WOMEN'S HEALTH: New breast cancer advances speed diagnosis, treatment
By Donna C. Gregory

Bra-fitter helps breast cancer survivors reclaim a 'perfect' shape
By Donna C. Gregory

As Debbie Smalley* admired her new shape in the mirror, she murmured quietly to herself, "This is perfect."

It had been eight years since she'd lost both of her breasts after a diagnosis of breast cancer. Since then, she'd mostly worn bulky shirts to cover where her breasts used to be. She'd never gotten around to being fitted for a bra and prosthesis - between family illnesses and transportation issues, there was always something else to deal with.

Carol Norman, R.N., owner of Town and Country Health Services & Supplies, Inc., remembers getting tears in her eyes as she witnessed Smalley's reaction to her new bustline.
"It can be quite emotional sometimes," said Norman. "It is such a rewarding opportunity to be able to give them back their shape after surgery."
Norman became a certified mastectomy fitter three years ago. Today, she offers bra-fittings for breast cancer patients at her office in Montpelier and at Ashland Medical Supply, Inc. She also does in-home consultations and employs a second bra-fitter in Fredericksburg.

"It's really a custom fit when you measure a person and select a product line for them," explained Norman. Clients can choose from more than 60 styles from bra-maker Jodee.

"Then we look at what prosthesis will fit to have a matching set of breasts. It's important to have that balance of weight," explained Norman.
Improper proportion can cause rounding in the shoulders and back.

"Prosthesis used to be so heavy, but there are very lightweight ones now that give good shape, good form," explained Norman.

That means clients can once again wear clothing that fits their body, not camouflages it.
In addition to regular bras, Norman also carries bathing suits and carrier bras that are worn right after surgery.

For more information on bra-fitting or to make an appointment, call (804) 883-6104 or (877) 883-6114.

*Name has been changed.
With new advances in detection and treatment, a diagnosis of breast cancer is no longer a death sentence. Below is a rundown of some of the latest innovations in breast cancer:

» MRI SCREENING While mammography is still the standard when it comes to detection, some physicians are now using MRI technology in women who are at high risk of breast cancer.

"The technology has advanced so that it's 96 percent sensitive of invasive cancer of the breast," said Dr. Jan Worthington, Bon Secours Health System's director of breast MRI. "It is also pretty sensitive for intraductal cancer in the recent literature."

MRI isn't for every woman, however. According to the latest guidelines issued by the American Cancer Society, yearly MRI screening is recommended for people with a 25 percent or greater lifetime risk of breast cancer. Physicians calculate risk based on family history and other clinical factors. Persons who have tested positive for the BRCA gene should also undergo MRI screening. The New England Journal of Medicine recommends that all persons newly diagnosed with breast cancer undergo a MRI.

"Those people have an increased chance of having breast cancer in another spot in the breast or breast cancer on the other side," explained Worthington.

» ONCOTYPE DX A gene test called Oncotype DX is now helping physicians tailor breast cancer treatment, saving some women from having to undergo the rigors of chemotherapy.

By testing a small amount of tissue removed from the breast during surgery, Oncotype DX can help predict the likelihood of reoccurrence in women with early stage breast cancer and assess the benefits of chemotherapy.

"Women in the low-risk group, about 50 percent of breast cancer patients, don't benefit from chemotherapy while those in the high-risk group do," explained Dr. James Khatcheressian, assistant professor with the Virginia Commonwealth University (VCU) Department of Internal Medicine.

Currently, VCU and the Massey Cancer Center are participating in a national study to determine if chemotherapy benefits women in the middle-risk group.

For more information on Oncotype DX, visit www.genomichealth.com.

» THE PINK KEY Richmond-based Vital Data LLC and local doctors have joined forces to develop the "Pink Key," a USB device that helps breast cancer patients become more proactive in their survivorship. Upon inserting the Pink Key into a computer, patients can access their medical records as well as the latest research data on breast cancer. There's also a prompting system that reminds patients of upcoming appointments or when they need to schedule their next mammogram.

Tom Blue, Vital Data's CEO, describes the Pink Key as a "consumer empowerment type of technology. Breast cancer is a condition that can reoccur years after the initial diagnosis, so a person is never entirely out of the woods. Because of that, people will often end up back in the care of the primary care doctors, and not a breast cancer specialist."

Since primary care physicians treat a host of problems, they are sometimes not current on the latest screening and treatment options for specific diseases like breast cancer.

"This is a tool, that in addition to the practical functionality, enables a person to stay up-to-date on the latest surveillance guidelines," explained Blue.

Vital Data recently released the first batch of the Pink Key to breast cancer patients. For more information, ask your physician, visit www.vitalkey.com or call (877) VITALKEY.

Dr. Jan Worthington, MD, serves as director of breast MRI with Bon Secours Health System, Inc. She is a diagnostic radiologist at Commonwealth Radiology at St. Mary's Hospital. Dr. James Khatcheressian, MD, is assistant professor in the division of Hematology/Oncology and Palliative Care with the Department of Internal Medicine at Virginia Commonwealth University/Massey Cancer Center.