1. Are you at risk?
Photo by Michael Dabbraccio
Take charge of
your breast
health
By Karen Pasacreta
Lynn Alcott, a patient of
Saint Raphael’s Women’s
Center for Breast Health, is
Procrastination. We’ve all put off something at one more risk factors for breast surrounded by a supportive
time or another. Call it human nature. We can’t help cancer does not mean a woman family, including husband
it – especially when the thing we put off potentially will develop the disease, some Joseph (not pictured) and
comes with news we don’t want to hear. women are not aware of their their children, Ashley, 18,
Still, if Lynn Alcott had undergone a mammogram risks or the importance of Joey, 4 , and Barbara, 11.
screening sooner rather than later, doctors might have screening.
caught her breast cancer earlier. But hindsight is 20-20 Early detection vital
and regret can paralyze one’s decisions to move forward
Early detection is vital to diagnosing breast cancer,
and do something about the situation now. And that’s
says Denise Barajas, M.D., director of Saint Raphael’s
how Alcott, who considers herself lucky, feels. Her
Women’s Center for Breast Health (WCBH) and a
breast cancer was caught at Stage 2 out of 4.
member of Alcott’s care team. “The use of
“I could have put the covers over my head, but I have
mammograms is the best tool we have to finding breast
three kids and I had to reassure them it’s OK,” said
cancer early and increasing the patient’s survival.”
Alcott, a 44-year-old Hamden resident who turned to
The American Cancer Society recommends women
the Hospital of Saint Raphael for her breast cancer care.
begin yearly mammograms starting at age 40. While
“I had to stay positive. You need to find your strength.”
the U.S. Preventative Task Force came out with other
Breast cancer is the most common cancer among
guidelines in 2009 that stated women in their 40s
American women and the second leading cause of
should not get yearly routine mammograms for early
cancer death in women, according to the Centers for
detection of breast cancer, the American College of
Disease Control and Prevention. While having one or
6 Saint Raphael’s SEPTEMBER/OCTOBER 2011

2. Obstetricians and Gynecologists But one of the biggest risk factors
clarified its stand in July, joining is family history. You could be at
the American Cancer Society with a higher risk for breast cancer if
the same recommendations – 40 your biological mother or sister
and yearly – as the preferred has been diagnosed – or, if your
guideline, Barajas said. aunts or either grandmother had
Begin as early as possible the disease. This can put you in
a category suggesting a need for
A woman should start
genetic screening to find out
performing breast self-exams in
whether you have inherited a
her 20s to know and understand
mutation in the BRCA 1 or
how her breasts feel and look
BRCA 2 genes.
normally and can then be aware
According to Barajas, younger
of any changes, should any occur,
?
women with breast cancer are
said Karen Johnson, M.D., a
more at risk for genetic
breast surgeon affiliated with law states that if a woman has
Saint Raphael’s. dense breast tissue on her
“The risk for breast cancer
is not high when you are
Did you know. . . mammograms, a follow-up letter
must be sent to notify her that
younger,” said Johnson, Saint Raphael’s Breast Center she has dense breast tissue and
“but you need to be was the first in the region and may benefit from screening; this
cognizant of what a change second in CT to be accredited can include a breast ultrasound or
is in your breast. Do you see by the National Accreditation a breast MRI examination, or
something different? Start Program for Breast Centers, both, depending on the woman’s
early so you know what you a distinction signifying a risk factors. A similar law was
are looking for. This can commitment to quality care. recently passed in Texas, and
start as early as the pre-teen multiple other states are presently
years with their pediatricians, considering similar legislation.
mutations. Alcott’s maternal
and girls need to be taught “One test is not better than
grandmother had died from
not to be embarrassed.” the other,” said Johnson, who
breast cancer, but Alcott had
Alcott’s ordeal began when is affiliated with Saint Raphael’s
tested negative for carrying the
she felt a small lump in her right new High-Risk Breast Health
mutation. Breast cancer is less
breast. “It felt like a hard grape,” Program, “but an ultrasound is
likely to be genetic if your family
Alcott recalled. “And I didn’t do a very good test in a skilled
members were diagnosed after
anything about it.” She actually radiologist’s hands and is an
menopause, Barajas explained.
told herself it would go away. But, excellent adjunct to a
over time, she felt a pervasive, dull Dense breast, new law mammogram.”
pain. After some complaining, One of the leading high-risk High-Risk program opens
Alcott was urged by her husband, factors for breast cancer is a large
Joseph, to get a mammogram – amount of dense breast tissue – Five years ago, Saint Raphael’s
her first ever. That was three fibrous and glandular tissue that established the WCBH to take a
months after she felt the lump. may hide a small cancer, causing personalized, holistic approach
At the end of November 2010, mammograms to be less sensitive to treating women with breast
she got the news. “I couldn’t for cancer detection. cancer. This year, the center
believe it,” she said. A new Connecticut law requires opened the High-Risk Breast
mammography reports to include Health Program for women who
Know your risks may be at higher risk for breast
information about breast density.
Simply being a woman puts cancer due to genetic mutations,
Connecticut was the first to pass
you at risk for breast cancer. dense breasts or other high-risk
this law, which came into effect in
The chance of getting breast factors.Through initial counseling,
2009 under former Gov. M. Jodi
cancer also increases with age. diagnostic testing and education,
Rell, a breast cancer survivor. The
SEPTEMBER/OCTOBER 2011 Saint Raphael’s 7

3. Breast
women can become educated about their risk factors “Radiation therapy can reconstruction
and learn more about mammograms or other testing also be delivered to medically Read about a
that may be appropriate. eligible patients using a
leading breast
“We saw a need in the community,” said Barajas, balloon-catheter-based
one of the program’s founders. “There are patients system,” Chung said. reconstruction
with questions that are often best answered by “Partial breast radiation, procedure that is
clinicians specializing in breast health. We also provide which involves treatment being offered by
an opportunity to talk to an expert and get them of only a portion of the Saint Raphael
up-to-date on current screening recommendations.” breast, has been offered to
surgeons on
If diagnosed, a multidisciplinary team approach highly selected patients since
of dedicated radiologists, pathologists, a patient 2008. Treatment times are page 12.
navigator, advanced practice registered nurse, breast significantly shorter than
surgeon and oncologists all work together to address with conventional treatment,” she explained.
the patient holistically. Weekly treatment planning Saint Raphael’s arsenal also includes 3D conformal
conferences help determine the best plan of care for radiation therapy, an advanced treatment planning
each patient. No referral is necessary. technology in which beams of radiation are shaped to
“The WCBH team reaches out to physicians with match and target the tumor, sparing healthy tissue.
information about how they may refer their patients Another new advance is Oncotype DX, a diagnostic
to the High-Risk Breast Health Program for more test for early-stage breast cancer that can determine
comprehensive evaluation,” said Paul Levesque, M.D., whether the patient needs chemotherapy or hormone
director of Saint Raphael’s Breast Imaging Center and therapy. “The results of this test, combined with other
one of the physicians affiliated with the program. features of the cancer, help patients make a more
Comprehensive imaging services include screening informed decision about whether or not to have
mammography, screening breast ultrasound, chemotherapy,” said Andrea Silber, M.D., a medical
diagnostic mammography, breast ultrasound, breast oncologist and co-director of the WCBH.
MRI and PET/CT, all using state-of-the-art A helping hand
equipment, he said.
Whatever your risk, a breast cancer diagnosis can
Advanced treatments be overwhelming. That’s where Maria Moura, R.N.,
After Alcott’s mammogram showed a mass in her the patient navigator at WCBH, has the very
right breast, it was followed up with a biopsy and important role of guiding the patient through this
MRI. In January 2011, she had a lumpectomy, a process, from education to diagnosis, testing services,
surgical operation in which a lump is removed from possible surgery and follow-up treatment.
the breast. Many women who undergo surgery for “I’m here to support both patients and physicians –
breast cancer also receive additional treatment, such to make sure nothing prevents patients from obtaining
as chemotherapy, hormone therapy or radiation. their care,” said Moura. “My role is to guide patients
According to Joyce Chung, M.D., a radiation through treatment and the recovery process.”
oncologist and a WCBH co-director, a combination of For Alcott, who completed chemotherapy in July
chemotherapy and radiation is a standard treatment to and whose radiation treatments will soon come to a
improve local control of the cancer cells and optimize close, the beginning of her diagnosis seems like a
survival rate in women who have a lumpectomy. Saint complete blur. She is grateful someone was able to
Raphael’s offers radiation treatment at its New Haven hold her hand and take her through the process. “I felt
and Hamden campus of the Father Michael J. very at ease at Saint Raphael’s,” she said. “They made
McGivney Center for Cancer Care. me feel like they were going to help me and make
“Radiation therapy uses high-powered beams of everything better.”
energy, such as X-rays, to kill cancer cells,” Chung Saint Raphael’s WCBH provides personalized,
explained. Saint Raphael’s cancer-fighting arsenal comprehensive treatment to patients with breast
includes linear accelerators that aim high-powered cancer. Call 1.888.577.9224 (WCBH) or visit
energy beams in a technique known as external srhs.org/breastcenter to learn more.
beam radiation.
For a list of High-Risk Breast Health Program physicians, visit srhs.org/breasthealthphysicians; or call 203.789.3972 for a listing.
8 Saint Raphael’s SEPTEMBER/OCTOBER 2011