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1 October 2017 I N S I D E T H I S I S S U E B R E A S T C A N C E R A W A R E N E S S 1 O P E N 2 E N R O L L M E N T F L U S H O T 3 C L I N I C S Facts about Breast Cancer in the United States One in eight women in the United States will be diagnosed with breast cancer in her lifetime. Breast cancer is the most commonly diagnosed cancer in women. E A R L Y 4 D E T E C T I O N E M P L O Y E E 5 W A L K Breast cancer is the second leading cause of cancer death among women. Each year it is estimated that over 246,660 women in the United States will be diagnosed with breast cancer and more than 40,000 will die. H E A L T H Y 6 R E C I P E C A L E N D A R O F E V E N T S B L O O D D R I V E 7 Although breast cancer in men is rare, an estimated 2,600 men will be diagnosed with breast cancer and approximately 440 will die each year. On average, every 2 minutes a woman is diagnosed with breast cancer and 1 woman will die of breast cancer every 13 minutes. A Global Burden According to the World Health Organization, breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands of women each year and affecting countries at all levels of modernization. Good News About Breast Cancer Trends In recent years, perhaps coinciding with the decline in prescriptive hormone replacement therapy after menopause, we have seen a gradual reduction in female breast cancer incidence rates among women aged 50 and older. Death rates from breast cancer have been declining since about 1990, in part due to better screening and early detection, increased awareness and continually improving treatment options.

2 P A G E 2 Day Date Morning Sessions Afternoon Sessions Location Address Wednesday 11/1/ a.m. City Council Chambers 212 N. Bonner Ave. Thursday 11/2/2017 3:30 p.m. City University 212 N. Border Tuesday 11/7/2017 7:30 a.m. 3:30 p.m. City University 212 N. Border Tuesday 11/14/2017 7:30 a.m. 3:30 p.m. City University 212 N. Border Thursday 11/16/ a.m. 5:30 p.m. City University 212 N. Border Tuesday 11/21/2017 7:30 a.m. 3:30 p.m. City University 212 N. Border Tuesday 11/28/2017 7:30 a.m. 3:30 p.m. City University 212 N. Border Thursday 11/30/ a.m. 5:30 p.m. City University 212 N. Border Please make plans to attend one of these open enrollment meetings. A video with the open enrollment information will be available on the Human Resources Benefit page of the city website by November 1st. A workshop will also be conducted during the open enrollment meetings to help employees who need assistance completing the required forms. ALL EMPLOYEES must complete a Coordination of Benefits form this year. EMPLOYEES MAKING CHANGES must complete the following forms: Open Enrollment Form Verification of Dependent Eligibility Form (if adding children) Section 125 Election Form (if changing Flexible Spending Account (FSA) and/or allocating your $500 stipend If you are opting out of the Short Term Disability benefit you will need to complete the Short Term Disability Opt Out form.

3 P A G E 3 The City of Tyler will be hosting two flu shot clinics for city employees and their family members. City employees must present their employee ID badge in order to receive their free vaccine. Family members must present their insurance ID card in order to receive a free vaccine. Those without an insurance card must pay $10. Please make checks payable to the Northeast Texas Public Health District or if paying with cash, please bring the exact amount. If you have questions please contact Jami Rogers in the Human Resources department at (903)

4 P A G E 4 Finding breast cancer early and getting state-of-the-art cancer treatment are the most important strategies to prevent deaths from breast cancer. Breast cancer that s found early, when it s small and has not spread, is easier to treat successfully. Getting regular screening tests is the most reliable way to find breast cancer early. The American Cancer Society has screening guidelines for women at average risk of breast cancer, and for those at higher-than-average risk for breast cancer. What are screening tests? The goal of screening tests for breast cancer is to find it before it causes symptoms (like a lump that can be felt). Screening refers to tests and exams used to find a disease in people who don t have any symptoms. Early detection means finding and diagnosing a disease earlier than if you d waited for symptoms to start. Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis (outlook) of a woman with this disease. Screening recommendations for women at average breast cancer risk. These guidelines are for women at average risk for breast cancer. A woman at average risk doesn t have a personal history of breast cancer, a family history of breast cancer, a genetic mutation know to increase risk of breast cancer (such a BRCA), and has not had chest radiation therapy before the age of 30. Women between 40 and 44 have the option to start screening with a mammogram every year. Women 45 to 54 should get mammograms every year. Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. All women should be familiar with how their breasts normally look and feel and report any changes to a health care provider right away. All women should understand what to expect when getting a mammogram for breast cancer screening what the test can and cannot do.

5 P A G E 5 Regular mammograms can help find breast cancer at an early state, when treatment is most successful. A mammogram can find breast changes that could be cancer years before physical symptoms develop. Results from many decades of research clearly show that women who have regular mammograms are more likely to have breast cancer found early, are less likely to need aggressive treatment like surgery to remove the breast (mastectomy) and chemotherapy, and are more likely to be cured. Mammograms are not perfect. They miss some cancers. And sometimes a woman will need more tests to find out if something found on a mammogram is or is not cancer. There s also a small possibility of being diagnosed with a cancer that never would have caused any problems had it not been found during screening. It s important that women getting mammograms know what to expect and understand the benefits and limitations of screening.

6 P A G E 6 Vegetable Migas Ingredients: 1/2 small red onion (finely chopped) 1/2 red bell pepper (seeded, finely chopped) 1/2 cup grated carrots 1/2 cup grated zucchini 1/2 cup finely chopped tomatoes 1/4 cup finely chopped green onions 1 jalapeno (finely chopped) Directions: 2 extra-large eggs 3 egg whites 1/4 cup water Dash of salt 1/8 tsp. ground black pepper 3 tsp. canola oil (divided) 3 (6-inch) corn tortillas, cut into 1-inch strips 2 Tbsp. low-sodium salsa Prepare all the vegetables: finely chop both the red onion half and bell pepper half, use a box grater to grate enough carrots and zucchini for 1/2 cup each. Finely chop tomatoes, scallions and jalapenos. In a small bowl, add eggs, egg whites, water, salt and pepper. Whisk together to combine using a fork. Use a knife or kitchen shears to cut each tortilla into 4 strips lengthwise. Then, slice each strip into 1- inch pieces. Reserve until needed. In a medium nonstick sauté pan, add 1 teaspoon oil and warm over medium-high heat. Add onions, bell peppers, carrots and zucchini. Stirring frequently, sauté; until vegetables are soft, about 4 to 5 minutes. Stir in tomatoes, scallions and jalapeno; cook 1 to 2 minutes and remove from heat. Transfer the vegetable mixture to a plate and reserve. Warm remaining 2 teaspoons oil over medium-high heat. Add tortilla strips and stirring constantly with a spatula, cook until golden, about 3 to 4 minutes. Quickly stir in salsa and cook for 1 minutes; stir in egg mixtures next. Continue to stir constantly until eggs are set, about 2 minutes. Remove from heat and mix in the reserved vegetables. Serve. Do you have a question about the City of Tyler benefits? Would you like to submit a health related article for the newsletter? Maybe you have a healthy recipe you would like to share. Please submit your ideas and/or questions to jrogers@tylertexas.com.

7 P A G E 7 Call (903) to schedule an appointment.