Breast Cancer: An Integrative Approach (2021-2023)

Overview

One out of every eight women in the US will be diagnosed with breast cancer during their lifetime, a number that has been increasing steadily over the past decade. The prevalence of breast cancer in men is also on the rise. Given the number of breast cancer diagnoses, practitioners must be equipped with up-to-date, comprehensive information about prevention, treatment, and survivorship.

Breast cancer treatment is complex and demanding. It is important that busy providers have the tools they can incorporate into conventional cancer treatment -- integrative interventions that new research shows can impact not only quality of life, but also cancer-specific outcomes. These powerful integrative adjuvants include stress management, exercise, sleep, and diet.

Practitioners trained in an integrative medicine model have the potential to improve outcomes, encourage optimism and resilience, and teach innovative, effective approaches to self-care in their patients. Information in this course will help practitioners better serve patients with breast cancer in all stages of treatment.

Learning Objectives

Breast Cancer Risk Reduction
Participants will be able to:

  • List key risk factors for breast cancer and identify modifiable risk factors.
  • Gain familiarity with the role of risk reduction in breast cancer subtypes.
  • Understand the Society recommendations, indications and limitations of breast cancer screening.
  • Define strategies to help patients address modifiable risk factors including alcohol intake, physical activity and obesity.
  • Discuss the role of dietary patterns and nutrition in breast cancer risk reduction.
  • Recognize the contributors and impact of insulin resistance in breast cancer risk.
  • Develop familiarity with lifestyle strategies to lower insulin resistance.
  • Review the role of environmental endocrine disruptors as risk factors for breast cancer.
  • Recognize genetic variants and mammographic findings that identify women at high risk for breast cancer and appropriately refer those patients for genetic screening, intensive surveillance, and risk reduction.
  • Apply evidence-based integrative approaches to breast cancer risk reduction using case-based learning.

Breast Cancer Treatment
Participants will be able to:

  • Gain appreciation of the role of biopsy in breast cancer diagnosis.
  • Discuss surgical options for breast cancer treatment and reconstructive surgery.
  • Gain insight into how to support patient dialogue and decision-making from a benefits:risk perspective in their surgical treatment decision making
  • Assess methods used to optimize surgical outcomes, improve patient experience, and reduce risk of surgical complications.
  • Describe classes of drug therapies and radiation therapy for breast cancer treatment, their associated adverse effects, and evidence-based approaches to prevent or minimize these effects.
  • Recognize the Traditional Chinese Medicine interpretation of the causes and treatment approaches to breast cancer, especially the use of acupuncture for addressing some of the adverse effects of conventional treatment.
  • Evaluate commonly used mind-body medicine approaches used to prepare and support women during breast cancer treatment.
  • Discuss the clinical evidence for nutrition, exercise, mind-body approaches, whole systems approaches and and dietary supplements which have been shown to improve the efficacy and/or mitigate adverse side effects of breast cancer chemotherapy.
  • Discuss the clinical evidence for integrative strategies which mitigate adverse side effects of breast cancer radiation therapy.
  • Apply evidence-based integrative medicine strategies to breast cancer using case-based learning that addresses a variety of diagnostic and treatment scenarios.

Breast Cancer Survivorship
Participants will be able to:

  • Discuss guidelines for post-treatment surveillance.
  • Gain familiarity with monitoring breast cancer patients for treatment-related effects and signs of recurrence post-treatment.
  • Discuss integrative medicine strategies, inclusive of diet, physical activity, stress management, and dietary supplementation to address modifiable risk factors for breast cancer recurrence.
  • Demonstrate approaches to prevent or reduce symptoms of physical weakness, functional impairment, lymphedema, and nerve damage caused by surgery and radiation therapy for breast cancer.
  • Identify the impact of long-term breast cancer endocrine therapy on general health, and discuss evidence-based integrative approaches to manage hot flashes, osteoporosis, and sexual function.
  • Assess evidence-based integrative medicine approaches to mental health after breast cancer treatment, including depression, anxiety, insomnia, and fatigue.
  • Apply evidence-based integrative medicine strategies in case-based learning format to address the complex needs of breast cancer survivors.

Curriculum

Course Modules

RISK REDUCTION
Breast Cancer Risk Reduction
Breast Cancer & Insulin Resistance
Breast Cancer & the Environment
High-Risk Patients

TREATMENT
Treatment Options
Reducing Adverse Effects of Drug Therapy
Reducing Adverse Effects of Radiation Therapy

SURVIVORSHIP
Monitoring and Decreasing Recurrence Risk
Physical Rehabilitation in Breast Cancer Survivors
Endocrine Considerations
Mental Health and Breast Cancer

EVALUATION & EXAM
Breast Cancer Evaluation
Breast Cancer Exam

Completion Requirements

Complete all the course work, course evaluation, and the final test with a score of 70% or better. Upon successful completion you will be able to print your certificate of completion.

Target Audience

Physicians, physician assistants, and other health practitioners who have interest in integrative medicine.

Certificate

When all of the above requirements are met (during the agreed upon timeline), a link for the completion certificate is available to download and print anytime from "My Account." If a specific credit type was selected at registration, your certificate will indicate earned credits.

Disclaimer

This course does not constitute medical advice. Healthcare providers should exercise their own independent medical judgment.

All case studies and patient scenarios in this course are used for illustrative purposes. All depictions of persons (other than faculty) are models and not actual patients.

Enrollment

You will have a maximum of 30 days access to the material from the start date. You can register and start immediately. If you register for the course and pay with a credit card you will have immediate access to the course. Once your registration is complete, logout and log back in and your course will be listed on the campus page. If you cannot remember your account information, click the Get Username and Password link on the login page and it will be emailed to you.

  1. Complete your registration, including payment of the invoice (find this on "My Account")
  2. Log out
  3. Then log back in
  4. If you cannot remember your account information, click the "Get Username and Password" link on the login page and it will be sent to the email address you used to register.
  5. Your course will be listed on the Community Hub page.

Breast Cancer: An Integrative Approach & Education Credit Info

COM CME

ACCME/AMA PRA Accreditation and CME Designation Statement

The University of Arizona College of Medicine — Tucson is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of Arizona College of Medicine — Tucson designates this enduring material for a maximum of 9 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course includes an assessment of 10 questions that you must answer 70% correctly or above in order to receive credit for participation. You are allowed unlimited re-attempts.

Current CME Approval Period: 06/28/2021 to 06/27/2023

Most Recent Review by Author: 04/12/2021

Date of Original Release: 08/03/2012

Conflict of Interest Disclosure Information

All Faculty, CME Planning Committee Members, and the CME Office Reviewers have disclosed that they do not have any relevant financial relationships with commercial interests that would constitute a conflict of interest concerning this CME activity.

Commercial Support

There is no commercial support for this activity.

Faculty / Authors

Ann Marie Chiasson, MD, MPH, CCFP; Director, Fellowship in Integrative Medicine, Andrew Weil Center for Integrative Medicine
Lise Alschuler, ND; Co-Director, Fellowship in Integrative Medicine, Andrew Weil Center for Integrative Medicine
Dawn Lemanne, MD, MPH; Founder, Oregon Integrative Oncology, Ashland, OR
Cheryl Beighle, MD; Partner, Pediatrician, Everett Clinic, Everett WA
Adi Benito-Herrero, MD; Owner and Director, Princeton Integral Endocrinology, Princeton, NJ
Bridget Bongaard, MD; Medical Director, Islands Hospice, Kahului, HI
Maggi Coplin, MD; Oncologist, Oncology Locums, Chesterfield, MO
Karolynn Echols-Lara, MD; Chief of Female Pelvic Medicine and Reconstructive Surgery in Ob/Gyn at Thomas Jefferson University, Philadelphia PA
Pio Guerrero, MD; Attending Physician, Colorado Rehabilitation Specialists, Colorado Springs, CO
Steven Gurgevich, PhD; Clinical Asst Professor of Medicine and Director, The Mind-Body Clinic, Tucson, Arizona
James Holleman, MD; Surgeon, St. Luke's Surgical Associates, Columbus, NC
Ayemoethu Ma, MD; Director of Breast Surgery, Mt. Sinai - St. Luke's, New York, NY
Robert Pendergrast, MD; Associate Professor at Georgia Health Sciences University
Jaimie Perkunas, DPT, E-RYT; Owner, Yoga Is Therapy, Tucson, AZ
Joanne Perron, MD; FACOG, Lecturer, UC Berkeley, Berkeley, CA
Santosh Rao, MD; Medical Director of Integrative Medicine, Banner MD Anderson Cancer Center, Gilbert, AZ
Justine Robbins, MEd, LMT, CLT, NCTMB; Lymphedema Therapist, Banner University of Arizona Cancer Center North, Tucson, AZ
Shilpa Saxena, MD; Founder/President, SevaMed Institute, Inc,Lutz, FL
Diljeet Singh, MD, DrPH; Gynecologic Onocolgy, Mid-Atlantic Permanente Group, McLean, VA
Sharon Taylor, MD; Retired, Durham, NC
Jingduan Yang, MD; Founder/Medical Director, Tao Institute of Mind & Body Medicine, Marlton, NJ
Rena Zimmerman, MD; Radiation Oncologist, Midwest Radiation Oncology Consultants, McHenry, IL

Planning Committee

Ann Marie Chiasson, MD, MPH, CCFP; Director, Fellowship in Integrative Medicine, Andrew Weil Center for Integrative Medicine
Lise Alschuler, ND; Co-Director, Fellowship in Integrative Medicine, Andrew Weil Center for Integrative Medicine