Graduating medical students celebrated at College convocation

Twenty-nine graduating medical students were honored at Senior Convocation, hosted by the College of Community Health Sciences May 19 at the Tuscaloosa River Market. Now physicians, the students are beginning their residency training in programs across 17 states.

The University of Alabama School of Medicine students completed their third and fourth years of clinical education at the College, which also functions as the Tuscaloosa Regional Campus for the School of Medicine. All students spend their first two years of medical school at the School of Medicine’s main campus in Birmingham, and then receive their clinical education at either the Birmingham campus or one of the regional campuses – Tuscaloosa, Huntsville and Montgomery.

The Tuscaloosa Regional Campus students also received awards at the Convocation from faculty, clinical staff and their peers. Scholarships were also presented.

On Saturday, May 20, the students joined their 158 classmates for commencement in Birmingham.


Awards given at Convocation:

Department and College Awards:
Robert F. Gloor Award in Community Medicine
Dr. Jessica Powell
Awarded for excellent performance in Community and Rural Medicine

William Owings Award in Family Medicine
Dr. Jessica Powell
Awarded for excellence in Family Medicine

Recognition of Rural Medical Scholars

Drs. Daniel Stanley, Scott Thomas, Jessica Powell, Amanda Turner Shaw and Caitlin Tidwell
Family/Rural Medicine Preceptor’s Award
Dr. Larry Skelton
Awarded annually to a community preceptor in Family Medicine/Community and Rural Medicine who exemplifies excellent teaching and role modeling for students.

William Winternitz Award in Internal Medicine
Dr. Steve Allon
Awarded for outstanding achievement in Internal Medicine during the third and fourth years. This student possesses an exceptional wealth of knowledge, is able to integrate the pathology of disease with the physiology of clinical skills, and practices with empathy, compassion and a desire to improve the patients with whom he or she comes in contact.

Neurology Award
Dr. Scott Thomas
Awarded for outstanding academic and clinical performance during the Neurology Clerkship.

Pediatrics Recognition Award
Dr. Maria Gulas
Awarded for outstanding interest, ability and the reflection of pleasure in helping parents and their children reach their full personal, social and educational potential.

Peter Bryce Award in Psychiatry
Dr. Caitlin Tidwell
Awarded for excellence exhibited by a medical student both academically and clinically during his/her Psychiatry Clerkship. This award is presented in honor of Dr. Peter Bryce, who was appointed the first superintendent of Bryce Hospital in Tuscaloosa. He and his wife, Ellen Clarkson Bryce, were cornerstones for Tuscaloosa society and tenacious advocates for people who experience mental illness.

Finney/Akers Memorial Award in Obstetrics and Gynecology
Dr. Chelsea Turgeon
Awarded to a student achieving outstanding academic and clinical success in Obstetrics and Gynecology. This award is presented in honor of former medical students James H. Akers and Teresa K. Finney.

William R. Shamblin, MD, Surgery Award
Dr. Julia Stiegler
Awarded to a student with the highest scholastic achievement during his or her third-year Surgery Clerkship. Dr. William R. Shamblin, a Tuscaloosa native and former Chair of the Department of Surgery, spent years educating medical students and Family Medicine residents. This award continues in his honor.

Interprofessional Excellence Award
Dr. Scott Thomas
This award recognizes the medical student who has best demonstrated excellence in communication skills, respect for staff and patients, and a commitment to working as an effective member of the health care team.

Larry Mayes Research Society Scholars
Drs. Chelsea Turgeon and Andrew Watson

Official Fellow Members:
Drs. Danielle Fincher, Caroline Watson, Reaves Crabtree, Julia Stiegler and Roshmi Bhattacharya

Student Research Award
Dr. Jessica Powell
Recognition of the pursuit of one or more research projects leading to a presentation or publication during the clinical years of medical training.

Scholastic Achievement Award
Dr. Caroline Kennemer
Awarded for superior performance in the clinical curriculum.

William R. Willard Award
Dr. Danielle Fincher

Established by the Bank of Moundville, this award is presented for outstanding contributions to the goals and mission of the College of Community Health Sciences as voted by the College faculty.


Faculty, Resident and Student Awards as determined by the graduating class
Faculty Recognition Award
Dr. Joseph Wallace
Awarded for outstanding contributions to undergraduate medical education during students’ junior year.

Community Preceptor Heroes Award
Drs. Bradley Bilton, Julia Boothe, Scott Boyken, Scott Davidson, Charles Gross, William Lenahan, Quinton Mathews and JD Shugrue
Awarded to community preceptors for outstanding contributions to undergraduate medical education.

Patrick McCue Award
Dr. A. Robert Sheppard
Awarded for outstanding contributions to undergraduate medical education during students’ senior year.

Resident Recognition Award
Dr. Blake DeWitt
Awarded for outstanding contributions to medical education.

James H. Akers Memorial Award
Dr. Nathan Sherrer
Awarded to a graduating senior for dedication to the art and science of medicine.


College Scholarships
Dr. Benjamin Collins Maxwell Endowed Scholarship
Dr. Ben Lee
Dr. Benjamin Collins Maxwell was a pioneer in Family Medicine practice who trained many Tuscaloosa medical students and family medicine residents in his practice in Atmore, Alabama. He was renowned for the degree of interest, patience and compassion he had for his patients. This scholarship was endowed by Dr. David and Mrs. Regina Maxwell to honor the legacy of Dr. Maxwell and of all primary care physicians, and to support the Rural Medical Scholars Program and academic excellence within the College of Community Health Sciences. Priority is given to graduating medical students who plan to practice rural primary care in Alabama, with a special consideration for students from Escambia County and the Rural Medical Scholars Program.

Reese Phifer, Jr., Memorial Foundation Scholarship in CCHS
Dr. Jessica Powell
The Reese Phifer Jr. Memorial Foundation Endowed Scholarship is awarded annually to promote the education of medical students at the College of Community Health Sciences/University of Alabama School of Medicine-Tuscaloosa Regional Campus. The Foundation was established by Mr. and Mrs. Reese Phifer in 1967 in memory of their son J. Reese Phifer, Jr., a student at The University of Alabama who died in 1964. The Foundation established the scholarship fund in 2014. Priority is given to current fourth-year medical students who intend to complete their residency at The University of Alabama Family Medicine Residency, which the college operates, and who have an interest in spending part of their residency training in Fayette, Alabama.

Robert E. Pieroni, MD, and Family Endowed Scholarship
Dr. Danielle Fincher
The Robert E. Pieroni, MD, and Family Endowed Scholarship was established by Dr. and Mrs. Robert Pieroni to support medical students intending to enter primary care.

Robinson part of panel focusing on concussion prevention and treatment

Dr. Jimmy Robinson, who holds the Endowed Chair of Sports Medicine for Family Physicians at the College of Community Health Sciences, was part of a panel discussion last month that focused on concussion prevention, diagnosis, treatment and management.

Robinson, who is also the lead team physician for UA Athletics, was joined on the University of Alabama at Birmingham panel by Dr. M. Heath Hale, lead team physician for UAB Athletics, and Dr. Siraj Abdullah, sports medicine physician for Auburn University.

“The more we learn about concussions, the more we realize what we don’t know about concussions,” Robinson said.

The panel discussion is part of ongoing efforts among researchers and medical professionals at UAB looking for answers in how to best protect the brain and treat traumatic brain injuries.

“The research that continues to come out of UAB enhances the care we are able to provide our athletes,” Hale said. “New helmet research to protect our football players’ brains, baseline testing for all student-athletes in the case that they receive a concussion, and even research on the appropriate time for our student-athletes to return to the classroom play an important role in how we care for concussed student-athletes each day.”

Robinson was instrumental in helping pass legislation in Alabama in 2011 to protect younger athletes from concussions as a founding member of a task force created by the Neuropsychology Department at Children’s Hospital in Birmingham. The law requires athletes and their parents and coaches to be educated about the signs and symptoms of concussions. The law also requires athletes who show signs or symptoms of a concussion to get physician approval before returning to their sport.

Robinson, who has served as lead team physician for UA Athletics since 1989, is also the team physician for many Tuscaloosa area high schools. He is director of the College’s Dr. Bill deShazo Sports Medicine Center and oversees the College’s Sports Medicine Fellowship for Family Physicians.

Prevention best way to avoid Zika Virus

By Amelia Neumeister

“It’s a story that begins with a bug,” said Dr. Heather Taylor, associate professor of Pediatrics at the College of Community Health Sciences, as she began her May 1 lecture as part of the Mini Medical School Program hosted by the College and UA’s OLLI program.

In her talk, titled “Zika Virus,” Taylor explained that the mosquito Aedes Aegypti is the vector, or carrier, of the Zika Virus, as well as three other major diseases – Yellow Fever, Dengue Fever and Chikungunya Virus. She said this mosquito is such a good carrier of these diseases because it has developed an immunity to many pesticides and other chemicals, and will lay eggs in standing water.

Almost 40 percent of the world’s population is at risk for the diseases carried by the Aedes Aegypti mosquito, Taylor said.

The Zika Virus was first identified in Uganda’s Ziika Forest in 1947, and the first human case was documented in 1952. Over time, several small outbreaks were identified, with the first large outbreak occurring in 2007 in the South Pacific, on Yap Island in Micronesia. More than 73 percent of the island’s population was infected.

It wasn’t until 2015 when Brazil experienced a major outbreak of the Zika Virus that research about the disease began to change, Taylor said. Before this outbreak, the Zika Virus was considered a mild disease with only about a quarter of those infected showing symptoms, and with symptoms lasting for about a week. After the outbreak in Brazil, researchers found a link between Zika Virus, microcephaly infants and Guillain-Barre Syndrome.

“Zika Virus is playing from very different rules that the other flaviviruses that are mosquito born,” Taylor said.

She said the Zika Virus breaks the rules because it is not spread the same way as other viruses. “We know that it’s not spread through touching, coughing, sneezing or breastfeeding. So it’s different from other viruses in that it’s not spread by respiratory secretions.”

The Zika Virus is spread by mosquito bites, blood and sexual intercourse.

While testing for the Zika Virus exists, it is not yet widespread. “At this point, the health departments are controlling Zika testing so they can make sure the people that need those tests can have access to them,” Taylor said. “The CDC is controlling testing for people who really need it – people who have been exposed to the virus and who are symptomatic or pregnant.”

Unfortunately, there is no treatment for the Zika Virus, Taylor said. “The only weapon we have for fighting it is prevention.” Four vaccines are currently being tested and are targeted for females who have the potential to get pregnant in the future. Testing is also underway on genetically modified mosquitos designed to fight the Aedes Aegypti mosquito.

There are several stages of prevention, Taylor said, “But they all go back to that bug.”

The stages are: avoid being bitten; avoid traveling to areas that have experienced an outbreak; and if travel is necessary, or if you live in an affected area, wear long-sleeve shirts and long pants, spray the insecticide Permethrin on your clothing, use a bed net, if indoors keep the doors closed and use air conditioning and keep screens on doors and windows.

Summer Sun Safety: Avoiding the Dangers of the Sun’s Rays

By Kim Eaton

Those beautiful golden summer rays might look quite appealing after springtime showers, but if you’re not careful, that summer sun can turn dangerous, and fast.

“Exertional heat illness is one of the leading causes of death in young athletes each year,” says Dr. Ed Geno, assistant professor in the Department of Family, Internal, and Rural Medicine at the College of Community Health Sciences. “Children and the elderly are also more at risk. The elderly do not have the same cardiovascular ability to sweat and get the heat out of their system. There are also many medications that can predispose someone to heat injury of any kind.”

There are several types of heat illness. Heat cramps and heat exhaustion are the most common, while heat stroke is the most severe. People often know when they are hot, but with heat stroke, the core body temperature is elevated above 104 degrees and those individuals can start to exhibit brain symptoms – trouble walking, seizures and hallucinations and loss of consciousness, Geno says. Other symptoms may include headache, skin redness and warmth, rapid breathing and heartbeat, diarrhea and vomiting, muscle cramps and lack of sweating.

“The severity of heat stroke is directly related to the length of time someone is hot,” Geno says. “ So, if you start having symptoms of heat crams or heat exhaustion – heavy sweating, nausea, headache, faintness, dizziness, muscle cramps – you need to stop and immediately begin cooling your body down to prevent heat stroke.”

You can do this by spraying your body with cool water or taking a cool shower; moving into the shade, an air-conditioned car or by using a fan; drinking water or sports drinks, but never alcohol; removing extra clothing; or putting a cold pack on the back of your neck or under your armpits. If you do suffer from heat stroke or see people exhibiting symptoms, they need to be treated by a physician, Geno says.

If you know you are going to be in the sun for any length of time, make an effort to avoid any kind of heat illness, he says. “You can do this by gradually increasing your exercise rather than starting at full force, and drinking enough fluids so you do not feel thirsty,” Geno says. “Wear lightweight clothing and do activities earlier or later in the day. And never leave someone in a hot car.”

Managing diabetes to stay healthy

By Amelia Neumeister

Controlling blood sugar is important for people with diabetes, but other conditions need to be managed as well to provide the best health outcomes, according to Dr. Jared Ellis, assistant professor of family medicine for the College of Community Health Sciences and associate director of its Family Medicine Residency.

During a presentation for the Mini Medical School Program, a lecture series the College provides in collaboration with UA’s Osher Lifelong Learning Institute, Ellis spoke about ways diabetes can manage their disease to stay healthy.

He said controlling blood sugar is important in managing microvascular issues associated with diabetes, such as damage to eyes, kidneys and nerves. “This is impacted by sugar control,” Ellis said in his presentation, “Providing quality care for the improvement of diabetes.”

Diabetes is the top cause of acquired blindness in the US, Ellis said, explaining that for diabetics, tiny blood vessels behind the eyes can become blocked and there can be bleeding. Diabetics also have a higher risk of cataracts and glaucoma.

Diabetes is also the No. 1 cause of kidney failure in the US, and it can lead to diabetic neuropathy, which reduces the blood supply to nerves, causing a loss of feeling, typically beginning in the feet. “Getting the sugar down helps,” Ellis said.

Blood sugar control has less of an impact on macro vascular diseases associated with diabetes, such as heart attack, stroke, or peripheral vascular disease, Ellis said, adding that good blood pressure and cholesterol control are more important. “We want to see more good than bad cholesterol,” he said.

In addition, people with diabetes are more susceptible to infections, so they should stay up-to-date on their immunizations, particularly for flu, pneumonia, tetanus and pertussis.

Blood sugar can be controlled through diet, exercise and medication. Ellis suggested making reasonable changes to diet, but “eating closer to the vine and tree is important. Read food labels, although that can be tricky.” He said diabetics shouldn’t be discouraged if they can’t get to the gym to exercise. “Just move. If it’s a nice day, park farther from the door. Moving more is the key.”

His prescription for self-management of diabetes: “Be knowledgeable, be proactive and not reactive, and keep up with your lab results.”

CCHS hosts orientation for incoming medical students

The College of Community Health Sciences hosted 33 University of Alabama School of Medicine students April 27 and 28 who will complete their third and fourth years of medical school in Tuscaloosa.

In its role as a regional campus for the School of Medicine, the College provides clinical education for a portion of medical students, who complete the first two years of medical school at the School of Medicine’s main campus in Birmingham, and their third and fourth years at either Birmingham or one of the school’s regional campuses in Tuscaloosa, Huntsville or Montgomery.

During the orientation in Tuscaloosa, medical students learned about the College’s clerkships, participated in electronic medical record training and toured DCH Regional Medical Center. Most of the students are Alabamians, while others are from Georgia, Oregon, Connecticut and other states.

Dr. Richard Streiffer, dean of the College, told the students that while the College’s clinical education is oriented toward primary care, it provides exposure to and experience in other specialties. “Our focus is on primary care, but not exclusively,” he said. “We provide a very good, general professional education of physicians. We have students going into every discipline from this campus.”

Streiffer explained that an emphasis on primary care is important for a number of reasons. The US spends more on primary care than most industrialized nations yet has poorer health outcomes. Primary care, meanwhile, is associated with better access to care at lower costs. Alabama continues to have a shortage of primary care physicians. The US has an aging population suffering from chronic diseases and conditions that primary care is best suited to handle. And, finally, primary care takes into consideration social determinants of health – factors like socioeconomic status, education, physical environments, employment and social support networks, as well as access to care.

“Medical schools are largely funded by public money, so a social mission that medical schools have is to train physicians to meet the needs of society, Streiffer said, adding that the mission of the College is to improve health in communities by educating and training doctors for Alabama and the Southeast region.

He said the College’s education efforts are also interprofessional. “You will interact with students from nursing, social work and pharmacy, and you can take a culinary medicine course. You will work with our residents. We have an interprofessional faculty, and University Medical Center is a full-service practice.”

The College operates The University of Alabama Family Medicine Residency, the second largest family medicine residency in the US and one of the oldest. University Medical Center, the largest community practice in West Alabama, is also operated by the College and is the base for its clinical teaching program. UMC provides direct health care services in the areas of: primary care, including family medicine, internal medicine, pediatrics and geriatrics; psychiatry and behavioral medicine; women’s health, including obstetrics and gynecology; and sports medicine. UMC also has telemedicine services and evening hours. The practice saw nearly 155,000 patients last year.

Mental illness hits closer to home than you might think

By Kim Eaton

Did you know?

In an average US city with 20,000 people, 840 will have been diagnosed with depression. That is an average of 13.3 million people in the US with diagnosed depression.

Mental illness does not discriminate. It can impact anyone and everyone, not just in Tuscaloosa or Alabama, but nationally and internationally.

“Depression has increased by 18 percent since 2005 and is now the leading cause of ill-health and disability worldwide, with more than 300 million people suffering,” said Dr. John Burkhardt, an assistant professor of Psychiatry and Behavioral Medicine for the College of Community Health Sciences and a practicing clinical health psychologist at University Medical Center, which the College operates.

That number is only those diagnosed with depression, Burkhardt added. There are many people suffering from undiagnosed mental illness. Depression also puts people at risk for other medical conditions, like increased risk of cardiovascular disease, diabetes, stroke and Alzheimer’s disease.

May is Mental Health Awareness Month, and to raise awareness of this health issue, faculty from the College’s Department of Psychiatry and Behavioral Medicine provided, throughout the month, media interviews and patient information about various mental health topics – depression, anxiety, substance abuse, ADHD and healthy lifestyles – as well as weekly mindfulness segments for College employees.

So, what is mental health?

Mental health ultimately has to do with how someone functions in his or her world.

“All of us will go through periods when we may experience depression or anxiety,” Burkhardt said. “And for some of us, we will experience more problems functioning in one or multiple areas, whether it be work, home or interpersonally. Being in good mental health means having the resources and coping skills to manage these times, but most importantly to remain functional, which means being able to manage the various areas of your life successfully, such as work, parenting, play, relationships, exercise, home, etc.”

Since Burkhardt moved to Tuscaloosa two years ago, he has seen a broad range of mental illness in his clinic at University Medical Center. He sees a lot of depression and anxiety, but said Alabama as a whole has problems with drug abuse, either prescribed or non-prescribed. He also sees many people trying to cope with some form of trauma in their life.

“There is not one common problem,” Burkhardt said. “Mental illness exists in many forms and is closer to home than we think.”

Despite the prevalence of mental illness, access to care and being able to afford care are two of the biggest challenges for individuals. When looking at mental health provider ratios, top US providers have a 360:1 patient-to-provider ratio; Alabama is 1,260:1; and Tuscaloosa is 890:1. This is the ratio of the county population to the number of mental health providers, including psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, mental health providers who treat alcohol and other drug abuse and advanced practice nurses specializing in mental health care. About 30 percent of Alabama’s population lives in a county designated as a Mental Health Professional Shortage area.

To help fill in the gap, The University of Alabama and the College offer multiple resources to students, faculty and staff, as well as the community. These include the Betty Shirley Clinic at University Medical Center, Student Health Center, Counseling Center, Psychology Clinic, Employee Assistance Program and the Capstone Family Therapy Clinic.

Another challenge is the stigma surrounding mental illness, which might prevent someone from seeking help. There are several misconceptions, the most common being that it does not happen to “everyday or regular people” and if someone gets diagnosed then there is something severely wrong with them.

“Stigma plays a big role in this,” Burkhardt said. “Negative emotions and reactions are apparent when the topic of mental illness arises. People get these negative pictures in their head whether it be from movies they have seen or their own perceptions of what people with poor mental health present like. They don’t understand that the severity can range from mild to severe, so they always assume it’s severe. We are now just getting to a point where people can talk about mental illness without feeling like they have been hiding a dirty secret.”

Another misconception is that people should just be able to “get over it” because life is not easy. While it is true life is full of challenges, having poor mental health does not mean they are a failure or cannot manage their life. But it also doesn’t mean they can do it themselves.

“There is help for you,” Burkhardt said. “Just because you have a diagnosis does not mean your life has to stop. Many individuals live a full life managing their mental illness.”


Leeper, Paxon join College

Dr. Connie Leeper joined the College of Community Health Sciences as an assistant professor in the Department of Family, Internal, and Rural Medicine.

Leeper graduated cum laude from Duke University with a bachelor’s degree in Biology. She earned her medical degree and a Master’s of Public Health from the University of Alabama at Birmingham.

She completed a family medicine residency at the Ventura Family Medicine Residency in Ventura, California, where she served as a chief resident. Leeper also completed an obstetric fellowship at Natividad Medical Center in Salinas, California.

Dr. Raheem Paxton joined the College of Community Health Sciences as an associate professor in the Department of Community Medicine and Population Health and as an investigator for the College’s Institute for Rural Health Research.

Previously, Paxton was an assistant professor in the School of Public Health at The University of North Texas Health Science Center in Fort Worth, Texas, with a joint appointment at the university’s Center for Alzheimer’s and Neurodegenerative Research in the Institute of Aging.

Paxton graduated cum laude from Morehouse College in Atlanta with a bachelor’s degree in Psychology. He earned a master’s degree in Kinesiology from Kansas State University in Manhattan, Kansas, and a PhD in Public Health/Health Promotion, Education, and Behavior from the University of South Carolina in Columbia, South Carolina.

His post-graduate training includes a research fellowship in Intervention Development/Dissemination Research at the Cancer Research Center of Hawaii in Honolulu, Hawaii, and a research fellowship in Health Disparities in Cancer Survivorship at The University of Texas MD Anderson Cancer Center in Houston, Texas.

UA-Pickens County Partnership project focuses on well-being of children and families

Pickens County Head Start, in collaboration with The University of Alabama-Pickens County Partnership, implemented a program during 2016-2017 school year to promote child and family well-being.

The program, Power PATH, provides classroom and parent programs to promote social and emotional well-being in Head Start preschoolers and their caregivers.

Preschool teachers in six classrooms at Pickens County Head Start were trained to implement the Preschool PATHS Social Emotional Learning Program. The program provides a framework and weekly lesson plans designed to teach children such life skills as emotional and behavioral self-regulation, friendship and social skills, and how to solve problems with others in a calm, caring way. Head Start staff members were also trained to implement a corresponding parent program that teaches parents how to encourage children’s use of these skills at home.

By the end of the current school year, Pickens County Head Start teachers and staff will have the resources and training needed to continue to implement the Power PATH classroom and parent programs long-term. The program is being evaluated to assess its impact on children, families and Head Start personnel.

The project is one of a number of pilot grants funded by the UA-Pickens County Partnership. As part of the project, Cynthia Simpson, executive director of Pickens County Community Action Committee and Community Development Corporation Inc. is partnering with UA faculty: Dr. Caroline Boxmeyer, an associate professor of Psychiatry and Behavioral Medicine with UA’s College of Community Health Sciences; Dr. Ansley Gilpin, an associate professor of Psychology; and Dr. Jason DeCaro, an associate Professor of Anthropology.

The UA-Pickens County Partnership works to place UA students in medicine, nursing, social work, nutrition, psychology and health education – and potentially other fields – in Pickens County for internships and experiences. Through the partnership, the rural, underserved county is provided with additional health resources, and UA students receive real world training in their respective areas of study.

Screening, prevention important in combatting breast cancer

By Erin Tech

While family history is a risk factor for breast cancer, well more than half of breast cancer cases occur sporadically and are not hereditary, said Dr. Helen Krontiras, who provided the Dr. Joe W. and Virginia Hursey O’Neal Endowed Lecture for the College of Community Health Sciences on May 2.

Krontiras, a breast surgical oncologist and Medical Director of the UAB Multidisciplinary Breast Clinic in Birmingham, Alabama, spoke about the importance of prevention and early detection of breast cancer. She is also co-Director of the Breast Cancer Prevention and Risk Assessment Clinic at UAB.

The endowed lecture was created by Dr. Joe O’Neal, a long-time Tuscaloosa surgeon, to support the teaching of breast cancer prevention and early detection and to honor his wife, Virginia Hursey O’Neal, who died from breast cancer in 2001.

Krontiras said early detection of breast cancer has improved because of better screening.

Mammograms, which provide an x-ray picture of the breast, can be used to check for breast cancer in women who have no signs or symptoms of the disease, or to check lumps or for other signs of breast cancer. But there are limitations, Krontiras said, as a diagnosis via mammogram is more difficult for women with dense breasts. In 2013, Alabama passed the Breast Cancer Prevention Education Act, which requires that patients be informed of their breast density.

MRIs, for example a Tomosynthesis Mammogram (3-D), allows radiologists to evaluate the breast one “slice” at a time, Krontiras said. The method improves cancer detection rates and lowers screening “call backs,” she said.

For patients who can’t have an MRI, contrast-enhanced spectral mammography provides the next best means of screening, she said.

With increased screening, however, comes the potential for overtreatment, Krontiras said. Studies have shown there is the possibility for overtreatment in regard to ductal carcinoma in situ (DCIS), which is the presence of abnormal cells inside a milk duct in the breast and considered to be the earliest form of breast cancer. DCIS is noninvasive, meaning it hasn’t spread out of the milk duct to invade other parts of the breast. Some studies have suggested not taking action for DCIS.

Because “finding cancer early does not always save lives,” Krontiras said prevention is important. She recommends breast health awareness and clinical breast exams beginning at age 40, and to have a lifestyle – maintain a healthy diet, exercise, and limit alcohol consumption. Obesity, high caloric intake and lack of physical activity could be a greater cause of breast cancer than tobacco by the year 2030, she said.

Krontiras earned her medical degree and completed her residency at UAB before completing a surgical breast fellowship at Northwestern University in Evanston, Illinois. She is also a senior scientist at the UAB Comprehensive Cancer Center and her primary research interest is chemoprevention of breast cancer.

The late Dr. Joe O’Neal played a key role in the early years of the College, assisting with surgery education efforts. He earned a medical degree in 1954 from the Medical College of Alabama in Birmingham and, after completing residency training, established a surgical practice in Tuscaloosa.