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When fear takes over and anxiety dominates decisions, people often have knee-jerk reactions to the situations they face. The response to a breast cancer diagnosis is one of the most well-known examples of this intense emotional process.  Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma or stage 0 breast cancer, is a non-invasive or pre-invasive breast cancer found in the milk duct, according to most experts [1]. A pproximately 56,500 women get diagnosed with DCIS every year [2]. Most of these women have lumpectomies followed by radiation therapy [3], and some have mastectomies [4], but should they? Nicole Argento, a New Jersey mother of two and an executive creative in the beauty brand space, was recently diagnosed with DCIS after a routine mammogram. “Hearing my diagnosis made me panic. I was buzzing through a blizzard of fear,” said Nicole in an interview. Upon turning to Google, Nicole quickly found that DCIS is a breast cancer that can be removed with surgery, as stated by the American Cancer Society and National Cancer Institute [2, 5]. Later, a surgeon recommended a mastectomy followed by radiation therapy. Nicole’s fears skyrocketed as a result. But instead of simply bowing to the fear of cancer, Nicole became anxious about the procedure that would alter her body and require reconstruction. The effects of radiation also alarmed her. “They treated me like I was dying, but they also told me they could make me look like a movie star. I felt like I was in a chop shop, so I decided to investigate,” she said. Another Google search led Nicole to Pennsylvania-based Dr. Jennifer Simmons, an integrative oncologist, functional medicine physician, and former breast surgeon. After watching Dr. Jenn's podcasts, Nicole made an appointment and purchased her book, The Smart Woman's Guide to Breast Cancer , which she read from cover to cover in a matter of hours.  During an interview, Dr. Jenn explained, “DCIS is not cancer. In fact, the name needs to be changed. Women need to know that there is no urgency with a diagnosis of DCIS. They should not feel like surgery is emergent.”  Dr. Jenn also informed Nicole that only three types of breast cancer require immediate surgery and other extreme measures. These types are inflammatory breast cancer, breast cancer that has caused a fracture, and brain metastases.  “The different ways of thinking about a breast cancer diagnosis were confusing,” said Nicole. “I needed more information, for sure.” In addition to meeting with Dr. Jenn, Nicole underwent genetic testing and was relieved to learn that she does not have “a breast cancer gene.” Nicole had quite a few mammograms, two biopsies, and an MRI as well. “Having back-to-back mammograms and waiting for the biopsy results was torturous,” she admitted. Nicole also asked for other opinions about her pathology reports. The final diagnosis was borderline atypical ductal hyperplasia (ADH) and DCIS, with the MRI showing that there were no other causes for concern. “ADH is benign. Both ADH and DCIS do not require immediate surgery. Patients have time to understand their situation and integrate approaches that could stabilize, reduce, or even eliminate abnormal cells encapsulated by the milk duct,” said Dr. Jenn. Given all of the information, Nicole has opted for a functional medicine approach. “I am working with Dr. Jenn on a very specific protocol based on many contributing factors. We are still investigating a few areas, but we began with bloodwork and a GI map. Focusing first on restoring my gut health to help reduce inflammation in my body is vital,” said Nicole. Moving forward, Dr. Jenn will monitor Nicole’s progress, particularly checking for cell doubling, using Quantitative Transmission (QT) Ultrasound, which the FDA approved as an adjunct to mammography [6]. QT imaging is known for being comfortable, safe, radiation-free, fast, and efficient, with 40 times the resolution of an MRI. Any next steps for Nicole will depend on each ultrasound and other relevant considerations.  Nicole's outlook is hopeful. “I view healing as a holistic, joyful, and inspired experience, rather than an overwhelming chore. Knowing that it will be a longer process, I am not rushing it. I am floating through rather than pushing against, trying to heal on multiple levels, emotionally, spiritually, and physically. I am taking time for myself, slowing down, trusting this process, and working with other healers through cognitive behavioral therapy, energy healing, meditation, acupuncture, and Chinese herbs.” Photo credit: Nicole Argento Disclaimer: The content of this article is for informational purposes only and should not be considered professional medical advice. References  Ductal carcinoma in situ (DCIS) - Symptoms and causes. Mayo Clinic. Accessed June 14, 2024. https://www.mayoclinic.org/diseases-conditions/dcis/symptoms-causes/syc-20371889 Breast Cancer Statistics | How Common Is Breast Cancer? Accessed June 14, 2024. https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html Goodwin A, Parker S, Ghersi D, Wilcken N. Post-operative radiotherapy for ductal carcinoma in situ of the breast. Cochrane Breast Cancer Group, ed. Cochrane Database of Systematic Reviews . Published online November 21, 2013. doi:10.1002/14651858.CD000563.pub7 Hwang ES. The Impact of Surgery on Ductal Carcinoma In Situ Outcomes: The Use of Mastectomy. JNCI Monographs . 2010;2010(41):197-199. doi:10.1093/jncimonographs/lgq032 Breast Cancer—Patient Version - NCI. Accessed June 14, 2024. https://www.cancer.gov/types/breast Malik B, Terry R, Wiskin J, Lenox M. Quantitative transmission ultrasound tomography: Imaging and performance characteristics. Medical Physics . 2018;45(7):3063-3075. doi:10.1002/mp.12957

Like yourself, many healthcare students, established providers, and university professors are concerned about patients in marginalized groups due to the inequities they face. This frustration is compounded by knowledge of attacks on equity, diversity, inclusion, and belonging (EDIB) efforts in healthcare. What if there was a way to close some of the gaps and improve crucial services for underserved populations without increased hostility [1]?   Feeling frustrated or anxious about the current healthcare landscape is understandable. Medical institutions and professional organizations have become battlegrounds for attacks on EDIB efforts that originated from higher education inclusion programs. For example, a lawsuit against the Medical Board of California aims to stop a one-hour CME training on implicit bias [2]. One hour . Moreover, a recent study outside of the healthcare setting found that opposition toward a marginalized group can grow when just one person displays discriminatory behavior [3]. Taken to extremes, prejudicial acts have negatively impacted people within all levels of society and could continue to do so if no intervention efforts are made.   Lori Tarke, DHsc, an executive director and EDIB strategist in New Jersey, h as paid attention. “So many of my students, colleagues, friends, and family members were distressed by experiences of discrimination,” she says. In response to these experiences, Dr. Tarke gathered a team of volunteers to create Bridge to Visibility (BTV), a nonprofit organization that increases the representation of minoritized patients, students, and providers through healthcare conferences. “Rise Up, our first healthcare conference in September 2023, was held to address the systemic issues affecting the LGBTQ+ population,” recalls Dr. Tarke. “Later, we expanded our focus to include the Latinx and African-American communities. People in these and other minority groups face health equity issues, such as a lack of access to quality care and providers who understand them.”    Sponsored by Atlantic Health System, the first Rise Up LGBTQ+ healthcare conference was held on the campus of St. Elizabeth’s University in Florham Park. This conference brought people together to discuss trauma-informed care for youth, normalize the creation of non-traditional families, and spotlight the challenges of older adulthood, among other topics. “Attendees experienced a much-needed event that encouraged ‘pride’ on a deeper level and in a more comprehensive, health-centered arena,” says Tarke. “They were grateful to be able to collaborate with like-minded professionals within a celebratory learning environment. People were moved to tears because they needed a venue like this to validate their concerns, motivate them to take action, and create avenues for opportunity. It was lovely to see.”    BTV’s next Rise Up conference will entertain attendees while delving even more deeply into effective ways of improving healthcare experiences and outcomes for LGBTQ+ community members. The event will be held in September 2024 at the Galloping Hill Park and Golf Course in Kenilworth. “Sabrina Dias from The Voice  will perform and our honorees are inspiring members of their individual communities, which I think everyone will appreciate,” says Dr. Tarke. The upcoming conference will offer workshops and seminars on such topics as financial abuse among the elderly, a whole-person approach to health, intimate partner violence, minority stress, the representation of grief and healing in writing, and the prevention of and treatment options for sexually transmitted infections.   And if that isn’t enough, in February 2025, the Adelantando Healthcare Conference will bring together some of the most powerful voices in the Latine/o/a/x community. “Interacting with providers who are better equipped to support community needs and potential future colleagues—all gathered together for a full day—is a fantastic and rare networking opportunity,” says Dr. Tarke. “Most people don’t usually get a chance to meet these types of individuals outside of a clinical setting, but this conference will create unique opportunities for aligned discussion and collaboration.” Last but not least, attending Thrive, the BTV conference in November 2025, could motivate you and other like-minded people to take action on behalf of the Black community. “Our goal with this event is to inspire even more students from the African-American community to become healthcare providers and to educate current providers about important healthcare issues facing the African-American community,” explains Dr. Tarke. BTV is also currently accepting nominations for five awards: Excellence in Education, Healthcare, Service, Courage and Visibility, and Lifetime Achievement. To nominate someone, send an email to contact@bridgetovisibility.org .   Bridge to Visibility is here to stay, but the organization could use your help. “As long as we can sustain our conferences, we will continue to offer them,” says Tarke. “We’re an all-volunteer organization, so support and involvement from the larger community are essential.”   Visit   Bridge to Visibility  to learn more about its upcoming events, inquire about volunteering, or buy tickets for yourself or a friend. Photo credit: Lori Tarke, DHsc References 1.   Health Disparities: Creating Health Care Equity for Minorities. United Way NCA. Accessed July 16, 2024.   https://unitedwaynca.org/blog/healthcare-disparities/   2.   Blackstock OJ, Isom JE, Legha RK. Health care is the new battlefront for anti-DEI attacks. Opara IN, ed. PLOS Glob Public Health . 2024;4(4):e0003131. doi:10.1371/journal.pgph.0003131   3.   Hostility towards minorities can be contagious. ScienceDaily. Accessed July 16, 2024. https://www.sciencedaily.com/releases/2018/05/180509093843.htm