1. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
Title slide
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

2. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
Breast cancer knows no prejudice and affects Native women just as it does other women.
Most Non-Native women are diagnosed with breast cancer after the age of 50.
However, based on women in the “National Native American Cancer Survivors’ Support Network” about half of Native women diagnosed with breast cancer were younger than age 50.
Although most American Indian and Alaska Native women who are diagnosed with breast cancer are 40 years old and older, some younger Native women have also been diagnosed.
These three photos are of women enrolled in the National Native American Breast Cancer Survivors’ Support Network ( ). These and others have helped Native American Cancer Research (NACR) develop cancer education support resource materials. We hope this product is of use to you and your community.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

3. All four are employees of NACR.
Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
Lisa Harjo, MA (Choctaw) took the leadership role in modifying this education product.
Terri Rattler (Oglala) helped to refine the product and assisted Ms. Harjo in the focus group evaluation and pretesting.
Linda Burhansstipanov (Linda Bee) (Cherokee) helped refine and added the scientific and cultural-specific information and layout of the product.
Rick Clark helped modify graphics to respond to focus group members’ suggestions and expert reviewers’ comments.
All four are employees of NACR.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

4. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
NACR staff have wanted to develop culturally relevant resources such as this material for many years. However, to do so in a conscientious, scientific, and culturally respectful manner requires funding.
We are very thankful to the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation for supporting our local NACR program, “Native American Women’s Wellness through Awareness” (NAWWA). Through their support in 2002, NACR staff were able to develop, pretest, and disseminate this product.
NACR is a partner with Mayo Clinic’s Native American Programs (“Spirit of EAGLES”, the Native CIRCLE, and the Native WEB). “Spirit of EAGLES” funding partially supported the refinement and dissemination of this product.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

5. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
Linda Krebs, RN, AOCN, PhD, provided a very detailed review of scientific accuracy.
Catherine A. Offutt, was the Project Coordinator of the Pathways to a Healthy Life project, which was supported by the national Susan G. Komen Breast Cancer Foundation in 1999 (grant #9820). This was a partnership among the women’s Health Coordinators from the Navajo Nation, Hopi Tribe, Indian Health Service, the New Mexico Breast and Cervical Cancer Program, Zuni and Apache Nations. The graphics from their lovely and effective booklet were used or modified for use within this product.
The Rocky Mountain Cancer Information Service Partnership Program developed the original flip chart which served as the model for this product, Spread the Word about Mammograms and the Pap Test: An Educational Resource for Health Care Professions. Pub. No This product is limited to breast because NACR is awaiting approval to use graphics from another American Indian program within the Cervix Health product.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

6. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
This is an introductory slide with a focus of the message we want to leave with them. It is presented here in case the women are unable to take part in the entire health education session.
NAWWA is the name of our local Denver program. It stands for Native American Women’s Wellness through Awareness.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

7. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
This section is designed to provide some background about breast tissue and breast cancer occurrence ... Women who have an abnormal breast health screening frequently want to have information such as what is included in this section to help them understand the changes in their breasts.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

8. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
Most people are unfamiliar with the anatomy of the breast and especially where the lymph nodes are located. This slide and the next are to help show the tissues which make up the breast area.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

9. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
This diagram makes a distinction between milk ducts and the lobes. The lobes in the breast are the second most common location for breast cancer to begin to develop.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

10. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
The previous slides showed the types of tissue that most breast cancers begin to grow in.
This slide divides the breast into four areas and shows how common breast cancer is found in each of the four areas of the breast.
Breast cancer under the nipple is more common than most people realize. This is why it is very important to make certain the breast self exam includes the nipple area.
Specimens of tumors or growths in the nipple area usually have to be sent away to laboratories which have specialized equipment that is needed to identify the cancer cells in or below the nipple.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

11. There are about fifteen different types of breast cancer.
Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
There are about fifteen different types of breast cancer.
But the most common begins to develop in the milk ducts of the breasts. This does not mean than it begins while a woman is breast feeding or that it is related in any way to breast feeding. It also does not mean that if a woman breast fed and later developed cancer that her child/children received breast cancer cells in their milk. These are common questions from Native women.
Even for women who never breast fed their children, or who never had children, the mild ducts of the breast are still the most common location for breast cancer to begin.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

12. There are over fifteen different types of breast cancer.
Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
This table is just to illustrate some of the more common types of cancer.
There are over fifteen different types of breast cancer.
As the table shows, 78% of all breast cancers are ductal or lobular.
Note that breast cancer “in situ” refers to tumor cells which have not become invasive yet. If they are not removed or treated, they will continue to grow and invade surrounding tissues.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

13. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
Lisa Harjo and Terri Rattler answer both the local Denver number and the toll free number.
The CIS number goes to whichever CIS is closest to your location. For example, in Denver, we reach the Rocky Mountain CIS offices.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

14. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
Brochures
Breast Cancer
Cervical Cancer
Endometrial Cancer
Prostate Cancer
Lung Cancer
Dietary Needs of Cancer Patients
Cancer Control Materials
Smoking and Smoking Cessation
Dietary Habits and Healthy Eating
Healthy Living Styles
Videos
Wellness
Native Nutrition
PAP Smear/Cervical Cancer
Tobacco and Health
Stories of AI/AN Cancer Survivors
Smoking Cessation
Online Resources
American Indian Resource Center
Association of American Indian Physicians
Center for American Indian Research and Education (CAIRE)
Native American Resources on the Internet
Native American Cancer Initiatives, Inc
Indian Health Services
Minnesota Indian Affairs Council
Susan G. Komen Breast Cancer Foundation
American Cancer Society
Center for Disease Control and Prevention (CDC)
Native American Women's Health Education Resource Center
Northwest Portland Area Indian Health Board
Other Resources
Extensive Bibliography
Access to Medical Journals and Reference Materials
Grant Information
Speakers Bureau
Introduction.10
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

15. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
These are the local public health educators and Native Sisters and are available to help local women take part in screening, receive personalized breast health education, and similar related functions.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives

16. Get on the Path to Breast Wellness -- Denver NAWWA Program ( ) of NACR ( ); Survivors’ Network
This is the national headquarters for any queries from women within or outside of Colorado.
Thank you for taking time to visit with us and talk about breast health.
Be well.
Supported by the Denver Affiliate of the Susan G. Komen Breast Cancer Foundation; Mayo Clinic’s Spirit of EAGLES, and Native American Cancer Initiatives