Moving Beyond Awareness to Breast Cancer Prevention

It’s that time of year when the world looks a little more pink.  Retailers decorate their stores with pink ribbons and the promise to donate a portion of their sales to the fight. There are the pink M&M’s. There are pink cereal boxes lining the cereal isle. There are pink ribbons everywhere. But what does all this pink really mean?

I received an email the other day, asking me to donate to a breast cancer foundation during October because it is breast cancer awareness month. In this email the organization stated that in this country, a woman dies of breast cancer every 13 minutes. The email went on to explain that a portion of the money they raised would provide funding for screening mammograms, because they believe that this is the best way to save lives. I don’t dispute that early detection is saving lives, but what if the emphasis was not just about screening, early detection or how well we treat the disease? It got me wondering: what if women understood how to prevent the disease in the first place?  How many breast cancer deaths could be averted?

For many women, breast cancer awareness is a reminder to schedule their mammogram.Walking Shoes   For others it can mean purchasing an item from a retailer with the hope that it will somehow help the cause.  For many of us, it’s a time to hear inspiring stories of survivors who found their own lump, then made it through a mastectomy and grueling chemotherapy treatments.   These stories are very compelling and these women deserve our admiration and praise.   But somewhere along the line, the end goal became awareness, and awareness simply became synonymous with prevention.  And although awareness can lead to increased screening, we should not stop there.

What if we changed the paradigm in which most of us see breast cancer?  What if we banded together – mothers, sisters, daughters and grandmothers, aunts, and all of those that love us  – and demanded that we do more than just be aware.  What if the message was about how to actually prevent breast cancer in the first place?

Unfortunately, prevention is not sexy.  Prevention doesn’t make anybody – especially corporations – wealthy.  Prevention isn’t easy, and its not convenient.  Prevention doesn’t happen overnight.  Prevention involves commitment and hard work and a long term vision.   The struggle with prevention touches all of the cornerstones of our culture: sex, money, convenience and instant gratification.

We all know that our health care system is broken, and tends to be more of a “sick care” system.  In the current model, Providers are not rewarded for promoting prevention, but instead find themselves prescribing costly imaging and cancer treatments.   Cancer, diabetes and heart disease would dramatically decrease if we practiced prevention.   Imagine if we replaced every pink ribbon with a picture of a vegetable and a pair of walking shoes.   Or if we incented women to make lifestyle changes and offered information about breast cancer prevention at our malls, grocery stores, libraries and in schools.  What if our health insurance actually paid for prevention?

And yet, we know that many cancers are the result of our lifestyle.   There is growing evidence that the choices we make everyday affect our health in profound ways.  Each of us has the power to prevent disease; but the problem is that many of us don’t know it.  Its time to take back our power.

It’s not easy to make changes in our lifestyle; but with determination and will, it can done.  The key is to empower women to understand that the choices they make everyday affect their health and their risk of breast cancer.  Through education and information about lifestyle choices, plus tools and strategies that can help integrate gradual changes, women and men will be motivated to make changes that are sustainable and will lead to less obesity, diseases like heart disease and diabetes and yes, less cancer.  We must demand it from the corporations, our legislators and government, and especially from ourselves.  We must change a health care system from one that rewards technology and sickness, to one that emphasizes prevention.  We must create a society and ultimately a lifestyle that allows us to adopt healthier lifestyles.

Here are a few ways to get started today:

Nutrition is a choice we make several times a day.  How much we eat and what we choose to put in our bodies has a powerful effect on our health.  Choose more whole foods and less processed foods.  Choose more vegetables and fruits and fewer carbs and starches.   We already know that the phytonutrients in fruits and vegetables are powerful tools against cancer.  These include broccoli, kale, blueberries, spinach, garlic and onions just to name a few.  Obesity increases risk of all cancers ; if you shed those extra pounds, your risk of breast cancer decreases.

Exercise is another way to prevent and reduce recurrence.    More and more research is showing that moderate exercise for at least 30 minutes a day can reduce the risk of a recurrence of cancer.  Walking is the best form of exercise and doesn’t cost anything, so get moving!  Even if you don’t lose weight, exercise helps to reduce your cancer risks.

Managing stress in our lives can help improve our body’s ability to resist cancer, since stress can weaken our immune system.  Tune into your body and understand how you manage stress.   Learn to meditate; find time for something you enjoy once a week and reach out to spend time with a friend.

Reducing Environmental Toxins.  It’s important to remember that the choices we make about our home cleaning products, water bottles, plastics, dry cleaning, and the personal-care items we choose also affect our health.  For more information about environmental toxins go to the Environmental Working Group site at

We all know that bad habits are hard to change.   But be patient with yourself:  the rewards will be not only realized in better health, but also in feeling better than you ever have before.  Continue to have regular mammograms and don’t forget to do your monthly breast exams, but also remember that each of us has the power to prevent cancer by the choices we make every day.  This October, I want to see more women empowered to make informed choices everyday that reduce their risk of breast cancer for not only themselves, but for their children and generations to come.

Posted in advocacy, Breast Cancer, Exercise, Nutrition | Tagged , , | 1 Comment

The Realities of the “Big C”

It wasn’t that many years ago that cancer was the elephant in the room and rarely discussed openly.  With over 12 million Americans diagnosed with cancer in this country, it is forcing it’s way into many living rooms, kitchen tables and television sets.  Showtime’s dramedy “The Big C” about Cathy Jamison, a middle age mother, wife, sister and teacher who is struggling to find her way after a stage 4  melanoma diagnosis, has recently captured my attention.

Laura Linney in The Big C

Cathy, brilliantly played by Laura Linney, spent the first season keeping the diagnosis from everybody while she contemplated what life really meant to her.   She and her husband separated, she had an affair, bought a red sports car and began plans to put the long desired swimming pool in the back yard.  She befriended the wacky neighbor across the street that she had never bothered to get to know, and discovered that she really liked her, quirks and all.

For the first time in her life, Cathy was living life intentionally and in the moment.   She visited acupuncturists and “bee healers” before deciding to tell her estranged husband, son and friends about her cancer.

The second season is where the show really dives into the realities of living with cancer. Cathy reunites with her husband and begins treatment that involves participating in a clinical trial.  Her husband is laid off from his job and he is forced to take a job in a retail store just so that he can get minimal medical benefits and pay some of the mounting health care bills resulting from being underinsured. Throughout it all, Cathy is trying to keep her job and make it through her treatments while hanging onto some semblance of hope that she may survive longer than expected.

Her teenage son is going through his own adolescent struggles with his identity as the kid whose mom has cancer (Cathy is a teacher at his school) and coming to terms with the idea that she may not live to see him graduate from high school.

Cathy befriends a fellow melanoma patient who is not faring as well as she is, but undeniably understands her journey.  She is supporting a brother with mental health issues, and is taking in one of her students who needs a home for last year of high school. She struggles to discipline a teenage son who is pushing his boundaries more than his teenage peers. The show also touches on the  struggle with sexual intimacy that affects many cancer survivors.

The realities of cancer are difficult and challenging, and can be different for everyone.  Although some of the side stories often feel more like distractions, many of the themes highlighted in the “Big C” realistically depict the challenges of living with cancer and its impact on loved ones, work and friends.   Fortunately for us, the story is not complete; there is plenty of fertile ground to cover in the next season and beyond.

Cancer changes not only the cancer patient and the survivor, but everyone around them.  Cathy is evolving into a new person as a result of her cancer experience.   She is living a life of more acceptance and non-judgment, all the while striving to live in the moment and deepen her connection to those around her.  She is working to strengthen her sense of gratitude.

For some, cancer is an opportunity to develop a profound sense of meaning, purpose and peace in their life – but it’s not easy.   It takes a will to not get lost in the despair and to try to see the good, the positive and to laugh at oneself along the way.

Ironically, in facing her own mortality, Cathy is feeling more alive than ever before.  That is a reality of cancer for which I am truly grateful.


Posted in Intimacy, Melanoma | Leave a comment

I’m a survivor! Now What?

In a fairly short amount of time, you have received a diagnosis, prognosis, and treatment.  Now what?  Well, what’s left? Staying healthy!  Many lifestyle changes play a role in the success of survivorship:   emotional support, nutrition, and exercise just to name a few.

Those who become diagnosed with cancer often find comfort and relief from a large support network made up of family and friends.  In many cases, these same family members and friends act as caregivers and offer medical care with the goal being improved quality of life.  Selecting your support system isHealthy Living important because these people will help you before, during and even after your treatment – ensuring you stay well.  Most importantly, they will help you deal with new emotions, attend support group meetings with you, and assist you in finding healthy ways to manage your stress.

Usually, finding a more holistic approach to their health helps survivors in a few ways.  A number of survivors attribute their success to dietary changes and mind-body medicine.  A healthy diet is one of the most significant natural approaches to fighting cancers.  Proper nutrition can help the body best attack cancerous cells, increase a patient’s strength and energy during chemotherapy or radiation therapy and improve someone’s quality of life. Meditation, long commended for its ability to help people manage pain and stress, may be beneficial for mesothelioma patients looking for holistic alternatives for treatment. Yoga, which combines meditation and gentle exercise, can give patients an outlet for their anxiety while improving their general health.

The Mesothelioma Center offers free literature and advocacy services for patients and families who have been affected by mesothelioma or other asbestos related diseases.  For additional information, visit www.asbestos.comFollow us on Twitter for daily updates on ways to stay healthy, and Like us on Facebook to engage with others in the cancer community by sharing resources.

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A Lesson in Gratitude

Remembering Emily

It’s been 4 years this week since the world lost an incredible light, Thankful Emily Jane Dade.

This week, I am remembering Emily by posting some of her writings (with her family’s permission) from the last few weeks of her life.  Her gratitude while facing death is awe-inspiring, and she continues to challenge me to practice gratitude in my life everyday.


May 15, 2007

My dear Tulips,

As I put my fingers to the keys, something tells me that this is going to be  the hardest post for me yet. I have so much to share, and I think this may be my last opportunity to do so. I’m getting so tired now. I think after this  post, I’ll pass the update torch on to my family, so that I can focus on  resting and preparing for my transition.

So where to begin? What to share with all of you, my precious tulips, who have  carried me through thick and thin, who have shared joy in my small victories, suffered with me in my times of greatest defeat. What mere words can possibly speak all the contents of my heart? I guess I’ll just open it up and see what comes out.

It’s been profound, going through this dying process around Mother’s day.  Anyone who knows me knows that being Alexander and Dorothy’s Mommy is EVERYTHING to me. The hardest part in my cancer journey has been, without a  doubt, the impact that I know it will have on them. And so, to celebrate Mother’s Day with my babies this year, knowing that it is the last year we will all be celebrating it together in body, that was very, very hard. I just want to grab hold of them and never let go. I know they will be ok. I do. With every fiber of my being, I know that they are in the BEST hands, that they have the BEST daddy, the BEST grandparents, the BEST family and friends, that they have  all the BEST tools to get through this in the least traumatic way possible. And I know with equal certainty that it is only my body that will be gone, that my spirit will still be alive, and will dwell in their hearts forever.

But it doesn’t make it hurt any less to know that it won’t be me tucking them in at night, blowing their sweet dreams into their sweet little ears.  That I won’t be at the next basketball game or gymnastics performance, cheering my heart out alongside the other moms. That I won’t be able to teach Dorothy about puberty, or to help Alexander figure out the mystery that is the female species. All the things that you need to have a physical body in order to do. That makes me very sad. Again, I know they are in the best hands. I know they’ll be ok. But I still wish it was gonna be me. My hands.

But, I trust in the Higher Power, God, the Universe. I know that there is a reason for this. I am not meant to know the reason yet, but I know there is one. I believe with all my heart that, as sad as it is, as much as I wish is wasn’t so, this is my path, this is my children’s path, this is my husband’s path, and all will be as it is supposed to be. And so, I allow myself to be sad, but I accept that it is supposed to be this way, and I trust that they will all be ok.

The last thing I want to share with you is my gratitude. This goes above and beyond those two little words, “thank you”. The two concepts aren’t even in the same ballpark. The gratitude I feel coursing through my heart is something that I don’t know if I can begin to describe. It’s not just about being grateful.  It’s not just a feeling. It’s like, it’s like a state of being. One that we can all strive for. We can find gratitude in every aspect of our lives. “Count your blessings” is so cliché, but the power it gives me to truly FEEL the gratitude for the innumerable blessings in my life, it’s unbelievable. To be facing death, and still be able to feel gratitude of this depth, it’s profound. And for that, I am truly grateful. I am THANKFUL. For each of you, even those of you I’ve never met. For the endless stream of love and support, friendship, camaraderie, light and prayers that you have shared, and continue to share, with me and my family. For sharing your selves with me.

For now, that’s all. I send you my love, my light, my joy, and my gratitude, every minute of every day…


Emily died at the age of 30 from breast cancer, but her spirit lives on in all of us, her Tulips.

Posted in Breast Cancer, Survivorship | Tagged , , , | 2 Comments

Information is Key to Understanding Fertility Options

I had an adult survivor of a childhood cancer tell me recently that she was very thankful to be alive but felt she paid a very high price for  that survival, as she had recently discovered that she was infertile as a result of her treatment.  She was hopeful that somehow her experience could be translated into improved options for future childhood cancer survivors. She wondered: had she known or had access to fertility preservation methods before she began cancer treatment, would she (and her parents) have made a different treatment decision?  Would her fertility options be different now?

When you or your child has cancer, life-saving treatment  is, of course, your first priority.  While there have been major improvements in both childhood cancer and adult onset cancer survival,  many of these treatments can put survivors at risk for infertility.  Fertility—the ability to conceive a child or maintain a pregnancy—can become impaired from some cancers or cancer treatments.  Although infertility can be one of the most distressing of the long term effects, the good news is that there is increasing success with improved fertility preservation techniques, and treatments are becoming less toxic.

A cancer diagnosis is overwhelming enough on its own.  The focus is on finding the best doctors and most successful treatment.  Unfortunately, sometimes survivors are not aware that infertility may be a consequence of their treatment.  Beginning the conversation can be difficult for both the provider and patient, but it is necessary.

Which Treatments are most likely to cause Infertility, and who is at most Risk for Infertility?

Not all cancers and cancer treatments cause infertility and it is important to understand your individual risks.  Chemotherapy can damage eggs and sperm, as well as the cells in the ovaries and testicles that produce sex hormones. Radiation can reduce the chances of fertility when treatment is directed at the ovaries or testicles, the nearby pelvis or abdomen, or the whole body. Future infertility also can result from radiation to the brain. In girls and women, high-doses of radiation to the pelvis may damage reproductive organs, making it harder to get pregnant and to carry a baby.

The effect that cancer treatment may have on fertility depends on many factors, including the person’s age at the time of cancer therapy, the specific type and location of the cancer, and the type and dose of treatment that was given.  In girls, infertility may be less of a risk when treatment is before puberty.  Similarly, the closer to menopause a woman may be, the greater risk she will have to be pushed into menopause and become infertile.  Women with breast cancer may be advised to not attempt pregnancy after treatment because it may increase their risk of the cancer returning.

How do you best Advocate for yourself or your Child?

Become informed.  Ask your oncologist about the risk of infertility with the proposed treatment options. Ask about fertility-saving options.  Read and research and don’t be afraid to ask questions.  Ask for a referral to fertility specialist to discuss your options.

Many times, it is very difficult to think about future fertility at a time when you and your family are overwhelmed with fear and sifting through lots of information.  The primary concern is always about choosing the best treatment to preserve your life or the life of a loved one – this is understandably so.

Patients and survivors often are unsure about what types of  questions to ask about their fertility options.  Physicians and healthcare providers can do their part by becoming well informed about resources and fertility specialists in their community. Sometimes the hardest part is just broaching the topic.  Follow this link for tips on starting the conversation:

Resources for Healthcare Providers and Patients

Save My Fertility is an authoritative resource for adult cancer patients and the parents of children with cancer who want to learn more about:

  • Preserving their fertility before and during cancer treatment, and
  • Protecting their hormonal health after treatment. also provides information and guidance to oncologists, endocrinologists, and other health care providers concerned with the reproductive health of cancer patients and survivors.  They have developed mobile phone applications, pocket guides and patient information.

Fertile Hope

Fertile Hope is a LIVESTRONG initiative dedicated to providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility.

American Society of Reproductive Medicine

ASRM is a very good resource about all aspects of the reproductive lifecycle.  The website also has a list of states that mandate some form of insurance coverage for  infertility  treatments.

Posted in advocacy, Chemotherapy, Childhood Cancer, fertility, Radiation | Tagged , | 1 Comment

From Cancer Patient to Cancer Survivor

This short film illustrates the importance of survivorship care after treatment ends.

It’s not just about living but living well after cancer!

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Yoga Improves Life – During Breast Cancer Treatment and Beyond

I have fallen in and out of regular yoga practice for many years, but every time I get back into a yoga routine, I find that my stress level decreases.

I recently picked up “Poser; My life in 23 Yoga Poses” by Claire Dederer.  When this anxious and virtuous new Seattle mother discovers yoga, she is able to find more joy in her life.  Through yoga, she is better able to  ease her transition to the more demanding lifestyle parenting requires.

It makes perfect sense, then, that yoga helps women during breast cancer treatment and beyond as they also make a difficult transition to a more physically and emotionally demanding time.

A recent study looked at 163 women with breast cancer who were undergoing radiation therapy. They were an average age of 52 years old. The women were divided into three groups – a yoga group, a simple stretching group and a group who received no instruction in yoga or stretching.

Women who practiced yoga had the largest decline in their cortisol levels across the day, indicating that yoga had the ability to improve regulation of stress hormone. This is important because higher stress hormone levels have been linked to worse outcomes in breast cancer.

At one, three and six months after radiation therapy, women who practiced yoga during the treatment period reported greater benefits to physical functioning and general health. They were also more likely to perceive positive life changes from their cancer experience than either of the other groups.

“The combination of mind and body practices that are part of yoga clearly have tremendous potential to help patients manage the psychosocial and physical distress associated with treatment and life after cancer, beyond the benefits of simple stretching,” explained Professor Lorenzo Cohen, the lead researcher at the University of Texas

“The transition from active therapy back to everyday life can be very stressful as patients no longer receive the same level of medical care and attention. Teaching patients a mind-body technique like yoga as a coping skill can make the transition less difficult,” the researchers  suggested.

Details of these findings are due to be presented next month at the 47th annual meeting of the American Society of Clinical Oncology.

At its roots, yoga was originally developed as a discipline intended to help people achieve spiritual enlightenment.  Yoga is a now more commonly a practice that helps people learn to relax and to integrate the mind, body and spirit – something we all need, cancer or no cancer, in our chaotic and stressful lives.  We have understood that stress has an adverse effect on our health and immune systems;  now we are beginning to see the evidence to back up what we have known intuitively.

Maybe this time I am more motivated to stick with it.


Cohen, Lorenzo et al. “Effect of yoga on QOL, cortisol rhythm, and HRV for women with breast cancer undergoing radiotherapy.” American Society of Clinical Oncology. June 2011.

Yoga reduces breast cancer stress” – 5/22/2011, Deborah Condon, Irish Times

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Enjoy your Java, Ladies and Gentlemen!

Coffee - by Paul, from

A positive link between coffee and lowered cancer risk?  This is a vice that is actually good for you.

I no longer feel guilty about drinking my cup of joe each morning.  Recently I’ve started using my French Press because I’ve found that I just like the taste of  the pressed coffee better than the drip coffee.  Turns out that French Pressed coffee is actually better for you. 

Here’s the proof:

Several studies suggest that women who drink coffee on a regular basis actually lower their risk for breast cancer.  One study suggested that women with a certain gene type who drink coffee altered the nature of estrogens circulating in the bloodstream, and lowered the risk of breast cancer.

A study published in 2010 showed that women who drank boiled coffee, such as that made in a French Press coffee maker, lowered their risk for breast cancer even more when compared with women who the drank filtered coffee made by drip coffee makers.  The beneficial effects of coffee are found in the fatty acids that are released from the coffee beans, which inhibit the growth of cancer cells.  The filters in drip coffee makers tend to remove these protective fatty acids, whereas French Press and boiled methods do not.

A paper just released from the Karolinski Institute in Sweden  provides more information regarding this topic.  Specifically, coffee appears to be associated with a reduced risk of estrogen receptor negative breast cancer, a less common but more aggressive form of the disease.

And there’s good news for men as well.  Coffee may reduce the risk of prostate cancer.   Researchers at Harvard studied nearly 48,000 men  over 2 decades and found that those who drank 6 cups of more per day were 20% less likely than men who didn’t drink coffee to develop prostate cancer.  Even men who drank less coffee still had reduced rates of the lethal type of prostate cancer and it didn’t matter if it was caffeinated or not.

Coffee is a powerful antioxidant.  So go ahead and enjoy that second cup without the guilt and try it unfiltered!


Lena Nilsson, Consumption of filtered and boiled coffee and the risk of incident cancer:  a prospective cohort study.  Cancer Causes & Control, 2010.

Posted in Estrogen, Nutrition, Research | Tagged , , , | 2 Comments

To soy or not?

Is soy safe after breast cancer?

There is plenty of confusion over soy and it’s effect on breast cancer.  This is understandable given the amount of conflicting information circulating.  Here is what breast cancer survivors need to know.

Rates of breast cancer are lower in countries such as China and Japan where soy is consumed at higher levels than the U.S.  Whether this can be attributed to the overall increased soy consumption by Asian women, or the fact that Asian girls typically begin to consume soy regularly at an earlier age then their Western counterparts, needs further study.  According to a recent article published in the Journal of Nutrition, its possible that moderate consumption of soy ingested earlier in life may have a protective effect later on.  It is also possible that a lifetime of soy consumption that begins at an early age may positively change the biology of tumors later on in life.

Another concern revolves around the different types of soy. Soy contains phytoestrogens that can mimic natural estrogen in the body.  Asian cultures tend to ingest more of the lightly processed soy products, such as tofu and soy milk; compare this to the American diet, which increasingly contains highly processed types of soy protein as an additive to foods such as cereals, bars and chips.

It’s important to note that the consumption of soy based foods was also associated with other characteristics of a healthy lifestyle, including exercise and high vegetable and fish intake.  This also may be contributing to better outcomes for women diagnosed with breast cancer.

One of the more recent studies to examine these questions in breast cancer survivors is the The Shanghai Breast Cancer Survival Study, a large, population-based cohort study of 5042 female breast cancer survivors in China. Women aged 20 to 75 years with diagnoses between March 2002 and April 2006 were recruited and followed up through June 2009.  This was the largest study to date to examine the relationship between soy intake, breast cancer recurrence, and survival.  These authors concluded that moderate soy intake was safe, and was associated with lower mortality and recurrence among breast cancer patients.

The bottom line: The latest studies seem to show that consuming soy in moderation appears to not have adverse effects for breast cancer survivors.  There is no evidence to suggest that supplementing with soy beyond normal dietary habit offers any protective effect for women with breast cancer and is not recommended.

As with everything, talk to your medical providers about your individual needs.


Posted in Estrogen, Nutrition | Tagged | 4 Comments

This News is Just Swell

There’s new good news in the world of breast cancer treatment.

A study  authored by Dr. Guilliano (the surgeon who first gave us sentinel node biopsy in 1994) and published in JAMA this past week confirms prior studies showing that axillary dissection does not impact overall survival from breast cancer.  The study confirms what has been debated for many years – that  it’s enough to know whether or not one lymph node is involved with cancer; the surgeon doesn’t need to take any more.  Reviewing the sentinel node status is enough to determine whether a woman will need adjuvant therapy. This study proves that in most cases, the lymph nodes can be left alone even if there are others involved with cancer:  the chemotherapy and radiation therapy will do just as good a job controlling the disease whether or not all the involved lymph nodes are removed. Why is this, you may be asking yourself?White Flower

Because of all the treatment options – surgery, chemotherapy, radiation therapy – it is the chemotherapy that provides the greatest survival benefit.  So for many years, we thought that cutting out as much cancer as possible, including removing every single lymph node that might contain even one cancer cell, would produce the best outcomes.  However, it is chemotherapy that works best to remove cancer cells, including the ones that might have taken up residence in the lymph nodes.  And all that is needed to know about the axillary (or armpit) to determine chemotherapy for many women, is whether or not the sentinel node is positive.

Ok, so its a little late for those women who are struggling with lymphedema (swelling of the nearby area where lymph nodes are removed or radiated, such as the arm for breast cancer).  But, its great news for any woman who will be diagnosed with breast cancer going forward. Now that we know that axillary dissection does not improve overall rates of survival, this invasive surgery, which is known to have numerous complications that can negatively affect womens’ quality of life, will become far less common.

Less lymphedema for the world is a very, very good thing.

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