"NBCC grassroots advo-

cates across the country

are reaching out to organi-

zations, researchers,

elected officials and, yes,

presidential candidates to

endorse Breast Cancer

Deadline 2020®.”

Nancy Ryan, President

NHBCC

Inside This Issue

To Screen or Not To

Screen………………1

A Word from the

President…………...2

In Remembrance….2

NHBCC Thanks

Donors……………...3

Thoughts on Annual

SABCS……………..4

Support Services

Fund………………...8

To Screen or Not To Screen? By Nancy Ryan, President, NHBCC

(Opinions in this article are those of

the author. The New Hampshire

Breast Cancer Coalition does not is-

sue breast cancer screening guide-

lines. NHBCC educates women about

screening controversies and encour-

ages them to make informed deci-

sions about screening.)

In the October 15, 2015, issue of the

Journal of the American Medical As-

sociation, the American Cancer Socie-

ty (ACS) published revised breast

cancer screening guidelines, reigniting

confusion about when and how often

a woman should have mammograms.

The new ACS guidelines recommend

women begin screening at age 45 (up

from age 40) and continue once a

year until age 54, then every other

year for as long as they are healthy

and likely to live another 10 years

(www.cancer.org).

WHO IS AFFECTED BY SCREEN-

ING GUIDELINES?

The breast cancer screening guide-

lines discussed in this article apply to

healthy, asymptomatic women who

are believed to be at average risk for

breast cancer. They do not apply to

women who experience or have expe-

rienced symptoms such as lumps, a

discharge, a strong family history, a

history of radiation to the chest, breast

biopsies or who know they carry a

mutation in the breast cancer genes

BRCA1 or BRCA2.

WHO ISSUES SCREENING GUIDE-

LINES?

At least six organizations, including

ACS, the World Health Organization

(WHO), National Comprehensive

Cancer Network (NCCN), American

College of Radiology (ACR), Ameri-

can College of Obstetricians and Gy-

necologists (ACOG) and the United

States Preventive Services Task

Force (USPSTF) publish breast can-

cer screening recommendations.

Many organizations have different

recommendations. (In the UK, for in-

stance, the UK National Screening

Committee invites women ages 50-70

for screening every three years.) This

variation tells us that there is no magic

age to begin screening or how often to

screen. Controversy is most heated

around the guidelines for women

younger than 50 years of age.

(continued on page 6)

Winter 2016 Volume 22, Number 1

Raising Our Voices New Hampshire Breast Cancer Coalition

2

A Word from the President — Breast Cancer Deadline 2020® Update By Nancy Ryan, President, NHBCC

Launched in 2010, the National Breast

Cancer Coalition’s Breast Cancer

Deadline 2020® is a comprehensive,

strategic plan to know, by January 1,

2020, how to end deaths from breast

cancer. The plan includes science,

legislation and grassroots action.

The scientific

component of

Breast Cancer

Deadline

2020® is the

Artemis Pro-

ject®, focusing

on primary

prevention

(preventing

breast cancer from developing) and

understanding and preventing metas-

tasis (the process by which cancer

cells spread throughout the body).

Artemis participants are ready to begin

the preclinical phase of a preventive

vaccine. The metastasis group is in-

vestigating how the immune system

interacts with dormant tumor cells.

Furthermore, a seed grant was award-

ed “to create a database containing

genomic and clinical data from breast

cancer patients.”

Legislation called “The Accelerating

the End of Breast Cancer Act” (S. 746/

H.R. 1197) will establish a 10-

member, time-limited panel to oversee

the Deadline and to identify promising

research not currently being prioritized

to prevent breast cancer and metasta-

sis. As of January 25, 2016, S. 746

has 49 co-sponsors and H.R. 1197

has 228 co-sponsors. A tip of the hat

to all four members of New Hamp-

shire’s congressional delegation for

becoming co-sponsors of the Acceler-

ating the End of Breast Cancer Act:

Senator Jeanne Shaheen, Senator

Kelly Ayotte, Representative Annie

Kuster and Representative Frank

Guinta.

NBCC grassroots advocates across

the country are reaching out to organi-

zations, researchers, elected officials

and, yes, presidential candidates to

endorse Breast Cancer Deadline

2020®. In New Hampshire, Governor

Maggie Hassan, our entire congres-

sional delegation and nearly fifty mem-

bers of the New Hampshire state leg-

islature have endorsed the Deadline.

Our next president (whoever that may

be) must stand with those who are

calling for an end to breast cancer. My

Iowa colleagues, Christine Carpenter

and Lori Seawel, and I are reaching

out to secure Deadline endorsements

from presidential candidates. As of

January 25, 2016, (in alphabetical or-

der) Jeb Bush, Chris Christie, Hillary

Clinton, Lindsey Graham, Bobby

Jindal, John Kasich and Martin O’Mal-

ley have endorsed the Deadline

(although several have dropped out or

suspended their bid for the presiden-

cy).

To help secure endorsements for

Breast Cancer Deadline 2020®, con-

tact NHBCC at (603) 659-3482.

In Remembrance, Christine Way “Christine P. Way, (nee Mattern), 64, of Stow, MA, died September 17, 2015, after years of making every day count in the face of breast cancer.” This is the first sentence of the obitu-ary for Chris Way, whose sister, Grace Mattern, of Northwood, New Hamp-shire, invited NHBCC to share Chris’ story and blog with our breast cancer community. Chris was originally diag-nosed with breast cancer in 1991 at the age of 40. Following a recurrence in 2010, Chris began posting essays

on a website called “A Cancer Jour-ney With Chris, Thoughts and strug-gles of living with metastatic can-cer” (chriscancerjourney.wordpress.co

m/). In Chris’ own words, she started her blog “to have a public place where people can read the essays on my cancer journey. They are in-tended to provide support to others with difficult medical conditions.”

Reprinted here with permission of Chris’ husband is her April 23, 2015 journal entry called “Doorways.”

Doorways I am in a journaling class to explore my own life. In one of the last ses-sions the class was to pick a picture of a doorway and journal about it. The picture I chose and what I wrote is so relevant and current to my life right now that I was urged by some classmates to share my thoughts. Here in quotes is what I wrote.

“These doors go on and on; they could be infinite. There is a sense that your life can continually change. You don’t stay long in one place but each day brings a new challenge. Life both in the sentient world and the world of energy are in a constant flowing motion.

Pay attention to the space you are in but stay open to all the possibilities to come. It is the small things that matter. It is the becoming that be-comes the being. Always becoming. Pay attention to the process; that is who you are.”

When we journal in class we have a short time on each prompt so often what comes out is so honest. The sentiment above was the constant question from a philosophy professor I had in college. Is life about being or becoming? Since I have been diag-nosed with my cancer it is even clearer to me now than before, that we are in a constant state of change and it is the process that matters. Live life the best you can all the time.

A memorial service for Chris Way was held on Saturday, October 3, 2015 at the First Parish in Concord, Massachusetts.

3

ABTECH, Inc. - Swanzey, NH Alliance Data, Charna Pratt

ANuDu, Hair Salon and Beauty Spa - Lee, NH Bank of New Hampshire - Rochester, NH

Boarding for Breast Cancer - Redondo Beach, CA Concord Country Club - Concord, NH

Crescent Group, LLC, dba McDonald’s Ron Currier’s Hilltop Chevrolet - Somersworth, NH Delhaize American Shared Services Group, LLC -

Statewide Hannaford Supermarkets Duston Country Club Ladies League - Hopkinton, NH

Elavina Salon and Spa - Manchester, NH Fresh of Nashua - Nashua, NH

Gateways Community Services - Nashua, NH Green Envy Salon & Spa - Manchester, NH

Ryan Hadley, Screwballs Softball - Keene, NH Hampshire Family Dental - Raymond, NH

HandCraft Wine by Cheryl Indelicato - Monterey, CA Hollis Brookline (NH) Rotary Club

Kaizen Academy, LLC - Raymond, NH Koehler Landscape Construction Services - Amherst, NH

Lake Sunapee Bank - Sunapee, NH Laliberte Landscaping, LLC - Candia, NH

La-Z-Boy Furniture Gallery & Fallon’s Furniture - Manchester & Merrimack, NH

Lewis’ Towing & Auto Repair - Merrimack, NH Liberty Mutual - Dover, NH

Long Term Care Partners, LLC - Greenland, NH M.S. Walker - Somerville, MA

Macy’s Foundation Manchester High School Central Activity Fund - Manchester, NH

Merchants Automotive Group - Hooksett, NH Muddy Paw Sled Dog Kennel, LLC - Gorham, NH

NH Dept. of Administrative Services, Wellness Committee NH State Assoc. of Emblem Clubs - Hudson, NH

NH Women’s Golf Association, Stephanie Thomas Memorial Golf Tournament - Portsmouth, NH

NHTI, Concord’s Community College ONEHOPE Foundation - Newport Beach, CA

The Pinkerton Academy - Derry, NH Portsmouth Lodge of Elks No. 97 - Portsmouth, NH

Sree J. Raman, DMD PLLC - Manchester, NH Seabrook Girls Softball - Seabrook, NH

Souhegan High School Activity Fund - Amherst, NH Southern NH University Women’s Basketball - Manchester, NH

Unite for HER - Pocopson, PA United Steel Workers of America - Laconia, NH

NHBCC extends a Hearty

“Thank You” The New Hampshire Breast Cancer Coalition expresses deep gratitude to our individual donors and for the many community

fundraisers that support our mission. Listed here are the corporations, businesses and individuals whose unique community

fundraising activities or grants during 2015 provided critical financial support for NHBCC.

4

Thoughts on the 38th Annual SABCS

By Nancy Ryan, President, NHBCC

The 38th Annual San Antonio Breast

Cancer Symposium (SABCS), held from

December 8th to December 12th, 2015,

hosted over 7,500 attendees from over

95 countries. With hundreds of posters,

dozens of research presentations, ple-

nary lectures, “Hot Topics” sessions for

advocates and networking opportunities,

the information was overwhelming. As I

navigated the symposium, one word

kept coming to mind: complexity.

Research is revealing breast cancer to

be a far more complex disease than

when I was diagnosed in 1989. For

many years breast cancer treatment

decisions were based on tumor size,

lymph node status, tumor grade (how

abnormal the tumor cells and tissue look

under a microscope) and hormone re-

ceptor status (hormone receptors are

proteins that may signal cells to grow).

Treatment was often a “one size fits all.”

Today, patient education, research de-

sign and treatment decisions are im-

pacted by a deeper understanding of

cancer biology, genetics, complex bio-

logical pathways, treatment toxicities

and immunotherapy. All this, and more,

was presented at the 2015 SABCS.

SUBTYPES

Today, breast cancer is generally

grouped into four subtypes based on

many factors. The four subtypes, ac-

cording to hormonal status, are:

Luminal A: characterized as being estro-

gen receptor positive and/or progester-

one receptor positive (ER-positive and/

or PR-positive), HER2-negative (HER2

is the human epidermal growth factor

receptor 2, which promotes cancer cell

growth).

Luminal B: ER-positive and/or PR-

positive and HER2-positive.

Triple Negative (also called basal-like):

ER-negative, PR-negative, and HER2-

negative.

HER2 type: ER-negative, PR-negative

and HER2-positive.

One example of research involving sub-

types was presented from a Danish

Breast Cancer Cooperative Group study

hinting “chemotherapy improved DFS

(disease free survival) in 468 non-

Luminal A patients, but had no benefit in

165 Luminal A patients.” Aleix Prat, MD,

Ph.D., a medical oncologist, comment-

ed, “Results of this new study show us

that not only are subtypes prognostic,

but also predictive of chemotherapy

benefit.” The study sample was small

and based on tissue samples collected

25 years ago. Still, the finding may war-

rant further investigations of patients (by

subtype) treated with more current

chemotherapy to learn who might safely

forego toxic treatments.

GENOMIC ASSAYS

These are tests that analyze the activity

of multiple genes in early stage breast

cancer to predict treatment response

and/or outcome, which helps to guide

treatment. Several genomic tests are in

use for breast cancer including Onco-

type DX®, MammaPrint, Mammostrat

and Prosigna assay. Each test analyz-

es the activity of a unique, different

number of genes. Genomic Health, Inc.,

developers of the Oncotype DX® ge-

nomic test that analyzes the activity of

21 genes from a patient’s own tumor,

announced in San Antonio the results

from multiple studies that reconfirm this

test accurately predicts clinical out-

comes in patients with early stage, inva-

sive breast cancer.

Genomic Health, Inc. has also devel-

oped a diagnostic test for patients diag-

nosed with ductal carcinoma in situ

(DCIS). DCIS is the presence of abnor-

mal cells in the ducts, which have not

invaded other parts of the breast. An

estimated 60,000 women in the US are

diagnosed with DCIS annually. Because

we cannot predict which women with

DCIS will subsequently develop invasive

cancer, most patients are treated with

surgery often followed by radiation and

hormonal therapy. The Oncotype DX®

test for DCIS is an assay that examines

tissue removed during surgery to help

determine which women might subse-

quently develop invasive cancer and

therefore need more treatment, and

which women can safely forgo addition-

al treatment.

NEO-ADJUVANT TREATMENT

Neo-adjuvant treatment is chemothera-

py administered before surgery and in-

cludes subsequent evaluation of the

tumor response. A pCR or “pathologic

complete response” indicates no active

cancer cells remain. One presentation

considered patients with HER2-negative

breast cancer who received neo-

adjuvant chemotherapy, but, unfortu-

nately, were found to have residual dis-

ease when surgery was performed.

A study from Japan (CREATE-X or

Capecitabine for Residual Cancer as

Adjuvant Therapy) showed that adding

capecitabine (Xeloda) to adjuvant thera-

py following surgery extended disease-

free and overall survival for these pa-

tients. The study raised concerns be-

cause capecitabine is “quite toxic” ac-

cording to Steven Vogl, MD, a breast

cancer specialist from New York City.

This study exemplifies the increasing

complexity of risks and benefits by intro-

ducing neo-adjuvant treatment.

(continued on page 5)

5

(SABCS, cont. from page 4)

TOXICITIES

Some breast cancer treatments (such

as Herceptin®, a targeted treatment for

patients whose cancer cells make too

many copies of the gene HER2) in-

crease the likelihood of cardiovascular

damage in patients with early-stage

breast cancer. A five-year study by re-

searchers at the University of Alberta

and Alberta Health Services (the MAN-

TICORE trial, Multidisciplinary Approach

to Novel Therapies in Cardiology Oncol-

ogy Research) showed that beta-

blockers and ACE inhibitors (heart med-

ications) help prevent a drop in heart

function from cancer treatment. This is

doubly important because it may allow

the patient to continue treatment unin-

terrupted and also prevent heart failure.

Co-investigator Dr. Edith Pituskin noted,

“We think this is practice-changing…

This will improve the safety of the can-

cer treatment that we provide.” Other

attendees suggested “practice-

changing” potential is there, but more

study is needed.

In her summary of the symposium,

Carol Matyka (Massachusetts Breast

Cancer Deadline Action Network) noted,

“The good news: growing evidence that

we can reduce/eliminate toxic treat-

ments like chemo and radiation for

SOME breast cancers. The challenge:

Identifying the individual patients who

will or will not benefit from these treat-

ments.”

IMMUNOTHERAPY

Immunotherapy has interested cancer

researchers on and off for decades, but

is currently receiving much attention.

Some research focuses on checkpoint

inhibitors, a class of agents that inhibit

pathways that block the body’s immune

response to foreign cells, freeing up the

immune system to attack and kill tu-

mors. In MedPage Today, staff writer

Charles Bankhead summarized a pre-

liminary, small clinical study from the

SABCS meeting showing that a sub-

group of patients with advanced hor-

mone-sensitive breast cancer had

“infrequent but durable responses to the

immune checkpoint inhibitor pembroli-

zumab (Keytruda).” Another investiga-

tional antibody called atezolizumab led

to “confirmed objective responses in 10

of 24 patients when used in combination

with nab-paclitaxel (Abraxane).” These

are small studies, but indicative of this

very active, and complicated, area of

research.

EDUCATION

With so many variables, educating pa-

tients and the general public about

breast cancer research and treatment is

also becoming more complex. For in-

stance, symposium attendees cited the

rising rates of mastectomy in the United

States (including bilateral mastectomy)

despite evidence reaching back to clini-

cal trials conducted in the 1980’s show-

ing equivalent survival with lumpectomy

plus radiation for early breast cancer.

But in one SABCS presentation, a re-

view of insurance claims for breast sur-

gery from 2000 to 2011 revealed,

“Mastectomy with reconstruction is more

costly and has more complications after

surgery than lumpectomy with whole-

breast irradiation, while the rate of can-

cer recurrence and survival is essential-

ly the same under both regi-

mens.” (Mastectomy No Better Than

Lumpectomy For Early Breast Cancer,

National Public Radio, December 10,

2015).

This trend towards more mastectomies

is worrisome. In the symposium’s Wil-

liam L. McGuire Memorial Lecture, Nor-

man Wolmark, MD, cited social media’s

role in medical decision-making. Are

patients distrustful of scientific evidence

or their physicians (and more likely to

believe what they read on Facebook or

Twitter)? Or are they fueled by fear? As

Susan Love, MD, wrote in her SABCS

summary, “We seem to be losing our

respect for science.”

FINAL THOUGHT

This article covers only the tip of the

“research iceberg” presented at the

2015 SABCS. The complexity of breast

cancer research, treatment and educa-

tion underscores the urgency of Breast

Cancer Deadline 2020®, the National

Breast Cancer Coalition’s comprehen-

sive, strategic plan to know, by January

1, 2020, how to end deaths from breast

cancer. Many of the SABCS presenta-

tions focused on treatment. Breast Can-

cer Deadline 2020® focuses on primary

prevention and understanding and pre-

venting metastasis — the two areas of

research where progress will, indeed,

save the most lives.

To read more about the 2015 San Antonio Breast

Cancer Symposium, here are several helpful re-

sources: https://www.sabcs.org/Resources

http://www.cancertodaymag.org/EventCoverage/

Pages/toc.aspx

http://www.medpagetoday.com/MeetingCoverage/

SABCS

Volunteers

Welcome

Thanks to many of you, news of the

good work that NHBCC is doing in

New Hampshire has spread. While

this is very exciting, it also creates

challenges.

As a grassroots, all volunteer organi-

zation, we are often in need of more

helping hands including help repre-

senting NHBCC at local events and

interest in future Board positions. If

you would like to support NHBCC

with the precious gifts of your time

and talent, please give us a call at

(603) 659-3482 or email: NancyAlic-

eR@cs.com. As always, thank you

for supporting NHBCC.

6

(To Screen or Not to Screen cont. from page 1)

RESPONSE TO THE ACS GUIDE-

LINES

The response to the new ACS guide-

lines was predictable. Screening propo-

nents were up in arms. Others, citing

analyses by the US Preventive Services

Task Force (USPSTF) and the

Cochrane Collaboration, noted that

mammograms have not resulted in the

breast cancer mortality reduction we

hoped for twenty or thirty years ago.

Donald Berry, a biostatistician at the MD

Anderson Cancer Center in Houston,

Texas, stated in The Cancer Letter

(October 23, 2015), “Rather than picking

an arbitrary starting age, the most hon-

est recommendation we can make to

women is that we don’t know what to

recommend. We should help them un-

derstand why that is so by communi-

cating in an unbiased fashion the pros

and cons of screening depending on

age…and the associated uncertainties.”

Also in the Cancer Letter (October 23,

2015), Otis Brawley, MD, FACP, chief

medical officer for the ACS, stated, “In

the case of mammography for breast

cancer, there have been years of overly

simplistic messaging hyping the benefits

and not recognizing the limitations.”

UNITED STATES PREVENTIVE SER-

VICES TASK FORCE

The revised ACS guidelines come clos-

er to those recently updated by the US

Preventive Services Task Force

(USPSTF). Created in 1984, the

USPSTF is an “independent, volunteer

panel of national experts in prevention

and evidence-based medicine.” The

USPSTF provides rigorous reviews and

independent analyses, free of conflict-of

-interest, to help physicians and patients

decide what is right for them. The

USPSTF published its revised “Final

Recommendations” in the Annals of In-

ternal Medicine on January 12, 2016:

“The USPSTF recommends biennial

screening mammography for women

aged 50 to 74 years. The decision to

start screening mammography in wom-

en prior to age 50 years should be an

individual one. Women who place a

higher value on the potential benefit

than the potential harms may choose to

begin biennial screening between the

ages of 40 and 49 years. The USPSTF

concludes that the current evidence is

insufficient to assess the balance of

benefits and harms of screening mam-

mography in women aged 75 years or

older.” (http://

screeningforbreastcancer.org/)

The omnibus government spending bill

passed by Congress in December 2015

includes language from the “Protecting

Access to Lifesaving Screenings

Act” (PALS Act) mandating a two-year

moratorium on the implementation of the

recommendations by the USPSTF on

breast cancer mammography screening.

Unfortunately, in my opinion, the mora-

torium reflects a disregard for the integ-

rity and independence of the very agen-

cy created to review the evidence for

effectiveness of clinical preventive ser-

vices and to develop recommendations

for these services.

The National Breast Cancer Coalition

(NBCC) issued this statement in re-

sponse to the updated USPSTF guide-

lines:

“We at NBCC support the final breast

cancer screening recommendations by

the USPSTF and view them as good

news for women. The USPSTF guide-

lines, among the many other versions

out in the public, best reflect the actual

science of population screening. The

recommendations also are in keeping

with NBCC’s long-held position that the

public should be given much more infor-

mation about the harms and benefits of

mammography screening so that wom-

en can make better informed decisions.”

COCHRANE COLLABORATION

The Cochrane Collaboration has also

conducted rigorous analyses of breast

cancer screening trials. The Cochrane

Collaboration comprises a group of

37,000 contributors from more than 130

countries who “work together to produce

credible, accessible health information

that is free from commercial sponsor-

ship and other conflicts of interest.”

Among other conclusions, the Cochrane

Collaboration offers the following per-

spective on screening for breast cancer

(http://www.cochrane.org/CD001877/

BREASTCA_screening-for-breast-

cancer-with-mammography):

If we assume that screening reduces

breast cancer mortality by 15% and that

overdiagnosis and overtreatment is at

30%, it means that for every 2000 wom-

en invited for screening throughout 10

years, one will avoid dying of breast

cancer and 10 healthy women, who

would not have been diagnosed if there

had not been screening, will be treated

unnecessarily. Furthermore, more than

200 women will experience important

psychological distress including anxiety

and uncertainty for years because of

false positive findings…Recent observa-

tional studies show more overdiagnosis

than in the (earlier) trials and very little

or no reduction in the incidence of ad-

vanced cancers with screening.

WHAT ABOUT DUCTAL CARCINOMA

IN SITU (DCIS)?

Ductal carcinoma in situ (DCIS) is a

term to describe abnormal cells growing

in the ducts that may or may not pro-

gress to invasive breast cancer. Be-

cause women are living longer and

more women are having mammograms,

the incidence of DCIS increased over

seven-fold from 1980 to 2007 (National

Breast Cancer Coalition). The ACS esti-

mates that about 60,000 US women

receive this diagnosis annually.

(continued on page 7)

7

(To Screen or Not to Screen cont. from page 6)

Because we cannot tell which women

with DCIS will subsequently develop

invasive breast cancer and which DCIS

can safely be left alone, we treat all

these women with surgery and often

radiation and hormonal therapy. This

can lead to “overtreatment,” which may

come with significant harms. Despite the

uptick in DCIS diagnoses, the number of

invasive breast cancer diagnoses is not

dropping (National Breast Cancer Coali-

tion). Even with the addition of newer

technologies, such as 3-D mammogra-

phy (breast tomosynthesis), we do not

know if finding and treating all these

DCIS lesions will affect mortality.

BIOLOGY MATTERS

Not all breast cancers are alike. Sharon

Begley, writing in the Boston Globe

(October 20, 2015), summarized what

we know about screening this way:

It turns out that some cancers detected

by mammograms would never have

posed a threat to a woman’s health or

life. Others are so slow-growing that

even if they’re not detected until they

cause symptoms, they’re treatable. Still

others are so aggressive that even

catching them early is too late.

SHARED DECISION MAKING

The New Hampshire Comprehensive

Cancer Collaboration (NHCCC) has

convened a team of volunteers who are

working to educate New Hampshire citi-

zens about the value of Shared Deci-

sion Making in health care. The In-

formed Medical Decisions Foundation

(http://

www.informedmedicaldecisions.org/)

defines Shared Decision Making (SDM)

this way:

Shared decision making (SDM) is a col-

laborative process that allows patients

and their providers to make health care

decisions together, taking into account

the best scientific evidence available, as

well as the patient’s values and prefer-

ences. SDM honors both the provider’s

expert knowledge and the patient’s right

Make checks payable to: NH

Breast Cancer Coalition.

Mail to: NHBCC, 18 Belle Ln,

Lee NH 03861-6438 or

donate via PayPal at

www.nhbcc.org.

NHBCC welcomes your partic-

ipation even if you are unable

to contribute this year.

NHBCC is a non-profit, tax

exempt organization. All dona-

tions are tax deductible.

SUPPORT THE NEW HAMPSHIRE

BREAST CANCER COALITION TODAY

I would like to receive NHBCC news and updates.

I am willing to help on NHBCC projects or committees.

Enclosed is my financial contribution to support NHBCC’s mission and work.

Name (print)_______________________________________________________

Street/Apt.________________________________________________________

City____________________________ State_____________ Zip_____________

Email Address_____________________________________________________

Telephone Number _________________________________________________

Enclosed is: ___$20 ___$50 ___$100 ___$200 ___OTHER

to be fully informed of all care op-

tions and the potential harms and

benefits.

In my opinion, any way you look at

the data, the benefits of mammogra-

phy are modest for women under 50,

increase as a woman ages and are

unknown for women ages 75 and

older. Cancer screening recommen-

dations do vary and change over

time. This is why it is so important to

make your decisions about screen-

ing in consultation with a trusted

health care provider.

For additional viewpoints about screening for

breast cancer, visit these websites:

http://www.uspreventiveservicestaskforce.org/

Page/Document/UpdateSummaryFinal/breast-

cancer-screening1

http://www.acr.org/About-Us/Media-Center/

Press-Releases/2015-Press-

Releases/20151020-ACR-SBI-Recommend-

Mammography-at-Age-40

http://bcaction.org/resources/breast-cancer-

action-toolkits/

http://nordic.cochrane.org/mammography-

screening-leaflet

18 Belle Lane | Lee, NH 03861-6438

Change Service Requested

PLACE STAMP HERE

Support Services Fund Update Since NHBCC designed and launched the Support Services Fund

(SSF) in 2006, we have assisted over 500 New Hampshire breast

cancer patients navigate difficult and trying financial crises during

their breast cancer treatment. The SSF is a fund of last resort for

women, men and families who need help paying for the basic neces-

sities of daily living, so they can focus on their breast cancer treat-

ment and getting well. A month’s rent, heating oil or propane, utilities,

car repair, child-care, a medical co-pay or COBRA — expenses

many of us take for granted — are a few of the expenses that the

SSF covers. This program is made possible only by the support and

generosity of individuals, businesses and corporations who want to

help. As an all-volunteer organization, NHBCC puts every SSF dollar

to use immediately to assist patients and make a meaningful differ-

ence in their lives. If you, or someone you know, is battling breast

cancer and might need financial assistance from the NHBCC Sup-

port Services Fund, visit our web site (nhbcc.org) to download an

application form. Complete the one page application and take it to

your social worker to sign. NHBCC is here to help.

Year Amount

Requested Amount Authorized

2014 $172,578 $82,000

2013 $ 67,126 $45,069

2012 $204,955 $47,631

2011 $112,070 $60,018

2010 $180,777 $36,922

2009 $ 28,076 $11,629

2008 $ 88,168 $12,881

NHBCC receives requests for more financial expenses than

we are currently capable of fulfilling. With your support,

NHBCC can provide additional critical financial aid to

breast cancer patients in need. To help, visit

www.nhbcc.org.