Are There New Guidelines for Breast Screening?

Posted on August 4, 2011 by Dr. Richard Clarfeld

A recent article in the Wall Street Journal highlights conflicting recommendations with regards to breast screening, especially for women ages 40-49. Let’s examine them:

The American College of Obstetrics and Gynecology have revised their previous guidelines of every 1-2 years for women ages 40-49 and now recommend yearly mammograms. They acknowledge that breast cancers develop more rapidly in younger women so that the screening interval should be at shorter intervals. It is true that younger women have more interval breast cancers. These tumors are biologically more aggressive and are detected as lumps or areas of texture change between mammographic studies. Although screening annually makes sense, recommending mammography does not. Continue reading →

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Pedal Against Cancer

Posted on July 21, 2011 by Dr. Kristi Harrington

Enjoying Whidbey Island

Training continues, as does our team’s fundraising efforts – we have now more than doubled our original fundraising goal of $3,000! Check out the Seattle Echelon Gran Fondo website.

This weekend, I was camping with my family and some good friends of ours on Whidbey Island. The “real” kind of camping, in tents. I had to bring my bike and get in a training ride, as I figured I’d better not just sit around with a week to go before our big event, the Seattle Echelon Gran Fondo. I felt a little bit like a loser, leaving everyone to go off on my own to ride my bike….

View while I was waiting for the ferry on Whidbey Island

But, my rewards were many! I was treated to beautiful views of Whidbey Island, some warmish, DRY weather, and I saw three deer. In fact, I even CYCLED with one! I was riding on the wide shoulder of highway 525 and spooked a deer hiding in the tall grass next to the road. It ran along with me for about 10 yards, before dashing off into the trees. I can tell you, that was pretty awesome, seeing those big deer “butt” muscles pumping away in front of me. Pretty inspiring! And, my prayers were answered when it didn’t leap in front of me and reduce me to a quivering heap on the roadside.

It just goes to show you that there is beauty in every day, and sometimes in unexpected places! Please think of me this weekend as my team and I bike to support the Fred Hutchinson Cancer Research Center and the Livestrong Foundation.

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Patient’s Perspective: My Doctor Found a Lump

Posted on July 14, 2011 by Mary Beth Walker

I’m the webmaster for Overlake and I’m always behind the scenes. I never dreamed I would have something worth sharing here. But I do. I’m in my late 30’s and my OB/GYN found a lump in my breast. I am very happy to say I got the biopsy results yesterday and it’s benign. Phew! But now I have a new outlook on breast health and the importance of taking an active role in my healthcare.

Exactly two weeks ago I was stunned when my OB/GYN, Dr. Mitchell Nudelman, was performing a clinical breast exam as part of a regular office visit and his hands stopped moving; he got a serious look on his face and asked, “How long has this lump been here?” I was so confused I didn’t know how to answer. To be honest I didn’t even know the lump was there because I do not perform breast self exams (BSE) on a regular basis. Confession, I rarely do BSEs. I stammered, “Umm, I’m not sure, a while I think,” while he continued to palpate it (feel it) and gauge the size. Continue reading →

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Bicycling 100 Miles to Fight Cancer

Posted on July 13, 2011 by Dr. Kristi Harrington


I’m pretty excited about an event that some friends and I are participating in, so I thought I would share…

The event is called the Seattle Echelon Gran Fondo, and it’s a bike riding event on the Kitsap Peninsula to raise money for the Fred Hutchinson Cancer Research Center and the Livestrong Foundation. I believe strongly in these two organizations, because their causes are near and dear to my heart – research and cancer treatment, and living full lives with cancer and after cancer treatment.

The other really great thing about this event is that it gives me goals to shoot for and, in tune with my “surgical personality,” I am very goal-oriented. What are the goals? First, all six of my team members and I are committed to riding 100 miles on our bikes in one day AND THE COURSE IS NOT FLAT! This is going to be sort of a big deal, as prior to training for this event, I had not even been on my road bike in 12 years…I really don’t count riding my “mommy cruiser” to the park with my kids as bike-riding (it’s more like herding cats than biking!). Second, each of us set fund raising goals for ourselves, and as a team we pledged to raise $3,000! That’s kind of a lot of money and a nice contribution for these two great organizations. Continue reading →

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Family History and Breast Cancer

Posted on June 7, 2011 by Dr. Kristi Harrington

Most women who get breast cancer have no significant family history of breast cancer period. The amount of press that family history and genetic testing get is way out of proportion to how important they actually are for the average woman.

The only risk factor that you need for getting breast cancer is being female. Men do get breast cancer, but at a much smaller incidence than women do. Most women who get breast cancer get what we call sporadic breast cancers. This means that their cancer by chance, not due to an error in their DNA (see below) that was passed down through their family.

All women are at risk for developing breast cancer, and that risk increases as we age. Continue reading →

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What Makes Sentinel Lymph Nodes Special?

Posted on June 3, 2011 by Dr. Richard Clarfeld

Sentinel nodes are few in number, usually less than four. These nodes are removed and sent to the pathologist. Each node is sectioned every 2 mm and examined under the microscope. Thin sections make it possible to find the smallest metastases. Small numbers of lymph nodes make this tedious process practical.

Removing all of the axillary lymph nodes is sometimes necessary, but disrupts the normal flow of lymph fluid from the arm and chest wall across the axilla back to the central circulation. This disruption can lead to lymphedema, a backup of lymph fluid. Lymphedema may lead to a lifetime of arm swelling and neurologic symptoms. Continue reading →

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Why the Recent Fuss About Lymph Nodes?

Posted on May 31, 2011 by Dr. Richard Clarfeld

The American College of Surgeons recently reported that women undergoing lumpectomy with positive sentinel lymph nodes can safely avoid removal of their remaining nodes if they also receive whole breast radiation. The radiation plan will cover most of the remaining lymph nodes. This would prevent any further growth and spread of cancer cells and greatly reduce the risk of lymphedema – arm swelling. This news was validating for the breast health team at Overlake because we have offered this option for several years.

Which lymph nodes are we talking about?

We are primarily interested in the lymph nodes in the armpit axilla. Continue reading →

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