“I'm sorry. I don't have good news for you. Your biopsy showed cancer.” Words that every woman dreads.
In 2007, about 200,000 women will hear these words from their doctor following a breast biopsy. Can a woman be prepared to deal with such news? Can the impact of such words be lessened if a woman is better educated?
The first thing to consider is that breast cancer is not a death sentence. We are so programmed to think that cancer is terminal. Early stage breast cancer without spread to the lymph nodes has a 95 percent five-year survival rate. More and more breast cancers are found in early stages as women and their doctors are being proactive in breast cancer screening programs.
Today, many women have breast cancers that are found only on screening mammograms, long before a lump is able to be felt on either a breast self exam or on examination by a physician.
The second thing to remember is that a diagnosis of breast cancer does not automatically equal a woman losing her breast. At least 75 percent of breast cancers detected are amenable to some form of breast conserving surgery where the entire breast is not removed. Newer surgical techniques and different types of radiation therapy allow women to save their breast despite a diagnosis of cancer. Certain forms of chemotherapy and hormonal treatment are sometimes offered before any surgery is done. This may allow for shrinkage of larger tumors that would otherwise require a mastectomy to a size that facilitates breast conservation surgery.
The third thing to know is that the risk of one of the most devastating complications of breast surgery, arm swelling, has been greatly decreased with newer surgical techniques. Using a special nuclear tracer and a blue dye, the specific lymph nodes draining the breast can be identified. This allows the surgeon to do less dissection under the arm. Less lymphatic tissue is disrupted, giving a much lower chance of post-operative arm swelling (lymphedema).
Finally, it is important to know that most women have options when it comes to breast cancer management. There are some instances where mastectomy (removal of the breast) is truly the best option. When the skin is involved, if the tumor is very large, if there is a large tumor in comparison to breast size, or if the pathologist's report shows a very aggressive tumor, mastectomy may be the best treatment. Some women choose mastectomy because they do not want to undergo radiation treatment, and some women just want to feel they are doing the most they personally can to treat their breast cancer.
For most women, however, the opportunity to save their breast if possible may be something that makes their diagnosis a little easier to handle. Breast conservation surgery is also called partial mastectomy or lumpectomy. When breast tissue is left behind, radiation therapy should always be part of the treatment plan as surgery alone results in an unacceptably high chance of recurrence in the affected breast.
There are now options for radiation therapy as well. The traditional means of giving radiation was to treat the whole breast from an external source. This is still a very accepted means of delivering radiation. The duration of treatment is usually about six weeks. Treatments normally are given five days a week for the entire six-week period.
Because of the long duration of treatment and because most beast cancer was found to recur right at the area where the original tumor was removed, a newer means of giving radiation is through a catheter placed directly into the lumpectomy site giving the highest dose of radiation directly to the area from where the tumor was removed. This type of radiation is given two times a day for only five days. The catheter is easily removed after the last treatment.
Breast cancer is a disease best treated by a team of doctors. These include the primary care physician, surgeon, radiologist, pathologist, medical oncologist, radiation oncologist and (if needed) a plastic surgeon. Women are best prepared to face the diagnosis of breast cancer when they educate themselves, ask questions and seek the opinion of the multiple specialists who are involved in breast cancer management.
Having some control over deciding which treatment is right for an individual may help a woman when it seems that her entire life has been disrupted. A diagnosis of breast cancer will never be easy to deal with, but being informed and able to make an educated decision may lessen the impact of those devastating words.
Dr. Deborah Geer is a general surgeon with a special interest in breast surgery. Reach her
at 253-4536.
The first thing to consider is that breast cancer is not a death sentence. We are so programmed to think that cancer is terminal. Early stage breast cancer without spread to the lymph nodes has a 95 percent five-year survival rate. More and more breast cancers are found in early stages as women and their doctors are being proactive in breast cancer screening programs.
Today, many women have breast cancers that are found only on screening mammograms, long before a lump is able to be felt on either a breast self exam or on examination by a physician.
The second thing to remember is that a diagnosis of breast cancer does not automatically equal a woman losing her breast. At least 75 percent of breast cancers detected are amenable to some form of breast conserving surgery where the entire breast is not removed. Newer surgical techniques and different types of radiation therapy allow women to save their breast despite a diagnosis of cancer. Certain forms of chemotherapy and hormonal treatment are sometimes offered before any surgery is done. This may allow for shrinkage of larger tumors that would otherwise require a mastectomy to a size that facilitates breast conservation surgery.
The third thing to know is that the risk of one of the most devastating complications of breast surgery, arm swelling, has been greatly decreased with newer surgical techniques. Using a special nuclear tracer and a blue dye, the specific lymph nodes draining the breast can be identified. This allows the surgeon to do less dissection under the arm. Less lymphatic tissue is disrupted, giving a much lower chance of post-operative arm swelling (lymphedema).
Finally, it is important to know that most women have options when it comes to breast cancer management. There are some instances where mastectomy (removal of the breast) is truly the best option. When the skin is involved, if the tumor is very large, if there is a large tumor in comparison to breast size, or if the pathologist's report shows a very aggressive tumor, mastectomy may be the best treatment. Some women choose mastectomy because they do not want to undergo radiation treatment, and some women just want to feel they are doing the most they personally can to treat their breast cancer.
For most women, however, the opportunity to save their breast if possible may be something that makes their diagnosis a little easier to handle. Breast conservation surgery is also called partial mastectomy or lumpectomy. When breast tissue is left behind, radiation therapy should always be part of the treatment plan as surgery alone results in an unacceptably high chance of recurrence in the affected breast.
There are now options for radiation therapy as well. The traditional means of giving radiation was to treat the whole breast from an external source. This is still a very accepted means of delivering radiation. The duration of treatment is usually about six weeks. Treatments normally are given five days a week for the entire six-week period.
Because of the long duration of treatment and because most beast cancer was found to recur right at the area where the original tumor was removed, a newer means of giving radiation is through a catheter placed directly into the lumpectomy site giving the highest dose of radiation directly to the area from where the tumor was removed. This type of radiation is given two times a day for only five days. The catheter is easily removed after the last treatment.
Breast cancer is a disease best treated by a team of doctors. These include the primary care physician, surgeon, radiologist, pathologist, medical oncologist, radiation oncologist and (if needed) a plastic surgeon. Women are best prepared to face the diagnosis of breast cancer when they educate themselves, ask questions and seek the opinion of the multiple specialists who are involved in breast cancer management.
Having some control over deciding which treatment is right for an individual may help a woman when it seems that her entire life has been disrupted. A diagnosis of breast cancer will never be easy to deal with, but being informed and able to make an educated decision may lessen the impact of those devastating words.
Dr. Deborah Geer is a general surgeon with a special interest in breast surgery. Reach her
at 253-4536.
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Think again. wrote on May 22, 2007 2:03 PM: