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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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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.
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Getting to Know Renown's Canine Companions
A slobbery kiss, a wagging tail, a judgement-free smile. There are few things better than the love and attention of a canine companion. At Renown Health, we have a loyal and playful group of pet therapy teams. This volunteer program uses animal-assisted interactions (AAI) and animal-assisted therapy (AAT) to provide comfort, reduce boredom, increase social interactions, improve mood, boost general well-being and – perhaps most importantly – bring smiles to our patients’ faces. Benefits of AAT & AAI: Lowers blood pressure and heart rate by relieving anxiety Helps in pain management Eases feelings of depression, loneliness, boredom and isolation Stimulates communication Encourages physical activity For more information about the program, a complete list of our teams or to get involved, click here. Meet Keno and Linda Linda, Keno’s human, has volunteered as one-half of a therapy dog team for more than 14 years. Keno is her third Newfoundland, and he is a sweet and cuddly 2-year-old pup, who, according to Linds, thinks is a lap dog. “My mother was in assisted living for almost 10 years, and I saw what an impact a therapy dog can have,” Linda said. When she moved to Reno from Portland six years ago, she immediately contacted Renown. A Memory the Stands Out: A patient in the ICU was not responsive because of oxygen deprivation due to almost drowning. Linda and Keno went into the patient’s room at his physical therapist’s request, and the therapist asked the patient to reach out and pet the dog. After the third request, he moved his hand toward the dog, and his mother burst into tears. It was the first time the patient had moved since his accident. Linda and Keno went back several days in a row, and soon the patient was talking, sitting up and eating on his own. Meet Madi and Clark Madi, Clark’s human, is an employee at Renown, and Clark made it a family affair by joining the team in Sept. 2021. Clark is a unique pup with an amazing demeanor who adores everyone as much as they adore him. He is a hardworking Goldendoodle who loves to be a goofball at home when he’s off the clock. Why They Became a Therapy Dog Team: Madi was inspired to get Clark trained as a therapy dog because, as an employee at Renown, she was always so happy to see dogs walking around, and she knew that I wanted to provide that same relief to others. Her favorite thing about being a Renown volunteer is the joy it spreads to those working and the patients they are caring for. Meet Richard and Raven Raven is a four old Belgian Malinois who has been working as a therapy dog for two and a half years. She is calm, friendly and loves having her tummy rubbed. “The therapy dog teams are just one little part of Fighting the Good Fight,” Raven’s human Richard said. A Memory that Stands Out: Raven and Richard were assigned to the Sierra oncology ward one shift and visited a woman who had a picture of her dog displayed next to her bed. Raven immediately went to the bedside and the patient started petting her. As she spent more time petting Raven, Richard could see the stress disappearing from her face. He later learned that it was the patient’s first chemotherapy infusion, and Raven gave her the peace and the strength she needed to face the chemotherapy head-on. Meet Savannah and Hallie Hallie and Savannah’s journey as a therapy dog team began in 2017 at the Morgan Stanley Children’s Hospital in New York and has also taken them to San Francisco General Hospital and Stanford Hospital. The duo moved to Reno in 2020 and immediately joined the Renown Pet Therapy Program. A friend, energetic and cuddly American Cocker Spaniel, Hallie especially loves spending time with the young children at the hospital. A Memory That Stands Out: Savannah remembers one visit to a patient in the Children’s Emergency Room who was struggling with suicidal thoughts. Having struggled with mental health herself, Savannah felt a deep connection to the patient and a need to help. She recalls placing Hallie on the patient’s bed a seeing a “very small hint of a smile.” Savannah later learned that the Renown nurses hadn’t seen the patient smile in days. It was that moment that made Savannah realize what a profound impact Hallie can have on patients. Meet Chivas and Donna Chivas was a McNab/Border Collie mix who volunteered at Renown with her human Donna for two years. With help from Donna, Chivas was a master at reading situations in the hospital and reacting accordingly. For example, if a patient was afraid of dogs, she would sit with her back to the person so she didn’t come off as threatening. Contrarily, she would lie down on the floor when playing with young children to let them pet her on their level. Why They Became a Pet Therapy Team: This dynamic duo started out as a member of a local pet therapy group. During the height of the COVID-19 shutdown, they participated in outdoor pet therapy parades for various hospitals in the area. Donna and Chivas met Renown Volunteer Coordinator Wendy Peuket at one of the parades and she inspired Donna to pursue becoming a registered therapy dog team for Renown's Therapy Dog Program. Chivas sadly passed away unexpectedly in early December 2021, and the world is a whole lot dimmer place without Chivas’ light shining brightly.
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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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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.