Issue link: https://blog.providence.org/i/1526583
Health Matters: Providence Sonoma County | 7 Beating Breast Cancer In honor of Breast Cancer Awareness Month, two physicians share the latest advancements in treatment, genetic testing guidance and more. T eams at Providence's three hospitals in Sonoma County—Providence Santa Rosa Memorial Hospital, Petaluma Valley Hospital and Healdsburg Hospital— collaborate to deliver leading-edge, compassionate breast cancer care. "I am right there with patients, hoping for good news and sharing the pain of bad news," says Anusuya Mokashi, MD, who is the medical director of radiology and first woman chief of staff at Petaluma Valley Hospital. She's also the director of mammography at Healdsburg Hospital. This sentiment is echoed by breast surgeon Elizabeth Tito, MD, who is also the medical director for Santa Rosa Memorial's Breast Center. Dr. Tito provides individualized treatment while easing her patients' way. "I take the 'less is more' approach—less toxicity with the same outcome," she says. We talked to Dr. Mokashi and Dr. Tito to learn how the hospitals are working together to detect breast cancer early and help individuals meet the physical and emotional challenges that may come with a cancer diagnosis. Tell us about your breast cancer screening and detection efforts. Dr. Mokashi: We all serve the community by providing screening mammograms, which can lead to earlier detection, less invasive treatment and improved outcomes. Both Petaluma Valley Hospital and Santa Rosa Memorial offer 3D mammography, which enhances detection by allowing for a more detailed view of the breast tissue, as well as diagnostic evaluations. MRI is available when necessary. We also encourage breast self-exams alongside regular screening mammograms. How do the hospitals work together to offer high-quality breast cancer care? Dr. Mokashi: By working collaboratively, we can schedule patients for comprehensive assessments, including further imaging and biopsies when necessary, in a timely fashion. When cancer is diagnosed, a multidisciplinary team of surgeons, medical oncologists, radiation oncologists, radiologists and pathologists meet to develop an individualized treatment plan for each patient. What are some of the most important treatment advancements that you use? Dr. Tito: We are learning that the genetic profile of a tumor 's cells is more important than its size and grade. In certain cases, we can use that to decide if a woman needs chemotherapy in addition to taking a pill that blocks estrogen; in these cases, 85% of women only need to take the pill. Also, based on their cancer 's gene profile, some older women no longer need to have their lymph nodes surgically removed. What are your guidelines for genetic testing for breast cancer risk? Dr. Tito: We want to find gene mutations linked to the disease—awareness is important for a patient's own treatment as well as for her entire family. Using a questionnaire, we determine if a woman who is getting a screening mammogram qualifies for genetic testing. If she does, she is offered it at the same time. What does the future of breast cancer treatment look like? Dr. Mokashi: As our understanding grows, we refine our approaches to tailor the treatment to the individual, aiming for the best possible outcomes with minimal impact on their body and life. For example, radiation therapy today is much more targeted and has significantly fewer side effects than before. As progress continues, treatment becomes increasingly personalized. Ongoing research aims to improve detection using artificial intelligence and exploring cellular-level diagnosis. How do you ease someone's way emotionally through their cancer journey? Dr. Tito: From the very first visit, our goal is to help people feel more hopeful and less anxious. We all work as a large team to provide strong support throughout treatment. We offer yoga, art, qigong and traditional support groups, as well as a survivorship program to help patients recover. Our goal is not to just treat the cancer but to help the whole person reengage fully back into life. To schedule an appointment at a Providence facility near you, visit providence.org/ treatments/mammography. REACHING UNDERSERVED WOMEN According to the American Cancer Society, while Hispanic women have a lower breast cancer rate than white women, they are approximately 10% more likely to be diagnosed at a later stage, when it's harder to treat. To increase access to screening mammograms, Providence is creating outreach opportunities in Sonoma County. "We are working with community health centers through our health equity team, led by Dr. Monica Ferguson, to set up weekend screening events, walk-in appointment dates and more," Dr. Tito says.