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Research Shows Genetic Approaches to Breast Cancer Screenings Yield More Accurate Results
Clinical researchers with the Healthy Nevada Project co-author research paper with findings that emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. Breast cancer is a leading cause of cancer death among women in the United States. According to the American Cancer Society, about 1 in 8 women will develop breast cancer and about 1 in 39 women will die from breast cancer. Breast cancer is associated with increased age, hereditary factors, obesity, and alcohol use. Since 1990, breast cancer death rates have declined progressively due to advancements in treatment and detection. In Nevada there are an estimated 2,310 new breast cancer cases a year, and genetic mutations such as in the genes BRCA1 or BRCA2 remain a top risk factor for this prevalent disease. Recognizing the urgency for progress in breast cancer research, a collaborative effort between physicians, advanced practice providers and scientists from the Healthy Nevada Project® (HNP) and Helix have unveiled groundbreaking research. This study explores how genetic screenings are a necessary supplement to traditional testing methods, together offering more accurate insights into a patient's likelihood of developing breast cancer in the future. HNP is operated by Renown Genomic Medicine and the Institute for Health Innovation and is one of the largest community-based population health studies in the country. Their team works in collaboration with Helix, a leader in precision health that delivers comprehensive genomic solutions. Together, this dynamic partnership aims to understand breast cancer risk factors and pave the way for more effective preventative measures. The combined research team studied 25,591 female HNP participants to evaluate the performance of different genetic screening approaches to identify women at high risk of breast cancer. The results of this research suggest that a combined monogenic, or single-gene, and polygenic, or multi-gene, approach to breast cancer screenings helped produce more accurate results and more closely identify study participants who have a high genetic risk of developing the disease. "Based on this research, we are advocating a shift in approach which would improve breast cancer risk assessment through a combination of effective family history ascertainment and genetic screening,” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project, research professor at the University of Nevada, Reno School of Medicine and co-author of the breast cancer research paper. “This tailored approach, founded on the assessment of individual genetic risk, not only intends to elevate patient well-being but also will improve efficiency and equity in healthcare." Complementing the team’s research on leveraging genetics to identify women at low genetic risk of breast cancer that could safely defer mammogram screenings by five to 10 years that was released in late 2023 in JAMA Oncology, the study suggests that incorporating genetic information can assist in personalizing breast cancer screenings and optimizing the use of screening resources. "Existing disparities persist across various facets of breast cancer screening and treatment; however, genetic screening is clearly a powerful tool to help facilitate early intervention for those at higher risk,” said Jamie Schnell Blitstein, APRN, a primary care nurse practitioner at Renown Health and co-author of the breast cancer research paper. “By placing a heightened focus on risk, we underscore the pivotal role of preventative breast cancer screening.” Despite the availability of effective methods for early screening, co-authors of this research found that 78 percent of women with a family history of breast cancer had their risk ascertained only after a breast cancer diagnosis. The findings emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. “These findings that can profoundly impact how healthcare is delivered were only made possible by all the participants who were willing to consent to research,” said Alex Bolze, PhD from Helix and co-author of the publication. “Broad-scale collaboration projects like these between Renown Health and UNR that engage large populations where participants share both their genetic information as well as electronic health records drive advancements in preventative medicine, as well as fundamental biological research.” The research paper was officially accepted on Jan. 29, 2024, and will be published by Elsevier, Inc. on behalf of the American College of Medical Genetics and Genomics. The contents of the paper will appear in the international journal Genetics in Medicine Open. Read the full article by visiting sciencedirect.com. The Healthy Nevada Project is currently recruiting new study participants. Free to all Nevadans with a saliva sample or blood draw, participants and their referring providers receive access to whole-exome sequencing and clinical grade results that help provide insight into their unique genetic risks tied to heart disease and certain cancers. If you are interested in enrolling in the study, schedule a Virtual Consent Appointment through MyChart or contact the Renown Institute for Health Innovation at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About Renown Health Renown Health is the region’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the largest community-based genetic population health study, the Healthy Nevada Project®. To join the Renown Health team, visit renown.org/careers. About Helix Helix is the leading population genomics and viral surveillance company operating at the intersection of clinical care, research, and data analytics. Helix enables health systems, life sciences companies, payers, and government partners to accelerate the integration of genomic data into patient care and public health decision-making. Learn more at helix.com.
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Researchers at Renown Seek Convalescent Plasma Study Participants
Physician researchers seek to understand how the immune system responds to COVID-19 and create a healthier Nevada. During the early stages of the pandemic, convalescent plasma was considered the only viable treatment option available for patients with COVID-19. Convalescent plasma is the component of the blood from recovered patients that may contain COVID-19 antibodies that help fight the infection. The National Institutes of Health has since developed treatment guidelines for COVID-19 based on clinical trial data and many studies are still underway worldwide assessing various additional treatment options. Convalescent plasma was in high demand but difficult to locate for COVID-19 patients in the northern Nevada area. A 24-year-old nursing assistant, Austin Meegan, was hospitalized and spent weeks staving off kidney and lung failure before learning he was eligible for an experimental blood transfusion that showed promise in treating COVID-19. Doctors estimated Meegan had only about a 3% chance of tracking down a donor to match his rare blood type. A COVID-19 survivor, Thomas Gibson, a Texas resident with the same blood type, traveled to Reno to donate his viral antibodies and a convalescent plasma donation credited with helping to save Meegan’s life. Physician clinical researchers and scientists at Renown and the University of Nevada, Reno School of Medicine (UNR Med) knew they needed to create better options for patients and physicians. Clinical researchers developed a study to help other patients like Austin, and pleaded for donations from recovered COVID-19 patients to donate their convalescent plasma. The researcher teams looked to understand how the body’s immune system responds to the virus over time, to aid them in developing new treatments for COVID-19. “The world’s capacity to get through the COVID crisis will depend on four things — science, technology, innovation and partnerships, says Tony Slonim, MD, DrPH, President and CEO of Renown Health. “Taking lab bench discoveries to the bedside of patients in an efficacious and timely manner is not easy, but with UNR Med and our partners, we are making great strides in advancing clinical research which has the power to save lives and to create a healthier Nevada.” “It’s tremendously promising to partner on clinical research that will not only help us better understand the disease, but help inform treatment for those combatting COVID-19 that has had such a devastating impact on Nevadans, our nation and the world,” says UNR Med Dean Thomas L. Schwenk, MD. Renown, UNR Med and other area health care partners collaborated with Vitalant to collect plasma from recovered donors for a study on the treatment's efficacy. Eligible donors are at least 18 years old, weigh more than 110 pounds and are healthy. Donors had fully recovered from a confirmed diagnosis of COVID-19. Project coordinators at the Renown Research Office were overwhelmed by the community’s support and plasma blood donations. Additional partnerships with the Washoe County Health District, the State of Nevada and the Governor’s office, Saint Mary’s Medical Center, Northern Nevada Medical Center, Carson Tahoe Health and the VA Sierra Nevada Health Care System, along with many area health care providers helped the team meet their goals of enrolling 120 eligible participants in the study. “Our success in this study rests heavily on the support of our great community, as well as the innovation and collaboration demonstrated by Renown and UNR Med,” said Sara Healy, MD, MPH, principal investigator of the study and a pediatric infectious disease physician at Renown Children’s Hospital and UNR Med. “We are proud to be at the forefront of conducting essential research during such a pivotal time in history, and look forward to our continued partnership as we continue this important work.” “The control of COVID-19 in our communities relies on testing. The study that is being launched to develop a sensitive, specific and easier way to collect specimens (blood) is advancing the field and brings promise towards getting to our common goal of having the right diagnostic test for the right clinical situation at the right time,” says Mark Riddle, MD, DrPH, FISTM, associate investigator of the study and associate dean for clinical research and professor at UNR Med's Department of Internal Medicine and Medical Research. The research team is now asking area residents to participate in a study to analyze the efficacy of two COVID-19 tests. Participants will undergo two blood tests: one being a finger stick to provide results for a rapid test, and the other is a traditional venipuncture draw confirming the presence or absence of COVID-19 antibodies. This study is a collaboration with InBios International, Inc., a leading biotechnology company based in Seattle. Researchers are seeking: Individuals who have confirmed positive for COVID-19 and who have recently recovered from the virus. Study participants must be within 7-28 days from the onset of their symptoms. Individuals who have recently tested negative for COVID-19 and have never tested positive. Those who are interested in participating in the study may contact project coordinators at the Renown Research Office at (775) 982-3646, or via e-mail at covidplasmascreening@renown.org, 7:30 A.M. – 5:00 P.M., Monday through Friday. Individuals aged 18-75 in general good health are encouraged to consider participating in this ongoing study. There is no cost to participate in this study and participation is voluntary. An individual’s decision to participate will not affect their current or future relations with their health care provider(s), health district, or the community. Those who decide to participate are free to withdraw at any time. “Time is of the essence with COVID. If we can get test results to people and their clinicians in a more timely way, we can make a faster diagnosis of a patient's condition, says Christopher M. Kozlowski, MD, MHA, Renown's institutional research officer and Medical Director/VP of Renown Institute for Heart & Vascular Health. “As we refine the accuracy of our testing; we are applying sensitivity and specificity testing for true negative and true positive results. This provides people with more timely and accurate results and better quality care.” About Renown Health Renown Health is a locally governed, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to improve the care and the health of our community. About the University of Nevada, Reno School of Medicine The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Established in 1969, UNR Med is improving the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu.
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Elementary Schoolers: Take Part in Free Virtual Vision Screening
Renown Children’s Hospital pediatric ophthalmologist Dr. Mitchell Strominger hosts state-wide virtual event to provide routine vison screenings for children and Walk with a Doc. Renown Children’s Hospital pediatric ophthalmologist Dr. Mitchell Strominger is set to host a virtual Walk with a Doc event on Sunday, June 14 at 10 a.m. for elementary school children and their parents. During this free event, Dr. Strominger will give a brief, kid-friendly talk about the importance of routine vision screenings and show parents how to conduct a vision screening with their kids at home. He will close out the morning session with a live Q&A. Following the event, families are encouraged to get outside and enjoy a walk in the great outdoors. The event is sponsored by Renown Children’s Hospital and free to participants, however you must register to receive the link to attend. “Vision is important for learning, experiencing new things and interacting with others, which is why it’s critical for children to get vision screenings early and routinely,” said Dr. Strominger. “The best time to screen a child’s vision is kindergarten through third grade as the cells in the brain responsible for vision are continuously developing up until age eight. If we detect vision problems early, we here at Renown Children’s Hospital have the expertise and technology to correct these vision problems and enable children to live healthy, productive lives.” Individuals who register for this event will be emailed a vision-screening sheet to help facilitate an at-home screening, as well as a form to send back to their child’s pediatrician or pediatric ophthalmologist upon completion to determine the best course of action. Dr. Strominger added, “Many parents and schools have put off vision screenings due to COVID- 19 school closings, hesitations of safely leaving their homes or potential financial costs. I am pleased to host this virtual event on behalf of Renown Children’s Hospital, to engage kids and parents in a conversation on the importance of vision and to remind the community that we are here to help and provide the care they need, both in-person and virtually—be it over a smart phone, tablet or computer screen.” This virtual event will take place in the newly renovated Fianna’s Healing Garden which re-opens later this month and has been funded 100% by donations through the Renown Health Foundation. Located in the heart of Renown Regional Medical Center, the healing garden serves as place to enjoy the serenity and beauty of the outdoors. Dr. Strominger is one of 26 pediatric subspecialists recruited to Renown Children’s Hospital since 2016, thanks to the Pennington Foundation's $7.5 million donation made to the non-profit Renown Health Foundation to expand children’s health services. June marks the four-year anniversary of the Nevada Chapter of the American Academy of Pediatrics’ (Nevada APP) participation in the national Walk with A Doc event. Dr. Strominger is the secretary and treasurer for the Nevada AAP. From pediatric specialties, 24/7 ER care and surgery, to imaging, pediatric ICU and child life specialists, Renown Children’s Hospital is dedicated to helping kids feel welcome, safe and well cared for. Through each visit, parents can expect the highest level of care for their child’s health and well-being from birth and beyond. To support Renown Children’s Hospital and help local children in need get access to vital health services like routine vision screenings, please visit the Renown Health Foundation. About Renown Health Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, Renown Children’s Hospital, Renown Rehabilitation Hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. For more information, visit renown.org.
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Breast Surgical Oncology
Breast Surgery Care at Renown Health Renown Breast Surgery Care, located within the Center for Advanced Medicine B, is a comprehensive, fully integrated breast surgery clinic, addressing a wide spectrum of breast problems ranging from benign to cancerous: Benign breast conditions such as fibroadenoma, phyllodes tumors, and nipple discharge Breast cancer risk assessment and genetics High risk breast lesions such as atypical ductal hyperplasia, atypical lobular hyperplasia, LCIS, papillary lesions, and radial scars Advanced breast cancer surgical techniques including oncoplastic surgery for best aesthetic outcomes possible and nipple sparing mastectomies, working closely with skilled plastic reconstructive surgeons. Our highly experienced breast surgical oncologists are continuing to expand our team to better meet the evolving needs of our community and beyond. We are excited to soon be incorporating an oncology wellness team who can further support our patients with focused nutritional guidance, functional assessments for prehabilitation needs prior to surgery or medical treatments, and guidance for development of physical activity and other exercise programs, for best outcomes in cancer treatment as well as future risk reduction. The National Accreditation Program for Breast Centers (NAPBC) is a rigorous process designed to ensure high quality care for breast centers by meeting thoughtfully created standards that are constantly being reviewed and updated for ongoing improvement of patient care. We are the only NAPBC-accredited program in Northern Nevada.
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5 Ways to Prevent Diabetes
November is National Diabetes Month, and with cases of the disease at an all-time high in the U.S., individuals must do everything they can to stay healthy. Learn more about diabetes prevention and also how to stop prediabetes in its tracks with these five helpful tips. Diabetes is a disease that is increasingly making its way into the public consciousness, and not in a good way. In fact, according to USA Today, diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness — and many more who are at risk for developing it. And those with prediabetes are at risk for developing type 2 diabetes in 10 years or less, according to the Mayo Clinic. The American Medical Association notes that 4 million U.S. adults have prediabetes. Check out the American Diabetes Association’s prediabetes risk test. The good news: There are ways to manage — and even reverse — prediabetes. Renown’s Certified Diabetes Educator Stephen Compston, RD, LD, CDE, shares five steps for managing blood sugar and also avoiding an eventual diagnosis. How to Prevent Diabetes Eat healthy foods. Plan meals that limit (not eliminate) foods that contain carbohydrates, which raise your blood sugar. Carbohydrates include starches, fruits, milk, yogurt, starchy vegetables (corn, peas, potatoes) and sweets. “Substitute more non-starchy vegetables into your meals to stay satisfied for fewer carbohydrates and calories,” Compston says. Exercise. Blood sugar is the body’s basic energy source. When you exercise, you are lowering your blood sugar. “People with prediabetes usually want to stay off of medication, so they must add something to their normal regimen that lowers blood sugar,” Compston says. “In this case, exercise is medicine.” Lose weight. A small decrease in your weight can drastically decrease your risk of developing diabetes in the future. The Diabetes Prevention Program study showed that a 7 percent decrease in body weight (14 pounds for a 200 pound person) can reduce a person’s risk of developing the disease by 58 percent. Get more rest. Studies link sleep issues to an increased risk of insulin resistance. It can also make it harder to lose weight. Thus, people that don’t get adequate sleep are at an increased risk for developing type 2 diabetes. See your doctor regularly. Schedule an appointment with your primary care provider at least once a year so you can track your health together. “A regular check-up and lab work can help identify what your blood sugars are doing so you and your doctor can develop a good plan for delaying the onset of diabetes,” Compston says.
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Ladies! Get Screened for Breast Cancer
Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.
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Type 2 Diabetes: What You Should Know
Type 2 diabetes, formerly known as adult-onset diabetes, is on the rise for adults and children in the United States. Although genetics play a role, you can take steps today to lower your risk of developing this life-altering condition. Michael Raymund Gonzales, MD with Renown Endocrinology answered our questions about Type 2 diabetes and gave us some useful tips for prevention. What effect does diabetes have on the body? And who’s most at risk? First, it’s important to know the difference between the two most common types of diabetes: Type 1 diabetes is the result of the body’s inability to make insulin, which is a hormone your body needs to be able to use sugar, or glucose, for energy. Type 1 is not preventable, and people who have it were either born with it or they developed it later in life due to an autoimmune process that attacked the pancreas that went unrecognized. Type 2 diabetes occurs when the body makes the insulin hormone, but it might not make enough or work well enough for the body to use sugar for energy. This is called insulin resistance. This condition usually develops later in life but is preventable with proper diet, exercise and weight loss. However, due to the obesity epidemic, type 2 diabetes is occurring more often in younger individuals. Diabetes hurts the body’s ability to break down glucose, so rather than it being used for energy, glucose stays in the bloodstream, which can cause problems. But with early detection and the help of your doctor, diabetes can be managed so that complications are avoided. Left unmanaged, however, diabetes can affect major organs and lead to heart and blood vessel disease, nerve damage, kidney damage, eye damage, skin conditions and more. Type 2 diabetes also results from risk factors that you can’t control, including your family history, race and age. However, there are a few risk factors that you can watch out for, such as being overweight, inactivity, diet choices, having high blood pressure and high cholesterol and triglycerides.
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8 Important Health Screenings for Men
Men are generally less likely to visit their doctor for exams, screenings, and consults compared to women. To address this, we've collaborated with Dr. Bonnie Ferrara of Renown Health, to compile a list of eight essential screenings that can help men maintain their health. 1. Blood Pressure Tests Ages 20+ Blood Pressure tests measure the pressure in your arteries as your heart pumps. Biennial (every two years) checks are recommended if you have normal blood pressure or more frequently if you have high blood pressure (hypertension) or low blood pressure (hypotension). The United States Preventative Services Taskforce cites normal blood pressure below 120 systolic (top number) and 80 diastolic (bottom number). 2. Cholesterol Screening Ages 20+ High levels of cholesterol increase your risk of stroke and heart disease. A simple blood test will help your healthcare provider determine your numbers and if you're at risk. If you have a family history of diabetes or heart disease, you may need yearly screenings. But, again, your doctor can provide the best course of action.
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Lung Cancer Screening and Early Detection
Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution. What are the risk factors of lung cancer? Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk. People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening. People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.
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Prevention Against STIs Matters
According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new sexually transmitted infection (STI) cases in the United States each year, with rates continuing to increase. What you may not know is most STIs are preventable. We talked with Renown Adolescent Medicine Specialist, Caroline Barangan, MD to learn more about STIs. How Can You Get an STI? The CDC (Center for Disease Control) says that STIs are acquired through sexual contact. There are bacteria, viruses or parasites that can cause an STI which may pass from person to person in blood, semen, vaginal and other bodily fluids. How Do You Know if You Have an STI? STIs can have a range of signs and symptoms such as: Warts, bumps or sores on or near the penis, vagina, mouth or anus Swelling, redness or severe itching near the penis or vagina Discharge from the penis Vaginal bleeding that’s not your period Painful or uncomfortable sex Vaginal discharge that has an unpleasant odor, causes irritation or is a different color or amount than usual Weight loss, diarrhea or night sweats Aches, pains, fever and chills Jaundice (yellowing of the skin and whites of the eyes) Painful or frequent urination Sore throat if you engage in oral sex It’s important to know that the majority of people who have an STI commonly have no symptoms at all, which is why it’s important to get regularly tested once you have had any sexual activity. Young people less than 25 years of age should be screened on a yearly basis at minimum.
