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Heather Flanagan, ARNP-C
mybreastcanceranswers (Nurse (Verified) )| Communities: Breast Cancer | Answers: 15 |
| Member Since: Oct. 2011 |
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Professional Statement
Founder of mybreastcanceranswers.com to help women navigate their breast cancer journey and know what questions to ask.
Professional Info
Credential: APN
State Licenses: FL
Specialty: Oncology
Languages: English
Gender: Female
Nursing school: University of Florida
Areas of expertise:
Surgical Oncology
Oncology
Family Health
Research interests: Breast cancer
Webpage:
www.mybreastcanceranswers.com
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Personal Bio (My story)
Heather Flanagan, ARNP-C is a board certified family nurse practitioner in the state of Florida. She graduated from the University of Florida in 2007 with a master’s degree in nursing and attended the University of South Florida where she received a bachelor’s degree in nursing science in 2004. Ms. Flanagan’s nursing experience has been in women’s health and oncology. Currently she works for a private practice breast surgeon in Brandon, Fl and assists in the care of women with breast abnormalities and breast cancer. She has always taken a special interest in education and patient advocacy and via this interest she created My Breast Cancer Answers please link to www.mybreastcanceranswers.com). Her website is dedicated to providing women with factual knowledge to assist them when going through breast surgeries, biopsies, and diagnostic testing. Ms. Flanagan hopes her website will enhance a person’s relationship with their healthcare provider by allowing them to know what questions to ask so they can receive optimal care. Her mission is to provide people with the knowledge to make themselves an advocate for their healthcare. From mammograms to breast MRI’s to breast pathology make sure you check out www.mybreastcanceranswers.com to become an advocate for your breast health.
mybreastcanceranswers Activities
Molecular breast imaging is also known as breast specific gamma imaging or BSGI. Molecular breast imaging is promising as it can find cancers with a sensitivity of less than 3mm (this is better than MRI). The drawback is the high level of radiation currently associated with MBI. There are many centers working on the technology of MBI to get the radiation level of MBI to an acceptable dose. I look forward to this advancement as I feel it would be an excellent, more sensitive screening test once the radiation level is lowered. Here is my overview of BSGI.
BSGI stands for breast specific gamma imaging. BSGI is a fairly new technique that involves injecting a radioactive substance technetium (t-99) into a patient's veins and then scanning their breast with a gamma camera.
The gamma camera takes images of the breast and the areas where the radioactive substance has concentrated (this may indicate a breast cancer) will show up darker.
Pros of BSGI are increased sensitivity for detecting tumors at a smaller size than other available imaging techniques.
Cons of BSGI are the higher amount of radiation the person is exposed to during the test.
Some considerations: This test is reasonable for a person to have performed if they are first diagnosed with breast cancer to assess for occult cancers in either breast. Another scenario is a person who cannot have an MRI but requires a more sensitive test. Currently this is NOT a test for women to have yearly, too much radiation!
To read more in depth information on BSGI please visithttp://www.mybreastcanceranswers.com/bsgi-breast-specific-gamma-imaging
Resources:
http://www.medscape.com/viewarticle/727881
http://www.gm-ideas.com/
www.dilon.com
BSGI stands for breast specific gamma imaging. BSGI is a fairly new technique that involves injecting a radioactive substance technetium (t-99) into a patient's veins and then scanning their breast with a gamma camera.
The gamma camera takes images of the breast and the areas where the radioactive substance has concentrated (this may indicate a breast cancer) will show up darker.
Pros of BSGI are increased sensitivity for detecting tumors at a smaller size than other available imaging techniques.
Cons of BSGI are the higher amount of radiation the person is exposed to during the test.
Some considerations: This test is reasonable for a person to have performed if they are first diagnosed with breast cancer to assess for occult cancers in either breast. Another scenario is a person who cannot have an MRI but requires a more sensitive test. Currently this is NOT a test for women to have yearly, too much radiation!
To read more in depth information on BSGI please visithttp://www.mybreastcanceranswers.com/bsgi-breast-specific-gamma-imaging
Resources:
http://www.medscape.com/viewarticle/727881
http://www.gm-ideas.com/
www.dilon.com
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Breast Cancer Screening, Breast Imaging, Molecular Breast Imaging, Mammography
1
Answer |
1 year ago
Oncotype DX is a test designed for women with an early stage breast cancer, negative lymph nodes, and estrogen receptor positive breast cancer. The purpose of Oncotype DX is to determine whether seemingly low risk women, per their diagnosis, would benefit from chemotherapy.
If a person has a more advanced stage of breast cancer, positive lymph nodes, triple negative breast cancer, or another factor that would require chemotherapy then the oncologist does not order Oncotype DX because they already know the person requires chemotherapy.
So in your case I think you do not need the Oncotype DX because you are already having chemotherapy.
You may want to read more about Oncotype DX at the Genomics website...
http://www.genomichealth.com/en-US/OncotypeDX.aspx
Thanks,
Heather
If a person has a more advanced stage of breast cancer, positive lymph nodes, triple negative breast cancer, or another factor that would require chemotherapy then the oncologist does not order Oncotype DX because they already know the person requires chemotherapy.
So in your case I think you do not need the Oncotype DX because you are already having chemotherapy.
You may want to read more about Oncotype DX at the Genomics website...
http://www.genomichealth.com/en-US/OncotypeDX.aspx
Thanks,
Heather
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Oncotype DX, Breast Cancer Tests, Breast Cancer, Tests, Chemotherapy
1
Answer |
1 year ago
Your surgeon or oncologist would be the best resources to explain your pathology report. It is helpful to obtain a copy of the final pathology report and write down the questions you have about the report prior to your appointment. This way you go into your appointment prepared to have a discussion with your healthcare provider.
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Communication, Pathology, Pathology Report, Doctor Communication
1
Answer |
1 year ago
Debbie,
This is an excellent question...due to HIPPA laws we can only speak with the patient's family members that are listed on the patient's chart regarding the patient's specific case.
Usually I recommend everyone write their questions down to bring into the patient's appointment. This includes spouse, children, sibling, etc questions.
Unfortunately, I find that many times children are left out of the equation unless they are adult children. It is very important for all close family members to understand the patients condition and proposed treatment.
I personally am only able to answer questions of those family members who come in or call with questions and as said before they must be on the approved patient's HIPPA list.
This is an excellent question...due to HIPPA laws we can only speak with the patient's family members that are listed on the patient's chart regarding the patient's specific case.
Usually I recommend everyone write their questions down to bring into the patient's appointment. This includes spouse, children, sibling, etc questions.
Unfortunately, I find that many times children are left out of the equation unless they are adult children. It is very important for all close family members to understand the patients condition and proposed treatment.
I personally am only able to answer questions of those family members who come in or call with questions and as said before they must be on the approved patient's HIPPA list.
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Communication, Family Communication, Family Members
1
Answer |
1 year ago
It all depends on the lab...I have worked with one lab who has a 48 hour turn around period. I feel a more realistic time period is 3-5 days and this is what I tell my patients. This time will account for any holidays, non working days, or delay at the lab. This is based on my personal experience with a variety of labs.
Always ask your healthcare provider for their estimated time period based on the lab where they will be sending your specimen.
Thanks,
Heather
Always ask your healthcare provider for their estimated time period based on the lab where they will be sending your specimen.
Thanks,
Heather
1
Answer |
1 year ago
I suggest that you see your breast specialist (surgeon) to have the area assessed. The lumps could likely be related to scar tissue, but you always want to err on the side of caution and make sure they are not a recurrance.
As for the underam arm ache...
Make sure you have full range of motion in that arm if it is the one where your lymph nodes where removed. Likely it is scar tissue or something like that but you should see a healthcare provider to determine if there could be other causes for this aching.
Thanks,
Heather
As for the underam arm ache...
Make sure you have full range of motion in that arm if it is the one where your lymph nodes where removed. Likely it is scar tissue or something like that but you should see a healthcare provider to determine if there could be other causes for this aching.
Thanks,
Heather
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Lump In Breast, Breast Cancer, Potential Symptoms, Symptoms, Aches, Lumps, Survivor
1
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1 year ago
1) 3D mammograms are also called tomosynthesis and they are superior to 2D (regular) mammograms. This type of imaging is a special kind of mammogram that produces a 3D image of the breast. The image is obtained by using several low dose x-rays taken at different angles. The breast is compressed similar to the way it is for a mammogram except the x-ray tube moves in a circular arc around the breast; the imaging is completed in less than 10 seconds.
The reasons tomosynthesis is superior to 2D mammograms are:
Less breast compression (less discomfort)
Shorter length of time for test to be completed (10 seconds vs. several minutes)
More pictures are obtained in multiple different angles of the breast (more accurate)
A 3D image makes it easier to find an abnormality than traditional mammogram.
2) There are some discrepancies in the difference in amount of radiation exposure between standard mammogram versus 3D mammogram.
According to the American College of Radiology there is about twice the amount of radiation in a 3D mammogram but “it improved the accuracy with which radiologists detected cancers, decreasing the number of women recalled for a diagnostic workup.”
A study published in Radiographics, peer-reviewed journal, lists the radiation dose of tomosynthesis at 145 mrad.
Just an fyi, the National Cancer Institute lists an average two-view mammogram as delivering 200-400mrad.
Everything I read and studied listed the doses for 3D mammogram as being under 300mrad (see resources below).
Thanks,
Heather
Resources:
http://www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional/page6
http://www.acr.org/SecondaryMainMenuCategories/NewsPublications/FeaturedCategories/CurrentACRNews/FDA-approves-first-3-d-mammography-system.aspx
http://radiographics.rsna.org/content/27/suppl_1/S231.full#sec-2
http://www.acrin.org/PATIENTS/ABOUTIMAGINGEXAMSANDAGENTS/ABOUTMAMMOGRAPHYANDTOMOSYNTHESIS.aspx
The reasons tomosynthesis is superior to 2D mammograms are:
Less breast compression (less discomfort)
Shorter length of time for test to be completed (10 seconds vs. several minutes)
More pictures are obtained in multiple different angles of the breast (more accurate)
A 3D image makes it easier to find an abnormality than traditional mammogram.
2) There are some discrepancies in the difference in amount of radiation exposure between standard mammogram versus 3D mammogram.
According to the American College of Radiology there is about twice the amount of radiation in a 3D mammogram but “it improved the accuracy with which radiologists detected cancers, decreasing the number of women recalled for a diagnostic workup.”
A study published in Radiographics, peer-reviewed journal, lists the radiation dose of tomosynthesis at 145 mrad.
Just an fyi, the National Cancer Institute lists an average two-view mammogram as delivering 200-400mrad.
Everything I read and studied listed the doses for 3D mammogram as being under 300mrad (see resources below).
Thanks,
Heather
Resources:
http://www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional/page6
http://www.acr.org/SecondaryMainMenuCategories/NewsPublications/FeaturedCategories/CurrentACRNews/FDA-approves-first-3-d-mammography-system.aspx
http://radiographics.rsna.org/content/27/suppl_1/S231.full#sec-2
http://www.acrin.org/PATIENTS/ABOUTIMAGINGEXAMSANDAGENTS/ABOUTMAMMOGRAPHYANDTOMOSYNTHESIS.aspx
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) 3D Breast Imaging, Breast Cancer Screening, Radiation, Mammogram, Breast Imaging, 3d Mammography
1
Answer |
1 year ago
mybreastcanceranswers (Nurse (Verified)) asked the question in topic(s) Breast Cancer Tests, Breast Cancer, Assay Tests, Tests, Cancer Tests
2
Answers |
1 year ago
If you have symptoms that are worrisome of IBC or Paget's disease of the breast it is important that you have a skin/punch biopsy to rule out this diagnosis.
I would urge any woman who is experiencing symptoms to get a second opinion such as seeing another pcp or even going to a dermatologist. If your insurance does not require referrals make an appointment to see a breast specialist/surgeon. Do NOT ignore any symptoms because every person has a different severity in their presentation of IBC or Paget's disease of the breast.
Hope that helps.
Heather
www.mybreastcanceranswers.com
I would urge any woman who is experiencing symptoms to get a second opinion such as seeing another pcp or even going to a dermatologist. If your insurance does not require referrals make an appointment to see a breast specialist/surgeon. Do NOT ignore any symptoms because every person has a different severity in their presentation of IBC or Paget's disease of the breast.
Hope that helps.
Heather
www.mybreastcanceranswers.com
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Inflammatory Breast Cancer Symptoms, Inflammatory Breast Cancer, Breast Cancer, Symptoms, Doctor-Patient Relationship, Doctor Communication, Breast Cancer Symptoms
1
Answer |
1 year ago
The registration is necessary should there ever be a recall or problem with the implant then the company can find out which people have the affected implant.
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Breast Implants, Silicone Breast Implants, Breasts
1
Answer |
1 year ago
mybreastcanceranswers (Nurse (Verified)) asked the question in topic(s) Nipple Sparing Mastectomy, Nipple Sparing Mastectomy Contraindications, Contraindications, Breast Surgery, Surgery, Mastectomy
1
Answer |
1 year ago
What about BSGI or PEM? Are you talking about what if the DCIS is generalized or contained in one spot?
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Breast Cancer, Mammogram, Diagnostic Tools, Breast Cancer Diagnosis
2
Answers |
1 year ago
mybreastcanceranswers (Nurse (Verified)) asked the question in topic(s) Inflammatory Breast Cancer, Inflammatory Breast Cancer Clinical Trials, Clinical Trials, Breast Cancer Clinical Trials
1
Answer |
1 year ago
mybreastcanceranswers (Nurse (Verified)) asked the question in topic(s) Inflammatory Breast Cancer, Breast Cancer, Inflammatory Breast Cancer Pictures, Breast Cancer Pictures
2
Answers |
1 year ago
mybreastcanceranswers (Nurse (Verified)) asked the question in topic(s) Breast Surgery Side Effects, Movement Problems, Breast Surgery, Muscle Problems, DIEP Flap Breast Reconstruction, Surgery Side Effects, Nerve Problems
1
Answer |
1 year ago
mybreastcanceranswers (Nurse (Verified)) asked the question in topic(s) Breast Surgery, Breast Reconstruction, Surgery, Diabetic, DIEP Flap Breast Reconstruction
1
Answer |
1 year ago
You will learn if you have a gene mutation on BRCA1 or 2. Just b/c you are negative does not mean you do not have some type of genetic predisposition for breast cancer, just means you do not have that specific mutation.
Check out my section on BRCA as its very informative
http://www.mybreastcanceranswers.com/brca/brca
Heather
www.mybreastcanceranswers.com
Check out my section on BRCA as its very informative
http://www.mybreastcanceranswers.com/brca/brca
Heather
www.mybreastcanceranswers.com
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) BRCA-1, Genetics, Genetic Tests, BRCA-2, Genes
1
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1 year ago
I would only share what you feel comfortable with and only share it with those you trust. You never have to share personal info to anyone at work and sometimes sadly sharing may place you at a disadvantage. I would keep quiet until you are hired and feel as though you can trust those around you. Best of luck to you in your decision may it turn out the best for you!
Heather
www.mybreastcanceranswers.com
Heather
www.mybreastcanceranswers.com
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Client, Career, Work, Personal Health Information, Job, Employer, Privacy
1
Answer |
1 year ago
It should not be a problem as it doesn't interfere with your ability to move/perform your job. You never have to tell your employer/future employer about your cancer status if you do not feel comfortable. You may want to mention you had a surgery that made you likely to build up fluid in your arm and you have a special sleeve you must wear. What types of questions have you been asked specifically?
Heather
www.mybreastcanceranswers.com
some helpful links for lymphedema
http://www.mybreastcanceranswers.com/the-latest-and-greatest-news/a-newtool-may-predict-lymphedema-risk-before-symptoms-appear
http://www.mybreastcanceranswers.com/lymphedema/lymphedema
Heather
www.mybreastcanceranswers.com
some helpful links for lymphedema
http://www.mybreastcanceranswers.com/the-latest-and-greatest-news/a-newtool-may-predict-lymphedema-risk-before-symptoms-appear
http://www.mybreastcanceranswers.com/lymphedema/lymphedema
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Workplace, Career, Compression Sleeve, Work, Employer, Workplace Tips
1
Answer |
1 year ago
redness, hot to the touch, hard feeling, green drainage, fever and/or chills, pain that gets worse not better after surgery. Remember to contact your surgeon if you notice any new symptom.
Heather
www.mybreastcanceranswers.com
Heather
www.mybreastcanceranswers.com
New answer by mybreastcanceranswers (Nurse (Verified)) in topic(s) Infection, Surgery, Infection Symptoms
1
Answer |
1 year ago
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