Illustrations depicting different stages of Breast Cancer, from AstraZeneca.

Here is a suggested article for winter skin care, written by Diana Sun, M.D., F.A.A.D.

Your skin may need extra care when you are receiving chemotherapy or radiation during the winter months.   The amount of oil that your glands naturally secrete to lubricate and protect your skin may be reduced when you are taking some chemotherapy medications. In addition, the cold winter air and the hot dry air from heaters can further reduce the moisture of your skin.  This can cause dryness, itching or flaking, and may sometimes lead to rashes.

There are some simple steps that you can take to not only keep your skin soft and supple, but also make it beautiful and radiant as well.

Maintain good health.  Be sure to keep yourself well hydrated and be sure to eat nutritious foods.  Drink plenty of fluid, especially water.   Unless your medications or medical condition requires the restriction of certain food groups, be sure to have a diet rich in whole grains, fruits and vegetables of all different colors (greens, reds, oranges, yellows, blues), and protein from a wide variety of sources (fish, poultry, beef, pork, lamb, beans and legumes, nuts, dairy).  Exercise regularly if you are feeling up to it.  And seek the emotional support of your family and friends and support groups.

Keep your showers short and avoid very hot water.   If your bathroom is steamy and foggy when you are done, then it is too long and too hot.  Wash your face and body gently each day using cleansers that are free of fragrances or dyes.  You may wish to gently massage your skin with a clean washcloth or gentle body scrub once or twice a week to exfoliate the dead surface skin.   Avoid exfoliating areas where the skin is sensitive, such as recently healed surgical sites, radiation sites, port sites, and the like.  These areas can be gently massaged with just your fingertips.   Check with your doctor about the care of these areas.

Immediately after your shower, apply a generous amount of moisturizer all over your face and body.  For very dry skin, heavy emollients such as Aquaphor ointment, Eucerin Cream, or even Vaseline Petroleum jelly applied lightly to wet skin can “lock in” moisture and leave the skin soft and smooth.  You can also consider natural alternatives such as safflower oil or shea butter, which are available at natural and organic food stores as well as many grocery stores and pharmacies.    For those with normal to dry skin, look for any fragrance-free, dye-free moisturizer.  Some excellent creams include CeraVe cream (which contain ceramides to replenish your skin) and Cetaphil cream.

When going outdoors, be sure to generously apply sunscreen to all of your exposed skin.  Use a sunscreen that has a high SPF number (at least 45) and check the label to make certain that it protects your skin from both UVA and UVB rays.   Look for ingredients such as micronized zinc oxide as the sole ingredient, or if several sunscreen agents are used, then  look for Parsol 1789 (also known as Avobenzone).

Finally, if your skin is very sensitive, protect it from the cold and wind.  Apply a generous amount of moisturizer with sunscreen before heading outside on a windy day.  You can also protect your skin by wearing a hooded coat or jacket, or by wrapping a scarf loosely around your lower face.

Written by:

Diana Sun, Dermatologist
Diana K. Sun, M.D., F.A.A.D.
Diplomate, American Board of Dermatology
Clinical Assistant Professor in Dermatology, SUNY at Stony Brook
Consultant Physician, Veterans Administration Medical Center at Northport

1 in 8 women will develop breast cancer in their lifetime

8 of 9 breast cancer patients have no direct family relative afflicted with the disease

70% of women who develop breast cancer have no identifiable risk factors other than age

…and younger women face unique breast health issues:

Breast cancer is the leading cause of death for American women ages 35 to 50

Younger women with breast cancer have worse outcomes and more advanced disease than older women

Breast cancer diagnosis within two years of childbirth has nearly 50% mortality

Excluding skin cancer, the breast is the leading site of cancer among women.

Breast cancer also ranks as women’s number one health concern today, as warranted by the following statistics:

In the United States, the average woman has a 12.5 percent lifetime risk of developing invasive breast cancer

The American Cancer Society estimates that over 180,000 new cases of invasive breast cancer will be diagnosed this year

Over 50,000 additional cases of in situ breast cancer will be diagnosed

An estimated 40,000 U.S. women are expected to die from this disease this year

Source:  NeoMatrix- Beast Health solutions.

Check out the very comprehensive breast cancer page on the Johns Hopkins site.

Here is an excerpt:

About this Cancer

Breast cancer is one of the most frequently diagnosed cancers among women in the United States. While incidence rates have continued to rise, deaths due to breast cancer are beginning to decline. This decline is largely attributable to earlier detection and improved treatments. Mammography and other newly-developed diagnostic techniques allow breast cancers to be detected before they cause any physical symptoms. New molecular genetic findings have allowed experts to identify those women at greatest risk for developing the disease. In addition, oncologists’ ability to differentiate specific types of breast cancer, such as pre and post menopausal, have allowed for the precise tailoring of therapies and improved survival rates. In fact, there are more than 1.6 million breast cancer survivors in the U.S. today because of better diagnosis, treatments, and increasing knowledge about breast cancer.

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Useful FAQ about HALO Screening  from the NeoMatrix website.

Why is screening for breast cancer risk so important?

1 in 8 women will develop breast cancer in their lifetime, but to date, it’s been very difficult to identify who is at risk. Traditional methods of breast cancer screening have limiting factors. Women under the age of 40 are not usually getting regular mammograms. For women over 40, mammograms often do not detect abnormal changes until about 8 years after changes have begun to take place. Mammograms are also not as effective in women with dense breasts. HALO is a screening tool that can help identify women at greatest risk, years earlier, allowing for earlier intervention and increasing chances for survival.

What is the difference between a risk screening test and a diagnostic test? ?
A risk screening test allows physicians to group patients without symptoms in different categories from low to high risk. A diagnostic test confirms whether or not patients with symptoms actually have a disease. HALO is a risk screening test and works much like a cholesterol screen for potential cardiovascular disease. Just because you have high cholesterol doesn’t mean you have heart disease. Similarly, just because you have atypia does not mean you have breast cancer.

Does HALO replace mammograms?
No, HALO is a complement to mammograms. Mammograms look for lesions (cancer) and are most effective as women age. HALO is looking for abnormal cells, years before they might turn into a lesion, and the test is effective in women as young as 25. If you already have a growth in your milk ducts when you first have a HALO test, it’s possible that the affected duct could be blocked so that HALO could not collect a fluid sample. This is why it’s important to continue with routine mammograms and breast exams.

What about family history?
Those who have a mother, sister or daughter with breast cancer are approximately 2 times more likely to develop the disease. Those who have atypia are 4 to 5 times more likely to develop breast cancer. Screening for atypia with HALO will help you and your doctor identify cellular changes, closely monitor them and develop an optimal care path.

How does the HALO Breast Pap Test work?
HALO combines warmth, massage and suction to bring nipple aspirate fluid (NAF) to the surface. NAF is found I the milk ducts where 95% of all breast cancers originate. The entire cycle is five minutes and is easily incorporated into your well-woman visit. If you produce fluid, the sample is then sent to the lab and analyzed for cellular abnormalities.

Who should have HALO and how often?
This is an annual test for all non-lactating women 25 and over. Women over 55 tend to decrease their production of NAF and mammograms become more effective at this stage. Women over 55 who produce NAF should continue to have annual HALO tests.

Is the procedure painful?
Most women find the test easy to tolerate. In a clinical study with 500 women, 88% said they would recommend it to their friends. On a 1 – 10 scale, the average discomfort rating for the HALO was about a 4 while those same women rated their mammogram an 8.

How many women produce fluid?
About half of all women will produce fluid. Not producing fluid with the HALO test is considered a normal result, meaning you are at normal risk, not elevated risk for developing breast cancer.

What if I don’t produce fluid?
If you don’t produce fluid, this is considered a normal result. You are at normal risk, not elevated risk for developing breast cancer. Women who do not produce NAF one year may produce NAF the next year, therefore the HALO Breast Pap Test should be conducted annually.

If I have atypia, does it mean I have breast cancer?
No. It simply means you are at a higher risk than someone without atypia. In fact, only about 1% to 2% of women screened have atypia and often atypia corrects itself.

What do I do if I get an abnormal result?
There are specific carepaths for your consideration. In general, if you have an abnormal result you will likely be referred to a breast center. The breast specialist has several options in 3 broad categories:

Full risk assessment questionnaire and counseling about preventive measures

Diagnostic mammogram, Ultrasound, or MRI

More aggressive options to include medication such as tamoxifen; procedures like ductal lavage, ductoscopy, or ductal excision, etc.

How long does it take to get results?
Typically it takes three to five days. Your doctor’s office will notify you of the results.

Is HALO FDA cleared?
Yes, HALO is FDA cleared.

Is HALO reimbursed by my insurance company?
The collection of NAF with the HALO system is not yet reimbursed by insurance companies. Contact your doctor about your cost for the HALO test. If you produce fluid during the HALO test, your doctor’s office will send the sample to the lab to be evaluated. The charges associated with the lab are covered by most insurance companies.

Can I have a HALO if I have breast implants?
It depends on the type of implant. If your incision is not around the entire nipple and the milk ducts are not compromised, you may have the HALO.

Can I have a HALO if I’ve had a breast reduction?
It is best to discuss this with your doctor. You may be a candidate for HALO if your entire nipple was not removed and the milk ducts were not compromised.

Can I have a HALO if I have a nipple ring?
Yes, however you must remove the ring(s) and the milk ducts must not be compromised.

Is color of Nipple Aspirate (NAF) important?
No. NAF can be any color.

Can I have a HALO test if I am breast feeding?
No. You must wait at least 6 months after your last breast feeding to have a HALO test.

Article Source: NeoMatrix- Beast Health solutions.

Here is a comprehensive article from the The consumer website of the National Comprehensive Cancer Network that can help you through the making the right treatment decisions for yourself.

Breast Cancer – Stage I, II, and III

Cancer of the breast is the most frequently diagnosed cancer in U.S. women. *

If you have been diagnosed with stage I, II, or III breast cancer, you probably have many questions and concerns about treatment. This treatment summary, based on the NCCN Clinical Practice Guidelines in Oncology™, will help you understand the best available treatments for stage I, II, or III breast cancer. Talk to your doctor about these options so that together you can decide on a treatment plan that is right for you.

Background
Stages I, II, and III breast cancer are known as invasive cancers. This means they have spread beyond the breast tissue where the cancer started and into surrounding healthy breast tissue.  In some cases, the cancer may also have spread to lymph nodes in or near the breast. This summary covers ductal, lobular, metaplastic, adenoid cystic, medullary, tubular, and colloid breast cancers.

Diagnosis

A breast lump, an abnormal mammogram or an abnormal ultrasound test each may suggest breast cancer, but only a biopsy of breast tissue can confirm or rule out the disease.

Your biopsy sample provides the doctor with information about:

Where the breast the cancer began (e.g., the ducts, a network of tubes connecting the milk glands to the nipple, or the lobules, the milk glands themselves).

Whether the cancer is noninvasive (localized to the duct or lobe) or invasive (has spread beyond site of origin)

The grade of the tumor cells, i.e., how much the cancer cells resemble healthy cells under a microscope. Generally, Grade 1 breast cancer is most like normal breast tissue and grows slowly while Grade 3 does not look like normal breast tissue and grows more quickly.

Whether important breast cancer tumor markers, which provide information that can predict how the tumor will respond to therapy, are present on the tumor cells.  (See Hormone Therapy and Targeted Therapy sections below.)

Staging

Staging describes the extent or severity of a cancer diagnosis. Women with stage I breast cancer have small tumors that have not spread to either the lymph nodes or other distant sites.  Women with stage II disease generally have smaller tumors and either no or minimal lymph node involvement and no metastasis (spread of the disease to distant organs).

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