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One Size Does Not Fit All

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New Research Gives Insight into Breast Cancer; Fuels Hope for a Cure.

Although controversy has surrounded actress and activist Angelina Jolie during most of her career, her decision last year to submit to a voluntary double mastectomy may be one of the most debated. Jolie did not have breast cancer. Instead, she sought to prevent the disease from ever striking after discovering that she carried two gene mutations that could trigger breast cancer.

At the heart of this well-publicized decision lies the fact that more than seven decades of science is now giving women the opportunity to take action.

“Women are not only taking control of their lives and breast health, but also helping millions of women do the same,” said Dr. Hoda Anton-Culver, principal investigator and epidemiologist at the Athena Breast Health Network, a statewide project of the University of California.

Founded in 2009, Athena has created a new model for breast cancer research by uniting women, physicians and researchers, studying more than 6,000 women at five UC medical centers or affiliates. The cornerstone of their approach is to treat women as individuals, not a compilation of statistics.

“If we treat you as an average, the average does not come close to reality,” Anton-Culver said. “The faster research gets us closer to tailoring medicine to personal conditions, the better off women will be.”

Locally, Athena operates out of UC Irvine Medical Center. Women coming for breast screenings complete an electronic health history questionnaire, allowing Athena to give them a personalized risk assessment to guide their breast health plan. They then can take informed action.

She and other researchers who are part of the Orange County Breast Cancer Initiative have a goal of ending breast cancer in Orange County by 2020. The county’s diverse population is the perfect laboratory for research because it is one of the leading breast cancer clusters in California, according to the American Cancer Society.

Although more than 100 in every 100,000 women will develop breast cancer each year, the disease strikes women differently based on their age at diagnosis and ethnicity, Anton-Culver explains. African-American and Hispanic women under 40 are more likely to be diagnosed than Asian Pacific Islander or non-Hispanic white women in the same age bracket. However, the highest frequency of diagnosis occurs among women of all ethnicities between the ages 40 and 69.

Because of the variation in risk levels, Anton-Culver is adamant that each woman needs to understand her individual risk factors.

Documented risk factors include a family history of breast cancer, having had hormone therapy, being overweight, having diabetes, excessive alcohol drinking or smoking. And, of course, the presence of mutations in the BRCA1 and BRCA2 genes, which Angelina Jolie catapulted to the national dialogue. Women can learn whether they carry the gene defect through a blood test and then discuss treatment options with their physicians and families.

Before that happens, however, Anton-Culver is as fiery about prevention as she is risk education.

“Screening saves lives. It diagnoses cancer early. More than 200,000 women are diagnosed with breast cancer every year in the United States, and 40,000 of them die. It is serious.”

She urges women to talk with their physicians to discuss the timing of their first mammogram as well as establishing test frequency based on their personal and medical histories.

“It’s an exciting time in breast cancer research. We know a lot more than we did 20 years ago,” Anton-Culver says. “We are translating these discoveries into unique prevention and treatment plans for each woman in real time, and driving hard toward the finish line of finding a cure”.

October is national Breast Cancer Awareness month. Now is the perfect time to learn more by visiting Athena Breast Health Network or finding local nonprofits offering breast cancer prevention, screening, and treatment at OCNonprofit Central.

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Shelley Hoss is president of the Orange County Community Foundation. She can be reached at shoss@oc-cf.org.

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