Breast Center Bulletin 161

by | Jun 7, 2014 | Newsletters

Select  2014 Conference Quotes
The Breast Center Bulletin  ▪  May 2014

The Conference Planning Committee works for over ten months developing the annual conference.  Our goal is to provide useful breast center information and current clinical information for the entire breast care team.  With our numerous and varied venues at the conference, each discipline has ample opportunity to learn, discuss and share with colleagues.  Our hope is that the entire team can attend the conference.  Below are just nine of 62 comments on the evaluations and they reflect the content quality, course structure and interdisciplinary nature of the conference.  Other comments will be shared as an attachment to The Breast Center Bulletin over the course of the year and no quote will be repeated.

  • It was very valuable to meet professionals from all over the country to compare and discuss excellence in service and new research.
  • The conference was intellectually stimulating, exhilarating and exhausting all in a positive way!
  • Excellent variety of information geared to all professionals and specialties from physician to nurse navigator to radiology technologist.
  • This conference invites you to think outside of the box and to evaluate and consider eliminating those 'sacred cows' that no longer serve a valuable function in your center.
  • This conference was wonderful. I learned something at every session that I attended.
  • Everyone that manages, navigates or directs a breast center should attend this conference.
  • Really motivated our group to come back and get to work building a program our community can be proud of.
  • NCBC has it all: resources, expertise, knowledge and impact – and they share it all year.
  • The information received at this conference was extremely helpful to my goal of obtaining information on Centers of Excellence.

NETWORKING – NCoBC

Julie Susi,Administrator
Breast Care Specialists of Maine at Mercy Hospital
Portland, Maine

Networking 1

The Networking Group at the NCoBC yearly National Breast Center Conference gives attendees the opportunity to meet and network, both professionally and socially, with others from around the world.

“I love the networking with other women.”

This group/service was formed several years ago in response to feedback obtained from the conference evaluations forms. The attendees identified a desire to make contact with others at the conference wishing to network professionally and to take advantage of the entertainment opportunities in Las Vegas.  Some attendees simply wanted to have someone to take a walk with down the strip or share a dinner after the conference.  Julie Susi agreed to take on the task of organizing this networking group.

“Once a member of the Networking group, always a member"

Julie, along with Ann Livingston RN, BSN, CBEC (Sinai Grace Hospital, Mammography/Radiology in Detroit, Michigan), organize the networking each year. They gather information about Las Vegas activities and organize meetings and dinners during the conference that bring people together.  After the first meeting of each year, it is easy to put groups together for shows, walking, gambling, dancing or dinner. The feedback from past attendees of this group has been glowing.  Many are appreciative of the opportunity to meet in small group settings to talk about work, family, what they learned that day at conference - and have fun!

“Thank you for making the conference a friendlier place.”

This year proved to be another successful networking year.  While the group welcomed back past members, they also welcomed many new members.  Julie brought back a “Move & Groove” class to the agenda which was very well attended.  She taught an hour long exercise class for all ages/levels.  Comments: “It was great to get up and move and have fun after sitting all day.” Others asked, “Can you teach this every night of conference next year?” One attendee was glad it was more of an exercise class vs. Zumba/Dance.  Many requested that this class be offered more than one night at next year’s conference.  Julie hopes to have more classes like this (morning and evening) at future conferences.

Networking 2

They both look forward each year to meeting the new attendees of the group and welcoming back those who have attended in the past. Relationships have been long lasting and cherished.  Many make friendships at the conference and communicate with each other over the following year – until they meet again at the next NCoBC conference. The group’s motto is “Once a member of the Networking group, always a member!”   Everyone is invited to take advantage of this wonderful opportunity to learn, build new relationships, and enjoy Las Vegas with an amazing group of people!

Sexuality and Breast Cancer

Sandra Finestone, PhD
Executive Director, Hope Wellness Center & Private Practice, Irvine, CA

SandyFinestonephotojpg_sm

More than 200,000 women in the United States every year are told they have breast cancer.(1)  The year that follows is filled with testing, surgeries and adjuvant treatments.  During that year, those of us who treat these breast cancer patients sometimes forget that they are women filled with fear and anxiety. Clinicians are often so focused on treating the disease and handling the effects of treatment, that we sometimes forget that these women are also trying to deal with the everyday challenges of being a woman, a mother, a coworker, a spouse, a lover - all in addition to dealing with the effects of diagnosis and treatment.

It is quite common to think that cancer patients do not have any interest in sex or the desire for intimacy.(2)  Sexuality and sensuality are way down at the bottom of the list, or not on the list at all, of things to be discussed with these patients when there is limited time and limited resources to help them on their journey.  And, the truth of the matter is, most health care professionals are not comfortable discussing these issues with patients as noted by Dr. Ann Katz in her handbook for healthcare providers, “Breaking the Silence on Cancer and Sexuality.”(3)

Physicians, for the most part, rely on patients to bring up the subject yet most patients are embarrassed to discuss something that seems trivial in the light of dealing with a life threatening disease.  However, researchers at the University of California, San Francisco have demonstrated that sexual activity can boost the immune system (4) and a study done in Scotland indicated sexual activity could lower your stress and blood pressure.(5)

As many as 85% of breast cancer patients have issues about sexuality during and after treatment.

Research indicates as many as 85% of breast cancer patients have issues about sexuality during and after treatment.(6)  These include body image issues, lack of libido, vaginal dryness, fatigue, and others.  If a woman has lost a breast, lost her hair, is feeling nauseous and is exhausted from treatment but has a husband who has normal needs regarding sexual intimacy, this can create stress, feelings of guilt and tension in the relationship.  Partners of these patients are often not given much, or any, information about the physical changes a patient will experience or the potential emotional stress these changes may create for both partners.  If couples did not have the ability to discuss issues of sexuality before the diagnosis, it is likely to become an even greater problem after the diagnosis.

There are a number of variables that impact a couples’ sexual activity.  Among those are age, length of relationship, sexual history, partner’s health and sexual functioning and the stability of the relationship. Those couples whose sexual activity is normally high may experience much more of an impact when health issues interfere than those whose activity level is of lower priority in their relationship.  Research indicates that couples do not vary their sexual behavior spontaneously.  They continue to engage in the same range and type of sexual activity, perhaps unadvisedly, even when the result is significant sexual disruption or pain during intercourse for women.(7)

The key is to begin the conversation.

Younger women face additional challenges when they are diagnosed with breast cancer.  A recent article in the New York Times entitled “Life Interrupted: Crazy, Unsexy Cancer Tips” (8) clearly stated the challenges of young women dealing with cancer.  The author noted that “sex is not at the center of the conversation in the oncology unit…far from it. Sex and cancer felt like a shameful secret.”  She continued to write that at twenty four her peers are dating, marrying and having children while she is not.  She is embarrassed about the changes that have taken place in her body from chemotherapy, changes that included hot flashes, infertility and early menopause.  “My cancer treatments are causing internal and external changes in my body that leave me feeling confused, vulnerable, frustrated and verifiably unsexy.”  She went on to say that she and her other “cancer” friends can give each other emotional support, but they are at a loss when it comes to answering crucial medical questions about sexual health and cancer.

Many couples would benefit from some degree of sexual education prior to or during treatment to provide them with information and suggestions to adjust their sexual activities to meet their new challenges in a more flexible and satisfying way.  The key is to begin the conversation. Every time I have spoken to groups on this subject, the response has been overwhelming.

Jack Annon’s model for sexuality counseling provides a useful framework for counseling couples who may be experiencing difficulties due to a cancer diagnosis and those who are yet unaware the impact the diagnosis may have on their intimate sexual relationships. This four-stage model often referred to as PLISSIT is an acronym for the following:

P : Permission. Mention sexuality changes while also addressing cancer-related changes. This gives your patient permission to think about the two together, which legitimizes the topic.

LI: Limited Information. Give the patient limited information about the sexuality changes that can stem from treatment.

SS: Specific Suggestions. Make specific suggestions that address sexual dysfunction. For instance, if the patient complains of vaginal dryness, suggest she use a vaginal lubricant.

IT: Intense Therapy. If the patient needs more intense therapy than you can provide, refer her to a mental health practitioner (e.g. psychologist, psychiatrist or social worker).

There are several resources listed at the conclusion of this article including professional organizations and books.  Referrals can be found on the AASECT website which provides a list of certified therapists by geography.   In addition, there are recent articles in The Breast Center Bulletin by Michael L. Krychman, MD and Diana Parks, MS, CNM, WHMP that relate to this topic.

Breast Cancer Sexuality, Sensuality and Intimacy: Part I

Surgical, Radiation, and Chemotherapeutic Causes

Breast Cancer Sexuality, Sensuality and Intimacy: Part II

Practical and Clinical Treatment Paradigms

Dr. Sandra Finestone is a psychologist who is the Executive Director of Hope Wellness Center with a practice in Irvine, California who has lectured all over the world and who has counseled thousands of patients’ with a cancer diagnosis. She is herself a breast cancer survivor.

RESOURCES

Professional Organizations

Books

  • 100 Questions about Intimacy and Sexuality after a Breast Cancer Diagnosis Krychman M, Kellogg S, Finestone S.
  • Breaking the Silence on Cancer and Sexuality: A handbook for Healthcare Professionals  Katz, Anne
  • Women, Cancer, Sex  Katz, Anne
  • Sexuality for Women with Cancer  American Cancer Society

Articles

  • “Approaches to Sexual Dysfunction in Breast Cancer Survivors”, Goodman, Alice. The Oncology Nurse, February 2013, Vol 6, No 1 pp 10-11
  • “Sexuality and Body Image Concerns after Treatment for Breast Cancer” Shell, Judith. Oncology Nurse Edition, April 2008, Vol 22, No 4, pp 38-40

REFERENCES

www.cancer.org/treatment/treatmentandsideeffects/physicalsideeffects

  • Breaking the Silence on Cancer and Sexuality: A Handbook for Healthcare Providers.

Katz, Anne RN, Ph.D., 2007 Pittsburg, Oncology Nursing Society Publishing Division

  • New Science, Issue 17, April 1999
  • WebMD

www.webmd.com/sex-relationships/features/chronic-illness

  • American Cancer Society – Sexuality for Women with Cancer

www.cancer.org/treatment/treatmentandsideeffects/physicalsideeffects

  • New England Journal of Medicine,

Frank E., Anderson C., Rubinstein D., 1978, July 20; 299(3):111-5

  • New York Times, Health, “Life Interrupted”

Jaouad, Suleika, February 14, 2013

 

2014 Impact Award

National Consortium of Breast Centers
Connie Rufenbarger

Connie-Rufenbarger-Impact-Winner_sm

The National Consortium of Breast Center's (NCBC) Impact Award goes to a specific individual or organization that has made a significant impact on the general area of breast health.  This year, the NCBC President, Gary Levine, MD and the organization’s founder, Barbara Rabinowitz, PhD, MSW, RN presented this award to Connie Rufenbarger, a breast cancer survivor and advocate extraordinaire.

Among many accomplishments, Connie Rufenbarger served as an early member of the NCBC Board and supported the efforts and success of NCBC’s development and organization. Mrs. Rufenbarger developed the Catherine Peachy Fund [CPF] in memory of a friend and colleague.  The funds from the CPF have supported over 2.5 million dollars in breast cancer research in Indiana.

She serves on the Executive Committee of the Susan G. Komen Tissue Bank at the IU Simon Cancer Center.  The Komen Tissue Bank is the only repository in the world for normal breast tissue and matched serum, plasma and DNA.  The research results stand to make a unique contribution to science.  She personally championed the tissue bank which is housed at the IU Simon Cancer Center..

She has served on the Translational Breast Cancer Research Consortium, reviewed grants for the Department of Defense  Breast Cancer Research program and others. She is the recipient of numerous awards recognizing her exceptional and meaningful contributions. The National Consortium of Breast Centers was proud to be among those recognizing the difference Connie Rufenbarger is making in women's lives.

http://komentissuebank.iu.edu/wp-content/uploads/downloads/2012/02/KTB-full-story-Michael-Schug1.pdf

Impact Award Recipients

2001 to 2014

2014:  Connie Rufenbarger

2013:  Dennis Slamon, MD, PhD

2012:  Colleen Johnson, RN, NP, MPH, CBPN-IC; Suzanne Taylor, MD, CBEC; Cathy Cole, RNC, NP, MPH, CHES, CBPN-IC; Shireen Braner, PA, RT(R)(M)(QM), CBEC, CBPN-IC; Bret Miller; Teresa Montgomery; Candy Warinner; Robert Miller Sr.; Peggy Miller; Michael Wetherwax and Jenae Wetherwax

2011: Louise Miller, RT(R)(M)

2010: Col. Craig Shriver, MD, FACS

2009: Henry T. Lynch, MD

2008: Victor Vogel, MD, MHS, FACP

2007: Claudia Z. Lee, MBA

2006: Ernie Bodai, MD

2005: Amy Langer

2004: William G. Eklund, MD

2003: Lillie Shockney, RN, BN, MAS

2002: Laszlo Tabar, MD, FACR (Hon)

2001: Melvin J. Silverstein, MD, FACS

 

2014 Inspiration Award

National Consortium of Breast Centers
Laszlo Tabar, MD, FACR (Hon)

Inspiration-Award-Tabar_sm

Each year the Inspiration Award honors a professional or lay person who has contributed to the field of breast care.  Though their deeds and actions, they have gone above and beyond what would normally be expected for their position.   They are looked upon as mentors or examples of “how to do it right.”

This year, we were especially pleased to present the Inspiration Award to a physician who has contributed so much to the NCBC as well as to women across the world.  Dr. Laszlo Tabar is the father of screening mammography, a method to diagnose breast cancer at the earliest stage.  Dr. Tabar, along with his thousands of followers (radiologists), has saved countless numbers of lives through early diagnosis.  The term “Tabar trained” is considered a description of a quality radiologist.  Beyond his clinical achievements, he works tirelessly to teach physicians across the globe how to read mammograms as well as writing many books and articles on the subject.  For the NCBC, he has come year after year to lecture and educate doctors, nurses, radiology technologists and others who are interested in early diagnosis.

After nearly 40 years in this field, he continues to contribute passionately to teaching, writing and lecturing.  His motivation is to do the right thing for women around the world since 1977.

The NCBC was proud to present the 2014 Inspiration Award to Dr. Laszlo Tabar for his truly inspiring work in our field.

Inspiration Award Recipients

2005 to 2014

2014:  Lazlo Tabar, MD, FACR (Hon)

2013:  Benjamin O. Anderson, MD

2012:  Steven Schorr

2011: John W. Cumming

2010: J.B. Askew MD, Jr. and Phillip G. Sutton, MD, FACS

2009: Teresita Macarol, RT(R)(M)(QM), CBPN-IC

2008: Barbara Rabinowitz, PhD, MSW, RN

2007: Blake Cady, MD, FACS, MSHA

2006: Deb Wiggins, BA

2005: Olivia Newton John