the breast duct become cancer cells. This is also known as “stage zero” breast cancer. DCIS is a very early stage of cancer and as a result it is considered to be highly treatable. It is also non-invasive, as the cancerous cells have not spread to other tissue areas in the body. DCIS does not usually present with noticeable symptoms. Though uncommon, some patients have reported experiencing discharge from the nipples or feeling a lump in the breast. Detection and diagnoses have increased since the increased implementation of routine mammogram screenings. Today, DCIS accounts for between 20-25% of breast cancer diagnoses [1]. DCIS and Risk DCIS itself is not life-threatening, but the main concern is that if left untreated, it could progress into invasive breast cancer, meaning stage 1 or higher invasive ductal carcinoma (IDC). Individuals with DCIS have a higher-than-average risk of developing IDC, but there is not enough information to accurately predict which cases will progress and which will not. To this day, it is controversial among researchers about whether to consider DCIS as a “real” cancer and recommend treatment, versus recommending less-invasive measures such as active surveillance. However, there is agreement that more research on biomarkers (specific molecules or characteristics in the body that can help give more specific information about a disease) is necessary in order to differentiate risk across cases and make more specific recommendations tailored to each individual patient [2, 3]. Evaluation and Treatment Currently, almost all patients diagnosed with DCIS are treated [3]. There are a variety of treatment options for those with a DCIS diagnosis [4, 5, 6]: Surgery Breast-conserving surgery (BCS), or a lumpectomy, involves removing the local region of affected cells. This is often followed by radiation therapy (RT). Breast-removing surgery, or a mastectomy, involves surgically removing all breast tissue. This may be followed with breast reconstruction surgery, and does not usually involve any RT. Radiation therapy Radiation therapy (RT) will often follow BCS as an adjuvant treatment, with the purpose of killing any remaining cells and reducing the recurrence rate. Hormone therapy If the DCIS shows estrogen or progesterone receptors, hormone therapy could be recommended as a treatment option. Examples of hormone therapies include tamoxifen (which blocks estrogen receptors) and aromatase inhibitors (which lowers estrogen levels for postmenopausal women). This treatment would not be given alone, but rather as an adjuvant treatment after a surgery. Surgery and other therapies can be very effective, but are also invasive and do not come without risks. There are a multitude of active surveillance research trials, where researchers are evaluating whether there is a change in outcomes between those who receive medical treatment upfront for DCIS, versus those who do not, and instead, regularly check in with their clinical team for routine examinations and imaging. The results of these studies may help clinicians better understand if it is possible for certain patients with DCIS to avoid surgery [5]. If you or a loved one have been diagnosed with DCIS, be sure to speak to your healthcare provider to see what options are available, as well as the pros and cons of these different options. Results currently show that with a timely diagnosis and appropriate treatment plan, survival outcomes for DCIS are very high, with a 10-year breast cancer-specific survival rate of about 98% [7]. Treatment routes can also be very specifically tailored to each individual based on important and unique factors such as their disease type, overall health status, age, and personal preferences. Together, your healthcare team can help you figure out what management option is the best fit for you. Learn More: Diagnosed with DCIS After a Mammogram Find Your Tribe May Your Smile Always Be Brighter Than Any Obstacle You Face A Call For Self-Advocacy References: Tomlinson-Hansen, S., Khan, M., & Cassaro, S. (2023). Breast Ductal Carcinoma in Situ. In StatPearls. StatPearls Publishing. American Association for Cancer Research. (2023, January 4). Research updates. Leading Discoveries Magazine. https://leadingdiscoveries.aacr.org/research-updates-9/ Schmitz, R. S. J. M., Wilthagen, E. A., van Duijnhoven, F., van Oirsouw, M., Verschuur, E., Lynch, T., Punglia, R. S., Hwang, E. S., Wesseling, J., Schmidt, M. K., Bleiker, E. M. A., Engelhardt, E. G., & Grand Challenge Precision Consortium (2022). Prediction Models and Decision Aids for Women with Ductal Carcinoma In Situ: A Systematic Literature Review. Cancers, 14(13), 3259. Mayo Foundation for Medical Education and Research. (2022, May 18). Ductal carcinoma in situ (DCIS). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/dcis/diagnosis-treatment/drc-20371895 Grimm, L. J., Rahbar, H., Abdelmalak, M., Hall, A. H., & Ryser, M. D. (2021). Ductal carcinoma in situ: State-of-the-art review. Radiology, 302(2), 246–255. Van Seijen, M., Lips, E. H., Thompson, A. M., Nik-Zainal, S., Futreal, A., Hwang, E. S., Verschuur, E., Lane, J., Jonkers, J., Rea, D. W., Wesseling, J., & PRECISION team (2019). Ductal carcinoma in situ: to treat or not to treat, that is the question. British journal of cancer, 121(4), 285–292. Elshof, L. E., Schmidt, M. K., Rutgers, E. J. T., van Leeuwen, F. E., Wesseling, J., & Schaapveld, M. (2018). Cause-specific Mortality in a Population-based Cohort of 9799 Women Treated for Ductal Carcinoma In Situ. Annals of surgery, 267(5), 952–958. Author bio: Kelly Hsu I am a recent graduate of Wellesley College (Class of ‘21), where I studied neuroscience. I am currently working as a Clinical Research Coordinator at the Massachusetts General Hospital Cancer Center on several patient-centered outcomes research studies. Through my experiences, I have developed passions for health education, psychosocial oncology, and palliative care. I plan to attend medical school next fall, where I hope to keep pursuing these interests. SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Sara Kandler The last time I saw you in that wine-colored polo sweatshirt was at the so-called rehab center just before your right leg started to swell, hives rising like a red tide toward your chest drawing you back to the ER where your clothes were tucked under the gurney and three days later stuffed into a Stop & Shop bag along with your hearing aids and extra batteries, nose spray, toothpicks and scraps of paper on which you wrote notes barely legible — don’t forget to call Audrey at the hospital, answer the email from the investment fund, there’s an old friend named Deborah on the list… The Stop & Shop bag rides in the back of my Honda atop a pile of posters by eighth graders, poems and drawings of love and devastation. I’m told to unpack my sorrow, my regrets. I can’t bring myself to unpack a thing. A small white hair, a tiny crumb, the scent of you, preserved. I keep these piled up artifacts with me, instead. Follow Sara Kandler: https://medium.com/@sarakandler Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events