Patient Care

Have breast cancer in family? Need to know risk? There’s an app for that

October 30, 2014 | by

Breast cancer risk is personal; breast cancer risk assessment should be, too. To that end, City of Hope researchers have developed a starting point to help women (and their doctors) with a family history of the disease begin that risk assessment process.

breast cancer risk app

An app developed at City of Hope helps women with a family history of breast cancer assess their breast cancer risk by age. Doctors find it useful, too.

The result is an iPhone app, called BRISK, for Breast Cancer Risk Assessment Application. It’s the work of City of Hope’s Division of Research Informatics, in collaboration with the Division of Clinical Cancer Genetics.

For women with a family history of the disease, the app walks them through their age-specific risk of developing the disease, beginning with a question about whether the family history involved a first-degree relative, a second-degree relative, a mother and paternal aunt, and so on.

The app clearly cautions that it is not fail-safe. It is not a substitution for a formal cancer risk assessment by a skilled physician. It doesn’t include risk factors other than family history, and it’s not to be used by women who are carriers of gene mutations making them more susceptible to breast cancer.

But it does help women and their physicians gain some perspective.

Here, Bita Nehoray, a genetic counselor in the Division of Clinical Cancer Genetics, answers questions about the app, its purpose and how it should be used: » Continue Reading

Cancer insights: Surgeon Dawn Hills on how to reduce breast cancer risk

October 29, 2014 | by

When it comes to breast cancer, women aren’t limited to getting screened and, if diagnosed, making appropriate treatment choices. They can also take a proactive stance in the fight against breast cancer by understanding key risk factors and practicing lifestyle habits that can help reduce their own breast cancer risk. Dawn M. Hills, M.D., director of breast surgical oncology at City of Hope | South Pasadena, explains. 

Dawn Hills, M.D.

Women can be proactive in the fight against breast cancer. Dawn Hills explains how.

Breast cancer is the most common cancer among American women.  Today, there are an estimated 2.8 million breast cancer survivors in the United States.  This month, through increased awareness, we create hope – hope needed to ultimately win our fight against breast cancer one woman at a time.

The causes of breast cancer are complex, but early detection has greatly improved breast cancer survivorship, which has tripled over the past 60 years. As we become more informed about breast cancer, its risk factors and, more important, how to reduce and ultimately prevent those risks, we get closer to making this a disease of the past.

Several factors contribute to breast cancer, including:

Estrogen exposure: Breast tissue development is highly sensitive to estrogen, so the more exposure a woman has to estrogen over her lifetime, the higher her risk for breast cancer. Menarche (first menstrual period) at an early age, or later-age menopause, may contribute to higher breast cancer risk. » Continue Reading

What are my genes telling me about my cancer risk?

October 27, 2014 | by

Genetics, genes, genome, genetic risk … Such terms are becoming increasingly familiar to even nonresearchers as studies and information about the human make-up become more extensive and more critical. At City of Hope, these words have long been part of our vocabulary. Researchers and physicians are studying patients’ personal cancer risks, taking into account family history and genetics, along with environmental and lifestyle factors, and then helping patients understand those risks.

cancer risks and genes

Genes play a crucial role in cancer risk. Get more information on Nov. 11, as four City of Hope experts dive into the connection between genes and disease.

To further explain the connection between genes and cancer, City of Hope will host an Ask the Experts program, “Cancer: Is it in my genes?” on Nov. 11 at the Duarte, California, campus. Moderator Linda H. Malkas, Ph.D., deputy director of basic research and a professor in the Department of Molecular and Cellular Biology, will lead the panel discussion.

The featured City of Hope speakers are Joseph Alvarnas, M.D., director of medical quality; Sofia Wang, Ph.D., associate professor in the Department of Population Sciences; and Susan Neuhausen, Ph.D., The Morris & Horowitz Families Professor in Cancer Etiology & Outcomes Research in the Department of Population Sciences.

Here, Neuhausen, who has an extensive background in genetics research, explains genes’ role in cancer – and gives a preview of the Nov. 11 event.


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Meet our doctors: Radiologist Lusi Tumyan on breast cancer screening

October 25, 2014 | by

Mammograms are currently the best method to detect breast cancer early, when it’s easier to treat and before it’s big enough to feel or cause symptoms. But recent mammogram screening guidelines may have left some women confused about when to undergo annual testing.


Lusi Tumyan says women should work with their physicians on a personalized screening program.

Here Lusi Tumyan, M.D., chief of the Breast Imaging Section at City of Hope, explains some of the current and new breast imaging tools, and encourages women to work with their physician to decide on a personalized plan, based on individual breast cancer risk, of when to get screened.

What are the current technologies available for breast cancer screening?

The best and gold standard breast cancer screening test for women with low or average risk for breast cancer is a mammogram. It’s readily available and does not require special preparation other than washing off deodorants prior to the exam. For women who are at a higher risk for developing breast cancer (for example, women who have a family history of breast cancer, or possess the BRCA1 and BRCA2 genetic mutations), a breast ultrasound and/or magnetic resonance imaging (MRI) may be recommended for screening, in addition to mammogram. » Continue Reading

With breast cancer treatment, expertise – and research – matter

October 23, 2014 | by

The breast cancer statistic is attention-getting: One in eight women will be diagnosed with breast cancer during her lifetime. That doesn’t mean that, if you’re one of eight women at a dinner table, one of you is fated to have breast cancer (read more on that breast cancer statistic), but it does mean that the risk of developing breast cancer is not to be taken lightly. Neither is the decision on where to get breast cancer treatment.

Breast cancer treatment and research

In breast cancer treatment, location matters. That location should also be the home of research. City of Hope understands this.

As a nationally known biomedical research institution and as one of the nation’s few comprehensive cancer centers, City of Hope can provide access to therapies, research and clinical trials that other hospitals can’t.

Let’s start with clinical trials and research. The clinical trials available to City of Hope patients often stem from the research conducted on the City of Hope campus, where breast cancer specialists and researchers work together on therapies to improve survival and quality of life. Those clinical trials include assessments of new chemotherapy drugs, targeted therapies, hormone therapies, new surgical techniques and new radiation approaches — all focused on improving breast cancer treatment, detection and prevention. » Continue Reading

Advice from Rob: How to overcome anxiety during a hospital stay

October 22, 2014 | by
Cancer survivor Rob Darakjian

Cancer survivor Rob Darakjian shares tips on how to overcome anxiety and depression while being treated for cancer.

Rob Darakjian was diagnosed with acute lymphoblastic leukemia at just 19 years old. He began chemotherapy and was in and out of the hospital for four months. After his fourth round of treatment, he received a bone marrow transplantation from an anonymous donor. Today, he’s cancer free.

In his first post, he shared his story and explained what NOT to do when you’re depressed and have cancer. In his second post, he explained what cancer patients SHOULD do if they’re depressed. Here, he offers seven tips on how patients can confront cancer and anxiety.


How to ease anxiety: 

Listen, watch: I find this technique to be particularly helpful when I’m experiencing anxiety at almost any level. I call it “listen, watch” because that’s what I do: I try and place myself in the present moment by paying attention to what I can see and what I can hear. Try to pick up on everything you can hear, from your own breathing, to the faint sound of conversation somewhere outside. Then, after awhile turn to a different sense, say sight, and just look around your physical environment. » Continue Reading

International Medicine Program launches with Chinese outreach

October 20, 2014 | by
International Medicine Program

Our International Medicine Program is extending our expertise to patients abroad.

City of Hope is extending the reach of its lifesaving mission well beyond U.S. borders. To that end, three distinguished City of Hope leaders visited China earlier this year to lay the foundation for the institution’s new International Medicine Program.

The program is part of City of Hope’s strategic efforts to grow its clinical programs and find innovative ways to expand access to its high-quality care to patients worldwide. The program is designed to attract and support international patients coming to City of Hope for care, with the initial focus on China.

Outreach abroad and locally

The trio of City of Hope ambassadors — Steven Rosen, M.D., provost, chief scientific officer, director of Beckman Research Institute of City of Hope and director of the comprehensive cancer center; Yuman Fong, M.D., chair of the Department of Surgery and director of the International Medicine Program; and David Horne, Ph.D., vice provost and associate director of Beckman Research Institute — journeyed to major Chinese research and treatment institutions to build relationships with physicians and researchers and educate them about the institution’s cancer expertise. » Continue Reading

Brain metastasis from breast cancer: Our research means better treatments

October 17, 2014 | by

A hallmark of cancer is that it doesn’t always limit itself to a primary location. It spreads. Breast cancer and lung cancer in particular are prone to spread, or metastasize, to the brain. Often the brain metastasis isn’t discovered until years after the initial diagnosis, just when patients were beginning to regain some sense of normalcy and control over their lives.

Like many patients, Joan Rose-Hall thought she had completely recovered from breast cancer. She thought she was past the treatment, past the fear. Then she begin to experience changes, small things really, in her daily routine.

“I noticed that I had difficulty concentrating, difficulty finding my words. I became slow on the keyboard,” she says in the video above. “I actually thought I was cracking up.”

Rose-Hall didn’t associate the changes with her previous diagnosis of breast cancer. Many people wouldn’t.

Instead, she went to see a psychiatrist. That psychiatrist referred her to City of Hope.

» Continue Reading

Many patients unaware that breast cancer reconstruction is an option

October 15, 2014 | by

Most women who are treated for breast cancer with a mastectomy do not choose to undergo reconstructive surgery.

Breast implant

Only 42 percent of women opt for breast reconstruction after mastectomy, a new study finds. Lack of adequate insurance coverage is one reason, says City of Hope expert Laura Kruper.

The reasons for this, according to a recent JAMA Surgery study, vary. Nearly half say they do not want any additional surgery, while nearly 34 percent say breast cancer reconstruction simply isn’t important to them. Fear of implants is another oft-cited factor, including worries that the implants might interfere with detection of recurrence – a fear cancer experts say is not founded.

The study also identified lack of access as a troubling issue. About 18 percent of women said they were not aware that breast cancer reconstruction was an option. Despite federal laws requiring that most group insurance plans that cover mastectomies also cover reconstructive surgery, 12 percent of women cited lack of insurance.

Laura Kruper, M.D., director of the Rita Cooper Finkel and J. William Finkel Women’s Health Center, acknowledges that many women will opt out of reconstructive surgery. However, with her patients, she stresses the importance of evaluating their options and weighing those choices very carefully. » Continue Reading

Breast cancer risk: 6 things you can do to reduce (not eliminate) risk

October 14, 2014 | by

The leading risk factor for breast cancer is simply being a woman. The second top risk factor is getting older.

Lacing up sneakers

Many breast cancer risk factors, such as gender and aging, cannot be controlled. But lacing up for a walk a few times a week can put a dent in breast cancer risk.

Obviously, these two factors cannot be controlled, which is why all women should be aware of their risk and how to minimize those risks. Many risk factors can be mitigated, and simple changes can lead to a reduction in risk.

1. Know your family history. Have genetic screening if appropriate: The overwhelming majority of breast cancers – about 85 percent – occur in women who have no family history of cancer. However, as many as 10 percent of cases are linked to inherited genetic mutations, such as those on the BRCA1, BRCA2 or PALB2 genes. An estimated 55 to 65 percent of women who inherit a harmful BRCA1 mutation and 45 percent of women who inherit a harmful BRCA2 mutation will develop breast cancer by age 70. Women with family histories of breast or ovarian cancer should discuss screening options with their doctor.

If women opt for screening, a cancer risk counselor with training in cancer genetics will be best equipped to interpret test results and guide patients through their options. Identifying a gene mutation will open up more insurance-covered options, including more frequent mammograms and MRI screening. » Continue Reading