1. 9/29/15 Confidential & Proprietary Community Educator PowerPoint Presentation

2. Please complete pre-test. 210/7/15 Confidential & Proprietary

3. 3 OUR VISION: A WORLD WITHOUT BREAST CANCER 10/7/15 Confidential & Proprietary INTRODUCTION – SUSAN G. KOMEN

4. Our Promise: To save lives and end breast cancer forever by empowering people, ensuring quality care for all and energizing the science to find the cures. 410/7/15 Confidential & Proprietary

5. Breast Health/Cancer Information What is breast cancer? Statistics Breast Self-Awareness Messages Treatment Support Clinical trials Resources 5 INTRODUCTION – AGENDA 10/7/15 Confidential & Proprietary

6. At the end of this session, you should be able to: Define breast cancer. Discuss breast cancer statistics in China. Name the Komen Breast Self-Awareness Messages. State at least one fact associated with each Breast Self-Awareness Message. Name at least one action item associated with each Breast Self-Awareness Message. Name at least two risk factors that increase breast cancer risk. Name other breast imaging tests. 10/7/15 Confidential & Proprietary6 INTRODUCTION – SESSION OBJECTIVES

7. Everyone’s input is equally valued No idea is bad Only one conversation at a time No cell phones Are there other ground rules we should include? Have fun!! 710/7/15 Confidential & Proprietary INTRODUCTION – GROUND RULES

8. 9/29/158 Confidential & Proprietary WHAT DO YOUR BREASTS MEAN TO YOU? 10/7/15 Confidential & Proprietary8

9. When you hear the term breast cancer, what does it mean to you? 910/7/15 Confidential & Proprietary

10. THE GLOBAL BREAST CANCER CRISIS Somewhere in the world… A case of breast cancer is diagnosed every 19 seconds A woman dies from breast cancer every 60 seconds Over the next 25 years… Another 42 million new cases are expected worldwide Another 13 million people worldwide will die from breast cancer Globocan 2012- http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspxhttp://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx 10/7/15 Confidential & Proprietary10

11. 11 China, 2012 New Cases: 187,213* Deaths: 47,984* Every 60 seconds, somewhere in the world, someone dies from breast cancer USA, 2015 231,840** 40,290** 10/7/15 Confidential & Proprietary Breast Cancer Statistics – Estimates in China & USA

12. 12 China Average age at diagnosis is 40.6* USA Median age at diagnosis is 61** 10/7/15 Confidential & Proprietary Breast Cancer Statistics – Estimates in China & USA

13. 13 Breast cancer is a disease where cells in the breast tissue divide and grow without normal controls. 10/7/15 Confidential & Proprietary What is Breast Cancer?

14. 14 Breasts are primarily fat and breast tissue. Breast tissue is a complex network of lobules, lobes and ducts. Picture Credit: Dr. LI Yanping, Beijing Shijitan Hospital, CMU 10/7/15 Confidential & Proprietary Breast Anatomy & Physiology

15. 15 Many changes occur over a woman’s lifetime. Puberty Menstrual Cycle Pregnancy Post Menopause 10/7/15 Confidential & Proprietary Breast Structure & Anatomical Changes

16. 16 What causes breast cancer? 10/7/15 Confidential & Proprietary

17. 17 Gene mutations are spontaneous or inherited. Several inherited mutations have been linked to breast cancer - BRCA1 and BRCA2. Inherited mutations are associated with 5 – 10 percent of breast cancer in the U.S. Most breast cancer diagnosed in women are not due to inherited genetic mutations. 10/7/15 Confidential & Proprietary Genetics and Breast Cancer

18. 18 Tubular carcinoma Mucinous (colloid) carcinoma Papillary carcinoma Inflammatory Breast Cancer (IBC) Paget disease of the breast Triple Negative Breast cancer is not one disease; it is a family of diseases. 10/7/15 Confidential & Proprietary Names of Breast Cancer Tumors

19. 19 Benign = not cancerous Fibrocystic changes Common benign changes: - Hyperplasia - Cysts - Fibroadenomas Calcifications Not all breast problems are breast cancer. 10/7/15 Confidential & Proprietary Benign Breast Conditions

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21. 1. Know your risk 2. Know what is normal for you 3. Get screened 4. Make healthy lifestyle choices 2110/7/15 Confidential & Proprietary Komen Breast Self – Awareness Messages

22. 22 Talk to your mother’s and father’s families about your family health history Talk to a doctor about your risk of breast cancer 10/7/15 Confidential & Proprietary Key Message – Know Your Risk

23. KEY MESSAGE – KNOW YOUR RISK 23 What have you heard in your community about what increases the risk of breast cancer? 10/7/15 Confidential & Proprietary

24. Risk Factors & Risk Reduction Being female Having a family history of breast cancer Being overweight or obese after menopause Consuming alcohol Little or no breastfeeding Getting older 2410/7/15 Confidential & Proprietary Key Message – Know Your Risk

25. QUESTIONS? 2510/7/15 Confidential & Proprietary

26. 26 Know how your breasts look and feel It is ok to look at and feel your breasts Report changes to a doctor Can you name the changes that you should report? 10/7/15 Confidential & Proprietary Key Message – Know What is Normal for You

27. 27 Key Message – Know What is Normal for You 10/7/15 Confidential & Proprietary Breast changes that should be evaluated by a doctor:

28. 28 Key Message – Know What is Normal for You 10/7/15 Confidential & Proprietary Breast changes that should be evaluated by a doctor:

29. QUESTIONS? 2910/7/15 Confidential & Proprietary

30. Screening tests: Are offered to people who feel fine and who have no reason to suspect a breast problem Are different from tests that are done to evaluate a problem in the breast, which are called diagnostic tests 3010/7/15 Confidential & Proprietary Get Screened

31. 31 A Clinical Breast Exam, is a physical exam done by a doctor. In China, Dr. Jun REN (Professor of Medical Oncology, Executive Dean, Capital Medical University School of Oncology, Beijing, China. Director, Comprehensive Cancer Center, Beijing Shijitan Hospital,Capital Medical University. Beijing, China.) recommends a clinical breast exam as the primary screening test used for breast cancer. 10/7/15 Confidential & Proprietary Get Screened

32. Breast Ultrasound Mammography Breast Magnetic Resonance Imaging 3210/7/15 Confidential & Proprietary Other Imaging Tests

33. Breast ultrasound uses sound waves to make images of the breast. Breast ultrasound may be used in addition to other tests. 3310/7/15 Confidential & Proprietary Other Imaging Tests – Breast Ultrasound

34. 34 Breast ultrasound uses sound waves to make images of the breast. Breast ultrasound may be used in addition to other tests. 10/7/15 Confidential & Proprietary Other Imaging Tests – Breast Ultrasound

35. 35 Breast magnetic resonance imaging uses magnetic fields to create breast images. Breast magnetic resonance imaging may be used in addition to other tests. 10/7/15 Confidential & Proprietary Other Imaging Tests – Breast Magnetic Resonance Imaging

36. 36 9/29/1536 Confidential & Proprietary IF YOU OR YOUR FAMILY OR FRIENDS HAVEN’T BEEN SCREENED, WHY NOT? 10/7/15 Confidential & Proprietary

37. 37 9/29/1537 Confidential & Proprietary HOW DO YOU OVERCOME THESE BARRIERS? 10/7/15 Confidential & Proprietary

38. QUESTIONS? 3810/7/15 Confidential & Proprietary

39. Maintain a healthy weight Add exercise into your routine Limit alcohol intake Limit menopausal hormone use Breastfeed, if you can 39 Some risk factors can be controlled. 10/7/15 Confidential & Proprietary Key Message – Make Healthy Lifestyle Choices

40. 4010/7/15 Confidential & Proprietary Body Mass Index (BMI)

41. QUESTIONS? 4110/7/15 Confidential & Proprietary

42. Today, a biopsy is needed to make a diagnosis of breast cancer. 42 In a biopsy, cells are removed from the area of the breast where an abnormality was found and studied in a lab. There are several ways a biopsy can be done – some with a needle and some in the operating room. The findings from a biopsy are reported on a pathology report. Not all breast cancer is the same. 10/7/15 Confidential & Proprietary Biopsy and Diagnosis

43. Breast cancer can be found at different stages – the earlier the better. 43 Stage 0 - Ductal carcinoma in situ Stage 1 - Early breast cancer Stage 2 - Early breast cancer Stage 3 - Locally advanced Stage 4 - Metastatic breast cancer 10/7/15 Confidential & Proprietary Breast Cancer Staging

44. 44 Local treatments - Surgery – mastectomy, lumpectomy, reconstruction - Radiation Systemic treatments - Chemotherapy - Hormone therapy - Targeted biologic therapy 10/7/15 Confidential & Proprietary Treatment Options

45. QUESTIONS? 4510/7/15 Confidential & Proprietary

46. At the end of this session, you should be able to: Define breast cancer. Breast cancer statistics in China. Name the Komen Breast Self-Awareness Messages. State at least one fact associated with each Breast Self-Awareness Message. Name at least one action item associated with each Breast Self- Awareness Message. Name at least two risk factors that increase breast cancer risk. Name other breast imaging tests. 4610/7/15 Confidential & Proprietary Session Objectives

47. Breast cancer is a problem in our community. Know your risk. Know what is normal for you. Get screened. Make healthy lifestyle choices. Share something you learned today with someone you care about! 4710/7/15 Confidential & Proprietary To Review

48. www.pinkalliance.net www.komentoolkits.org 4810/7/15 Confidential & Proprietary Resources

49. Complete post-test and evaluation form. Review Intent to Act: My personal Goals form 4910/7/15 Confidential & Proprietary Post-Test & Wrapping Up

50. THE END! THANK YOU 50 2015 SUSAN G. KOMEN®. ALL RIGHTS RESERVED. UNAUTHORIZED REPRODUCTION IS PROHIBITED BY LAW. NO PART OF THIS PUBLICATION MAY BE DISCLOSED, DISTRIBUTED, REPRODUCED, STORED IN A RETRIEVAL SYSTEM OR TRANSMITTED IN ANY FORM OR BY ANY MEANS - ELECTRONIC, MECHANICAL, PHOTOCOPYING, RECORDING OR OTHERWISE - WITHOUT THE EXPRESS WRITTEN PERMISSION OF SUSAN G. KOMEN®. SUSAN G. KOMEN® DOES NOT ENDORSE, RECOMMEND OR MAKE ANY WARRANTIES OR REPRESENTATIONS AS TO THE ACCURACY, COMPLETENESS, TIMELINESS, QUALITY OR NON-INFRINGEMENT OF ANY OF THE INFORMATION CONTAINED HEREIN. ANY RESOURCES PROVIDED HEREIN ARE ONLY SUGGESTED AND ARE NOT A COMPLETE LISTING OF BREAST HEALTH AND BREAST CANCER MATERIALS OR INFORMATION. THE INFORMATION HEREIN IS NOT MEANT TO BE USED FOR SELF DIAGNOSIS OR TO REPLACE THE SERVICES OF A MEDICAL PROFESSIONAL. 10/7/15 Confidential & Proprietary

51. 51 If time permits 10/7/15 Confidential & Proprietary Extra Material

52. 52 Brainstorm the barriers keeping women from early detection and write them down on the sticky notes! Classify the barriers you found in one of the following sections (psychological, economic or social and cultural). What other classifications would you add? 10/7/15 Confidential & Proprietary Activity – Addressing Barriers

53. 5310/7/15 Confidential & Proprietary Activity – Addressing Barriers

54. 54 I have heard that exercising 30 minutes five times a week is good for me 10/7/15 Confidential & Proprietary Activity – Awareness

55. 55 I BELIEVE that exercising 30 minutes five times a week is good for me. 10/7/15 Confidential & Proprietary Activity – Understanding

56. 56 Last week, I exercised five times for 30 minutes. 10/7/15 Confidential & Proprietary Activity – Action