Welcome to IBJ’s “Business Cares: Breast Cancer Awareness” Microsite
This year we feature a number of encouraging developments in the effort to prevent and treat breast cancer.
- Community Health Network is working with researchers to bring more Phase 1 clinical trials to Indianapolis, making potentially life-saving treatments more available to Hoosiers.
- Two cancer survivors who started not-for-profits to raise breast cancer awareness among Black women have joined forces to further the cause.
- A local communications professional’s tale of delayed diagnosis and treatment caused by the COVID-19 pandemic is a reminder of the importance of early diagnosis.
- Precision medicine has radically changed how breast cancer is treated.
- Susan G. Komen is introducing new services designed to help patients successfully navigate the challenges of breast cancer treatment.
- A pair of IU Health oncologists give six tips for reducing breast cancer risk.
Thanks to the 36 companies and organizations listed below that sponsored this important section of IBJ. Their investment will fund a Breast Cancer awareness campaign throughout the month of October via print, digital and e-newsletter platforms.
And thanks to our readers. We hope you’ll support our sponsors as they join all of us in working to improve awareness and treatment of breast cancer.
Publisher, President & CEO
- American Structurepoint
- Andy Mohr Automotive
- Becknell Industrial
- Body One Physical Therapy
- Commercial Office Environments
- Cook Group
- Delta Dental
- F.A. Wilhelm Construction
- First Internet Bank
- Franciscan Health
- GEMCO Constructors
- GenTech Associates
- Greene County General Hospital
- Hendricks Regional
- Indiana Fever
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
- JBJ Legal/Jeselskis Brinkerhoff and Joseph JLL
- Katz Sapper Miller
- Keystone Dental Group
- Northwest Radiology
- Perspective Financial
- Radiology of Indiana/Community Imaging
- Roche Diagnostics
- ROI Search Group
- Shambaugh & Son
- Sheaff Brock Investment Advisors
- Susan Tibbs
- Tom Wood
- Toyota Motor North America
Thanks for supporting IBJ and the companies featured here as we all work together for better health.
Tai Chi Flow for Health
Wednesdays in October at 5:30 p.m. Virtual fitness classes available through Community Health Network. Call 317-621-4961 for more information.
Cardio Strength Training
Mondays (5 p.m.) and Thursdays (5:30 p.m.) in October. Virtual fitness classes available through Community Health Network. Call 317-621-4961 for more information.
Yoga with Amy
Wednesdays in October at 6 p.m. Virtual fitness classes available through Community Health Network. Call 317-621-4961 for more information.
Yoga with Jody
Thursdays in October at 6:30 p.m. Virtual fitness classes available through Community Health Network. Call 317-621-4961 for more information.
MONDAY, OCT. 4
Cooking for Wellness
For more information about this virtual workshop offered by Community Health Network, call 317.621.4961.
MONDAY, OCT. 11
Survivorship 101: The Basics
For more information about this virtual workshop offered by Community Health Network and to find out where you can get workshop materials, call 317.621.4961.
WEDNESDAY, OCT. 13
Lunch at Bar Louie
Greenwood, 12 p.m.-2 p.m. HouseMaster of Heartland Home Inspections is hosting get-togethers at favorite local hangouts in central Indiana throughout the month of October to benefit the Indiana Women In Need Foundation. Stop by and donate $5 or more to IWIN, and HouseMaster of Heartland will MATCH with a $5 donation. Beer and food is on us!
SATURDAY, OCT. 16
2021 Komen Indianapolis MORE THAN PINK Walk
Virtual and in-person, Celebration Plaza at White River State Park, 801 W. Washington St., Indianapolis. On-site registration begins at 9 a.m. Walk and virtual program begin at 10 a.m. For more information, join the MORE THAN PINK Walk Facebook page.
MONDAY, OCT. 18
Sexual Dysfunction and Body Image
For more information about this Zoom presentation offered by Community Health Network, call 317.621.4961.
WEDNESDAY, OCT. 20
Happy Hour at Rush on Main
Zionsville, 3 p.m.-5 p.m. HouseMaster of Heartland Home Inspections is hosting get-togethers at favorite local hangouts in central Indiana throughout the month of October to benefit the Indiana Women In Need Foundation. Stop by and donate $5 or more to IWIN, and HouseMaster of Heartland will MATCH with a $5 donation. Beer and food is on us!
WEDNESDAY, OCT. 20
1st Annual Pink & White Affair, raising awareness and donations for Susan G. Komen and Breast Cancer Awareness.
Downtown Indianapolis, 6 p.m. to 10 p.m., at the Biltwell Event Center, 950 S. White River Pkwy W. Drive. Join us for an evening packed with live interviews on the Pink Carpet, Charity Casino Tables, Music Powered by JF The Legend, and a Special Performance By EZINMA! Prepare your pink and white attire now for one of Indy’s most exciting and intimate experiences. For more information, visit firstname.lastname@example.org or call 317.647.0228.
THURSDAY, OCT. 21
Happy Hour at BJ’s Brewhouse
Avon, 4 p.m.-6 p.m. HouseMaster of Heartland Home Inspections is hosting get-togethers at favorite local hangouts in central Indiana throughout the month of October to benefit the Indiana Women In Need Foundation. Stop by and donate $5 or more to IWIN, and HouseMaster of Heartland will MATCH with a $5 donation. Beer and food is on us!
MONDAY, OCT. 25
For more information about this virtual workshop offered by Community Health Network, call 317.621.4961.
Groups merge to better address inequity in breast cancer prevention and outcomes
Content provided by the American Cancer Society
Lisa R. Hayes and Nadia E. Miller didn’t know each other when they were both diagnosed with triple negative breast cancer in 2007—Miller in January and Hayes in May. But their shared experiences as Black women fighting breast cancer brought them together years later with one goal in mind: to eliminate the disparities in cancer that disproportionately affect Black women.
According to the American Cancer Society, breast cancer is the most diagnosed cancer in women. And although Black women are diagnosed with breast cancer slightly less than white women, they face a 40 percent higher death rate from the same disease. In Marion County, the death rate is even higher, with Black women 41 percent more likely to die from breast cancer than white women.
Hayes recalls hearing the news about an Avon Foundation study in 2014 that found “Black women in Indianapolis had one of the highest mortality rates (at the time 42% more likely to die) for breast cancer.”
That finding, along with her own breast cancer experiences, motivated Hayes to take a leadership role in establishing the Reaching to End Disparities Alliance in 2015. Through the RED Alliance, Hayes partnered with predominantly African-American churches to recruit and train breast health advocates to serve in their congregations and help obtain more information and a better understanding about breast cancer issues in the city’s Black community.
For Miller, breast cancer was already deeply personal. Her sister had passed away from the disease when she was only 30 years old, just two years prior to Miller’s own diagnosis at the age of 26.
“One of the first things I realized when I was diagnosed, was that nobody looked like me on any of the materials I was given by my doctors,” she remembers. “So often, the ‘face of breast cancer’ is a 55-year-old white woman who doesn’t share the same culture and experiences that I face.”
That next year, Miller’s brother John founded Pink-4-Ever, with the goal of creating a breast cancer awareness movement in the minority community to dispel myths about breast cancer and to create an environment where “it’s okay to talk about breast cancer.”
Pink-4-Ever focused on conducting educational programs at churches and health fairs and offered support to families touched by breast cancer. It was through their shared missions and the work of their respective organizations that Hayes and Miller crossed paths. Then in January of this year, the two started exploring a merger of the two organizations.
“We ultimately realized that our organizations’ missions aligned, and we were working toward the same goal—a merger just made sense,” said Miller. The board of directors for both organizations agreed, and in July the two organizations became one—Pink-4-Ever Ending Disparities.
Earlier this year, Hayes and Miller were contacted by the American Cancer Society. “[The American Cancer Society is] committed to intentionally advancing health equity,” said Rachelle Anthony, senior manager of cancer-control strategic partnerships with the organization. “In order to reduce cancer disparities, we need to listen to the experiences and perspectives of people with cancer, their caregivers, and their communities, and engage them in the fight against cancer every step of the way. That’s why we are proud to partner with Pink-4-Ever Ending Disparities in Indianapolis.”
With funding from the American Cancer Society, Pink-4-Ever Ending Disparities is expanding its Breast Health Advocate Initiative to recruit and train 40 breast health advocates, distribute culturally sensitive breast cancer educational materials at 400 sites throughout Indianapolis and surrounding suburbs, and provide 320 one-on-one advocacy, navigation, and support interventions. That includes facilitating clinical breast exams, screening mammograms and diagnostic tests through partner organizations including Gennesaret Free Clinic, the Indiana Breast and Cervical Cancer Program or through appropriate health care providers.
“Expansion of this Initiative will better position us to connect with Black women in the community and help them with all their breast health needs—from screenings through treatment,” said Miller.
To learn more about how you can support the Breast Health Advocate Initiative and reduce breast cancer disparities in Indianapolis, visit pink-4-ever.org.
Offering access to Phase 1 clinical trials close to home
Content provided by Community Health Network
A new effort is providing more Community Health Network cancer patients with the opportunity to participate inPhase 1 clinical trials in Indianapolis, offering hope and help in the fight against cancer closer to home. Phase 1 trials are the first step in testing new medicines.
“Phase 1 programs present options for people who are out of options,” said Betsy Glowinski, who manages Community’s oncology research program. “It can offer hope to all patients, regardless of the stage of their disease.”
Glowinski manages an oncology research program led by Medical Director Bert O’Neil, a highly respected and renowned physician and researcher. He is working to enlist pharmaceutical companies and institutions that offer clinical trials to bring those studies to Community.
“Historically, people have had to travel, perhaps to Chicago or Texas or other places, to get access to experimental medicines when they have a condition where standard treatment has failed. That’s very common in cancer for standard treatments to work for some time and then stop. What’s important to us is having access to these experimental medicines here in Indiana so our patients can be treated with them in the same place they’ve received the rest of their treatment,” said Dr. O’Neil.
Until 2021, Community’s oncology research program focused largely on more traditional research studies for drugs closer to FDA approval, or drugs that had already been approved. Community’s oncologists could refer patients to early phase clinical research trials where they could receive novel treatment. However, the extraneous cost of travel, financial burden of not being able to earn an income while receiving treatment, and being away from family can deter patients from participating in trials. In 2020, Community referred 158 patients to institutions across the country for clinical trials—only two patients chose to participate.
By offering these potentially life changing treatments closer to home, Community can make the choice easier for patients.
Many times, the process starts with genetic testing. “Things have changed a lot in cancer in the last 10 years,” said Dr. O’Neil. “We now can get a tremendous amount of information about a cancer. Every cancer is different. Even cancers that start in the same place can be different genetically, and sometimes understanding what those genetic mutations are specifically can lead to specific drugs. There’s an ever-increasing number of examples of drugs created specifically to interact with a molecular abnormality. As these new drugs come out, we can find a patient based on genetic testing and then match them with a trial that makes the most sense for them with one of these new medications.”
Community has partnered with Tempus, a technology company that has built the world’s largest library of clinical and molecular data and an operating system that makes this information accessible to physicians. Tempus provides doctors with the genetic information needed to help choose potential medications and clinical trials.
“This Tempus network gives us a capability that’s pretty revolutionary,” said Dr. O’Neil. “When we do genetic testing and identify a person who would be eligible for one of those studies, we can actually get that trial open in 2 weeks and put that very patient on that trial right here at our center. This is a capability that relatively few places have had and we’re really excited to bring it to Indiana.”
In the past, opening a clinical trial could take anywhere from three to six months, not practical for cancer patients.
Clinical studies offer new insights into treatments that may provide better quality of life or a longer life with cancer.
“We’re also opening studies through partnerships with other pharma companies, including Lilly here in town, Amgen, AstraZeneca, Janssen, you name it. We’ve been surprisingly successful being that we’re new to this in getting people to commit trials to us. I think within the next year we’ll be looking at maybe 15-20 early phase studies open at Community, ” Dr. O’Neil said.
“I truly believe Community Health Network can become a regional referral source for experimental cancer therapies,” he said. “We just need to keep building the infrastructure to make it happen.”
7 things to know about getting a mammogram
Mammograms (breast x-rays) are the best screening tool we have to find breast cancer early, when it may be easier to treat. After you and your health care professional establish a screening schedule, it’ll help to know what to expect so it can go as smoothly as possible. Here’s what you need to know.
- What is a mammogram?
A mammogram is an x-ray of the breast that’s used to find breast changes. X-rays were first used to examine breast tissue nearly a century ago. Today, the x-ray machines used for mammograms produce lower energy x-rays and expose the breast to much less radiation compared with those in the past.
- Where do you get it?
Find a center that specializes in mammograms. The US Food and Drug Administration (FDA) certifies mammogram facilities that meet high professional standards of quality and safety. Ask to see the FDA certificate if one isn’t posted near the receptionist’s desk. And when you find a facility you like, stick with it. Having all your mammograms at the same facility will make it easier for doctors to compare images from one year to the next. If you’ve had mammograms done at other facilities, have those images sent to your new facility.
- When do you schedule it?
It’s best to schedule your mammogram about a week after your menstrual period. Your breasts won’t be as tender or swollen, which means less discomfort during the x-ray.
- What should you wear?
Wear a 2-piece outfit because you will need to remove your top and bra. Do not apply deodorant, antiperspirant, powder, lotion, or ointment on or around your chest on the day of your mammogram. These products can appear as white spots on the x-ray.
- What should you expect?
The entire procedure takes about 20 minutes. The breast is compressed between two plastic plates for a few seconds while an x-ray is taken. It’s repositioned (and compressed again) to take another view. This is then done on the other breast. Flattening the breast can be uncomfortable, but is needed to provide a clearer view.
- When do you get the results?
You should get your results within 10 days. If you don’t, you should call to ask about them. If doctors find something suspicious, you’ll likely be contacted within a week to take new pictures or get other tests. But that doesn’t mean you have cancer. A suspicious finding may be just dense breast tissue or a cyst. Other times, the image just isn’t clear and needs to be retaken. If this is your first mammogram, your doctor may want to look at an area more closely simply because there is no previous mammogram for comparison.
- What do you pay?
For uninsured or low-income women, free or low-cost mammogram services are available. Some of these programs are held during National Breast Cancer Month in October, while others are offered year round. Call the American Cancer Society at 1-800-227-2345 to find a program near you.
Precision medicine transforms breast cancer treatment
By Denise A. Croix, PhD
When my mother was diagnosed with breast cancer 32 years ago, the doctors prescribed tamoxifen, an important advance at the time because it targets cancer cells and does not have the side effects associated with chemotherapy. However, the doctors were uncertain about the duration of her therapy—for the rest of her life? 10 years? 5 years? Since there were few treatment options, she also underwent a mastectomy.
Fast-forward to 2016, when my first cousin on my mother’s side was diagnosed. This time, a combination of lumpectomy, radiation therapy and an oral drug was prescribed, based on her diagnosis and assessment of the likelihood of recurrence. While my mother and my cousin are both cancer survivors, my cousin’s smoother path to remission was paved in part by the armamentarium of diagnostic tools available today. Indeed, while the incidence of breast cancer has held steady over the past 20 years—with more than 280,000 new cases in the U.S. in 2021—the mortality rate has steadily declined. According to the American Cancer Society, breast cancer has a 5-year relative survival rate of 90.3%.
Enter precision medicine
The improvement in survival can be attributed to new developments in treatment and, just as important, the deeper understanding of this complex disease and our ability to diagnose breast cancer at the molecular level. Pinpointing the type of breast cancer and its origin enables the physician to deliver personalized treatment for each patient—a concept known as precision medicine. By identifying genes, proteins and other substances in the body, precision medicine helps your doctor tailor treatments—selecting treatments most likely to benefit the patient, while sparing the patient from those that are not likely to help. Scientists and doctors refer to these genes, proteins and other substances that can guide diagnosis and treatment as biomarkers. The identification of the biomarkers, unique to each patient, is the basis of an accurate diagnosis—telling the doctor exactly which specific cancer the patient has and therefore which treatments are the most effective.
Biomarkers of breast cancer
For an understanding of the role of biomarkers in cancer diagnosis, it is important to note that cancer cells are associated with abnormalities in their genes, such as having more than the normal number of copies of a gene (amplification), above normal production of the protein encoded by the gene (overexpression), or abnormalities in the DNA sequence of the gene (mutation). Biomarker testing looks for the products (proteins) produced by the genes, or directly at the genetic makeup of the disease tissue.
Today, three major biomarkers account for about 80% of breast cancer—estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor-2 (HER2). Together, ER and PgR are referred to as hormone receptors (HR).
HR-positive/HER2-negative accounts for 68% of breast cancer and has the most favorable survival rate, with many therapy options.
Ranking second in survival rate is HR-positive/HER2-positive, which accounts for 10% of breast cancer. A number of therapies are available that target the HER2 receptor on the tumor cells.
Ranking third in survival rate is HR-negative/ HER2-positive, accounting for 4% of breast cancer.
Triple-negative breast cancer (HRnegative/HER2-negative), sometimes called TNBC, accounts for 10% of breast cancer and has the least favorable survival rate. A new class of therapeutics known as immune checkpoint inhibitors is now available for TNBC patients.
Breast cancer biomarkers are most commonly identified using immunohistochemistry, which detects and identifies the proteins in breast tissue obtained through biopsy. Next generation sequencing, another diagnostic tool, is used to identify other potential mutations as well as determine risk of recurrence. Another commonly used diagnostic tool is gene expression profiling, which can help assess the likelihood of metastasis. A higher risk of metastasis may suggest a more aggressive treatment plan.
Early diagnosis is key
According to the National Cancer Institute, survival rate today is 99% at 5 years if the tumor is diagnosed while still localized to the breast. Survival rate falls to 85.8% once the tumor has spread to local lymph nodes and to 29% for cancer that has metastasized to other sites. These statistics reinforce the importance of routine screening. Currently, the American Cancer Society recommends annual mammography for women between 45 and 54, then every 2 years after the age of 55. A new development in mammography called digital breast tomosynthesis, also known as 3D mammography, is sometimes recommended for women with dense breasts. For higher risk patients, mammography may be supplemented with MRI.
A bright future
Based on improved survival rates over the years, and continuing research, there is every reason to be optimistic. But it all comes back to arming the doctor with early and accurate diagnosis. By leveraging advancing technology to characterize the cancer at the molecular level and thus enable targeted treatment, we can empower the patient to be an active participant in driving a positive outcome.
Komen needs your help to meet growing patient needs
By Jennifer Milewski
In a single moment, a person’s life can change forever. For many women—and men—that moment comes when they hear the words no one wants to hear: “you have breast cancer.”
There is life before breast cancer, and life after. Cancer takes an enormous toll on everyone, not just because of the emotional and physical strains that going through treatment takes, but also because of the financial pressures, even for those who have good insurance and a good-paying job. It can be even more burdensome if you don’t.
National Breast Cancer Awareness Month was first set aside more than 35 years ago to help bring awareness to a disease that was often only spoken of in whispers, and to increase early detection by inspiring women to get regular mammograms. The good news is that this focus on early detection has saved a lot of lives—decreasing the mortality rate for breast cancer by 41 percent since 1989. The bad news is that due to the coronavirus, that progress is at risk.
While we have seen decreases in the mortality rate thanks to early detection and advances in treatments, breast cancer is not cured. Even before the pandemic, more than 44,000 people were expected to die from the disease in the U.S. this year alone. Unfortunately, that number is likely to go up over the next few years due to the pandemic, which has had a major ripple effect on every aspect of our health care system and economy.
Many women delayed regular screening over the last 18 months. While screening rates are rebounding from pandemic lows, we are still catching up for many people who should have already been screened and diagnosed. This is expected to lead to a surge of new breast cancers, with later stage diagnoses and increased mortality.
That means in the age of COVID-19, our help is needed now more than ever. And thanks to recent changes to our operating structure and mission delivery, we are able to be there for people facing breast cancer—no matter where they live.
While Komen did consolidate and centralize many back-end operations, we continue to have staff in Indianapolis and in communities across the country. Our mission has not changed, but how we deliver it has. We remain ready to both support people who need help and provide meaningful ways for people who want to help to be able to share their passion for the cause and compassion for their neighbors.
Komen is now supporting those facing breast cancer today directly, through the Komen Patient Care Center, which is an integrated suite of direct-to-patient support services and tools, resources and guidance needed in every step of the breast cancer journey. This year we expect to serve at least 18,000 people through our free Breast Care Helpline, which provides emotional support from trained oncology social workers, who also provide guidance to Komen support and
additional local resources as needed. Demand for this service has increased 35 percent year-over-year.
One of the main areas of need we are encountering is financial assistance to help pay for a variety of expenses that often serve as barriers to getting care. No one should have to decide between treatment and paying their rent or putting food on the table. Thanks to the generosity of our supporters in Indianapolis and across the country, we are able to help through our Treatment Assistance Program. So far this year, we have fulfilled nearly 1,500 financial assistance requests, including more than 700 in August alone. That’s more than double the amount awarded compared to the same time last year. Overall, we’ve seen a 155 percent increase in demand for these services.
An increasing area of focus for us is providing help and guidance to people facing breast cancer by connecting them to a patient navigator. While we are growing our own team of patient navigators that can be accessed nationally through our Helpline, we are also developing a team of culturally competent navigators in many communities across the country, including soon in Indianapolis, that are focused on helping Black women overcome unique barriers to care that are contributing to them dying at higher rates than their white neighbors. These patient navigators can help people with everything from screening to appointments to paperwork, ensuring that they get the care they need. No one should have to face breast cancer alone.
We remain as committed as ever to doing everything we can to save lives from breast cancer. But we cannot do it alone. This October, we encourage you to do more than just wear a pink ribbon and voice your support. Participate in a walk, donate online, support a fundraiser, take one action to support those who need our help more than ever. Together, we can save lives and get us closer to seeing a day when no one dies from breast cancer.
Strategies to consider for lowering breast cancer risk
By Dr. Betty Fan and Dr. Meghan Beer
In 2020, breast cancer surpassed lung cancer as the most commonly diagnosed cancer worldwide. It is the second most common cause of cancer-related death in women in the United States, and approximately one in eight women will be diagnosed with breast cancer in their lifetime.
Screening mammograms continue to play a critical role in early diagnosis. Research developments and advancements in treatment have also led to better outcomes. However, women should also be aware of proactive steps they can take that may help lower their overall risk of developing breast cancer.
Studies have consistently demonstrated that obesity increases overall risk for breast cancer. A high BMI and/or weight gain during adulthood can increase the risk for breast cancer in postmenopausal women. Maintaining a healthy body weight can reduce breast cancer risk as well as help reduce the risk of breast cancer recurrence in breast cancer survivors.
Physical activity, in addition to a healthy diet, reduces the risk for breast cancer by up to 40%, especially in post-menopausal women. Women should strive to be active daily and avoid a sedentary lifestyle. Suggested goal is to incorporate at least 150-300 minutes of moderate-intensity physical activity per week (approximately 30 minutes a day, 5 days a week).
Research has shown that alcohol consumption is closely associated with increased risk for breast cancer. Women at higher risk for breast cancer should avoid alcohol as much as possible, as alcohol interacts with circulating hormones in the body. If you do choose to drink alcohol, do so in moderation. Women should limit their consumption to no more than one drink equivalent per day.
While studies are still ongoing, there is some suggestion that aside from the numerous health issues that arise from smoking, it may also have a link to an increased risk of breast cancer. Women who smoke should discuss smoking cessation strategies with their doctors.
Some women at high risk may be eligible to take a medication in order to help reduce their chances of getting breast cancer. These medications are known as selective estrogen receptor modulators, or SERMs, and they act by blocking estrogen effects in the breast tissue. This is an oral pill taken every day. Women who may be eligible include those with significant family history and/or previous atypical breast biopsies.
There are several known inherited genetic mutations that may increase a woman’s risk for breast cancer. It is important to discuss genetic testing with your doctor if you think you may be a candidate. Genetic testing eligibility is based on patterns of personal and family history of cancer and is directed at targeting individuals who may be likely to carry a mutation. Some women who test positive for a genetic mutation that increases their risk for breast cancer may be eligible for increased breast screening regimens or, in rare situations, prophylactic surgery. It is important to discuss this with your doctor before undergoing genetic testing.