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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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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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Takesha Cooper, M.D., Appointed Chair of Psychiatry & Behavioral Sciences
Takesha Cooper, MD, has joined the University of Nevada, Reno School of Medicine and Renown Health as Department Chair of Psychiatry and Behavioral Sciences. Dr. Cooper comes to the area from the University of California, Riverside School of Medicine where she served for seven years as clinical associate and then full professor in the Department of Psychiatry and Neurosciences, and associate training director for Child and Adolescent Psychiatry. Dr. Cooper previously served as associate medical director for the Riverside University Health System and Riverside County Department of Mental Health providing clinical and operational oversight for four regional psychiatric county clinics, and as an adjunct instructor of psychiatry at Stanford University School of Medicine. As a double board-certified child, adolescent, and adult psychiatrist, she also established a successful solo private practice serving patients from diverse backgrounds. At UC Riverside, Dr. Cooper held significant academic and leadership roles including vice chair of education, residency program director, chair of the Admissions Committee and equity advisor. Dr. Cooper will now build on the strong foundation established by Dr. Josh Fitzgerald, interim chair of the department, who will now serve as director of research for the department. Dr. Cooper will be responsible with Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown Health, for leading the Behavioral Health Program at the Institute where a team of nine psychiatrists, nurse practitioners and licensed professionals and counselors provide intensive outpatient treatment, partial hospitalization programs, Transcranial Magnetic Stimulation, Esketamine, hospital-based assessment and medication-assisted treatment to serve those struggling with mental illness and addiction across northern Nevada, Lake Tahoe and northern California. “We are delighted to have Dr. Cooper join the UNR Med/Renown team,” said Paul J. Hauptman, MD, dean of UNR Med and chief academic officer for Renown Health. “She brings a wealth of experience in multiple clinical settings, and we are confident that she will have a significant impact at a time of great need for mental health services, education, and research in northern Nevada. Dr. Cooper will do much to advance the mission of UNR Med which includes a commitment by the Department of Psychiatry to train the next generation of psychiatrists through a Psychiatry Residency and Child & Adolescent Psychiatry Fellowship training program. Education and training are provided in both urban and rural areas of northern Nevada.” Dr. Cooper earned her Doctor of Medicine Degree from the Keck School of Medicine at the University of Southern California and completed her residency at San Mateo County and fellowship at Stanford University. Prior to medical school, she obtained a Master of Science degree in Biochemistry and Molecular Biology from UC Riverside and her bachelor’s degree in Biochemistry and Molecular Biology from UC Santa Barbara. Dr. Cooper’s research explores the impact of Adverse Childhood Experiences on mental health outcomes in children and adults. She served as a clinical co-PI on a U54 funded grant aimed at reducing health disparities by engaging in community-based participatory research partnerships. “Dr. Cooper is an energetic, collaborative physician, researcher and mentor who cares deeply about improving the mental health and well-being of adults and children,” said Brian Erling, MD, MBA, President and CEO, Renown Health. “This is an exceptionally exciting time to advance health equity and to help improve mental health outcomes for people and communities across northern Nevada. We are excited that Dr. Cooper is joining our team. I know her talent, energy and leadership will further elevate our mission of outstanding care, exceptional training, innovative research, impactful advocacy and innovative community partnerships in mental health and addiction medicine.” Dr. Cooper is recognized for her passion for high-quality patient care and supports future practitioners through rigorous and culturally informed undergraduate and graduate medical education, research, and community collaboration. A 2022 graduate of the Executive Leadership in Academic Medicine (ELAM) program offered through Drexel University, she also maintains active involvement in national and state committees and journal editorial boards. The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents and fellows. UNR Med continues to improve 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. Renown Health is the region’s largest, locally governed, 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 locally owned not-for-profit insurance company, Hometown Health. 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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How to Safely Store Breast Milk
Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.
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4 Breastfeeding Tips for New Moms
While breastfeeding is natural, it's not always easy. We asked Certified Lactation Counselor Sarah Mitchell for some tips to help make the process easier for mom and baby. From increased infant immunity to improved maternal health and well-being, the benefits of breastfeeding are many. Still, only 60 percent of U.S. moms in the United States continue to breastfeed past their baby's first six months. There are for many reasons for why moms stop, including the mother's their need to return to work. We reached out spoke to Sarah Mitchell, a certified lactation counselor at The Lactation Connection at Renown, for some expert advice. Tip 1 At first, it's normal to expect obstacles. Even in cultures where close to 100 percent of moms breastfeed, they can experience issues, including getting the baby to "latch on," sore nipples, and milk production. In addition, it sometimes can take several weeks for mom and baby to get comfortable. Tip 2 Line up a coach, even before the baby is born. This can be a professional lactation coach, family member, or friend who is experienced and encouraging. While online videos can be helpful, most new moms need the one-on-one guidance that a coach can provide. Renown offers outstanding resources in its Lactation Connection center, including expert consultants, products, and support. Tip 3 Well ahead of the due date, set up a support network of friends, family members, or community groups such as La Leche League. Women historically have relied on extended support systems to help them with raising children, and breastfeeding is one of those areas that, while natural, still needs encouragement from the women who’ve been there. Tip 4 Don’t get discouraged if you need to supplement at times with formula. This, too, as it turns out, is not uncommon in other cultures. In other parts of the world, babies are given beverages and foods such as tea, broth, soup, juice, mashed bananas, and papaya. The American Academy of Pediatrics recommends supplementation only with approved formula -- but the point is, it’s ok to supplement if you need to. Finally, don’t forget the importance of breastfeeding for connecting with your baby. It’s essential to maintain breastfeeding over the weekends, preferably “on-demand,.” and will keep that special bond strong after you have returned to your job.
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Breast Feeding Doesn't Have To Mean Sore Nipples
If you think sore nipples are just a normal part of breastfeeding, think again. Robin Hollen, APRN, and Breastfeeding Medicine Specialist, says that nursing can be an enjoyable experience for mom and baby without pain and discomfort. A top concern of nursing moms within the first week after delivery is how to prevent sore nipples. Even moms who’ve nursed before struggle with this common issue. While many women think it is a regular part of the nursing experience, it is actually a sign that something isn’t quite right. “Nursing your baby should be enjoyable,” says Robin Hollen, Breastfeeding Medicine Specialist with Renown Health. For over 30 years Robin has been supporting moms to breastfeed. Below she shares some valuable information and tips, helping you create a happy and healthy breastfeeding experience for you and your baby. What causes sore nipples? The most common cause of sore nipples involves incorrect latching. For a proper latch, a baby’s mouth takes in the entire nipple and some of the breast, so that the nipple rests at the back of the mouth where the palate is soft. With an improper latch, the mouth may slip down to the tip of the nipple while the baby nurses. This constant pressure on your sensitive skin may cause discomfort and pain. A board-certified lactation consultant can help assess if your baby is latched correctly and troubleshoot your breastfeeding concerns. Less common causes of sore nipples include: • Improper tongue placement of baby • Clenching • Incorrect breast pump use How can a mother prevent sore nipples from an improper latch? Breastfeeding is a learning experience for both mom and baby. Ask for help with the latch so your baby learns it correctly and maintains its depth. In the past, new mothers were surrounded by a community of women — their own mothers, grandmothers, or other family and friends — to provide assistance and guidance with every latch at the beginning of an infant’s life. In today’s culture, new moms can find themselves on their own with no extended family to lend their knowledge. Nurses, pediatricians and lactation consultants now fill that role; they are the eyes and hands along with the much-needed experience to guide new mothers. Our Breastfeeding Medicine experts assist nursing moms with latch every day. Even a single visit with a lactation consultant observing your breastfeeding baby can provide valuable insight on achieving, and maintaining, the proper latch - preventing future nipple soreness and discomfort. How to heal sore nipples from breastfeeding To heal sore nipples, you must first fix the cause, and correcting the latch prevents further damage. A lactation consultant can also help you address the pain. Below are some breast healing tips: • Your own expressed breast milk is excellent to rub into the nipple for anti-bacterial protection. • For those moms who need more lubricant or fat than breast milk offers, use a lanolin or a cream that is labeled safe for the baby. • Soothies are a gel pads providing comfort in between feedings, but should not be used with lanolin products. • Breast shells, not to be confused with shields, can guard the nipples from irritation or pressure in between feedings. If you have more questions about preventing and healing sore nipples or general breastfeeding concerns, talk to your pediatrician or a Renown Health Breastfeeding Medicine specialist at 775-982-6365.
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Tips for Coping with Smoke-Related Health Problems
Millions of people across the west live in areas where air pollution can cause serious health problems. In addition, local air quality can affect our daily lives. Who is Affected? Kouros Farro, MD, a physician with Renown Urgent Care, advises that certain people are more likely to be affected when fine particle pollution reaches an unhealthy level. People who have asthma or other breathing conditions like chronic obstructive pulmonary disease (COPD). People who have heart disease or high blood pressure. Children and older adults. People of all ages who are doing extended or heavy physical activity like playing sports or working outdoors. “Everyone should take precautions when the air quality is unhealthy. Air pollution can aggravate heart and cardiovascular disease as well as lung diseases like asthma and COPD. When the air quality is unhealthy, people with these conditions may experience symptoms like chest pain, shortness of breath, wheezing, coughing, or fatigue. If you are experiencing any of these symptoms, use your inhalers as directed and contact your health care provider,” says Dr. Farro, who is board certified in family medicine and practices at Renown Urgent Care at 975 Ryland St. in Reno. “If you do not have a health care provider, there is a Renown Urgent Care office on almost every corner, with providers ready to see you.” Dr. Farro advises the following: Take it easy and listen to your body. Limit, change or postpone your physical activity level. If possible, stay away from local sources of air pollution like busy roads and wood fires. If you have asthma or other breathing conditions like COPD, make sure you have your relief/rescue inhaler with you. People with asthma should review and follow the direction in their written asthma action plan. Make an appointment to see your health provider to be sure you have an asthma action plan. Getting Same-Day Care Renown Urgent Care provides same-day treatment for a wide range of minor injuries, illnesses and medical concerns that are urgent but not life-threatening. Avoid the long wait times and high emergency room prices at 11 convenient sites, including Reno, Sparks, Carson City, USA Parkway, Fallon and Fernley. You can walk in or book ahead online. Make an Urgent Care Appointment Community Health Resources The Washoe County Health District offers online health information on its Smoke Smart website, including fire information, daily air quality information, fire and smoke maps and how to protect yourself. In addition, an online subscription page allows you to sign up for EnviroFlash, notifying you about air quality.
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