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3 Ways to Beat Breast Cancer: Prevent It, Detect It, Treat It With Personalized Care
Dr. Rachel Jendro leads a discussion on the prevention and treatment of breast cancer.
Featured Speaker:
Dr. Jendro received her Medical Degree from the Kentucky College of Osteopathic Medicine. Her general surgery internship and residency were completed at Grandview Medical Center in Dayton, Ohio. Dr. Jendro is board certified by the American College of Osteopathic Surgeons. As an Osteopathic Surgeon, Dr. Jendro is committed to each patient’s journey with compassion and support.
H. Lee Moffit Cancer Center and Research Institute is where Dr. Jendro completed her breast surgical oncology fellowship in Tampa, Florida. She studied under Dr. Charles Cox, a renowned pioneer in breast surgery. As a physician and breast surgical oncology fellow, Dr. Jendro completed focused surgical training on benign and malignant breast disease.
For eight years, Dr. Jendro served as a breast surgical oncologist with UNC Rex Hospital. She was an integral part in developing the multidisciplinary breast conference where patients are presented for collaborative discussions between surgeons, medical oncologists, radiation oncologists, radiologists, plastic surgeons, pathologists, genetic counselors, social workers, and clinical trials teams. She also served as the chair of the breast care committee at UNC Rex Hospital.
At General Surgery Associates, Dr. Jendro works closely with a multidisciplinary team in Lincoln to ensure the absolute best comprehensive plan of care for her breast patients. Dr. Jendro treats all benign and malignant breast disease. These include breast cancer, benign breast masses, breast cysts, breast pain, and nipple discharge. She also treats patients who are high risk for developing breast cancer due to family history and/or markers such as atypical hyperplasia. Dr. Jendro performs lumpectomies, mastectomies, nipple and skin sparing mastectomies, excisional biopsies, and ultrasound guided biopsies. She is certified in breast ultrasound by the American Society of Breast Surgeons. She is excited to be the first fellowship trained breast surgical oncologist in Lincoln.
Learn more about Rachel Jendro, DO, FACOS
Rachel Jendro, DO, FACOS,Bryan Breast Surgical Specialists
Dr. Rachel Jendro is originally from Eastern Kentucky. She attended the University of Kentucky where she played saxophone in the Wildcat Marching Band. Dr. Jendro graduated magna cum laude with a bachelor of science in Biology.Dr. Jendro received her Medical Degree from the Kentucky College of Osteopathic Medicine. Her general surgery internship and residency were completed at Grandview Medical Center in Dayton, Ohio. Dr. Jendro is board certified by the American College of Osteopathic Surgeons. As an Osteopathic Surgeon, Dr. Jendro is committed to each patient’s journey with compassion and support.
H. Lee Moffit Cancer Center and Research Institute is where Dr. Jendro completed her breast surgical oncology fellowship in Tampa, Florida. She studied under Dr. Charles Cox, a renowned pioneer in breast surgery. As a physician and breast surgical oncology fellow, Dr. Jendro completed focused surgical training on benign and malignant breast disease.
For eight years, Dr. Jendro served as a breast surgical oncologist with UNC Rex Hospital. She was an integral part in developing the multidisciplinary breast conference where patients are presented for collaborative discussions between surgeons, medical oncologists, radiation oncologists, radiologists, plastic surgeons, pathologists, genetic counselors, social workers, and clinical trials teams. She also served as the chair of the breast care committee at UNC Rex Hospital.
At General Surgery Associates, Dr. Jendro works closely with a multidisciplinary team in Lincoln to ensure the absolute best comprehensive plan of care for her breast patients. Dr. Jendro treats all benign and malignant breast disease. These include breast cancer, benign breast masses, breast cysts, breast pain, and nipple discharge. She also treats patients who are high risk for developing breast cancer due to family history and/or markers such as atypical hyperplasia. Dr. Jendro performs lumpectomies, mastectomies, nipple and skin sparing mastectomies, excisional biopsies, and ultrasound guided biopsies. She is certified in breast ultrasound by the American Society of Breast Surgeons. She is excited to be the first fellowship trained breast surgical oncologist in Lincoln.
Learn more about Rachel Jendro, DO, FACOS
Transcription:
3 Ways to Beat Breast Cancer: Prevent It, Detect It, Treat It With Personalized Care
Melanie Cole (Host): Welcome to Bryan Health Podcast. I'm Melanie Cole and today, we're talking about breast cancer. Joining me is Dr. Rachel Jendro. She's a breast surgical oncologist with Bryan Health. Dr. Jendro, it's such a pleasure to have you with us today. Before we get into this really important topic, tell us a little bit about yourself and your training.
Rachel Jendro, DO, FACOS (Guest): Hello, thank you so much for inviting me to be a part of your podcast. So, like you said, I'm Dr. Rachel Jendro and I'm from Kentucky originally, did medical school in Kentucky, and then I completed a general surgery residency in Ohio. After that five-year general surgery residency, I chose to apply for a Breast Surgical Oncology Fellowship.
So, I went to Moffitt Cancer Center and that is a cancer center in Tampa, Florida, and completed the Breast Surgical Oncology Fellowship there. And so my focus is entirely breast. So, all I do is breast surgery and take care of breast patients. And I absolutely love my patients and love what I do. And know this is what I was meant to do.
Host: I can hear the passion in your voice, your sweet voice, for what you do for a living and people I'm sure are lucky to have you as their doctor. So, why don't we talk a little bit about what you're seeing as far as incidence and awareness. Are more women getting screened Dr. Jendro?
Dr. Jendro: Screening has definitely improved over the years and we find breast cancers much earlier now due to that increased screening. So, we're definitely reaching more people with screening mammograms.
Host: What are some of the risk factors women should know. I mean, we're going to talk about mammograms and many women that I know and have known are a little concerned. They're scared about a mammogram. I don't think it hurts at all. And I've had a million of them. But tell us some of the risk factors that would predispose a woman to breast cancer and might send her earlier for mammogram. And then we're going to talk about really the indications for mammogram and when you start doing those.
Dr. Jendro: Sure. So, as far as risk factors for breast cancer, things that can increase your risk include being above your ideal body weight, smoking increases risk, alcohol use can increase risk, and now that really gets into when we're in our 50s. So, they've shown that, if you consume alcohol every day in your 50s, it's around a 7% increased risk for breast cancer. Family history of breast cancer, using a hormone replacement therapy and that's after menopause. Things such as having children and breastfeeding, both decrease your risk, exercise will decrease your risk. And that can be 30 minutes a day for three days a week. Also eating healthy will decrease your risk. One thing that folks may not think about is starting your menstrual cycles early, say 10 or 11, and going into menopause later in life will also increase breast cancer risk just due to the body's exposure to estrogen.
Host: So, then tell us about mammograms. There's been some confusion, there's confusion over the current recommendations from different organizations. Who should get screened? At what age? How often? Tell us why there's some confusion.
Dr. Jendro: Women need to start their mammograms at age 40. There were some recent guidelines that came out that pushed that back. And the breast societies that we follow still encourage age 40. So, if you look at the American Society of Breast Surgeons, the American Cancer Society, the National Comprehensive Cancer Network, your American Congress of OB-GYN, the American College of Surgeons; and we could go on all of those societies still recommend age 40. So, I definitely tell my patients start at age 40.
Host: And now mammography has changed over the years, right? It's not quite the same. Now we have 3D mammography also known as tomosynthesis. How is that different from that conventional mammography of our mother's day?
Dr. Jendro: So, the 3D mammograms are wonderful. I'm so thankful that we have progressed with our imaging. Every woman should get a 3D mammogram. It is just a much better picture. With our 2D images, it's basically two pictures of the breast. With 3D, it's more of a scan. There's approximately 16 to 18 pictures that are taken that scan through the breast. This will see your tissue much, much better, especially in those women with dense breast tissue, 3D imaging is far superior.
Host: Well, I'm glad that you brought up dense breast tissue. I'm one of those people that got those letters. So, every year now I have my 3D. But I also have a whole breast ultrasound. So, tell us about some of the other technologies that are available for women with dense breasts or for women who for some reason it's difficult to read.
Dr. Jendro: So, dense breast tissue can make the breast tissue harder to see through with a mammogram. Now, mammogram is still recommended as the most effective way to detect early breast cancer. However, with dense breast tissue, the mammogram may miss something. Breast tissue looks white and breast cancers look white.
So, if the breast tissue is very dense, it can be harder to see through that tissue. We can perform whole breast screening ultrasounds, and that's where an ultrasound is used to evaluate the whole breast on both sides. There are also breast MRIs that can be performed. That would probably be the best breast imaging. Breast MRIs can be costly and insurance companies may not want to cover that imaging. Whole breast ultrasound is a great way to go for cost savings and effectiveness.
Host: Well, thank you for telling us about that. So, now signs and symptoms of breast cancer. What should we be looking for if we're doing self-exams or something that we might notice?
Dr. Jendro: Women, even in their late teenage years to 20, should begin their own self breast exams. Getting to know your own tissue is the best way to notice a change or if something is different. Things to look for, if there is a new mass or a new lump in the breast, definitely get looked at, skin changes such as redness in the skin or dimpling in the skin. Definitely signs to look for. If you notice discharge from the nipple and that can be different colors. So we can see clears, yellows, greens, bloody, any discharge from the nipple should be evaluated. Nipple inversion, where the nipple is turning in or being pulled inward, definitely should get evaluated. The best thing for our ladies is to really do your own exams.
It should be once a month and the same time of a month. So, with your breast tissue, your breast tissue changes throughout the month with your cycles. So, your breast tissue will become lumpier and may be more swollen when your menstrual cycle is getting closer and then it changes again. So, try to do it the same time every month and in the shower is usually easier.
And breast tissue is lumpy. So, it can be intimidating for ladies to say, you know, everything feels lumpy. Well, your breast tissue should move around easy and be very soft. So, if you notice something that is a hard mass and it doesn't move very easily, something that wasn't there last time you checked, to definitely get looked at.
Host: So I guess this is a big fear of women certainly hearing that news, but if a woman is diagnosed, what's the next step Dr. Jendro? Where does she turn? What does she do next? Because that is devastating news and not really sure who to call.
Dr. Jendro: So, usually what happens is the lady will see her primary care physician or her GYN who does their breast exam and will order their mammogram and their ultrasound. If that imaging shows that a biopsy is needed, then they would proceed with their biopsy and be called with the results. And if that breast cancer diagnosis does come in, that's usually when I would see the patient next, as the surgeon. I would sit with that patient and just go over all of their imaging and their pathology and what that all means and explain it very well and just go over different options for surgery. We would then see a Medical Oncologist and then possibly a Radiation Oncologist. So it kind of depends on what type of cancer they have.
Host: Tell us about some of the options about treatments. You mentioned surgery and a medical oncologist, radiation oncologist.
Dr. Jendro: So with our ladies, we typically have three options for surgery. A lumpectomy is removing the mass from the breast, but not removing the breast. So, a lumpectomy is removing the mass. Most ladies will have radiation therapy after a lumpectomy. Radiation therapy is used to decrease the risk of recurrence for that breast cancer. Radiation therapy does not make ladies sick. So, it always sounds a little scary, but radiation therapy causes skin changes to the breast that will get better over time. But women don't get sick or feel bad with radiation therapy. What's called a partial breast conservation therapy would be the lumpectomy plus radiation.
They really decreased the length of radiation nowadays, showing that less time has the same outcome. So, the standard care for radiation therapy was typically six weeks, and it's every day for six weeks. That's really been shortened out to possibly three weeks depending on the patient. So, the radiation therapy has come a long way.
You can also perform a mastectomy, which is removing the breast. The patient may choose to have reconstruction or not to have reconstruction. That is up to them and their personal preference. With reconstruction, I work with a plastic surgeon and we will be there together on surgery day.
Different types of reconstruction include implant-based reconstruction and flap surgeries. Flap surgeries are using the patient's own tissue. So, a tram flap or a diep flap, D-I-E-P would be using their abdominal tissue. There is a latissimus flap that uses tissue from the back. So these are different options. I would have the patient meet with the plastic surgeon to discuss those different options and see what they're more comfortable with.
Host: That's fascinating. How cool, what you can do now to help women that are going through this journey of breast cancer. Before we wrap up and you've told us so much information packed into one little podcast, how is the woman's self-esteem and peace of mind certainly taken into account when you're working with these women that have been diagnosed, how do you work with them? I mean, you're just absolutely such a lovely lady. I can hear that. And so tell us a little bit about what you do with a patient when you're working with them and taking into account all of these things, all of these feelings that we're feeling, if we get diagnosed with breast cancer.
Dr. Jendro: Absolutely. This is a scary time. No one wants to hear the word cancer. So, it's just a scary time. There's high anxiety. The patients will come to my office. I've actually designed my office to be very feminine, we have you know pretty pictures on the walls and soft colors. And we just try to make it feel inviting. We have spa robes here for my ladies to wear during their exams, so they just feel a little more comfortable. I'll see them and we'll have our initial discussion. I'll perform their exam and I step out and let them get dressed. They're typically more comfortable when you have your own clothes on. I have a conference room in the office where we step across the hallway and we sit around the table and just spend lots of time discussing everything with them.
Bryan has nurse navigators also. And a nurse navigator is always present for our discussion. The nurse navigator is another layer of support for these ladies and they really help assess any social issues or financial issues, family situation. So, it really is encompassing all aspects of the patient. And we're not just focusing on this new diagnosis. We want to take care of all of them. And I just want to wrap these ladies up and just encourage them and know that I'm with them every step of the way, we will get through this. We just do it one step at a time. Other things we discuss at that appointment are genetic testing. So, we can go over just a lot of different aspects of their cancer or their treatment options, and just try to make them feel as comfortable as we can.
Host: Wow. Really, really great information, such a supportive environment at Bryan Health. Dr. Jendro, you really treat the whole person, not just their breast cancer. And thank you so much for sharing that with us today. And thank you for joining us and thank you to our Bryan Foundation partner Davis Design. That wraps up this episode of Bryan Health podcast.
Please visit our website at Bryan Health for more information, and to get connected with one of our providers like Dr. Jendro. Please also remember to subscribe, rate and review this podcast and all our other Bryan Health podcasts. And please share these shows ladies, with your friends and family on your social channels. We're learning from the experts at Bryan Health together. I'm Melanie Cole. Thanks so much for listening.
3 Ways to Beat Breast Cancer: Prevent It, Detect It, Treat It With Personalized Care
Melanie Cole (Host): Welcome to Bryan Health Podcast. I'm Melanie Cole and today, we're talking about breast cancer. Joining me is Dr. Rachel Jendro. She's a breast surgical oncologist with Bryan Health. Dr. Jendro, it's such a pleasure to have you with us today. Before we get into this really important topic, tell us a little bit about yourself and your training.
Rachel Jendro, DO, FACOS (Guest): Hello, thank you so much for inviting me to be a part of your podcast. So, like you said, I'm Dr. Rachel Jendro and I'm from Kentucky originally, did medical school in Kentucky, and then I completed a general surgery residency in Ohio. After that five-year general surgery residency, I chose to apply for a Breast Surgical Oncology Fellowship.
So, I went to Moffitt Cancer Center and that is a cancer center in Tampa, Florida, and completed the Breast Surgical Oncology Fellowship there. And so my focus is entirely breast. So, all I do is breast surgery and take care of breast patients. And I absolutely love my patients and love what I do. And know this is what I was meant to do.
Host: I can hear the passion in your voice, your sweet voice, for what you do for a living and people I'm sure are lucky to have you as their doctor. So, why don't we talk a little bit about what you're seeing as far as incidence and awareness. Are more women getting screened Dr. Jendro?
Dr. Jendro: Screening has definitely improved over the years and we find breast cancers much earlier now due to that increased screening. So, we're definitely reaching more people with screening mammograms.
Host: What are some of the risk factors women should know. I mean, we're going to talk about mammograms and many women that I know and have known are a little concerned. They're scared about a mammogram. I don't think it hurts at all. And I've had a million of them. But tell us some of the risk factors that would predispose a woman to breast cancer and might send her earlier for mammogram. And then we're going to talk about really the indications for mammogram and when you start doing those.
Dr. Jendro: Sure. So, as far as risk factors for breast cancer, things that can increase your risk include being above your ideal body weight, smoking increases risk, alcohol use can increase risk, and now that really gets into when we're in our 50s. So, they've shown that, if you consume alcohol every day in your 50s, it's around a 7% increased risk for breast cancer. Family history of breast cancer, using a hormone replacement therapy and that's after menopause. Things such as having children and breastfeeding, both decrease your risk, exercise will decrease your risk. And that can be 30 minutes a day for three days a week. Also eating healthy will decrease your risk. One thing that folks may not think about is starting your menstrual cycles early, say 10 or 11, and going into menopause later in life will also increase breast cancer risk just due to the body's exposure to estrogen.
Host: So, then tell us about mammograms. There's been some confusion, there's confusion over the current recommendations from different organizations. Who should get screened? At what age? How often? Tell us why there's some confusion.
Dr. Jendro: Women need to start their mammograms at age 40. There were some recent guidelines that came out that pushed that back. And the breast societies that we follow still encourage age 40. So, if you look at the American Society of Breast Surgeons, the American Cancer Society, the National Comprehensive Cancer Network, your American Congress of OB-GYN, the American College of Surgeons; and we could go on all of those societies still recommend age 40. So, I definitely tell my patients start at age 40.
Host: And now mammography has changed over the years, right? It's not quite the same. Now we have 3D mammography also known as tomosynthesis. How is that different from that conventional mammography of our mother's day?
Dr. Jendro: So, the 3D mammograms are wonderful. I'm so thankful that we have progressed with our imaging. Every woman should get a 3D mammogram. It is just a much better picture. With our 2D images, it's basically two pictures of the breast. With 3D, it's more of a scan. There's approximately 16 to 18 pictures that are taken that scan through the breast. This will see your tissue much, much better, especially in those women with dense breast tissue, 3D imaging is far superior.
Host: Well, I'm glad that you brought up dense breast tissue. I'm one of those people that got those letters. So, every year now I have my 3D. But I also have a whole breast ultrasound. So, tell us about some of the other technologies that are available for women with dense breasts or for women who for some reason it's difficult to read.
Dr. Jendro: So, dense breast tissue can make the breast tissue harder to see through with a mammogram. Now, mammogram is still recommended as the most effective way to detect early breast cancer. However, with dense breast tissue, the mammogram may miss something. Breast tissue looks white and breast cancers look white.
So, if the breast tissue is very dense, it can be harder to see through that tissue. We can perform whole breast screening ultrasounds, and that's where an ultrasound is used to evaluate the whole breast on both sides. There are also breast MRIs that can be performed. That would probably be the best breast imaging. Breast MRIs can be costly and insurance companies may not want to cover that imaging. Whole breast ultrasound is a great way to go for cost savings and effectiveness.
Host: Well, thank you for telling us about that. So, now signs and symptoms of breast cancer. What should we be looking for if we're doing self-exams or something that we might notice?
Dr. Jendro: Women, even in their late teenage years to 20, should begin their own self breast exams. Getting to know your own tissue is the best way to notice a change or if something is different. Things to look for, if there is a new mass or a new lump in the breast, definitely get looked at, skin changes such as redness in the skin or dimpling in the skin. Definitely signs to look for. If you notice discharge from the nipple and that can be different colors. So we can see clears, yellows, greens, bloody, any discharge from the nipple should be evaluated. Nipple inversion, where the nipple is turning in or being pulled inward, definitely should get evaluated. The best thing for our ladies is to really do your own exams.
It should be once a month and the same time of a month. So, with your breast tissue, your breast tissue changes throughout the month with your cycles. So, your breast tissue will become lumpier and may be more swollen when your menstrual cycle is getting closer and then it changes again. So, try to do it the same time every month and in the shower is usually easier.
And breast tissue is lumpy. So, it can be intimidating for ladies to say, you know, everything feels lumpy. Well, your breast tissue should move around easy and be very soft. So, if you notice something that is a hard mass and it doesn't move very easily, something that wasn't there last time you checked, to definitely get looked at.
Host: So I guess this is a big fear of women certainly hearing that news, but if a woman is diagnosed, what's the next step Dr. Jendro? Where does she turn? What does she do next? Because that is devastating news and not really sure who to call.
Dr. Jendro: So, usually what happens is the lady will see her primary care physician or her GYN who does their breast exam and will order their mammogram and their ultrasound. If that imaging shows that a biopsy is needed, then they would proceed with their biopsy and be called with the results. And if that breast cancer diagnosis does come in, that's usually when I would see the patient next, as the surgeon. I would sit with that patient and just go over all of their imaging and their pathology and what that all means and explain it very well and just go over different options for surgery. We would then see a Medical Oncologist and then possibly a Radiation Oncologist. So it kind of depends on what type of cancer they have.
Host: Tell us about some of the options about treatments. You mentioned surgery and a medical oncologist, radiation oncologist.
Dr. Jendro: So with our ladies, we typically have three options for surgery. A lumpectomy is removing the mass from the breast, but not removing the breast. So, a lumpectomy is removing the mass. Most ladies will have radiation therapy after a lumpectomy. Radiation therapy is used to decrease the risk of recurrence for that breast cancer. Radiation therapy does not make ladies sick. So, it always sounds a little scary, but radiation therapy causes skin changes to the breast that will get better over time. But women don't get sick or feel bad with radiation therapy. What's called a partial breast conservation therapy would be the lumpectomy plus radiation.
They really decreased the length of radiation nowadays, showing that less time has the same outcome. So, the standard care for radiation therapy was typically six weeks, and it's every day for six weeks. That's really been shortened out to possibly three weeks depending on the patient. So, the radiation therapy has come a long way.
You can also perform a mastectomy, which is removing the breast. The patient may choose to have reconstruction or not to have reconstruction. That is up to them and their personal preference. With reconstruction, I work with a plastic surgeon and we will be there together on surgery day.
Different types of reconstruction include implant-based reconstruction and flap surgeries. Flap surgeries are using the patient's own tissue. So, a tram flap or a diep flap, D-I-E-P would be using their abdominal tissue. There is a latissimus flap that uses tissue from the back. So these are different options. I would have the patient meet with the plastic surgeon to discuss those different options and see what they're more comfortable with.
Host: That's fascinating. How cool, what you can do now to help women that are going through this journey of breast cancer. Before we wrap up and you've told us so much information packed into one little podcast, how is the woman's self-esteem and peace of mind certainly taken into account when you're working with these women that have been diagnosed, how do you work with them? I mean, you're just absolutely such a lovely lady. I can hear that. And so tell us a little bit about what you do with a patient when you're working with them and taking into account all of these things, all of these feelings that we're feeling, if we get diagnosed with breast cancer.
Dr. Jendro: Absolutely. This is a scary time. No one wants to hear the word cancer. So, it's just a scary time. There's high anxiety. The patients will come to my office. I've actually designed my office to be very feminine, we have you know pretty pictures on the walls and soft colors. And we just try to make it feel inviting. We have spa robes here for my ladies to wear during their exams, so they just feel a little more comfortable. I'll see them and we'll have our initial discussion. I'll perform their exam and I step out and let them get dressed. They're typically more comfortable when you have your own clothes on. I have a conference room in the office where we step across the hallway and we sit around the table and just spend lots of time discussing everything with them.
Bryan has nurse navigators also. And a nurse navigator is always present for our discussion. The nurse navigator is another layer of support for these ladies and they really help assess any social issues or financial issues, family situation. So, it really is encompassing all aspects of the patient. And we're not just focusing on this new diagnosis. We want to take care of all of them. And I just want to wrap these ladies up and just encourage them and know that I'm with them every step of the way, we will get through this. We just do it one step at a time. Other things we discuss at that appointment are genetic testing. So, we can go over just a lot of different aspects of their cancer or their treatment options, and just try to make them feel as comfortable as we can.
Host: Wow. Really, really great information, such a supportive environment at Bryan Health. Dr. Jendro, you really treat the whole person, not just their breast cancer. And thank you so much for sharing that with us today. And thank you for joining us and thank you to our Bryan Foundation partner Davis Design. That wraps up this episode of Bryan Health podcast.
Please visit our website at Bryan Health for more information, and to get connected with one of our providers like Dr. Jendro. Please also remember to subscribe, rate and review this podcast and all our other Bryan Health podcasts. And please share these shows ladies, with your friends and family on your social channels. We're learning from the experts at Bryan Health together. I'm Melanie Cole. Thanks so much for listening.