National Breast Cancer Coalition

Call to Action December 2017

A Very Close Call: NBCC Advocates Help Save the DOD BCRP!

Earlier this year, Senator John McCain (R-AZ) inserted language in the National Defense Authorization Act (NDAA) that would end all of the Congressionally Directed Medical Research Programs (CDMRPs), including the Breast Cancer Research Program (BCRP).  As you know, the DOD BCRP started as a result of NBCC's campaign in 1992 to increase federal appropriations for breast cancer research. This program has made a real difference; it has advocates in leadership positions and focuses on innovative and impactful science that will end breast cancer. This year, NBCC mobilized our National Action Network and ratcheted up our advocacy on Capitol Hill to defeat McCain’s efforts. Senator Dick Durbin (D-IL) introduced an amendment co-sponsored by 54 Senators to remove the harmful provisions.  The Amendment had significant bipartisan sponsorship, but was refused a vote. The focus turned to the House and Senate conference as the House version of the bill did not include the harmful language.  NBCC advocates contacted key members to sign on to Dear Colleague letters in both the House and Senate and asked members to contact Chairs and Ranking Members of both House and Senate Armed Services Committees. Thanks to the hard work of NBCC advocates, the harmful provisions contained in the Senate NDAA bill that would have destroyed the DOD BCRP and all Congressionally Directed Medical Research Programs  were removed from the Conferenced bill! There is no doubt that it was the amazing work by the NBCC advocates that made the difference. Thank you so very, very much for this victory!

The DOD BCRP remains committed to supporting approaches that may provide important breakthroughs. In the struggle to understand, fight, and ultimately defeat breast cancer, the DOD BCRP continues to be one of the most effective tools in our arsenal.

NBCCxACA

Although much of our attention has been on saving the DOD Breast Cancer Research Program, NBCC has continued to focus efforts on protecting the ACA. NBCC advocates were essential in defeating the Graham-Cassidy bill, the Senate’s most recent effort to repeal and replace the ACA and we have continued to be part of the #protectourcare coalition.

While NBCC typically does not get involved in tax policy, we recognize that the tax bill that Senate Republicans passed most recently has provisions that would profoundly impede our mission to end breast cancer.

NBCC advocates pushed Senate Republicans to oppose the tax bill that included provisions that would take health care coverage away from 13 million people. Our network made it clear that the bill would cause people with and at risk of breast cancer to lose their health insurance. In the wee hours of December 2nd, the Senate passed the bill 51-49; with exception of Senator Bob Corker’s vote, all Republicans supported the bill and all Democrats voted against it.

There are differences between the House-passed and the Senate-passed bills and members now must move to a conference to work out those differences. We must continue our advocacy: tell your members of Congress to oppose this harmful legislation. Advocates are encouraged to contact their Representative and Senators and urge them to oppose this tax bill that will cause people with and at risk of breast cancer to lose their health insurance

2018 Advocate Leadership Summit & Lobby Day

The 2018 Advocate Leadership Summit will be held from April 28- May 1, 2018, to provide you with an opportunity to lead others toward a shared vision where no one else gets breast cancer—and no one dies of it.   

If you want to make a difference in women's lives, join NBCC in D.C. You will learn about public policy and what to do to make certain scientists have the funds needed to answer questions that will save lives. You will begin to understand what researchers are doing to harness the immune system, identify targets, and figure out how to stop women and men from getting breast cancer. You will have the opportunity to interact with renowned scientists and activists. You will meet other like-minded advocates who share your passion for ending breast cancer and saving lives. And you will learn more about Deadline 2020® and what the future holds for NBCC. 

On Tuesday, May 1, 2018, we will once again host a Lobby Day on Capitol Hill. As we move closer to Breast Cancer Deadline 2020®, it is vital that we push even harder to make the deadline a reality. Start by registering for the 2018 Advocate Leadership Summit today.

NBCC's 2018 Project LEAD® Institute

You can work side by side with scientists, help set a research agenda, and make certain important breast cancer questions are addressed. You can be a part of science. Through NBCC's ongoing education and training programs, we are committed to giving you the knowledge and tools necessary to be at the research table. 

The online application for NBCC’s premier science training program, Project LEAD® Institute, opens on February 19, 2018 and closes April 18, 2018. Details can be found on our website. Help us by sharing this information with advocates who are committed to Breast Cancer Deadline 2020®

NBCC's 22nd New York Gala

Thank you to everyone involved with NBCC’s 22nd New York Gala, including co-chairs Fabian Garcia, President and CEO of Revlon; Mark J. Alles, CEO of Celgene; and Sharon Nelles, Partner, Sullivan & Cromwell, and our dinner committee chairs: Dorian Goldman and Marvin Israelow, Liane and Luca Lindner, Violaine and John Bernbach and Carol and Terry Wall.  The Gala was a great success and we were very proud to honor Stephanie Disegni, President/CEO, Longchamp USA and Hinrich J. Woebcken, President/CEO, Volkswagen Group of America for their work in support of our cause. As always, the highlight of the Gala was hearing from our Grassroots Advocacy Award honorees.  Medha Deoras-Sutliff and Alysia Pringle were this year’s recipients, who were presented with their awards by our gracious special guest Amanda Stephens from Orange is the New Black.  Guests enjoyed an incredible performance by Laura Bell Bundy, recording artist, actress, songwriter, director, and producer.

2017 Gala Advocates, NY Gala, Advocates

From Left: Advocate Honoree Medha Deoras-Sutliff, NBCC President Fran Visco, and Advocate Honoree Alysia Pringle.

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Science Spotlight2

Questioning Overall Benefits of Treatment in Breast Cancer

When it comes to health care it may be natural to think that more is better. That is often incorrect, especially in breast cancer. At NBCC, we try very hard to not make assumptions and to look very carefully at the evidence behind any health care intervention.  And we look closely at the balance of benefit and harm.  Because treatment for cancer is pretty toxic, and the question has to be: does whatever benefit I may get from this drug or surgery or other treatment outweigh the harm it will cause? Note that we say “may get” and “will cause” because that is in fact the case.  We often do not know who will benefit from a therapy, but we can be pretty sure most people will be harmed.

All breast cancers are not the same, so it makes sense that treatments can no longer be “one-size fits all.” We did "one-size fits all" for a long time. And that makes it hard to change things. It is well-known that, once a treatment regimen is in place and becomes the “standard of care”, it can take a long time to remove it from practice, even when scientific evidence no longer supports its use.1 So patients and doctors need to give thoughtful consideration when deciding on a treatment plan, and must keep pace with the increasing knowledge of different subtypes of breast cancer and the variation in responses to treatment within the different subtypes.  Women are overtreated when they receive therapy that does not provide additional benefit and yet causes harm.

Let’s look at a couple of instances where “more” was not “better.” For example, NBCC has written a number of times about anthracyclines. Many women diagnosed with invasive breast cancer of different subtypes continue to receive the same adjuvant chemotherapy regimen, one including a controversial class of drugs called anthracyclines. This happens even though evidence shows that the drugs may only provide incremental benefit to a small group of patients, and could be replaced with a less toxic substitute. Especially in Europe, anthracyclines remain standard of care for most women.

A trial in the UK looked at the benefit of actually accelerating an anthracycline (epirubicin) and the results were published by Cameron, et al.2 The authors assessed whether efficacy could be improved without increasing toxicity when giving standard epirubicin followed by either CMF or capecitabine compared with accelerated epirubicin followed by either CMF or capecitabine in patients with node-positive or high-risk node-negative disease who had undergone complete excision. There was no significant difference in time to tumor recurrence (TTR) between the standard and the accelerated epirubicin groups. The capecitabine regimen was found to have less toxicity than CMF. However, for all treatment groups, there was no difference in overall survival for accelerated vs standard epirubicin.3

Another study looked at surgery overtreatment to see if removing just two or three sentinel lymph nodes alone is at least as good as axillary lymph node dissection (ALND) in women with high-risk breast cancer. The study found that ALND, which is removing many if not all nodes in the armpit, does not improve overall survival, after a 10 year follow up.4

It is difficult to make treatment decisions when dealing with a possibly lethal disease and conflicting information. But the process of making treatment decisions should always be focused on the overall clinical benefit for the patient.  We should be administering the most effective therapy with the least amount of toxicity for the patient. Progress and improvements in treatment require that adjustments be made as new evidence becomes available. If we truly want patient-centered care, then we should take away a treatment from standard care as quickly and easily as adding a new one, once the evidence supports a change. 1

References

  1. Anthracyclines. Retrieved from http://www.breastcancerdeadline2020.org/breast-cancer-information/specific-issues-in-breast-cancer/anthracyclines/
  2. Cameron D, Morden JP, Canney P, et al. Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomized UK TACT2 trial (CRUK/05/19): a multicenter, phase 3, open-label, randomized, controlled trial. The Lancet Oncology. 2017;18(7):929-945.
  3. Chew HK. Medicine Cabinet. Adjuvant therapy for breast cancer: who should get what? West J Med. 2001;174:284-287.
  4. Giuliano AE, Ballman KV, McCall L et al. Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis. The ACOSOG Z0011 (Alliance) randomized clinical trial. JAMA. 2017;318(10):918-926.

other news

Double Standards Concert

On November 12th, Tony Award nominee Laura Bell Bundy gathered fellow performers for Double Standards, a benefit concert in support of women's issues. The benefit was sponsored by NBCC long time supporter,  iS CLINICAL. NBCC was one of the beneficiaries of the star-studded event that included Laura Bell, Jessie Mueller, Denee Benton, Sara Bareilles, Rosie O’Donnell and others.

NBCC is grateful to have been a part of this incredible evening. 

Double Your Year End Gift

Make your year end gift go twice as far! Too many of us have lost women and men we love to breast cancer.  When Joyce Goldman's family wanted to honor her memory, they decided to dedicate part of the Joyce and Irving Goldman Family Foundation funds to help end this disease. The Foundation has offered to match every contribution received by NBCC before December 31, 2017―up to $100,000.  

Please click here and make your donation now before the end of the year.  Your donation will have twice the impact with the Goldman Family Foundation match.

DNA.Land

There is something you can do now to help end breast cancer. Have you had a genealogy test from 23 and Me or Ancestry.com or the like? We need you. NBCC has partnered with the New York Genome Center to develop a large-scale resource to study breast cancer. This project asks women and men who have participated in genealogy tests to upload their data and answer questions about breast cancer, including their family history. These genomic data, along with answers from the breast cancer questionnaire, developed by NBCC trained advocates, will be used to develop a resource that researchers can use to identify genetic variants that impact risk and recurrence of the disease. 

Remember: If you have had your DNA sequenced through a DTC genomic company such as 23andMe, Ancestry DNA, or FamilyTreeDNA, you can be part of this project. Please visit DNA.Land for more information. 

If you have not yet had your DNA sequenced, there are easy to follow instructions on how to obtain genomics information from the three most popular DTC websites on DNA.Land.

For more information or to ask questions, please email nbccdnaland@breastcancerdeadline2020.org.