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At Southeast Nebraska Cancer Center (SNCC), finding the best treatment for each patient is at the core of what they do.

Dr. Joni Tilford, a medical oncologist at SNCC’s 40th and Pine Lake location, says early detection is still a key factor in saving the lives of those diagnosed with breast cancer.

Crystal Kaster, 40, had not reached the recommended age for an annual mammogram screening when she noticed a swollen lymph node last November. She was diagnosed with Stage 3 invasive mammary carcinoma ductal cancer in January.

Kaster received three types of chemotherapy treatments at SNCC, where she bonded with the infusion nurses. Each Wednesday when she came in for her infusion treatments, the nurses would wear t-shirts Kaster made that read “Tougher than cancer, stronger together, Kaster’s Crew.” They donned them on her last day of chemotherapy last March, too.

“That’s kind of your family for a while,” said Kaster, who found herself visiting the infusion nurses when she returned to SNCC for her radiation treatments in September. SNCC chemotherapy nurse Rachael Owen also ran the Lincoln Halfsy (a half-marathon) with Kaster this past October.

Kaster praised her SNCC radiation oncologist, Dr. Mark Stavas, too. Dr. Stavas worked around her heart and breast implants following her bilateral mastectomy and reconstruction. “He took a lot of time and mapped it out specifically for me,” she explained.

Patient Sue Unvert, 51, followed Dr. Tilford to SNCC earlier this year. Unvert touted Tilford’s personability and empathy. “She just sits down and talks to you and connects,” she shared. “She really cares about you.”

Unvert is a supporter of self-exams and being your own advocate when abnormalities are found. Her own self-discovery of a small lump led to a diagnosis that a mammogram performed six months prior had not indicated. Unvert opted to have the one-centimeter tumor removed along with both breasts because of a family history of breast cancer. She didn’t require radiation.

In addition to chemotherapy infusion treatments and/or radiation, most breast cancer patients take anti-estrogen medication after other treatments are completed. Kaster’s current treatment includes a shot to suppress her ovaries from producing estrogen to feed any cancer and a 5-year regimen of aromatase inhibitors.

Dr. Tilford turns to targeted chemotherapy for metastatic breast cancer, which is cancer that has spread to other parts of the body. At the same time, she wants to work with her patients to help them determine the best treatment for them, factoring in their age, lifestyle and goals. “It’s an informed decision,” Dr. Tilford said. “They need to understand the risks involved versus the benefits.

“The idea of chemotherapy is to prolong their survival, not shorten it, while preserving quality of life,” she continued.

Antibodies to target genes that are going awry continue to be a therapy of choice for HER2 NEU breast cancer cases, Dr. Tilford said. Herceptin is an example of this more targeted therapy, and according to Dr. Tilford, has less toxicity and a better response than chemotherapy alone.

“Antibodies help improve the overall prognosis of HER2 patients,” Dr. Tilford explained.

Dr. Tilford advocates monthly breast checks one week after the completion of a woman’s cycle and paying attention to any change in shape or color of the breast, nipple discharge or lumps. Diagnostic mammograms, which include more views and images than a screening mammogram, can be requested to help with cancer detection. SNCC oncologists may also order breast MRIs or ultrasound to further assist in detecting abnormalities. Breast biopsies give them more information about the characteristics of the tumor so they can formulate a treatment plan.

SNCC provides comprehensive cancer care in Lincoln and 12 communities in Southeast Nebraska. It is composed of seven medical oncologists and two radiation oncologists, along with multiple supportive care services. For more information about SNCC visit

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L Magazine editor

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