Moving to a new city can be a daunting experience. When Diana Napper, founder of the Glimmer of Hope Foundation, moved from the calm of Pittsburgh to the hustle and bustle of New Jersey in the late seventies, she found peace in a powerful and personal partnership.
“I was a little intimidated by the entire area. I met a young woman who sort of mentored me, and gave me confidence. Her name was Carol Jo. We became very close friends.”
Sadly, Carol Jo lost her battle with cancer on Christmas Eve 1990. She had always encouraged Diana to fulfill her dream of opening a jewelry business, and was a driving force behind Diana’s desire to use her skills to help other women with the disease.
“One day she called me and said she was diagnosed with breast cancer, at the age of 50. She lived 11 months after diagnosis, which to me was horrific. But before she died, she told me that I was going to do something with jewelry, and that when it became big, to open a hospice in her name.”
Just prior to losing her friend to breast cancer, Diana moved back to Pittsburgh. It was there that she began a mission with her friend in mind. In 1993, Diana founded A Glimmer of Hope, and began raising funds selling her own designs. The first was a pin that channeled the life-altering pain of the ordeal of breast cancer into something more positive. A teardrop Swarovski crystal, representing the pain and emotion of the disease, topped with a single pearl, a symbol of hope, became a symbolic and hugely popular piece that kick-started a long, ambitious and brave fight to help find a cure for breast cancer once and for all.
Over the 22 years since it was established, Glimmer of Hope has played a vital role in raising awareness of breast cancer, getting better screening procedures implemented, and helping healthcare institutions provide the best possible care to their breast cancer patients.
In the US, a new diagnosis of breast cancer is made every two minutes. Figures from the CDC show that it is the most common cancer in women, killing 40,931 in 2011 alone. Recent research suggests that, at some point in their lifetime, one in eight women will be diagnosed with the disease.
Of all the work the foundation has achieved, Glimmer of Hope is most excited about its t recent endeavor: to make digital breast tomosynthesis, also called 3D mammography, more widely available to women across the United States.
Tomosynthesis is a method of performing mammography that yields high-resolution images using low dose X-rays, making it a more appealing option for many radiologists as compared to conventional mammography. Because of the image quality, radiologists can see clearly and have the potential for improved detectability of tumors and microcalcifications, which can indicate early stages of breast cancer. At this time, tomosynthesis is not widely recognized as a gold standard in mammography, but groups like Glimmer of Hope are looking to change that.
“I would really have to say that the most excited the foundation has been in its existence has been when we purchased GE’s breast tomosynthesis machine for the Allegheny Health Network in Pittsburgh,” said Diana. “Strictly for the fact that GE’s breast tomosynthesis has 40% less radiation. (For average and larger breasts (above 45 mm) as compared to other 3D breast tomosynthesis available in the U.S.).¹
Like Diana says, the technical advances brought by tomosynthesis eliminate some of the barriers to effective breast cancer diagnosis. The disease progresses rapidly, so the earlier and the more accurate the diagnosis, the better a patient’s chances are for survival.
“We don’t have a cure for breast cancer in our pocket. It’s not even 5 years away,” she continued. “So we need to diagnose this disease at a much earlier stage, to avoid chemotherapy and avoid the harmful chemicals that come with it. Let’s diagnose it at a stage where women can have early treatment and go on to live a life without having to suffer the harmful effects of chemotherapy. Breast tomosynthesis, to us, is one of the biggest breakthroughs we’ve ever seen.”
Mammography has been around for over 50 years, but the changes motioned by Diana are only recent breakthroughs. Mammography uses X-rays to image breast tissue, but with X-ray comes radiation. In cases where several mammograms need to be performed in a short period of time, there may be accumulated exposure to X-rays which can be concerning for patients who want to limit their radiation exposure.
To help better explain the importance of raising awareness, and of breast tomosynthesis technology, Dr William Poller, Network Director, Breast Imaging, Allegheny Health Network, Pittsburgh.
“When I came to Pittsburgh, mammography was still in its early stages,” said Dr Poller. At that time, we maybe only saw 12 or 13 patients a day. But come around 1990 or so, I thought, ‘It’s a great sub-specialty, I’m just going to devote as much time as I can to mammography.’ So from the 90s to the present time, over 20 years, I’ve devoted my whole life to mammography.”
Dr Poller said that, while Magnetic Resonance Imaging (MRI) is an imaging tool used by health care professionals which aids in the visualization of breast cancer, it is one of the least practical. “MRI is very precise and detailed, but expensive,” he said. “So you’ve got to be practical and say that mammography is going to be the best method to detect breast cancer. But there are limitations with mammography. But now we’re finding the small cancers , and doing less diagnostic work up, and that’s because of tomosynthesis.”
The issue around breast density has only been brought to public attention in recent years. According to Dr Poller, it is the women’s groups and charities that have almost single handedly fought for wider recognition of breast density as a serious contributing factor to breast cancer risk, and for better education for patients.
Dr Poller said that the fundraising and educational work done by people like Diana is just as important to women’s health as the advancements in technology and diagnostics, like tomosynthesis. “Women’s groups have a very strong lobby, it’s unbelievable,” said Dr Poller. “Without some of the women’s groups, we would not be where we are now.”
“For instance, we have some breast density laws in the country that have been pushed by women’s groups. So a big breakthrough was raising awareness, having the women be proactive, and then the next big thing has been the equipment that’s followed along.”
An obstacle to better diagnosis and screening of women for breast cancer is education and awareness. Awareness of breast density, awareness of the typical age when breast cancer risk increases, and even knowledge of what to look out for when self-checking.
What’s more, equality for women in healthcare is a pressing topic that we must remain aware of. Diana said that, while much progress has been made, we can always do better.
“Women are advancing in every avenue, in the workforce and so on. However, I still think that, primarily, diseases that affect men get more attention as even in the US; men control a lot of the money,” said Diana. “I think women are catching up on every level, however, I think there are still struggles here. We, as a country, can do better. We’re good, but we can always do better.”
¹ Comparison data determined on a phantom. N.W. Marshall and H. Bosmans, Medical Physics UZ Leuven, Application of the draft EUREF protocol for Quality Control of digital breast tomosynthesis (DBT) systems”, BHPA 2014.