Please Join the Before Forty Initiative & Help Us Save the Lives of Young Women Around the World
We walk for the cure. We ride for the cure. We eat yogurt for the cure. We wear jeans for the cure. But there is no cure, yet.
There are millions of breast cancer survivors thriving today. Many of the them were fortunate enough to have caught their cancer early while it is still in the treatable stage. However, many do not. These women battle their cancer every single day because their cancer was found too late. Of these women, a large proportion are young women, especially African American and Hispanic women.
These women often get diagnosed with the more aggressive, harder to treat form of breast cancer known as Triple Negative disease. This name refers to the fact that the cancer was not fueled by estrogen, progesterone nor does it carry the Her2Nue oncogene.
The American Cancer Society recommends that women get their FIRST mammogram, or baseline mammogram, at the age of forty. Insurance carriers use this standard to deny coverage for a younger woman who wants to get screened earlier than that.
The No Surrender Breast Cancer Foundation is asking you to help us help women who have never been screened for breast cancer. We want the guidelines to be changed. Women should get their baseline no later than their 35th birthday. Women of high risk categories, African American women, Hispanic women, women of Ashkenazi heritage, women with a family history of breast cancer, should get their first baseline at age 30. Studies prove that MRIs are superior to mammography in finding cancer when it is at its smallest, in younger women. Young women need breast MRIs for their baseline screening test.
The NSBCF wants insurance companies to stop denying coverage due to age, density of breast or insufficient medical reason for a proper screening before the age of forty.
Our Goal
- Increase awareness to young women about the risk of breast cancer. Inform them of the better prognosis and treatment options if their cancer is found early.
- Make the age of 35 be the standard for baseline screening. Make the age of 30 the standard for high risk groups.
- Get insurance companies to cover baseline MRIs and subsequent follow-up diagnostic tests if warranted.
- Increase awareness for African American and Hispanic women about Triple Negative Breast Cancer. Educate young women that African American and Hispanic women are at a higher risk of TNBC and have a poorer prognosis. The only way they can beat the disease, should they get it, is if it is found early.
What if ...
You found your cancer while it was still small?
You found your cancer before it spread to your nodes?
You found your triple negative cancer earlier?
You found your cancer so early you didn’t require chemo?
You found your cancer so tiny you could keep your breasts?
You found your cancer in time to preserve your fertility?
If only you knew earlier...
You know what all this means. You know what a difference it would have made in you life.
We can’t change the past - but we can change the future for the young women who don’t even know they have cancer - yet.
Take the Pledge ~ Recruit Five Women
Save Someone's Life
Join the Before Forty Initiative
Our logo says it all: She is strong, beautiful and taking aim at cancer. She has shot her arrow and broken through the bonds of pink ribbons to take a stand and be a part of the solution. You can be that person for someone whose life you can save.
Take The Pledge:
I _________________, refuse to stand by and let another woman endure what I had to in order to fight my cancer. I pledge to teach five young women about the importance of early detection. I will encourage them to get baseline breast screening by the age of 35, or if she is at high risk, at the age of 30. I will take the time to explain the difference it will make in her life if she finds her cancer early. I will give her a Before Forty Initiative pamphlet that details everything she needs to know. I will fight for her to get follow up care if something suspicious is found. I will make sure she never, ever “watches and waits” for her cancer to grow. I will reassure her that mammograms may be uncomfortable for a moment, but they can save her life. I will tell her what a breast ultrasound is. I will walk her through a breast MRI, so she is unafraid. Because I am a survivor, I will be an active participant in protecting women until there is cure, because until that day comes, early detection is our only defense. I will be a part of the solution.
Name: __________________________________________
Address: _________________________________________
________________________________________________
email:____________________________________________
The Initiative’s Levels of Dedication:
The Archer
Saves the lives of 5-10 women
A Trailblazer
Saves the lives of 10-19 women
A Warrior
Saves the lives of 20-49 women
The Conquerer
Saves the lives of 50+ women
To save a life, please copy and paste this Pledge Form and mail it to
No Surrender Breast Cancer Foundation, PO Box 84, Locust Valley, New York 11560
All we are asking for is your pledge and a tax deductible donation of $10. This donation will help fund our national campaign, because we won't stop until every woman knows how vital this information is.
We will send you the informational pamphlets you require for your recruits and any other information that will help you help those women who were US years ago, before we found our cancers. Let's do this- Let's make a real difference while we wait for the Cure.
Thank you.
Ferne Dixon and Gina Maisano
A Promise Kept... meet Ferne
Ferne Dixon was a beautiful, caring, talented printer who put off getting her first mammogram until she was 41, when she was diagnosed. But she had to fight to get it. She had no family history and as she said, “I wasn't taken seriously when I found my lump. I believe if the medical professionals I initially went to see would have taken me a bit more seriously and stopped prescribing antibiotics, telling me the lump was benign and I was too young to have breast cancer without even giving me mammogram or ultrasound, maybe it might have been caught before it went to the nodes.”
Ferne did aggressive chemotherapy, radiation and had a lumpectomy. Four months after she finished her radiation treatments she discovered her cancer had returned to her lungs which then spread to her liver and finally her brain.
Ferne’s tumor was Triple Negative. It had grown and spread to her lymph nodes.
If she had been screened before her 41st birthday, the likelihood that her tumor would have been found before it had a chance to become uncontrollable is high. She would have had a fighting chance against her Triple Negative Breast Cancer.
Ferne admitted that she didn’t think about mammograms or their importance before her diagnosis, “I just turned 41 when I found my lump, so was pretty on time in getting the mammogram. Although if I didn't have a lump, I probably would have waited to get one.”
This illustrates the battle that is being fought every day and young women, especially African American women, are paying for it with their lives. They don’t get screened early enough. When something is found a young woman is not taken seriously. The medical community needs to acknowledge this disparity.
Ferne was Gina Maisano’s best friend. Gina is the founder of the No Surrender Breast Cancer Foundation. She had also been diagnosed with a very aggressive Triple Negative tumor. The only difference was she had a baseline mammogram at age 35 and had yearly check-ups after that. When she was 39 a shadow was seen on one of her breasts. It was her tumor. It had the same features as Ferne’s. But because Gina’s was found earlier, she was able to fight the TNBC.
We do not want this story to repeat itself. EVERYONE should have a fighting chance.
We don’t have a cure yet for breast cancer. But we do have ONE WEAPON: Early Detection.
Please Help Us Spread the Word. Please Take the Pledge below and become an advocate for those who do not even know they have cancer yet. You CAN make a difference - right now.
We need your voices to tell your friends and neighbors about the importance of early diagnosis.
We need your financial support to change the guidelines nationally, make insurance carriers cover early screening, and educate young women and Hispanic and African American women about how this simple step may save their lives.
About a month before Ferne left this earth she said to Gina,
“I know I won’t ever fall in love or get married or have a baby. But I am really trying to fight this thing and I feel I have been blessed that I have survived as long as I have.”
Every woman should have a chance to fall in love and get married and have a child. Don’t let cancer rob another young woman of that chance.
Please help us. Take the pledge Today.
New Study Proves Why Before Forty Initiative is so Vital!
We have been working on spreading the word about The Before Forty Initiative. Read this new study and understand how important this work is:
A new study finds that African ancestry is linked to a more aggressive type of cancer called "triple negative."
Harry Jackson Jr.
McClatchy Tribune
July 23, 2010
A new study finds that African ancestry is linked to a more aggressive type of cancer that is more deadly.
Researchers at the University of Michigan Comprehensive Cancer Center in Ann Arbor found that, among women with breast cancer, 82 percent of African women had the breast cancer called "triple negative," 26 percent of African-Americans had the variety, and 16 percent of white Americans had it. In technical terms: Triple negative breast cancer is negative for three markers used to determine treatment: the estrogen receptor, the progesterone receptor and HER-2/neu.
Recent advances in breast cancer treatments target each of the receptors, but targeting all three is a major problem, said Dr. Lisa A. Newman, director of the Breast Care Center at the University of Michigan Comprehensive Cancer Center. "Outcome disparities are therefore likely to increase, because fewer African-American women are candidates for these newer treatments," she said.
These results and results from prior studies indicate a genetic link for the form of breast cancer a woman might develop. Prior studies have shown that while African-American women are less likely than white women to develop breast cancer, those who are diagnosed are usually younger and more likely to die from the disease.
Other studies have shown a hereditary breast cancer risk associated with racial-ethnic identity - most commonly among Ashkenazi Jewish women. Researchers looked at African-American women and white women diagnosed with breast cancer at the Henry Ford Health System in Detroit.
Researchers also looked at African women diagnosed at the Komfo Anokye Teaching Hospital in Ghana. Ghanaian women were diagnosed at a younger age than American women, with larger tumors, had more advanced cancer and were more likely to have the triple negative test results.
Researchers said the recent findings may help science find women predisposed to more aggressive and deadly cancers. The study is in the online journal "Cancer."
Breast cancer statistics: 194,280 Americans will be diagnosed with breast cancer this year and 40,610 will die from the disease, according to the American Cancer Society.
WHY WE NEED YOUR SUPPORT
There is now proof that the US Task Force has done damage. This group of people announced in the fall that women under 50 years of age do not need mammograms. The No Surrender Breast Cancer Foundation is vehemently against this decision and has made our opinion known.
Our Before Forty Initiative is working hard to get the word out to all women that Early Detection is your BEST defense. If you want the highest chance of beating cancer: find it while it is still small. That is why we are educating women about the importance of baseline screenings BEFORE the age of Forty and follow-up care that involves not only mammography, but ultra sound and breast MRI.
We need your help to help us save the lives of women.
Please see our BEFORE FORTY INITIATIVE HERE.
Please DONATE to our foundation to help us. We need funding.
Read today's news, and you will find more proof why it is our duty to protect the women who come after us.
Mammogram screening down 13 percent since 'flawed' recommendations
By Aimee Heckel Camera Staff Writer
Posted: 06/23/2010 09:14:36 AM MDT
Read more: Mammogram screening down 13 percent since 'flawed' recommendations - Boulder Daily Camera http://www.dailycamera.com/lifestyles/ci_15351198#ixzz0ri8xRW5J
DailyCamera.com
Terry Stiven, of Lafayette, almost didn't get the test.
She had no family history of breast cancer. She'd had mammograms in the past, and she had no signs of cancer.
Then, this fall, the United States Preventative Service Task Force released new recommendations: Women between 40 and 49 years old don't need mammograms. The benefits of testing don't outweigh the risks, the task force said.
Now, it seemed there was no reason to get the 10-minute, slightly uncomfortable screening. In February, Stiven, 46, went ahead and got tested anyway, expecting nothing.
She had cancer.
Not invasive breast cancer, though. Doctors removed the lump, and she had four weeks of radiation. The experience was frightening, but not damaging.
Today -- just four months later -- Stiven is cancer-free, with extremely low chances of it returning. She still has both breasts, she runs triathlons and her life expectancy has not been shortened.
"If I'd waited four years, I don't know if I would have been alive," she says.
Stiven is one reason of many that local doctors have launched an aggressive campaign to counter the U.S. Preventative Task Force's advisory.
"Getting a mammogram is one of the most important things a woman can do to live a long, healthy life," says David Oppenheimer, the chief physician of the mammography department of the Boulder Community Hospital.
And he's not just talking about women older than 50.
One third of women diagnosed with breast cancer in Boulder County are between 40 and 49 years old, according to the Boulder Community Hospital. More than 40 percent are younger than 50 -- the task force's "arbitrary" age cut-off, Oppenheimer says.
Since the task force's recommendation, the hospital's imaging department reports a 13 percent decline in mammograms -- the majority among women in their 40s and 50s.
Nanna Bo Christensen, the Boulder Community Hospital's Breast Health Navigator, attributes this drop at least in part to the national recommendation.
Other women may be afraid they can't afford it -- even though it is illegal in Colorado for insurance companies not to cover screenings for women age 40 and older. The Women's Wellness Connection offers financial support for women who need it, too, says Christensen.
"Mammography saves lives," she says. "The key to survival is early detecting."
In fact, the younger the woman, the faster the breast cancer grows, doctors say, due to higher levels of estrogen, which feeds the cancer cells.
And if you find cancer before it spreads to the lymph nodes, Oppenheimer says, doctors have a 97 percent chance of curing it. Once it hits the lymphs, the cure rate plunges.
The number of women who die from breast cancer is down since 1990, and experts say that's primarily due to increases in the number of women being screened.
So why would a government panel recommend against something that statistics show helps save lives?
The task force looked at false-positive tests and the related anxiety, unnecessary biopsies and exposure to radiation.
Oppenheimer asserts data used for the recommendation was scientifically flawed, and that the task force left out several important studies to skew the numbers in favor of its recommendation. As to the radiation question, he says about 1 in 3 million mammograms actually causes cancer.
"However, we know that one in eight women are going to get breast cancer in their lives, so the advantages far outweigh the tiny risk," he says.
Mammograms detect cancer 90 percent of the time, the hospital says, making them the most effective screening tool.
A slew of organizations have since denounced the recommendation, including the National Cancer Institute, the American Cancer Society, the Susan G. Komen Breast Cancer Foundation, Avon Foundation, the Obama Administration, American College of Radiology, American Society of Breast Imaging, American College of Obstetricians and Gynecologists.
"Now we as physicians and a health care community have a huge job on our hands to re-educate the community," Oppenheimer says. "Once people stop getting tested, it's a huge effort to convince people to start again."
The U.S. task force also said women older than 50 only need to get a mammogram every two years instead of annually.
When Jill Kamon, of Boulder, heard that, she says she was horrified.
Kamon was diagnosed at age 51 with breast cancer. If she had followed the recommendations, she would have skipped the mammogram that found the small lump in the back of her breast. The cancer would have had a year to grow before her next mammogram. She couldn't feel it with a self-exam.
"To me, the mammogram and radiologist who read the mammogram completely saved my life. There is no question," says Kamon, who had a double mastectomy in the summer of 2007. The lump was only 6 millimeters big, but it was growing aggressively.
"I'd had a mammogram exactly one year earlier that was clear," she says. "That dot was not there."
By the numbers:
13 percent -- Decrease in mammograms at the Boulder Community Hospital since the U.S.
Preventative Service Task Force recommendation in the fall. The majority of these women are in their 40s and 50s.
30 percent -- Decrease in breast cancer's death rate since 1990, nationally.
42 percent -- Of women diagnosed with breast cancer at the Boulder Community Hospital were younger than 50; 32 percent were in their 40s.
More than 30 percent -- Decreased death rate, due to mammography screenings for women in their 40s.
One in eight -- American women are affected by breast cancer.
97 percent -- Chance of curing breast cancer if it's caught before spreading to the lymph nodes.
About 1 in 3 million -- Chance of the radiation from a mammogram causing breast cancer.
Sources: Boulder Community Hospital, Susan G. Komen for the Cure.
Breast Cancer Screening: MRI Sensitive, No Added Value With Mammography, Study Suggests
ScienceDaily (Mar. 8, 2010) — Do we need a revision of current recommendations for breast cancer screening? According to a recent prospective multicenter cohort study published in the Journal of Clinical Oncology, this appears advisable at least for young women carrying an increased risk of breast cancer. The results of the EVA trial confirm once more that magnetic resonance imaging (MRI) is substantially more accurate for early diagnosis of breast cancer than digital mammography or breast ultrasound: MRI is three times more sensitive for breast cancer than digital mammography.
For the EVA trial, almost 700 women were enrolled. Aim of the trial was to refine existing guidelines for surveillance of women at high and moderately increased risk of breast cancer. Findings suggest that in these women, MRI is essential for early diagnosis -- and that a mammogram or an ultrasound examination does not increase the "cancer yield" compared to what is achieved by MRI alone. Researchers conclude that annual MRI is not only necessary, but in fact sufficient for screening young women at elevated risk of breast cancer. In women undergoing screening MRI, mammograms will have no benefit and should be discontinued. Moreover, MRI screening is important not only for women at high risk, but also for those at moderately increased risk.
Between 2002 and 2007, the EVA trial recruited 687 women who carried a moderately increased risk of breast cancer (lifetime risk of 20% and over). Women underwent 1679 screening rounds consisting of annual MRI, annual digital mammography and half-annual screening ultrasound examinations. During this time span, 27 women received a new diagnosis of invasive cancer or DCIS (Ductal Carcinoma In Situ).
Of all imaging methods under investigation (digital mammography, ultrasound and MRI), MRI offered by far the highest sensitivity: MRI identified 93% of breast cancers. 37% of cancers were picked up by ultrasound. The lowest sensitivity was achieved by digital mammography, which identified only one-third of breast cancers (33%). These results confirm once more that MRI is essential for surveillance not only of women at high risk, but also for women at moderately increased risk of breast cancer. Moreover, the results contradict current guidelines according to which mammography is considered indispensable for breast cancer screening. One aim of the EVA trial was to question this concept and to ask whether it is still appropriate to require that MRI should only be used in addition to mammography. The results speak for themselves: If an MRI is available, then the added value of mammography is literally negligible. Researchers conclude that MRI is necessary as well as sufficient for screening young women at elevated risk of breast cancer. Since mammography appears to be unnecessary in women undergoing MRI, its use is no longer justifiable, and current guidelines should be revised to reflect this.
Current guidelines questionable
Current guidelines for women at high familial risk of breast cancer recommend annual MRI (with or without ultrasound) and annual MRI starting at age 25-30. "These guidelines were set up based on little or no scientific evidence, and mainly reflect expert opinion," summarizes Prof. Christiane Kuhl, radiologist at the University of Bonn and principal investigator of the EVA trial. "In the light of the results of the EVA trial, such recommendations should be revisited." This seems even more important because digital mammography uses x-rays (ionizing radiation) to detect breast cancer. "The radiation dose associated with regular mammographic screening is clearly acceptable and safe," underscores Kuhl. "However, regular mammographic screening usually starts at age 40-50." The situation is different if systematic annual mammographic screening is started at age 25-30. "Not only because these women will undergo more mammograms and therefore will experience a cumulative lifetime radiation dose that will be substantially higher, but also because the breast tissue of young women is more vulnerable to the mutagenic effects of radiation." This appears to be especially true for BRCA mutation carriers. "Accordingly, we impose more radiation on less radiation-tolerant breast tissue -- for a very limited, if any, diagnostic benefit." Therefore, Kuhl advocates a revision of existing guidelines: "It is no longer justifiable to insist on annual mammographic screening women in their thirties if they have access to screening MRI."
MRI is a mature technology
In the past, MRI was used strictly in addition to mammography only. The allegedly high rate of "false positive" diagnoses and the allegedly insufficient sensitivity for DCIS were the main reason to discourage its use as a stand-alone method for breast cancer screening. "In this multicenter trial, with basic quality assurance implemented not only for mammography, but also for MRI, we were able to prove that false positive diagnoses are avoidable if MRI studies are interpreted with adequate radiologist expertise." In the EVA cohort, the Positive Predictive Value achieved with MRI was already even higher than that of mammography or breast ultrasound. "Moreover, we found that MRI offered the highest sensitivity especially for DCIS," adds Dr. Kuhl. "It is simply wrong to state that we need a mammogram to detect intraductal cancer."
Kuhl et al. Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA Trial. Journal of Clinical Oncology, 2010; DOI: 10.1200/JCO.2009.23.0839
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