Greater Sacramento Chapter Oncology Nursing Society Newsletter

Transcription

1 W I N T E R / Greater Sacramento Chapter Oncology Nursing Society Newsletter Hello GSCONS Membership, It is that time of year for our chapter to get ready for elections to the board. We have a number of open positions. We are looking for some new faces to join the board and continue to lead change within our community of oncology nurses. Have you thought about being more involved in our local ONS chapter? Maybe thought about taking on a leadership role within the chapter? But didn t know what being more involved or taking a leadership role looked like or involved.positions available: President Elect Secretary Membership Committee Chairpersons Nominating Committee Chairpersons Contact Jamie or Cynthia to submit nominations or express interest! Cynthia James <cynthia.james32@gmail.com> Chapter Leadership President - Kristie Howlett Past-President - Kay Harse President-Elect - Kim Schmidt Treasurer - Dale Johnson Secretary - Jeannine Graves Membership Committee Chairperson (s) Linda Lambert/Kathryn Williams Nominating Committee Chairperson (s) Cynthia James/Beverly Nicholson Program Chair Committee Chairperson (s) Michelle Clark/Megan Ober Director at Large - Jaime Lee Newsletter Lauri Brunton/ Danna Wood

2 30 th Anniversary Celebration The Greater Sacramento Chapter of the Oncology Nursing Society celebrated its 30 th Anniversary at the Chapter meeting this past October The celebration took place at Piatti s restaurant in Sacramento. Jaime Lee, Director at Large, served as master of ceremonies. A brief history of the chapter was provided as recognition of the charter/founding members and past presidents. Charter members and past presidents were presented with a bouquet of flowers. Patti Palmer, RN, MS, AOCN was our speaker for the evening festivities. Patti is also a charter member of the chapter as well as a past president. Her outstanding talk was entitled: 30 years of Oncology Nursing: Maintaining Work/Life Balance and Passion for Your Work. You can find Patti s power point on our chapter s website located on the ONS website. Go to our Greater Sacramento Virtual Community on-line at sacramento.vc.ons.org. Under Chapter Resources, you will find the power point. It was an amazing evening and a great way to review where we started and where we are headed! 2

3 2014 ASCO Breast Cancer Symposium Written by Mary Pare, RN, CBCN, Breast Cancer Navigator Sutter Cancer Centers Sacramento Last year a member of my book group stated Good news! We don t need mammograms any more. What a relief! While I attempted to correct her misconception I found myself wishing I had a better command of the facts regarding the controversy surrounding breast cancer screening guidelines. Consequently, I am grateful to have been able to attend a lecture by Stephen Feig M.D., a radiologist at the University of California, at the American Society of Clinical Oncology Breast Symposium. My attendance was made possible, in part, from a scholarship from our chapter. Thank you members for your support! Dr. Feig s lecture was titled Does One Size Fit all? The Tailored Screening Debate. The focus of this lecture was to review some of the breast screening research and to refute the United States Preventative Services Task Force (USPTF) recommendations regarding breast cancer screening. The USPTF proposed recommendations are, for normal risk women, to begin screening at age 50. Rather than receiving annual mammograms, women s screenings should occur every other year up to age 75. After age 75 women are recommended to stop getting screening mammograms. High risk women would begin breast screening with mammography beginning at age 40. Dr. Feig presented data from the Swedish Two County trial. The purpose of this trial was to estimate the long-term (29 years) effect of mammographic screening on breast cancer mortality. The trial demonstrated a 31% decrease in mortality in those women who were screened annually. A larger trial from Sweden demonstrated a 41% reduction in mortality for those who were screened. As significant as these reductions in mortality are, they many not represent the current benefit in reducing mortality associated with screening mammography. Screening trials from earlier eras often did not standardize the screening intervals. The time range could be anywhere from 12 to 33 months. Screening mammograms in that era often consisted of one view rather than the two views that are the current standard of care for screening mammography. In addition, older trials used analog film rather than digital mammography. Theses advance in technique and technology have increased the accuracy of screening mammograms. The American Cancer Society (ACS) mammography screening guidelines for women of average risk includes annual screening starting at the age of 40. There is no upper age limit. Screening should continue as long as the woman is in good health. When to stop screening is determined by the woman s life expectancy. If the woman s life expectancy is less that 5 years and/or the woman has a significant co-morbid condition that would preclude treatment, then screening mammography can stop. For high risk women screening can be supplemented with breast ultrasound, or breast MRI. 3

4 The American College of Radiology and the Society of Breast Imaging (ACR/SBI) have developed mammography screening guidelines for women who have a higher risk of developing breast cancer. Higher risk is defined as having a known BRCA1 or 2 gene mutation or being genetically untested with a first degree relative (a mother, a sister or a daughter) who has a BRCA1 or 2 mutation. For this population, mammographic screening should begin at ages years old. In addition, a woman with a first degree relative with pre-menopausal breast cancer or a woman with a > 20% lifetime risk of developing breast cancer based on family history, should begin annual mammographic screening at years of age or 10 years earlier than the age that the youngest affected relative was diagnosed with breast cancer, whichever is later. Women who received mantle radiation when they were between years of age (usually for Hodgkin lymphoma) should start their annual screening 8 years after radiation has ended, but not before age 25. Women with biopsy proven: LCIS (lobular carcinoma in situ), ALH (atypical lobular hyperplasia), DCIS (ductal carcinoma in situ), IDC (invasive ductal carcinoma), ILC (invasive lobular carcinoma), or ovarian cancer should begin annual mammographic screening from the time of diagnosis. ACR/BCI MRI screening guidelines for a woman at high risk (as defined as a woman who has a known BRCA1or 2 gene mutation and her first degree relatives, or a woman with a > 20% lifetime risk of developing breast cancer) should begin annual MRI screening at age 30. Women who received mantle radiation should start their annual screening 8 years after radiation has ended. Screening MRI may also be considered with a 15-20% lifetime risk due to personal history of breast cancer, ovarian cancer or biopsy proven ADH. (In my experience insurance companies will often not authorize this procedure.) MRI and mammography are complementary exams. MRI should not be used to replace screening mammography. The benefit for implementing the ACR/SBI guidelines as opposed to the proposed USPTF guidelines is a reduction in breast cancer mortality. With the ACR/SBI guidelines mortality is reduced 39.8% as compared to 23.2%. Starting mammographic screening for all women beginning at age 40 should continue, as 20% of women whose deaths were attributed to breast cancer were diagnosed in their forties. About 40% of years of life lost from breast cancer are from cases diagnosed between 40 and 49. Screening women over age 70 is also important. 40% of all breast cancer cases occur in women older than 70 years of age. Women are living longer. Based on current life expectancy data, women age 70 are expected to live another 15 years; women at age 80, another 9 years; and women at age 90, another 5 years. Appropriate screening and treatment can prevent death from breast cancer in elderly women group. The argument in support of less screening is as a society we cannot afford this financial cost. Yet, the cost per year per life saved from breast cancer screening is $17,000. In comparison, the cost per year per life saved for seatbelts and airbags is $32,000. As of yet we have not developed a method to identify all low risk women who can safely undergo less frequent screening. Factors that have been considered are low breast density and negative family history. Yet in one study, 61% of women years of age, with a screening detected breast cancer, had no family history of breast cancer. I hope you will find this report of the information presented at the conference helpful when you are asked questions about the current recommendations for annual breast screening. 4

5 GSAONS Star Party Tuesday-May 12, 2015 Dante Club-Sacramento Is there someone you work with who you feel has demonstrated exceptional qualities in patient care? If so, please forward his/her name place of employment and a brief summary of 200 words or less detailing why you feel he/she is a Star in Patient Care. You and your star will be guests for the event where you will be able to present your star with an award. Members in your department and the star s family are encouraged to attend and join in the celebration. Dinner will be provided for you, your star and guests as you network with other stars in our medical community. Please forward your information to Linda Lambert at lamberml@sutterhealth.org no later than Tuesday, March 31. I will respond and provide you with invitations for your guests and final details about the event. Please share this with your nurse managers, nurse directors, physicians, and office managers who have their own star nurse!! You may me for more information as well!! Let s celebrate together!! Linda Lambert, RN BMT Clinical Program Manager lamberml@sutterhealth.org 5

6 Greater Sacramento Chapter Oncology Nursing Society (GSCONS) Symposium: Join us on Saturday March 14, :30 am to 4:45 pm See PDF flyer included with this GSCONS Newsletter for details Register Online Any Questions Please Contact Megan Ober by 6