For breast cancer patient, the touch of a hand made the difference

YeseniaHelping our community right here in Tucson get and stay healthy and keep on dancing is what Tucson Medical Center is all about. We’re showing off some of our fabulous community members in our latest commercials and you get to find out a little more about them here on our blog. Meet TMC dancer, Yesenia Lopez.

The last time Yesenia Lopez had surgery, she was 15 and having a tonsil removed.

But here she was, about to have surgery to remove cancer that was diagnosed when her doctors found a lump in her breast.

“What helped the most in that moment was the nurse holding my hand when they were putting me under,” Lopez recalled. “She said, ‘Everything is going to be OK. I will follow you all the way into surgery.’ She was still there at recovery and she stayed with me from the time I went under until the time I woke up.”

When Lopez found she had cancer, she knew she would come to TMC. It’s where she brought her two children, now grown, when they were sick. “TMC is a big part of our world as a family,” she said, adding her recovery in the hospital was great, with her husband of 27 years by her side. “We received really good treatment there. And I know people will say what they will about hospital food, but the food was good!”

Lopez has refocused on her health, including losing a few extra pounds and taking up hiking.

What would she tell a woman recently diagnosed with breast cancer?

“A lot of people worry from the time they get diagnosed, but when you get a good staff working with you and guiding you, it makes the worry go away,” she said, noting she has already referred friends with breast cancer to her surgical oncologist, Dr. Michele Boyce Ley.

“I would tell them that it’s a long journey and you have to have patience, but with the right team of doctors, and the right staff at the right hospital, the journey is much easier. I’ve been blessed. This has been a hiccup and I’m looking forward to life even more now.”

Breast cancer survivor spreading a message of body positivity

BethAnne King LobmillerBreastless and beautiful

When breast cancer survivor and advocate BethAnne King-Lobmiller was just 10 or 11 years old, she recalls accidentally barging in on her grandmother as she was changing her blouse. “I must have gasped or looked shocked … but she just smiled and invited me to come in and close the door. Then she explained to me why she didn’t have breasts.”

“She had a bilateral mastectomy in the 1970s, back when cancer surgery was radical and went deep, and as a result, she was completely flat.” King-Lobmiller recalls with a smile. “I had never noticed that she wore fake boobs – she even wore smaller ones in the summer to stay cooler – and none when she was in her pajamas.”

Possibly in part as a result of her grandmother’s unapologetic honesty and generosity in sharing her experience, King-Lobmiller dedicates herself to advocating for body-positivity after breast cancer. Breastless and Beautiful, the advocacy group she started, boasts more than 300 members and exists for women who have chosen not to undergo reconstruction after a mastectomy. Says King-Lobmiller, “I didn’t choose flat, it chose me … as corny as that sounds.”

But the journey to her current state of body-positivity took time, reflecting back on her own diagnosis, she says, “When I first heard that I was going to have a mastectomy, I was beside myself, I couldn’t’ accept it.”

“One of the things I noticed about myself as I attended support groups was that I was really more freaked out about it than anyone I knew. But I was just processing it and grieving the finality of the loss. I wasn’t soothing myself with the idea of the breasts I would have afterward, so it felt very raw and real.”

Choices post mastectomy include going flat

Not willing to go through additional surgery beyond her mastectomy, King-Lobmiller found there was an assumption among everyone from medical professionals to support groups that reconstruction would be the obvious choice. Going flat wasn’t an overt part of the mix.

“I’m not advocating for flatness, I’m asking for there to be a conversation about the option.”

Her philosophy is that, like most things, the more people see healthy, beautiful survivors who have chosen flat and the more the community knows about it, the more comfortable women will become with making the choice that is best for them.

“Honestly, hardly anyone notices. When they do, I think to myself, “Please say something to me” because I always want the opportunity to educate someone and help them to understand,” said King-Lobmiller.

“The idea that I’m not a feminine and beautiful woman because I don’t have breasts is ridiculous,” she said.

TMC’s dedicated Oncology Nurse Navigators are here to help with resources for patients and their families and information about support groups. And don’t forget to schedule your annual mammogram today.

Recent breast cancer diagnosis? Advice from breast cancer survivors

Vanessa H-B.jpg

Now what? Once you move beyond your initial reaction to a breast cancer diagnosis, whether it is disbelief, fear, anger or uncertainty, what should you do? We asked three breast cancer survivors for words of wisdom to the recently diagnosed.

1. Bring a trusted friend or family member as an advocate to your doctor’s appointments

When faced with a cancer diagnosis the options can seem daunting and the information overwhelming. It can be invaluable to have an advocate in the room to be a second set of ears. A person who is confident enough to ask questions, able to take notes and willing to process the information afterward with you. Advocates should understand their role prior to going to your appointment so they can be prepared.

2. Write down your questions

Create a written list of specific questions prior to your appointments to discuss with your doctor. Let your doctor know that you have questions at the beginning of your appointment.

3. Beware of Dr. Google

Dr. Michelle Boyce Ley, board-certified breast oncology surgeon, medical director of TMC’s Breast Health Program and a breast cancer survivor herself said, “Don’t google outcomes. I’ve seen what’s out there and they don’t look like my own patients.” Tess X, a patient of Dr. Boyce Ley’s, said “I didn’t do much reading outside the basics because you can really get into the weeds and pseudo-science. I looked up my particular variant of BRCA2 and did some calculations on risk over 10 years and lifetime, but I have a biology background. Then I talked with Dr. Boyce Ley to discuss my risks and treatment options.”

4. Talk to your doctor about risk and benefits

“Don’t assume the risks and benefits are the same as a friend’s with the same form of cancer,” Tess X said. Two people can have the same form of cancer, but the treatment plan might be quite different dependent on stage, location and the individual’s aversion to risk.

5. Ask about all the options including if there are options in treatment that they don’t offer.

“It makes me so sad when I give a talk and someone comes up afterward and says, ‘Why didn’t they offer me that?’” said Dr. Michelle Boyce Ley, . It’s important that your physician be willing to discuss all options with you, so you can participate in shared decision-making. “You can’t make a good decision unless you have the information.”

6. Don’t be afraid to share your diagnosis with others

“I met many survivors that way,” said Vanessa Hough Buck. “They have been an encouragement to me. Find a support group of survivors.”

7. Don’t avoid being in photographs while you’re going through treatment

“Even when you don’t feel your best, be in the picture. When I look back now, those are my favorite photos,” Buck said.

8. Let people know what you need from them

“Your friends and family have good intentions but don’t always know what to do. It’s alright to ask for specific help. And it’s OK to say ‘no’ to visitors,” Buck said.

 

Are you a breast cancer survivor? What advice would you give to the recently diagnosed?

TMC for Women has a high risk breast clinic that provides education, treatment options, and coordination to best help high risk patients choose their next steps.

 

 

Is genetic testing right for you in determining cancer risk?

should i get genetic testing to determine my risk for breast cancer?Medical advances have now allowed us to identify whether patients with certain inherited gene mutations have an increased risk of breast cancer.

Awareness is growing among patients that there are genes related to breast cancer and steps they can take to reduce future risk – but that doesn’t necessarily mean we should all get tested.

Here are some things to consider when deciding whether testing is appropriate for you:

Genetic testing will only provide insight into one area of risk.

You might still be high risk, even if the test shows no gene mutation. Maybe you have dense breasts, maybe you’ve never had kids, maybe you smoke, or you drink alcohol daily. Genetic abnormalities are associated with about 10 percent of cancer cases. That means no matter your test result, if you have factors that place you at higher risk, it is still important to have regular screenings.

If you were tested 5 years ago or more, you may consider retesting.

Back then, tests were only looking for mutations in BRCA 1 and 2. Now, tests routinely look at more than 25 genes that have a connection to increased risk for cancer development.

Make sure testing is appropriate for you.

Testing is most appropriate for those with a family history across multiple generations. Some special populations, such as Ashkenazi Jews, also have a higher tendency toward mutation and would be good candidates for testing.

Genetic testing isn’t just for women.

Gene mutations don’t discriminate and men get breast cancer as well. Testing, however, is not recommended on minors since the mutations inform lifetime cancer risk and children are too young to consider potential interventions.

You’ll want someone with expertise to help with the results.

There are interventions that may reduce the risk of cancer, from more frequently screenings to medication and surgery. Your primary care physician may be a good place to start the conversation, but often a specialist in breast cancer risk is best equipped to partner with patients to help them identify the next steps that are right for them. TMC offers a High-Risk Breast Clinic . Please call 324-2778 for more information.

Dr. Michele Boyce Ley, a board-certified breast oncology surgeon, serves as medical director of TMC’s Breast Health Program. She is accepting new patients and is located at 2625 N. Craycroft Road.

TMC High Risk Breast Clinic – Personalized care, options and support

Are you at an increased risk for breast cancer? One in eight women will be diagnosed with breast cancer in their lifetime. How do you know if you are high risk? If you are at high risk – what’s next?

Tucson Medical Center has designed a clinic just for women who have these questions about developing breast cancer. The TMC High Risk Breast Clinic is focused on providing in-depth education, advanced diagnostics and compassionate support to best help high risk patients choose their next steps. TMC’s experienced high-risk team recognizes that every woman’s risk factors are different and will assess risk, and then tailor a personalized care plan based on each patient’s individual needs.

A team approach

michele boyce ley md breast cancer surgeonPatients will work with a team of breast-health professionals –who have decades of diagnostic and treatment experience. The team includes a women’s health nurse practitioner, a certified nurse navigator, and a breast surgical oncologist. In addition, patients have access to imaging specialists and genetic counseling.

“The multidisciplinary approach is central to an effective high risk program,” said Medical Director Dr. Michele Boyce Ley, a board-certified, fellowship-trained breast surgical oncologist and a fellow of the American College of Surgeons.

As a breast cancer survivor, Dr. Boyce Ley brings a unique perspective to the clinic, empathizing with patients on their journey.

“Our team meets weekly to discuss the unique aspects of each patient’s care and challenges,” Boyce Ley explained. “We leave no stone unturned, and focus on making the best care recommendations to the most important member of the care team – the patient.”

Specialized services

The TMC High Risk Breast Clinic features state-of-the-art imaging diagnostics to facilitate early and accurate detection. The dedicated breast imaging center houses the latest equipment to provide the care team with clearer images, even for patients with dense breast tissue. On-site breast biopsies by experienced physicians offers convenience and timely results.

“Our next-level diagnostics provides clearer, overall images that help identify abnormalities earlier,” said Karen Narum, WHNP-BC, the board certified, women’s health nurse practitioner at the TMC High Risk Breast Clinic. “We use an advanced breast tomosynthesis, which combines enhanced mammography with modern computer software to create three-dimensional images of the breasts.”

A genetic-testing panel can be performed to further identify risk factors and provide additional information to help guide patients through the decisions and options that are available. If surgery is determined to be the best option, patients can rely on advanced surgical techniques, including nipple sparing mastectomy and Hidden Scar techniques, which are both effective and respectful of appearance.

Meaningful support and resources

The TMC breast-health nurse navigator will be by the patient’s side every step of the way, functioning as a personal advocate, answering questions, arranging visits with specialists, lining up tests and coordinating care.

“A high-risk diagnosis can be overwhelming,” says Mary Verplank, BSN, RN, breast-health nurse navigator. “We’re here to help with anything and everything – from scheduling appointments to connecting patients with community resources.”

The nurse navigators work one-on-one with patients and family members to:

• familiarize them with all aspects of the treatment plan.

• share hospital and community resources.

• coordinate support services that may address specific needs during treatment.

• help resolve any issues that may arise, from financial questions to transportation.

For further information or to schedule an appointment call the TMC breast health nurse navigator at (520) 324-4848 or Breast.Navigator@tmcaz.com.

Are you at high risk for breast cancer? Not sure? Take our Breast Cancer Health Risk Assessment. Following completion we send the report to your email address so that you may take it to your primary care provider. Have questions? Our certified nurse navigator will reach out to those at high risk.

breast cancer risk assessment

Second opinions, survival rates and treatment options: TMC One’s breast oncology surgeon weighs in on cancer diagnoses

Throughout the month of October, Breast Cancer Awareness Month, we tapped into the expertise of Dr. Michele Boyce Ley, TMC One’s new board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program. We’ve shared information with you including how to assess your breast cancer risk, asked her to weigh in on myths about breast screening including mammography and self-breast exams and had her tell us what to do – and consider – if you find a lump in your breast.

To round out this blog series, we asked her opinion on a story that was recently released by the Susan G. Komen organization titled: Debunking Five Common Myths About Breast Cancer Treatment.

We decided to focus on the three Dr. Boyce Ley thought would be the most meaningful.

Myth #1: I don’t have time to get a second opinion because I must begin treatment as soon as possible.

BDP36480First – that second opinion issue. “Second opinions are important for a couple of reasons,” said Dr. Boyce Ley. “Maybe the physician you initially went to isn’t a breast specialist. Or maybe they’re just not a good fit for you. Women need to know that it’s OK to find another doctor! Don’t worry about offending your current doctor or the person who referred you to them. It’s your health. People need to feel empowered to get multiple opinions.” Dr. Boyce Ley added that second opinions are also great because perhaps the first time around, you didn’t quite understand all of the information. Or maybe one physician has a treatment option that another doctor didn’t offer you.

Second – how soon after diagnosis should treatment start? The National Breast and Cervical Center Early Detection Program guidelines recommend starting treatment within 60 days of being diagnosed. Dr. Boyce Ley said that timeframe is readily accepted by most people – that two months is the maximum amount of time a patient should wait before starting therapy. She added that most patients in Southern Arizona begin therapy within a month of being diagnosed. “I think this is really hard for patients,” she said. “They feel like it’s an emergency, but realistically, it takes years for the cancer to grow. A couple of weeks in the life of breast cancer doesn’t change the outcome. Even a patient with an aggressive cancer will usually start therapy within a week or two.”

Myth #2: Everyone diagnosed with breast cancer dies from breast cancer or everyone diagnosed with breast cancer survives.

Dr. Boyce Ley stressed that breast cancer is not a death sentence. With modern treatment, an estimated 90 percent of women with early-stage breast cancer will go on to live five or more years after diagnosis without it recurring. Of course survival rates vary based on what stage the cancer is in and what kind of behavior the breast cancer has. According to the National Cancer Institute, there are about three million breast cancer survivors in the United States. However, more than 40,000 women and more than 400 men still die from breast cancer every year. The reality is that while most people will survive breast cancer, unfortunately some patients will not.

Myth #3: Chemotherapy and radiation therapy are more harmful than helpful.

Decades of breast cancer research have proven that chemotherapy and radiation therapy saves lives. “We know that these are two things that contribute to better survival,” said Dr. Boyce Ley. “Historically, doctors have gone from giving no chemotherapy to giving too much chemotherapy and now we’re working hard to give patients just the right amount.”

She added that doctors these days have lots of ways to analyze a patient’s cancer to identify more clearly what treatment would benefit the patient. This allows a treatment plan to be tailored to that specific patient. “We have ways to identify which patients are going to benefit from which targeted therapies,” said Dr. Boyce Ley. “The same can be said for targeted radiation. We have the ability to target one part of the breast where the cancer is and avoid radiation damage to the heart and lungs. Those are things we didn’t have available to us 15 years ago.”

Dr. Boyce Ley is accepting new patients! She is located at 2625 N. Craycroft Rd #201. Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075. For more information about our free mammogram program for uninsured women, call the TMC for Women Breast Center at
(520) 324-1286 to review qualifications and schedule an appointment.

You’ve found a lump in your breast. Now what?

Dr. Michele Boyce Ley, TMC One’s new board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program, has shared her expertise with us over the past few weeks about how to assess your breast cancer risk. She also helped us clarify some myths about breast screening including mammography, while stressing the importance of being aware of changes in your body. Having a good gauge on what your breasts normally feel like will help you know when something isn’t quite right.

So – what if you find something?

Dr. Boyce Ley said your best bet is to start with your primary care physician. Don’t have one? Chances are you’ll find one you totally connect with at TMC One. Your physician will typically order breast imaging. A mammogram and ultrasound can solve many questions without escalating it to a breast specialist.

BDP36503When should your first call be to a breast specialist? If you notice changes with your nipple or if your breast has suddenly changed color, size, shape or texture. Dr. Boyce Ley said she often sees women who, upon finding an abnormal mass in their breast, instantly jump to a worst case scenario – “who will take care of my kids when I die?” She advises women in this situation to keep this in mind: “Most of the time, it’s not going to be cancer,” said Dr. Boyce Ley, “but that still means you should pursue it. Even if you have an abnormal screening mammogram, the chance of finding a cancer is very small. A majority of the time, we may need to do further testing but oftentimes it turns out to be something benign like a cyst or overlapping breast tissue. Those are the two most common things we find.”

The take away message: Statistically, it’s unlikely that the mass you feel is going to be cancer.
If it is cancer, it
’s likely small and easily treatable.

If the initial imaging shows the mass is benign, but your physician recommends a biopsy, Dr. Boyce Ley said it’s not a bad idea to get a second opinion before getting a biopsy. Sometimes the recommendation to biopsy may differ from physician to physician and some things can be followed with imaging and exams. You may feel an urgency to get an answer but taking your time to make a good choice is important. However, Dr. Boyce Ley cautioned that if a biopsy is recommended for you, follow through with it because it could save your life.

“So many women come in with ideas that they’ve gotten from their friends and neighbors instead of medical professionals. They’ve already decided that they’re dying or that they need a double mastectomy. As a breast surgeon, it can be very hard to unwind that thinking. Is it important to get into someone quickly? Yes. But breast cancer is not an emergency. A difference of one or two days – even a week – is not going to make a difference with your treatment. In the age of quick information that we live in, while it’s possible to find information easily, it’s not necessarily helpful.”  Dr. Boyce Ley gave this advice: “Get the facts. Figure out your options. And then come up with a game plan that’s best for YOU.”

Dr. Boyce Ley is accepting new patients!
She is located at 2625 N Craycroft Rd #201.
Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075. For more information about our free mammogram program for uninsured women, call the TMC for Women Breast Center at
(520) 324-1286 to review qualifications and schedule an appointment.

Screening and mammography myths – what’s your “normal?”

BDP36471We are continuing our weekly blog series with Dr. Michele Boyce Ley, TMC One’s new board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program. Last week she shared with us highly valuable information about how to figure out if you’re really at high risk for breast cancer or not.

This week we’re focusing on how to sort out truths vs. myths when it comes to screening and mammography.

As women, we’re told to do our self-breast exam “when we pay our rent.” Or “on the same day every month as our birthday.” There are even apps to remind you. Most of us know we should do them. But the reality is, we don’t.

Are self-exams encouraged? And should you really be doing them? “Absolutely,” said Dr. Boyce Ley. “We want women to become really self-aware when it comes to their breast health. We want them to do monthly self-exams so that they become familiar with what their normal is. If they do regular checks and know what their breasts feel like, it’s easier to discover when something feels out of the ordinary. If you’re aware of it, you can monitor it and get in to see a breast specialist if necessary. When it comes to self-exams, it’s best to do it the first week after your menstrual cycle.”

Dr. Michele Boyce Ley Board-Certified, Breast Surgical Oncology Medical Director, TMC Breast Health Program

Dr. Michele Boyce Ley
Board-Certified, Breast Surgical Oncology
Medical Director, TMC Breast Health Program

Dr. Boyce Ley explained that there is chatter in the medical world that monthly self-exams may cause unnecessary imaging and biopsies. One of the many challenges, she explained, is that while there are a lot of risk factors we know about, there are also a lot of risk factors we don’t know about. It can be difficult to definitively decide that a 35-year-old, for example, should have a mammogram. “That’s when it’s appropriate for that patient to see a breast specialist,” she said. “If you’ve tried to figure out if you’re considered high risk or not, and you’re still unsure, or if you just need guidance to sort it all out, have a breast specialist help you,” she said. If a woman is identified as high risk, then imaging starts earlier.

▪ What about the risk of being exposed to so much radiation during a mammogram?

It may be recommended that younger people who are identified as high risk get mammograms every other year instead of annually at first. Or perhaps your doctor wants to combine a mammogram with an MRI. “Generally, radiation risks aren’t any higher than they were with regular film screen mammograms from 15 years ago,” said Dr. Boyce Ley. “MRI is a test without any radiation.”

▪ There are 2D and 3D mammograms. How do I figure out which kind I need?

Film screen mammography is a thing of the past. These days, all mammography is done digitally. A 2D, or standard mammogram, captures all of the layers of the breast tissue stacked on top of each other. During a 3D mammogram, the x-ray camera rotates around the breast, getting a picture of multiple layers of the breast. Those layers can then be separated out for an even more precise view. For a majority of patients, standard digital mammography is still very good. Doctors have found, however, that for all patients, especially those with dense breasts, 3D mammography allows them to do fewer call backs. That means that there is a smaller chance that you’d have to be called back in for a follow-up mammogram or ultrasound. “The detection rate for cancer is higher with 3D mammography, as it allows us to find more small cancers,” explained Dr. Boyce Ley. “The downside is it can cost more.”

At TMC’s Breast Center, both 2D and 3D mammography is performed. If you’re considering a 3D mammogram, be sure to check with your insurance first to see what it covers.

▪ I have breast implants. Do I have to do anything differently?

No. The screening recommendations are the same. Dr. Boyce Ley said that implants can distort the breast tissue. In some cases, implants can make it easier to find a lump by feeling the breast tissue during a monthly self-exam. On the flipside, in some cases, it may make it harder to find a lump by imaging since the breast tissue is being pushed around by the implant. It can be difficult to visualize all the breast tissue since the implant often distorts it.

▪ Does where I get screened matter?

Yes, according to Dr. Boyce Ley. Before you schedule your mammogram, do your research. Ask if your scan is going to be reviewed by a breast imaging specialist or radiologist with a specific focus who is able to give you an accurate interpretation. “You want to have your breast imaging read by someone who almost exclusively does mammographic imaging,” said Dr. Boyce Ley. “There are so many changes in technology and what we learn about the breast. It’s important to have someone who is highly experienced.”

Dr. Boyce Ley recommends asking a few questions when you call to schedule your appointment. Ask things like, “Can you tell me about your radiologist? Can I look them up online? Are they fellowship trained in breast imaging or are they a general radiologist? What percentage of their time do they read mammograms?”

At TMC’s Breast Center, all of our radiologists are trained as general radiologists and then receive specialized training in breast imaging. Additionally, our lead radiologist, Dr. Matthew Bell, as well as Dr. Shayna Klein are both fellowship trained in breast imaging. All of our radiologists must keep their training current, so you can be confident that if you get a mammogram at TMC, it’s being read by clinicians who are specially trained in reading mammograms.

Dr. Boyce Ley is accepting new patients!
She is located at 2625 N. Craycroft Rd #201.
Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075.

Spread the word about when to have your first screening mammogram and the FREE screening mammograms for uninsured women by entering our TMC for Women photo contest. Snap a picture of you and your BFF and enter for a chance at a fabulous prize.   http://woobox.com/chcztiPhotoContestBFF

Thinking pink for October and assessing your breast cancer risk

BDP36545October is recognized as Breast Cancer Awareness month, and with so much information readily available under the “pink cloud,” we agree with you that sometimes it all can be overwhelming. So your grandma and your aunt had breast cancer – but your mom didn’t. Are you considered high risk or not? What is the magic age for a mammogram these days – is it still 40? What’s this I hear about starting at age 35? And with all the attention about Angelina Jolie’s recent double mastectomy, is that really the only way to ensure that you never fall victim to this devastating disease? With an overload of information available at your fingertips about breast cancer, what’s the best way to dissect it all?

We sat down with TMC One’s new breast oncology surgeon Dr. Michele Boyce Ley. She’s a board-certified breast cancer surgeon and medical director of TMC’s Breast Health Program. Dr. Boyce Ley brings high-level, compassionate specialty care to TMC’s well established and respected program. We asked her to break down the most important things you should know about breast cancer and we’re going to share her thoughts in a new post each week throughout the month of October.

First up: that high-risk question.

As women, we are all at risk of getting breast cancer. Yes, men are also at risk. But simply being a woman is the number one risk factor. Others include:

∙ getting older
∙ family history
∙ not having children or having children after age 35
∙ receiving hormone replacement therapy
∙ obesity
∙ lack of exercise
∙ more than four alcoholic drinks a week

Let’s focus on that family history for a bit. Dr. Boyce Ley explains the key here is if multiple people from multiple generations in your family have been diagnosed, then you’re considered high-risk. “If your aunt had breast cancer when she was 65, for example, it’s probably not as important as if your mom had breast cancer at age 45,” she said.

Additionally, there are some easy-to-use scoring methods online to help you figure out if you’re high-risk or not. Dr. Boyce Ley is a fan of the bright pink website that offers a user-friendly tool. The National Cancer Institute also offers an online assessment. Still not sure? It’s best to get established with a breast specialist to assess your risk and what to do about it. A breast specialist can also help you figure out your breast density which oftentimes can be another risk factor.

Genetic testing is also an option, but proceed with caution. It’s not for everybody, and there are lots of caveats to it. Dr. Boyce Ley says it really needs to be done by a breast health specialist. Testing used to be limited to just testing for the BRCA 1 and 2 genes. Now there are numerous companies which offer genetic testing for up to 25 different markers. Certainly good information to have, but oftentimes it turns into a case of “We have this info. Now what do we do with it?”

While these mutations have been identified, it takes a highly trained team of clinicians to know how to interpret the results. Genetic testing can make a big difference in the treatment planning but it’s not a one-size-fits-all approach. “The testing can be helpful, but it’s not helpful in the same way for every person,” said Dr. Boyce Ley.

“I always tell my patients who want to pursue genetic testing this: Let’s think this through. If you get the testing done, and you get these results, what are you going to do about it? Your motivation might be to protect yourself or simply to help your children figure out their risk.”

Dr. Boyce Ley warns, however, that testing can have implications for an entire family. “Sometimes there is guilt associated with it if people realize they have passed this gene on to their kids. This isn’t like getting a blood test and finding out you have high cholesterol. It’s a bit more complex than that,” she said. That’s why it’s important to sit down and talk with an expert. Insurance coverage of genetic testing has gotten measurably better with the exception of Medicare, which is more restrictive in covering the cost.

Bottom line: Have a plan before you get genetic testing done.

Doctors continue to develop a better understanding about what characteristics constitute a high-risk patient, and there are an assortment of new drug therapies in the pipeline that work to reduce a patient’s risk. “Just because you’re identified as high-risk doesn’t necessarily mean you need an invasive procedure,” Dr. Boyce Ley said.

Something super simple you can do that isn’t talked about much? Exercise and manage your weight. “It’s been shown over and over again that maintaining a healthy weight and exercising more than four times a week reduces the risk of breast cancer. Those are things you don’t need to see a doctor for. They’re not easy, but they’re free!” she said.

Dr. Boyce Ley is accepting new patients!
She is located at TMC One, 2424 N. Wyatt Dr. #100, on the TMC campus.
Call (520) 324-BRST (2778) to make an appointment.

TMC One welcomes breast oncology surgeon Dr. Michele Boyce Ley to guide prevention and treatment

Dr. Michele Boyce Ley Board-Certified, Breast Surgical Oncology Medical Director, TMC Breast Health Program

Dr. Michele Boyce Ley
Board-Certified, Breast Surgical Oncology
Medical Director, TMC Breast Health Program

TMC One is expanding the scope of services available to you. We are thrilled to welcome Michele Boyce Ley, M.D., a board-certified breast cancer surgeon and medical director of TMC’s Breast Health Program. Dr. Boyce Ley brings high-level, compassionate specialty care to our well established and respected program. She is also fluent in Spanish.

Dr. Boyce Ley shares some insight into why she chose this field, what she thinks is the biggest misconception about breast cancer and how a string of profound experiences within her own family impacted how she treats each and every patient.

What is your background? 

I was raised in Northern California and have lived in Tucson since 2000. I graduated from Northwestern University with a bachelor’s degree in molecular and cellular biology. I completed medical school at St. Louis University and moved to Tucson for my general surgery residency at the University of Arizona.

I completed a fellowship in breast surgical oncology at the University of California San Francisco, Carol Frank Buck Breast Care Center in 2006 before establishing a breast surgical oncology practice in Tucson. Most recently, I was the director of breast surgery at the University of Arizona and associate professor of surgery.

What inspired you to go into breast surgical oncology?

I was always interested in the biology of cancer. It is so incredibly complex on a cellular and molecular level. Additionally, when you add in the human element – that the disease is happening in a person who has a set of values, beliefs and an individual health status, it adds another layer of complexity. It is very rewarding to take all of these issues into account when helping a patient choose a therapeutic pathway.

How do you help primary care physicians care for their patients with breast cancer?

I like to communicate with referring physicians to inform them of what their patients’ treatment options are. A lot of the information I pass on is educational including information about new evaluation and treatment options as well as updates on recent research.

We hear a lot about breast cancer in the media. What do you think is the biggest misconception about it?

Everyone who is diagnosed with breast cancer, even if it is just pre-cancerous cells, worries that she will die from breast cancer. While there are about 45,000 deaths a year from breast cancer, the majority of patients with breast cancer have a 85-90 percent of a 10-year survival. This means that 10 years after diagnosis, 85-90 percent of these patients are still alive. There are certainly people who do not survive their disease, but these are primarily people in whom the breast cancer was diagnosed late, not properly treated or their particular type of cancer is extremely aggressive.

If a patient has not been diagnosed with breast cancer, but has it in her family history, do you recommend she get established with a specialist like yourself for regular checks/preventative care?

There is great interest in breast health to know your risk. The best way to assess your risk is to meet with a breast specialist to accurately take a history, estimate risk and develop a prevention plan. This plan usually includes regular breast exams, imaging and lifestyle modifications. Sometimes a prevention plan includes risk-reducing surgery or medications.

You’ve lived in Tucson for 15 years. Is there anything in regards to breast health/breast cancer prevention that you’ve found is unique in this part of the country?

One of my goals in returning to practice after my fellowship at UCSF was to raise the level of breast cancer care in Southern Arizona. This has certainly happened as immediate breast reconstruction and nipple-sparing mastectomies have become more commonplace. I hope that we continue to improve our access to routine breast care, breast health education and wellness education.

What interests you outside of work?

I love to cook up healthy meals and I like baking desserts – especially sugar-free ones! I have recently adopted a low-carbohydrate lifestyle that has been both a challenge and a reward. I have two children, Logan, 9, and Lauren, 4, who are bright and energetic. We try to spend time together when we’re not at school and work. My husband takes us camping and as a family, we enjoy adventuring in our time off!  It’s good for all of us to be outside and be unplugged. My other pastime is reading. My son and I have challenged each other to read 40 books this year. He’s ahead of me already! We are all looking forward to skiing this winter, as my daughter is ready to take lessons so that we can all hit the slopes together!

What has been your most valuable life experience that has impacted your medical career?

A few years ago, several of my family members were diagnosed with cancer in the same year. My father was diagnosed with leukemia and died after three years of incredibly difficult treatment. My aunt had a recurrence of her breast cancer and eventually passed away from it. Her daughter had a rare form of sarcoma and fortunately is doing well today. All three of my loved ones underwent intensive treatments over a varied amount of time. This was challenging for our family as we had family members who needed support in different parts of the country.

My father and my aunt were relatively young when they died at ages 64 and 62. My family and I felt robbed of the time we should have had with them and were saddened at the suffering they had to endure. Both my father and my aunt accepted hospice care, which was so good for them and our family. My father and my aunt did not want their lives to be defined by their cancer diagnoses. They wanted to live and be involved in the lives of their children and grandchildren. They saw beauty in every day they were given.

These experiences have changed the way I look at my life as well as how I see my patient’s lives. I know that not every treatment is necessary. I know that many treatments may have little benefit and incur risk of long-term effects. I also work to be more understanding of the whole picture of a patient’s life when faced with disease. They have families and pressures outside of their diagnosis that form their response to the illness. From a family perspective, it’s so wonderful to have a physician who “gets” you and sees you as a human – not just as a diagnosis.

How do you approach your relationship with your patients?

Patients are people with an illness, and in the case of breast cancer, these people don’t usually feel ill. I try to put my patients at ease initially to let them know that they will be cured with a little hard work. I often have to deliver news that is disappointing or surprising, so I try to be frank, yet gentle. I really enjoy getting to know my patients and their families. Regardless of our backgrounds, we are all people with feelings and personal challenges and triumphs.  I strive to make their experience of the breast cancer process a positive, triumphant part of their life.

Dr. Boyce Ley is accepting new patients!
She is located at 2625 N. Craycroft Rd #201.
Call (520) 324-BRST (2778) to make an appointment.

Sorting out breast-screening guidelines and more: Essential Women’s Health Update

It’s so confusing! One report says “mammogram every year.” The next says maybe not.  During the last two years there has been a lot of discussion regarding breast screening.  Most commonly these topics include who should receive a mammogram, when and how often.   Some wonder if mammography is still the best option.

If you have had these questions, come to TMC’s Essential Women’s Health Update on Wednesday, Sept. 21 from 5 – 8 p.m. in TMC’s Marshall Conference Center.

Among other topics, Karen Narum, NP, TMC for Women, will clarify the breast screening guidelines as recommended by professional organizations such as The American Cancer Society, The American College of Obstetrics and Gynecology,  and The American College of Radiology.  She will help you develop an understanding of how various imaging modalities are used in the examination of breast tissue and help you understand the steps to take if you notice a breast change.

Other presenters for this important event are:

Speaker panel includes:

  • Margaret Hoeft, FNP (ret), Patient Navigator
  • Heather Andrews, MD, Genesis OB/GYN
  • Alton V. Hallum III, MD, Arizona Oncology

The event is presented by TMC for Women in partnership with the National Ovarian Cancer Coalition, Arizona Oncology and Genesis Family OB/GYN


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461