THINK PINK2 | THE DAILY NEWS | THINK PINK | 2024 Preventing, diagnosing and treating breast disease The University of Texas Medical Branch is in-network for most major insurance plans. Contact our Breast Health team at (800) 917-8906 , visit our website at utmbhealth.com/breast-health or scan the QR code to find a specialist and schedule your appointment. Our state-of-the-art imaging, medical and surgical services provide the highest level of care to our patients. UTMB Health has been designated a Center of Excellence by the American College of Radiology and recognized as a National Accreditation Program for Breast Centers (NAPBC) by the American College of Surgeons along with Fellowship-trained breast radiologists and surgeons, patients are ensured they’ll receive the highest quality breast imaging and breast cancer care available in their communities. knows Breast Health SCAN TO LEARN MORE Our Breast Health services include: •Comprehensive Breast Imaging •Genetic Screening •Medical Oncology •Surgical Oncology •Radiation Oncology •Breast Reconstruction UTMB Health has over 130 years of expertise caring for women of all ages.2024 | THINK PINK | THE DAILY NEWS | 3 W hile there have been no major changes in the guidelines for breast health this year, ad- vances related to breast health have been in the news. The Food and Drug Administration approved a new rule that addresses the reporting of breast density on screening reports. Breast density is categorized into four categories: fatty, scattered tissue, heterogeneously dense or extremely dense. While about half of women fall into the last two categories, about 10 percent of women have ex- tremely dense breast tissue. This matters because a higher degree of breast density can make cancer detection more difficult. Added imaging using 3D mammography, ultrasound and magnetic reso- nance imaging is sometime indicated to achieve more thorough screening. Artificial intelligence has been a frequent topic as well. Researchers using big data are looking for biomarkers and other datapoints that might help tease out factors that indicate higher risks for breast cancer. While improved screening, new treatments and promising research continue to advance, experts advise women to focus on knowing their bodies, reducing their risks when possible and following screening guidelines. Throughout the month of October, UTMB Health will be out in the community sharing information and spreading awareness about breast cancer. From inter- active events to mobile mammography screenings, there’s no shortage of oppor- tunities to connect with the team. To find an event near you, scan the QR Code. UPCOMING EVENTS AN UPDATE ON BREAST HEALTH FOR 2024 CONTENTS Keeping breast health in check . 4 A decade of Think Pink ................ 5 Strap in for a special style show at Bra Dazzle .............. 6 UTMB’s mobile mammography program makes screenings accessible to women around the community ................. 8 Ella Thibodeaux’s story ................ 9 Bill Garwood’s story .................... 10 Lizzie Hernandez’ story ............... 11Keeping breast health in check Story by Leslie Sanderson T here is no one-size- fits-all approach to breast health. Even the experts differ on some details relat- ed to breast cancer screening. In addition, every person has different risk factors that may need to be considered. You never can be too young to learn about the signs, symptoms and risks of breast cancer. Here are some steps you can take to manage your breast health. You can begin this process as soon as you begin visits to the gynecologist — even in your teens or 20s. See below for tips on how to stay on top of your breast health. 3 STEPS TO STAY ON TOP OF BREAST HEALTH 1. Know Your Risk • Talk to family to learn about family health history. • Talk to your doctor about your risks for breast cancer. 2. Know Your Breasts • Know the “normal” look and feel of your breasts. • Use a mirror to see all areas of the breasts. • Discuss changes with your physician. 3. Get Screened • Make a plan with your doctor for the age and frequency of routine mammogram screenings and clinical examinations. • Take into account your family and personal risk factors. • Discuss what factors might change that plan in the future, such as new cancer diagnosis in the family or breast changes. ABOUT RISK AND SCREENING PROCEDURES Know what’s normal for your breasts While regular self-examinations in the shower are not encouraged like they were in the past, knowing the “normal” look and feel of your breasts still is important. Be sure to look in the mirror so you can see all areas of the breasts. See your health care provider if you notice any of these breast changes: • Lump, hard knot or thickening in the breast or underarm area • Swelling, warmth, redness or darkening of the skin of the breast • Change in the size or shape of the breast • Dimpling or puckering of the skin • Itchy, scaly sore or rash on the nipple • Pulling in of your nipple or other parts of the breast • Nipple discharge that starts suddenly • New pain in one spot that does not go away Know Risk Factors for Breast Cancer • Increasing age • Family history of breast or ovarian cancer • Having a breast cancer genetic mutation • Prior breast biopsy with finding of atypical hyperplasia or lobular carcinoma in situ • Early menarche (beginning of periods before age 12) • Late menopause (after 55) • Never having a baby or late first pregnancy • Menopausal hormone therapy with combination estrogen and progestin. (Estrogen-only pills do not increase risk.) • Certain ethnicities may have increased risk • Obesity • Alcohol consumption • Dense breasts on mammography • History of lymphoma with radiation to the chest KNOW ABOUT MAMMOGRAPHY AND GUIDELINES While age guidelines for mammog- raphy are important, they can change. Discuss your screening plans at each yearly exam with your PCP or Well Woman provider. Women 40 to 44: Optional mam- mogram screening can begin. Women 45 to 54 : Yearly mammo- grams are recommended. Women 55 and older: Contin- ue yearly mammograms or switch to mammograms every other year. Screening should continue if the per- son is healthy and expects to live at least 10 more years. These guidelines are for women at average risk for breast cancer. For screening purposes, a woman is consid- ered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer or a genetic mutation known to increase risk of breast cancer (such as in a BRCA gene) and has not had chest radiation therapy before the age of 30. Mammograms Everyone should know what to expect when getting a mammogram for breast cancer screening — what the test can and cannot do. Mammograms are low-dose X-rays of the breast. Reg- ular mammograms can help find breast cancer at an early stage when treat- ment is most likely to be successful. A mammogram can find breast changes of early cancers years before a lump is felt or other symptoms develop. Mammograms are not perfect. They miss some breast cancers. There also is a small chance of being diagnosed with a cancer that never would have caused any problems had it not been found during screen- ing. This is called overdiagnosis. It’s important that women getting mam- mograms know what to expect and understand the benefits and limita- tions of screening. 4 | THE DAILY NEWS | THINK PINK | 2024 GETTY IMAGES2024 | THINK PINK | THE DAILY NEWS | 5 F or 10 years, the Univer- sity of Texas Medical Branch has partnered with the Galveston County Daily News to run the Think Pink spe- cial publication. First published in October 2014, and the aim of the publication was to educate and inform readers about breast cancer treatments and the importance of screening mam- mograms. It also was intended to provide resources to breast cancer survivors. “As we’ve grown with Think Pink over the years, we have celebrated breast cancer survivors and helped them share their stories,” David Bethea, marketing director at UTMB, said. “Hearing them share their experiences and the strength the survivors have in their journey hope- fully inspires others to get screened. And if someone is currently going through breast cancer treatment, the stories help lift them up and give them strength.” While the specific design and contents of the piece has evolved over the years, the goal remains the same — to share information to help and educate the readers. “Throughout the years, we have probably helped tell over 40 patient and provider stories,” Bethea said. “We hope Think Pink will motivate folks who have been putting off their mammogram to take that next step and get screened. If that one person gets screened, then it’s worth the effort because with breast cancer, early detection is vital to saving lives.” A DECADE OF THINK PINK 10 years of sharing the trials, tribulations and triumphs of breast cancer Think Pink Think Pink A SPECIAL PRESENTATION BY 2019 A SPECIAL PRESENTATION BY 2018 A SPECIAL PRESENTATION BY A SPECIAL PRESENTATION BY THE DAILY NEWS A SPECIAL PRESENTATION BY 2020 A SPECIAL PRESENTATION BY THE DAILY NEWS GALVESTON COUNTY FROM 18-WHEELERS TO MAMMOGRAM VAN José Martinez finds his calling as a driver for UTMB’s mobile mammography unit. Page 6 3D MAMMOGRAPHY Tomosynthesis is a relatively new technology that is helping breast imagers with early detection of breast cancer. Page 4 BREAST CANCER IS NEITHER PINK NOR BLUE Michael Dale is one of the nearly 2,500 men diagnosed with breast cancer each year. Page 12 We Carry a Full line of Million Dollar Rustic 5301 Gulf Freeway, LaMarque • 409-986-7600 (I45 South, Exit 13)www.RusticFurnitureLand.com to Choose From! 1764 Exit 13 2004 N W S E 10 % WITH THE PURCHASE OF ANY TEMPUR-PEDIC Lifetime Guarantee Never to Fade! A SPECIAL PRESENTATION BY THE DAILY NEWS AND S ome of you might be wondering why you’re holding a pink newspa- per in your hands today. Well, it is quite simple: it mat- ters. October is National Breast Cancer Awareness Month — an event dedicated to bringing to the national conversation the risks, dangers, treatment options as well as the many inspiring stories associated with survivors. Our conversation takes place here in Galveston County. Nationally one out of eight women fi nd breast cancer in- jecting itself into their lives. And for each, the outcome can vary. But no matter what treatment choices exist or impact the cancer makes upon them, lives are for- ever changed. That is what we hope to con- vey in this very special publica- tion. If we can positively impact one life, we’ll have made a dif- ference in our world. Joining with our friends at the University of Texas Medical Branch, we are working togeth- er to create a body of work to raise awareness, educate and in- spire. UTMB is, without a doubt, a long-term part of the good health in Galveston County. UTMB’s assistance in this prod- uct is a great example of their stewardship. We hope you and your loved ones will fi nd this edition helpful. God Bless you all. Leonard Woolsey is president and publisher of The Daily News. Why I like the color pink Program helps women with gene mutation with a high-risk prognosis By BRONWYN TURNER | Correspondent A fter a double mastectomy, removal of her ovaries and two reconstructive surgeries, Lori Netherton doesn’t consider herself a survivor — she considers herself a warrior. “Cancer brought me to my knees, but I got back up swinging,” said Netherton, 52, who relentlessly contacts celebrities for autographed items to be raffl ed at fundraisers. The Galveston native is three years into a diagnosis of cancer traced to the BRCA mutation, a gene mutation with high-risk prognosis. Iris Murphy Crow, 67, of Texas City, had a bilateral prophylactic mastectomy almost two years ago after a positive BRCA test. She calls ‘Prevention is better than treatment’ Patients outline the ups and downs of treatment By BRONWYN TURNER | Correspondent D ebby Moncrief was getting ready for Christ- mas last year, not really concerned about her routine mammogram. The University of Texas Medical Branch business coordinator had no family history of breast cancer. She was 57, healthy, with three children and two grandchildren. “There was just no reason for me to get breast cancer,” she said. But trouble showed up on the mammogram, on the repeat mam- mogram, on the ultrasound and fi nally the biopsy. The surgeon ordered a breast MRI to scan both breasts, and the news got worse. Moncrief had cancer in both What to expect? Leonard Woolsey See BRCA | 8 COURTESY PHOTO/UTMB Debby Moncrief, business coordinator for UTMB’s Department of Neuroscience and Cell Biology, was preparing for Christmas when she learned she had cancer in both breasts — two diff erent kinds. See patients | 4 Medical branch off ers cutting-edge breast cancer treatment By BRONWYN TURNER | Correspondent H ematological on- cologist Dr. Maurice Willis, who coaches Hurricane youth football in his spare time, sees a winning game plan for breast cancer care here. Take a nationally accredited multidisciplinary team, the latest in technology, tailored treat- ments and risk-reduction re- search, and Galveston can play with the big boys. “I see what I do as a physician and a coach very similar because the object is to win the game, and the game is to try to beat the cancer,” said Willis, director of the University of Texas Medical Branch Hematology Oncology Clinic and Oncology Fellowship Program. “You’re not going to win every game. But you have to be organized, and when you come on the fi eld, you have to have a good showing.” Galveston has such a good showing that it’s been named a Center of Excellence by the American College of Radiology and accredited for the highest level of breast care by the Na- tional Accreditation Program for Breast Centers. This is cutting- edge breast cancer treatment, a far cry from what our grand- mothers feared. ‘The game is to try to beat the cancer’ will develop invasive breast cancer over the course of her lifetime. THE FACES OF CAREGIVERS Meet the medical professionals who work with breast cancer patients. Pages 5, 6, 9, 11, 16 THE NEW NORMAL The Cancer Survivorship Program at UTMB helps counsel breast can- cer patients to get back on track or start their new normal. Pages 14 9,000 AND COUNTING Since its inception 14 years ago, D’Feet Breast Cancer Inc. has pro- vided more than 9,000 screening mammograms. Page 6 COURTESY PHOTO/UTMB UTMB radiologist points to a suspicious mass in an ultrasound breast image. See treatment | 2STRAP IN FOR A SPECIAL STYLE SHOW AT BRA DAZZLE 6 | THE DAILY NEWS | THINK PINK | 2024 I t might seem a little strange to see grown men modeling bedazzled bras in front of a crowd of people at the Galveston Island Conven- tion Center at the San Luis Resort, Spa and Conference Center. But, men modeled dec- orated bras while wearing tutus and boas on Oct. 3. Although they certainly were going for a laugh, they also were very serious about their goal of raising funds to benefit the UTMB Mobile Mammography program. Since 1999, the Mobile Mammog- raphy program has offered women throughout the region the oppor- tunity to be screened for breast Men model bedazzled bras to raise breast cancer screening awareness “The twist this year was the style show. It’s not a typical show. There was a panel of male models who are prominent in our community who modeled the decorated bras while wearing tutus and feather boas. It was a riot.” APRIL CICCARELLO cancer in convenient locations around the community. Bra Dazzle, a fundraising event begun in 2010 by Galveston business leader Pam Schwertner, was inspired by a close friend who was undergoing breast can- cer treatment. “In the early years, Pam held the event at the Haak Winery in Santa Fe, but after 10 years, she retired and gave the event over to what are now called the ‘Men of Bra Dazzle,’” April Ciccarello, program manager for Physician and Community Engagement at UTMB, said. “Now, it’s being organized by Jimmy Fullen and 2024 | THINK PINK | THE DAILY NEWS | 7 ELLA THIBODEAUX APRIL CICCARELLO AND PAUL EDINBURGH PAUL EDINBURGH, JOE GIUSTI AND JIMMY FULLEN Paul Edinburgh of Galveston County Constable’s Office, Precinct 2, and Galveston County Commis- sioner Joe Giusti. These men took the event over in 2020, and they are committed to women’s health.” These men always were involved with the event, so asking them to take it over seemed a natural fit, Ciccarello said. “The men wanted to get even more recognition and awareness for the event across the county, hoping to involve local chambers of commerce and other community stakeholders,” she said. The evening’s run of show included a live auction, a raffle, a cash bar, a full dinner, a bra decorating contest and table decorating. “However, there’s a twist to the style show,” Ciccarello said. “It’s not a typical show. There was a panel of male models who are prominent in our community who modeled the decorated bras while wearing tutus and feather boas. It was a riot.” The bras are almost always decorated in honor or in memory of a loved one with breast cancer. “One of the highlights of the evening was a testimonial given by a breast cancer survivor, Ella Thibodeaux,” Ciccarello said. “We want to spread awareness particularly to uninsured women and underinsured women.” Thibodeaux had lost her job and her insurance benefits, skipped her annual mammogram and, a year later, was screened by the UTMB Mobile Mammog- raphy unit. She ultimately was diagnosed with stage 2 breast cancer. She was treated at UTMB Health and has been cancer-free for the last 10 years. “These are the lives we’re changing through these screenings, and many community partners are participating,” Ciccarello said. “It’s a true col- laboration in our community. We have events with partners, including Tanger Outlets, College of the Mainland, several school districts and chambers of commerce.” The event’s mood is upbeat, festive and lively, and funds raised help to maintain the highest quality of technology and service offered by the Mobile Mam- mography program. “Our goal is always to make the event bigger and better, to keep it going and to keep more women healthy,” Ciccarello said. “It’s a lot of fun and laughter, but it’s also serious. We are fortunate to have such a great partnership with the BraDazzle committee.” 8 | THE DAILY NEWS | THINK PINK | 2024 UTMB’S MOBILE MAMMOGRAPHY PROGRAM MAKES SCREENINGS ACCESSIBLE TO WOMEN AROUND THE COMMUNITY Early detection, early intervention means life can return to normal Story by Katherine Adams F or women who have diffi- culty driving to a location to receive medical care, mobile medical vehicles can bring life-saving screenings and resources directly to places that are more accessible to them. To better serve women in the commu- nity, particularly uninsured and underin- sured women, UTMB Health launched the Mobile Mammography program in 1999 and has been providing easier access to breast cancer screenings for women who need them. The Mobile Mammography Program offers women the opportunity to be screened using state-of-the-art tech- nology. The presence of the vehicle in areas highly frequented by women helps to remind everyone of the message that screenings are accessible, and early detection and intervention of breast cancer is vital, Senior Manager for UTMB’s Breast Imaging Clinical Opera- tions Rachel Thiesse-Yount said. “UTMB offers programs that support the goal of helping women in our com- munity gain access to screening mam- mography services,” Thiesse-Yount said. The annual BraDazzle event, in col- laboration with the Sante Fe Chamber of Commerce, focuses on fundraising to provide for the underinsured or uninsured women in Galveston County. It is vital for women to have access to mammography services because early detection and intervention is paramount, she said. Each year, there are multiple special events scheduled in the community that collaborate with UTMB to bring the mobile mammography coach to their function, she said. “In a year, we might log up to 4,000 miles of travel to meet the imaging needs of women,” she said. “Last year, UTMB supported 37 special events in the greater Galveston County and sur- rounding areas, including “appearanc- es” at Moody Gardens, Tanger Outlet Mall, St. Vincent’s House in Galveston, Galveston County Health Fair, church- es, schools, realty offices and the Gulf Coast Ford dealership.” “Last fiscal year, we imaged 450 pa- tients at these community-based special events,” she said. “UTMB collaborates with the Texas Department of Criminal Justice and the mobile mammography coach serves the female population at local facilities. We also provide access for screening mammography services to our Regional Women’s Clinics in Pearland, Conroe, Angleton, Katy, Beaumont and Sugar Land. This extension of services to the community ensures access to mam- mograms closer to home. In 2023, the mobile coach imaged over 1,500 women.” “We all know someone or have heard of someone in our circle of friends and family that received a breast cancer di- agnosis. We see or learn how detrimen- tal this diagnosis can be and how deeply it affects those fighting, both the patient and family and friends. The importance of annual screening mammograms cannot be overstated. Waiting should not be an option. Early detection and prevention are critical. Patients may not experience any symptoms and having piece of mind that your breast health is being managed timely is comforting.” “The importance of regular screenings can’t be overstated,” she said. “That’s why, the longer you wait and put off that early diagnosis, the more difficult it is to manage. You might have no idea that something is wrong, no pain or symptoms at all. The calcifications can be tiny, and you wouldn’t be able to feel them your- self. That’s why using mammography to image your tissue is so important. That’s how those calcifications are identified.” “Some patients might be fearful of the mammogram exam itself,” she said. “Breast tissue does require compression in order to fully assess the breast tissue, and patients may be fearful of that pro- cess. But I would impress upon women to remember the prevention element of this exam. The exam is over very quick- ly, and it is possible to speak with the mammography technologist to express concerns about the amount of compres- sion being used. There are ways to ad- just the compression to obtain excellent image quality all the while making your experience as pleasant as possible. Our intention is imaging without pain and minimizing discomfort.” “If a cancer is detected, UTMB has excellent oncologists and surgeons that will guide a patient’s care,” she said. “Breast cancer treatments have improved greatly along with overall survival rates. Finding normalcy after treatment is absolutely possible.” “Women give of themselves so much, and it’s important that we take care of ourselves so we can continue being wives, mothers and grandmothers,” she said. “The first step is to come and get that screening.” For uninsured or underinsured patients who would like to schedule a mammo- gram, contact the coordinator at 832- 505-1721. Story by Katherine Adams E lla Thibodeaux never missed a mammogram until 2013 when she was laid off from her job as an electronic technician. She thought she’d just skip that year because she had no insurance. She thought skipping one year would not matter. The next year, her friend told her that UTMB’s Mobile Mammography Unit would be coming to Greater St. Matthews Baptist Church in Hitch- cock, where she is a parishioner. “That day in 2014, I went to church, and then I went to the mobile mammography bus and had my mammogram,” she said. “I wasn’t sick at all. I didn’t have any symp- toms of anything. I was just told the mammogram was free, and I had no insurance. I was told not to worry about that, but just to be sure and go get the mammogram.” A few days later, Thibodeaux re- ceived a call from the doctor saying there was a spot on her mammo- gram that needed to be biopsied. “I had to go to the hospital, and again I said I had no insurance,” she said. “They said not to worry about that, and after they did the biopsy, they said it was stage two breast cancer. So, I had to have surgery, and they took all that out.” Not having insurance was extremely concerning to her in this situation. Re- sources in the form of patient naviga- tors, coordinators, social workers and more at UTMB guided her through the process of applying for insurance through the Affordable Care Act, and she paid nothing, she said. “UTMB just kept saying not to worry, they will help me, and they did,” she said. She started chemotherapy, which made her very anxious. “The first week I got my chemo, they talked to me, they prepped me and they relaxed me,” she said. “They told me I could go live my normal life, and they gave me my dose. They made sure I had a ride back and forth, and they made sure they kept talking to me and I stayed relaxed about everything.” Still, her hair fell out and she couldn’t eat, she said. She slept constantly and had to return for another round of chemo every two weeks. “I felt so bad,” she said. “And at the end of the chemo, I was getting ready for church, and I couldn’t breathe. I thought I was having a heart attack. I told myself I would go to UTMB after church and get checked out, but it didn’t happen like that.” She felt so unwell, she went straight to the hospital and was examined. “They thought there was another spot on my lung, but I knew God wasn’t going to let me go like that,” she said. “It turned out to be fluid on my lung. They took 17 ccs of fluid, and it was heart failure, not lung cancer. So, I got a cardiologist as well.” Receiving the highest quality med- ical intervention saved her life, but a nonprofit organization called Friends Thru the Fight, which offers financial assistance to those who are actively receiving breast or gynecological cancer treatments, helped save her emotionally and mentally, she said. “This group made a huge differ- ence for me,” she said. “They helped me through it. I was down and they picked me up. They said there will be life after all this. I wasn’t working, and I had no insurance and they brought me food, helped me financially and people came to visit me while I was going through the chemo. They didn’t just cure my body, they helped me in every other way, too.” Ten years later, Thibodeaux remains cancer-free, and her heart health also is good. Other women need to get their mammogram no matter what, and instead of worrying about cancer, “just go like it’s nothing,” she said. She owns her home and has worked as a bus aide for children in Texas City Independent School District for seven years. “Sometimes, I am on the bus with the kids with special needs, but some- times I’m just on any middle or high school bus,” she said. “And all the kids on the bus need the love because they don’t always get it from home, and that’s what I’m here to give.” Most importantly, she’s well enough to do whatever she’d like to do. She rides the bus in the morn- ings and afternoons, but during the day, she gets calls from her two adult sons and her grandchildren asking her to help them with some- thing, bring them something or do something with them. “I have my health back, and I can do everything I want to with my fam- ily now,” she said. “To women who don’t think it matters if they don’t get checked, please get checked. Cancer is a silent killer. It doesn’t hurt to have a spot; you don’t even know it’s there. And don’t let your non-insured status stop you, you will get help at UTMB. You just have to ask — that’s the magic word. Just ask. Don’t be ashamed. And do not miss a year of getting checked.” ‘DON’T LET YOUR NON-INSURED STATUS STOP YOU FROM GETTING CHECKED — UTMB WILL HELP’ 2024 | THINK PINK | THE DAILY NEWS | 9 Ella Thibodeaux’s storyNext >