By: Kamilia Kozlowski, MD
It is amazing to me when I am speaking to women that they are surprised and unaware that 80 % of breast cancers that are diagnosed every year are in women that do NOT have a family history of breast cancer. I think the main reason is that family history is stressed so much in the media. Our statistics at KCBC support this fact as well.
So at what age should the average risk women start screening for breast cancer? There has been so much confusion with the recommendations of the U.S. Preventative Task Force under Obama Care stating that instead of starting at age 40, start at 50 and stop screening at 74. I was even surprised when the American Cancer Society changed their guidelines to recommend starting at 45 doing yearly until 54 and then every other year. Unfortunately, I am seeing physicians not recommending screening for their older patients. We diagnose women in their nineties with breast cancer.
Here is a summary of a study published by the American Journal of Roentgenology In May 2017.
Starting breast cancer screening at 50 means that up to 20% of breast cancers could be missed – offering more proof that women between the ages of 40 and 49 should be screened regularly.
Screening mammography guidelines published by the U.S. Preventive Services Task Force (USPSTF) recommend that women begin biennial screening at age 50, While the American Cancer Society (ACS) recommends annual screening starting at age 45 through age 55, with biennial screening thereafter. Both organizations do state that the decision of when to start screening is up to women and their healthcare providers to discuss.
But these guidelines are dangerous, according to a team led by Dr. Jenifer Pitman of Weill Cornell Medical College in New Your City. Pitman and colleagues conducted a study to determine how many cancers might be missed if women between the ages of 40 and 49 were not screened.
“Women in their 40s would probably be interested in knowing what might happen if they were to choose to follow one recommendation over another,” the authors wrote. We found “that during the study period (2014-2016) women in their 40s overall had 18.8% of screen-detected breast cancers – more than 60% of which were invasive… Increasing the risk of a later stage at diagnosis and thus a poorer prognosis.”
I can support whole heartedly and encourage all women from the age of 40 to have a yearly mammogram. This table is food for thought when reviewing the average risk women in the U.S. that is diagnosed with breast cancer.
Incidence of Breast Cancer
A Woman with Average Risk
(No Family History of Breast Cancer)
1 out of 64 – Forty Year Olds
1 out of 50 – Fifty Year Olds
1 out of 25 – Sixty Year Olds
1 out of 12 – Seventy Year Olds
1 out of 8 – Eighty Year Olds
Average Doubling Time of a Breast Cancer:
80 % of women diagnosed every year have NO
Family History of Breast Cancer.
The proper time interval for screening of All
Women over 40:
The Knoxville Comprehensive Breast Center (KCBC) is the first in Tennessee – and is among just a handful of breast centers in the country – to offer an exciting new way to treat breast cancer by freezing the tumor.
This minimally invasive technique, called FROST (Freezing Instead of Resection of Small Tumors), can be done on an outpatient basis at KCBC using local anesthesia.
“There’s nothing better than seeing my patients walk out of the office happy to go home after the procedure because they know that their early stage breast cancer has been taken care of without surgery or a change in the shape of their breast,” said Kamilia Kozlowski, M.D., a clinical breast radiologist and founder of KCBC.
Freezing, also called cryoablation, has been used successfully for decades to treat several types of cancer, most commonly liver, lung and prostate. The process uses liquid nitrogen to freeze tumors and damage the adjacent blood vessels that fuel their growth. “We know that it works in other cancers,” Dr. Kozlowski says. “That is why we are participating in this clinical trial, to prove that it works in breast cancer.”
The technology uses a probe that channels liquid nitrogen to flow within a precise area of the needle so that it creates a freeze zone. This creates what Kozlowski calls an “iceball” around the tumor that freezes and kills it.
This is a minimally invasive procedure done under local anesthesia and ultrasound guidance in the office. The procedure can usually be done in under an hour. Patients can resume normal activity right away.
Kozlowski says FROST offers a safe, effective option for women with early-stage breast cancer (typically with a tumor size of 1.5 cm. or smaller), especially when they are not good candidates for standard treatments (for example, if they have other medical conditions that would make surgery risky). It is also less likely to disfigure the breast because no breast tissue is removed and the aftereffects are “minimal.” Patients receive imaging every six months after the treatment as follow-up.
Currently, the standard of care for early-stage breast cancer is surgery (lumpectomy or mastectomy) followed by radiation and/or chemotherapy. A major drawback of surgery is cosmetic and functional impairment of the breast.
An important added bonus of the FROST treatment is that it may stimulate an immune response in the body that will keep it on the lookout for any stray cancer cells, even after the tumor is destroyed.
“The thinking is that once we freeze the tumor cells and the dead cells enter the blood to be eliminated, the body will perceive them as abnormal and begin creating antibodies to them,” adds Lusi Tumyan, M.D., a diagnostic radiologist and assistant clinical professor in the Department of Diagnostic Radiology at City of Hope who is also participating in this clinical trial. “So not only do you get this freezing effect, you also get this immunological effect. It’s exciting and we should be looking at that effect also.”
An initial five-year, multicenter study of cryoablation to treat early-stage breast cancer sponsored by the National Cancer Institute found it to be 92 percent effective for complete ablation of invasive breast tumors smaller than 2 centimeters and 100 percent effective for complete ablation of invasive ductal breast cancer tumors smaller than 1 centimeter.
Results from this study led to the current FROST trial, for which Dr. Kozlowski is actively recruiting patients. The FROST Clinical Study is currently enrolling women age 50 and older with core needle biopsy proven clinical stage I, T1, (≤1.5 cm.) clinically node negative (N0), unifocal, hormone receptor positive and HER2/neu-negative invasive ductal carcinoma. For more information, please go to www.clinicaltrials.gov.
“This is the future. It offers a noninvasive treatment of breast cancer. Patients can come into our office and they go home the same day. It’s so rewarding to offer this advanced technology to our patients with early stage breast cancer, when appropriate,” said Dr. Kozlowski.
Since its inception in 1983, the Knoxville Comprehensive Breast Center was the first independent breast center of its kind in Tennessee. At KCBC Dr. Kamilia Kozlowski has developed Clinical Breast Radiology, a specialty which differs from traditional radiology in that clinical breast radiologists manage both the diagnostic and clinical aspects of care. Patients are not burdened with visits to multiple specialists, as clinical breast radiologists can diagnose and direct treatment in one setting.
KCBC is a multidisciplinary practice that delivers streamlined, cost-effective care in a comfortable setting. Specialists include clinical breast radiologists, a dedicated breast surgeon, medical oncologists, radiation oncologists, a breast pathologist, plastic and reconstructive surgeon and lymphedema specialist. Find out more by visiting http://www.knoxvillebreastcenter.com.
October 20th, 2017 – Knoxville Comprehensive Breast Center (KCBC) is putting a brand new mobile mammography unit on the road this October during Breast Cancer Awareness Month. The New Mobile is a 37-foot long coach equipped with the latest state of the art digital mammography equipment. The coach was designed especially for women by Dr. Kamilia Kozlowski, founder, and CEO of KCBC.
KCBC was one of the first Mobile Mammography Programs in the Southeast and has been providing mammograms to women since 1987. The Mobile reaches areas all across Tennessee, from Memphis to Kingsport and includes several areas in Eastern Kentucky. This year KCBC estimates the mobile will provide mammograms to over 3000 women.
Nancy Ortiz is the Operations Manager at KCBC and has been working with the mobile program since 1988. She says, “I love the new coach, it is designed with the patient’s convenience and comfort in mind, and gives women throughout the region easier access to mammography.”
There are many reasons that can make scheduling a mammogram difficult, distance to a facility, economics, and work schedules are some examples. That is why KCBC continues to provide access to top quality mammography through the mobile program. The mobile provides services at health fairs, job fairs, workplaces, health centers and more.
KCBC’s Mission Statement is “To Save Lives from the Disease of Breast Cancer” In Dr. Kozlowski’s words, “We are saving lives one mammogram at a time.”
Breast cancer is common in the United States and other developed countries, with one in eight women being diagnosed during their lifetime.
Most women who are diagnosed with breast cancer have no substantial risk factors. I cannot tell you how many patients I have had who tell me, “This can’t be breast cancer. I exercise every day. I eat really healthy and I have no family history of cancer. This can’t happen to me. I do everything right.” And yet they ARE diagnosed anyway.
Our BEST defense is a good offense. Since breast cancer is so very common, our best strategy is to minimize the impact, if and when we are diagnosed with this common disease. Anyone who treats breast cancer can tell you that the earlier the diagnosis, the more likely and easier it is to cure.
Keep in mind that 80% of breast cancers that are diagnosed are in women who have NO family history of breast cancer.
All women in their 40’s should undergo mammograms EVERY year. One out of every 64 forty year old woman, i.e., the average risk woman (a woman with no family history of breast cancer) is diagnosed with breast cancer. Women who are diagnosed with breast cancer in their 40’s make up almost a third of breast cancer deaths because cancers tend to be more aggressive in young women.
Having a mammogram every year results in the fewest breast cancer deaths at all ages. Some women may consider choosing to have a mammogram every other year after age 55. Yet the average doubling time of a breast cancer is one year. So the best interval for screening is one year. If you have dense breast tissue or any family history of breast cancer, you should still have a mammogram EVERY year because your risk is higher than average of having breast cancer.
If you have dense breast tissue, which appears white on the mammogram, you are more likely than the average woman to be diagnosed with breast cancer. In addition, that white tissue can make it harder to see cancers on mammography. Breast ultrasound screening is the best imaging exam to complement the mammogram to find cancers with a dense mammographic pattern. This has been proven in a number of studies.
Optimize your ability to beat this disease by getting a mammogram every year beginning at age 40. Although some women will choose to have less frequent mammograms as they get older, this is not a good idea. Our chances of getting breast cancer increase with age: 1 out 12 seventy-year old women get breast cancer and 1 out of 8 women in their eighties are diagnosed with breast cancer. If older women do not have any overwhelming health problems and are mobile, they should continue with annual mammography. If there is a family history of breast cancer, prior biopsies with abnormal cells or dense tissue, women should continue to get a mammogram EVERY year and ultrasound to help find breast cancers earlier. Help us help you!
In last month’s newsletter, I discussed KCBC’S position on “3D Mammography” there are advantages of breast ultrasound screening over “3D Mammography” despite the current craze over this 3D technique. First, to review “3D Mammography” it is not 3D imaging as it purports in its name. It cannot radiographically image the breast in all 3 dimensions. It still is 2D Mammography but takes multiples slices radiographically in 2 dimensions.
Secondly, the European trial, “ASTOUND Study” demonstrated that standard 2D Mammography which we are all familiar with and breast ultrasound screening found more breast cancers than “3D Mammography” alone.
A study was published in August in Radiology, one of the leading, well-respected monthly radiology journals, by Dr. Soo-Yeon Kim and colleagues from South Korea. The study commenced in January 2004 and was completed in March of 2011. The study included 501 women with breast cancer identified with breast screening ultrasound. Only 15.8% * of these women had high-risk factors for breast cancer. Their results showed that women with dense breasts whose mammograms were negative were also found to have their breast cancers detected on breast ultrasound screening, and had a five-year survival rate of 100% and a recurrence-free survival rate of 98%. They concluded that these results cement breast ultrasound’s important place in the arsenal of breast cancer screening tools. This is because the breast cancers were found when they were small and as a result a significant number of the breast cancers had not spread to local lymph nodes (90.8%) in the axilla. This is key to preventing spread of disease. These results have also been shown in American based studies as well. Keep in mind that women do not succumb to a breast cancer in the breast. This happens when the breast cancer spreads beyond the breast to vital organs. Therefore, it is important to find the breast cancer when it is small.
Additionally, 89% had a less aggressive breast conservation procedure due to the small size of the breast cancer.
It is important to screen women with mammographically dense breasts with breast ultrasound. There is no radiation exposure with breast ultrasound. These two imaging tools find significantly more numbers of breast cancer than “3D mammography” alone. “3D Mammography” has not proven itself to find small node negative breast cancers as of this date.
*15.8% the women in this study had high-risk factors for the developing breast cancer. This means that 84.2% of women were at low risk for developing breast cancer. Just as a reminder, breast cancer screening yearly for all women beginning at 40 is important because it is such a prevalent disease and is the number 1 cause of cancer in women in the U.S.
PROGRAM OVERVIEW – DOWNLOAD PDF FLYER
LIVESTRONG at the YMCA is an evidence-based program that helps adult cancer survivors reclaim their health and well-being following a cancer diagnosis. Participating YMCAs create a welcoming community in which survivors can improve their strength and physical fitness, diminish the severity of therapy side effects, develop supportive relationships, and improve their quality of life. Since 2007, the LIVESTRONG Foundation has been the YMCA’s partner in developing and delivering LIVESTRONG at the YMCA.
DESCRIPTION AND GOALS
⦁ Small group, supportive environment
⦁ 12-week program with two 90-minute sessions per week⦁ Includes cardiovascular conditioning, strength training, balance, and flexibility exercises⦁ Held in YMCA “Wellness Centers”⦁ Evaluation includes Functional and Quality of Life assessments before and after participation⦁ Facilitated by YMCA-certified Instructors
⦁ Includes cardiovascular conditioning, strength training, balance, and flexibility exercises⦁ Held in YMCA “Wellness Centers”⦁ Evaluation includes Functional and Quality of Life assessments before and after participation⦁ Facilitated by YMCA-certified Instructors
⦁ Held in YMCA “Wellness Centers”⦁ Evaluation includes Functional and Quality of Life assessments before and after participation⦁ Facilitated by YMCA-certified Instructors
⦁ Facilitated by YMCA-certified Instructors
IMPACTLIVESTRONG at the YMCA has proven to
⦁ Help survivors MEETOREXCEED the recommended amount of physical activity
⦁ Help survivors SIGNIFICANTLYINCREASE their cardiovascular endurance
⦁ IMPROVE cancer survivors’ overall quality of life and DECREASE their cancer-related fatigue
Any adult 18 years old or older who is living with or beyond cancer treatment.
2017 CLASSES IN KNOXVILLE ENROLLING NOW:
CANSLER FAMILY (Downtown) Mondays and Thursdays 6:30pm 7/31 to 10/26
DAVIS FAMILY (Farragut) Mondays and Thursdays 1:00pm 7/31 to 10/26
DOWNTOWN (Downtown) Mondays and Thursdays 9:00am 7/31 to 10/26
NORTH SIDE (Halls) Mondays and Wednesdays 11:00am 9/18 to 12/13
WEST SIDE (West Knox) Mondays and Thursdays 2:00pm 8/14 to 11/2
FOR MORE INFORMATION, CONTACT:
Vickey Beard, VP of Healthy Living
Medical Clearance Form
Dear Doctor _______________________________,
Your patient ________________________ has requested to participate in LIVESTRONG at the YMCA: A Cancer Survivor Exercise Program at the ________________ YMCA. At the start of this program, your client will participate in a fitness assessment, including the 6-minute walk test, one repetition max test for upper and lower body, and balance and flexibility test. Following the fitness assessment, your patient will partake in cardiorespiratory fitness, muscular strength and endurance, and flexibility and balance activities. A specific, individualized exercise program will be created for the participant based on the needs, interests and any recommendations you might have. The LIVESTRONG program is designed to start easy and become progressively more difficult over a 12 week period. All fitness assessments and exercise activities will be administered by qualified personnel trained in conducting exercise test and exercise programs.
Based on the LIVESTRONG at the YMCA intake form, your patient has indicated a diagnosed medical condition, coronary risk factor, and/or health condition that require a physician’s clearance prior to participation in the LIVESTRONG at the YMCA program.
By completing the form below, you are not assuming any responsibility for our administration of the fitness assessment or exercise program. If you know of any medical or other reasons why participation in the LIVESTRONG at the YMCA program would be unwise for your patient, please indicate so on this form.
If you have any questions regarding the LIVESTRONG at the YMCA program, please call the program coordinator.
Program Coordinator: Vickey Beard or Christine Canges Phone ( 865 )637-9622
Return Fax (865)766-8448
My patient, listed above, is:
_______Not cleared to exercise at this time
_______Cleared to exercise with no restrictions
_______Cleared to exercise with the following restrictions and/or recommendations
Physicians Name: __________________________________
Physicians Signature: _______________________________ Date: ____________
17th Annual KIM ROWDEN BREAST CANCER MEMORIAL FUND Golf Tournament
October 1, 2018 9:00 a.m.
Breast Cancer is a devastating disease that touches each and every one of us in some capacity. The best means we currently have to fight breast cancer is by early detection through annual screening mammography and, in some instances, a breast MRI.
The Kim Rowden Breast Cancer Memorial Fund is a non-profit memorial fund established by the Knoxville Comprehensive Breast Center. It provides funds for women with little or no resources to have the same breast care that every woman deserves – the best. Through the Kim Rowden Fund, disadvantaged women are able to receive mammographic screening, diagnosis, and treatment, if needed. The hope is to allow all women the same care, regardless of economic standing, because breast cancer does not discriminate.
The Fund was established in memory of Kim Rowden, a patient of the Knoxville Comprehensive Breast Center. Kim was twenty-five when she was diagnosed with breast cancer. She was a loving daughter, a warm-hearted and gifted young woman, and was engaged to be married. Kim had many talents: crafts, needlepoint, pianist, dancer, basketball, and golf; but her greatest talent was her ability to inspire everyone she met- including the medical team that fought to save her life.
Kim lived three more years after being diagnosed with breast cancer. Her breast cancer played a vital role in the detection of the BRCA1 and BRCA2 genes, the only two breast cancer genes to be identified as of yet in the human genome. Kim’s deep faith gave hope to all she encountered through her special embrace on life.
Kamilia Kozlowski, M.D.
Medical Director Knoxville Comprehensive Breast Center
KIM ROWDEN BREAST CANCER
October 1, 2018
700 Old Club Road, Loudon, TN 37774
-ALL PARTICIPANTS WILL RECEIVE-
Prizes going to 1st and 2nd place for 2 flights
Golf shirt and golf balls
Return play voucher at Tennessee National
Breakfast, snacks, and drinks on the course
Prizes for closest to the pin and longest drive (both male and female)
For more information contact:
865-583-1002 or [email protected]
Every once in a while the staff at Knoxville Comprehensive Breast Center comes across a great article that we really feel like we should share. Breast Cancer.Org just published the mostintriguing article regarding diet. The word diet can cause a bit of anxiety all by itself, the following article however discusses eating habits that can be good for you.
Eating Unhealthy Food
Diet is thought to be partly responsible for about 30% to 40% of all cancers. No food or diet can prevent you from getting breast cancer. But some foods can make your body the healthiest it can be, boost your immune system, and help keep your risk for breast cancer as low as possible. Research has shown that getting the nutrients you need from a variety of foods, especially fruits, vegetables, legumes, and whole grains, can make you feel your best and give your body the energy it needs. [pl_button type=”primary” link=”http://www.breastcancer.org/risk/factors/unhealthy_food” target=”blank”]Read More[/pl_button]
In the last few years, some experts have questioned whether DCIS
(ductal carcinoma-in-situ) is a breast cancer.
DCIS means that the cells that line the milk duct have become cancerous which is where most breast cancers begin. As time passes, the entire lumen of the ducts can be filled with the cancer cells. The duct wall then becomes weakened and the DCIS can break through the duct wall and involve the supporting tissues surrounding the duct which contains blood vessels and lymphatics. Now, the breast cancer is a locally invasive breast cancer. This situation can provide the stage when these cancer cells have the opportunity to travel by these conduits to the local lymph nodes in the axilla. This is analogous to sludge within a water pipe. As the sludge begins to accumulate with time, the sludge fills the entire diameter of the pipe which increases the pressure within the pipe and the pipe bursts with water gushing out.
Some experts believe that some DCIS reverts back to normal cells. However, no one has ever proven this theory! The naysayers who state that DCIS is not a cancer feel that women are being over-treated with lumpectomies and radiation therapy or mastectomies and therefore, increase the cost of medicine. Some of the disbelievers feel at the very most we should follow the DCIS with mammography as these cancers are never destined to bother them. These claimed “medical experts” are not dedicated breast radiologists who have read and followed thousands of women with their mammographic studies and other breast imaging techniques for years to know what they espouse to be true, is in fact, true.
With the advent of modern day mammography in the late seventies, DCIS diagnosis has increased yearly from an average of 3% to an average of 20-30% of all breast cancer diagnoses. This is wonderful news for women because women do not die from the DCIS within the breast. However, we all know this can happen but only when the breast cancer becomes locally invasive breast cancer that spreads beyond the breast to the axilla at which time the cancer could spread to vital organs.
Having been a clinical breast radiologist for over 30 years, I have diagnosed many cases of DCIS. There are some women who have chosen not to have surgery at the time of their diagnosis. It may take years; however, I can attest that all of these cancers progressed to locally invasive breast cancer.
So this monthly KCBC newsletter includes an article about a study recently presented at the American Society of Breast Surgeons annual meeting that negates the naysayers of medical experts who state that DCIS can be followed with mammography as DCIS is never destined to bother them.
Kamilia Kozlowski, M.D.
Medical Director of KCBC
ASBrS: No, we’re not overtreating DCIS
By Kate Madden Yee, AuntMinnie.com staff writer
April 15, 2016 — More than 50% of women diagnosed with ductal carcinoma in situ (DCIS) that is inadequately excised will develop a recurrence of the disease or invasive breast cancer within 10 years. This finding indicates that DCIS isn’t being overtreated, according to research presented at the American Society of Breast Surgeons (ASBrS) meeting in Dallas.
The study addresses a key question in the mammography screening debate: whether DCIS is being overdiagnosed and overtreated, Dr. Sadia Khan of the University of Southern California said at an ASBrS press conference. Some have suggested that DCIS should simply be tracked with regular mammography, but this approach could be dangerous, she said.
“DCIS mortality rates tend to be low, but recurrences may lead to more advanced breast disease and therefore more aggressive treatment later,” Khan said. “Given our results, a ‘watch-and-wait’ strategy would be harmful for many women.”
Watch the margins
Khan and colleagues included 1,919 pure DCIS cases, 720 of which were treated with tumor excision alone. Patients were classified into two groups based on the margin of disease-free tissue surrounding the excised tumor.
Women with margins smaller than 1 mm were advised to have a repeat surgical procedure; of these, 124 refused the additional surgery and were considered undertreated DCIS patients for the purpose of the study. The remaining women, 596, had cancer-free margins of at least 1 mm and were considered adequately treated.
The researchers also categorized women by severity of disease: grades I and II (low) or III (high).
Women with low-grade or high-grade DCIS and inadequate disease-free excision margins had a higher probability of recurrence at five and 10 years postdiagnosis than women who had adequate excision margins, Khan and colleagues found.
|Cancer recurrence in women with DCIS|
|Women with adequate margin excision (≥ 1 mm)||Women with inadequate margin excision (< 1 mm)|
|Low-grade DCIS recurrence rate|
|At 5 years||8%||18%|
|At 10 years||13%||53%|
|High-grade DCIS recurrence rate|
|At 5 years||23%||55%|
|At 10 years||36%||67%|
“These recurrence rates even for excision alone are too high, regardless of grade — and the rates for women with inadequate excision are worse,” Khan said. “It’s unacceptable. We need to continue with the DCIS treatment standard we have now, which is surgery that results in disease-free margins of 1 mm or more.”
The study results are important because many highly publicized DCIS studies have examined survival rates and not recurrence. But recurrence — especially of invasive disease — leads to more radical treatment than DCIS, which can have a significant negative effect on a woman’s life.
“Treatment for invasive breast cancer recurrence might include lymph node dissection, extensive radiation, or mastectomy, which could significantly lower a woman’s quality of life going forward,” Khan said in a statement released by ASBrS. “Preventing women from living with the aftermath of a subsequent treatment for invasive cancer is as important a goal as saving a life.”
Knoxville Comprehensive Breast Center is bringing back bone densitometry (DXA) to our facility.
Many of our patients and referring physicians have asked us to bring this service back to KCBC and we have listened to you!
What is DXA?
A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. The National Osteoporosis Foundation recommends a bone density test of the hip and spine by a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry.
You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone density test. Some people also call it a bone mass measurement test. This test uses a machine to measure your bone density. It estimates the amount of bone in your hip, spine and sometimes other bones. Your test result will help your healthcare provider make recommendations to help you protect your bones.
Who should have a DXA?
The National osteoporosis Foundation recommends that you have a bone density test if:
you are a woman age 65 or older
you are a man age 70 or older
you break a bone after age 50
you are a woman of menopausal age with risk factors
you are a postmenopausal woman under age 65 with risk factors
you are a man age 50-69 with risk factors
A bone density test may also be necessary if you have any of the following:
an X-ray of your spine showing a break or bone loss in your spine
back pain with a possible break in your spine
height loss of ½ inch or more within one year
total height loss of 1½ inches from your original height
If you have any questions about whether or not you need a DXA, you should call your primary care physician or call KCBC at 865-584-0291 and we will be glad to help you.
Lymphedema is an incurable but treatable medical condition caused by injury, trauma or congenital defects in the lymphatic system.
When the impairment becomes so great that the lymphatic fluid exceeds the lymphatic transport capacity, swelling results as an abnormal amount of protein-rich fluid collects in the tissues of the affected area.
Over time, lymphedema (especially if poorly treated) often results in number of complications including infections, disfigurement, pain, and disability. In fact, it may occasionally prove fatal to its sufferers. But while lymphedema cannot be cured, it can be very effectively managed, thus significantly reducing risk.
The recognized standard of care for lymphedema is Complete Decongestive Therapy (CDT). CDT comprises four interacting elements applied in two phases (acute and ongoing): manual lymph drainage (MLD), compression therapy, lymph drainage exercises, and skin care. Each of these four elements are interdependent and imperative to the overall success of treatment however the most basic element is the application of compression to the swollen body part.
Compression is to lymphedema what medication is to many other diseases – indispensible!
It is estimated that two to three million Americans suffer from lymphedema, possibly more. Due to a lack of awareness, information, and education (even within the medical community), lymphedema is often misdiagnosed or undiagnosed. Delays in diagnosis or treatment can result in rapid and unchecked progression of the disease.
Why This Legislation Is Needed
Currently, Medicare, and consequently many other policies, do not cover one of the critical components of lymphedema treatment, the medically necessary doctor-prescribed compression supplies used daily in lymphedema treatment. As a result, many patients suffer from recurrent infections, progressive degradation in their condition and eventual disability because they cannot afford the compression supplies required to maintain their condition.
Medicare’s failure to cover compression treatment supplies stems from the fact that these items cannot be classified under any existing benefit category in Medicare statute (law). The Center for Medicare Services (CMS) does not have the authority to add or redefine benefit categories, only Congress does, hence the need for this legislation. Please visit and help support:
Lymphedema Treatment Products, Manufacturers we carry at KCBC:
The Cancer Risk Assessment Center at KCBC is here for providers or individuals to learn more about their cancer risk, ways to lower that risk, and provide genetic counseling and testing. Through a risk assessment, we examine information regarding personal and family history that can influence cancer risk. The results will allow us to develop a personalized treatment plan with the expectation of prevention and or early detection for cancer. Below is more information regarding cancer risk and risk factors:
What does cancer risk mean? Risk is the probability that an event will happen. When talking about cancer, risk is used to describe the chance a person will develop cancer.
What is a risk factor? A risk factor is anything that increases a person’s chance of developing cancer. Risk factors influence the development of cancer but usually do not directly cause the cancer. Some people with multiple risk factors never develop cancer, while others with no known risk factors do.
Knowing risk information and risk factors can help a person and providers make informed decisions regarding lifestyle and healthcare decisions such as cancer screening tests (like mammogram or colonoscopy), as well as what age to start screening tests, or if another intervention like surgery or medication is available to lower cancer risk.
Evaluation at the center is available to any person concerned about their cancer risk due to personal or family history. A comprehensive risk assessment may include genetic testing. If genetic testing is appropriate for the individual, then pre and post-test genetic counseling is completed. This counseling becomes critical in order for an individual to know the implications, benefits, and limitations to testing.
Many times in order for health insurance companies to cover genetic testing costs a person needs to be evaluated by a board-certified provider with experience and training in cancer genetics. This can include medical geneticists, physicians and nurses with additional training in genetics, or genetic counselors.
In the past year many changes have occurred regarding breast cancer screening. Multiple recommendations have been released from the American Cancer Society, National Comprehensive Cancer Network, US Preventative Services Task Force (USPSTF), and American College of Obstetricians and Gynecologists. Each agency has different ages to begin and end screening, as well as frequency of imaging. Some of this variability in screening is only in reference to women at average risk for breast cancer. The new recommendations from the American Cancer Society and the USPSTF are not intended for women who have a moderate or high risk for breast cancer. The problem this poses is whether both the healthcare provider and woman know her risk level for breast cancer?
Article by: Elizabeth Shieh
As the leaders in Breast Cancer treatment and screening in East Tennessee, KCBC strives to bring our patients the most relevant information. We are committed to sharing great articles and information from other top medical providers.
Recently we came across an outstanding article form our friends at (SBI) The Society of Breast Imaging. The article addresses the age old question of “Do I really have to have a breast exam”?
Racial Disparities in Breast Cancer Screening
By: Dr. Sadia R. Choudhery
I get this weird phone call every July from my mom. “Do I really have to?” “Yes, mom, you do. Each and every single year.” My mom absolutely abhors mammograms, and she calls me every summer asking me if she really needs her annual mammogram, especially as she grows older. Her explanation is always that none of her mammograms have ever been positive and that her four sisters and my grandmother did just “fine” without ever having had regular mammograms. She is absolutely correct in saying that. Growing up in a South Asian household, regular “anything” (dental cleanings, annual checkups, mammograms) was an anomaly. Regardless, my mother is absolutely wrong in thinking that her oldest daughter (i.e. me) would ever give her a “pass” on her annual mammogram.
With so much contradicting information about when to screen and how often, it has become perplexing for patients to grasp the gist of screening mammography. This is even truer in minority communities. Here are some insights on racial disparities in breast cancer screening:
• African American women have an up to 42% higher rate of breast cancer mortality READ MORE
Recently our staff at Knoxville Comprehensive Breast Center came across the following NPR Story about BRCA and genetic testing that was on the radio yesterday 03/14/2016 from an oncologist at UT-Southwestern Medical Center. Oncologist Theodora Ross discusses the hereditary nature of cancer and her own predisposition to breast and ovarian cancer, which led her to have a double mastectomy and to have her ovaries removed.
Where achieving and maintaining EXCELLENCE in patient care is a top priority
We are proud to be an ACR accredited facility
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ACR accredited in mammography-A mammogram uses special x-ray technology specially de-signed for breasts to detect abnormal growths or changes in breast tissue. It is currently the best defense against breast cancer, as the x-rays can detect tumors and growths in earlier stag-es than a breast exam alone. Woman age 40 and older should receive a screening mammogram annually. A diagnostic mammogram is usually performed when a woman has a problem such as a lump or pain or to investigate abnormal findings found on a screening mammogram.
ACR accredited in breast ultrasound-Although a mammogram can usually be effectively used to view and diagnose breast tissue abnormalities, there are circumstances where ultrasound may also be used such as on women with dense breasts. Also known as sonography, this type of ultrasound uses sound waves emitted via a microphone-like transducer that bounce off of breast tissues and are interpreted by a computer into black and white images.
ACR accredited in breast MRI-Specifically designed for use in breast screening and diagnostics, a breast MRI involves a specially-designed machine that provides high resolution photos while maintaining breast sensitivity and comfort. The MRI technology – or Magnetic Resonance Imag-ing – takes several photos of the breasts. Those photos are combined to generate detailed pictures of the breast. KCBC is the only facility in the Knoxville area to have the Aurora system designed specifically for breast imaging.
ACR accredited in stereotactic biopsy-A procedure used to diagnose a small mass or calcifica-tion’s seen with the mammogram. Other image guided biopsies such as MRI biopsies and ultra-sound biopsies are also provided at KCBC. Which type of biopsy is best for the patient will de-
The goal of screening exams, such as mammograms, is to find cancers before they start to cause symptoms. Breast cancers that are found because they can be felt tend to be larger and are more likely to have already spread beyond the breast. Screening exams can find breast cancers when they are small and still confined to the breast.[pl_button type=”primary” link=”http://www.knoxvillebreastcenter.com/request-an-appointment/” target=”blank”]Request An Appointment [/pl_button]