Mastectomy or lumpectomy? Chemotherapy? Breast reconstruction? Radiation?
These are just a few of the decisions a breast cancer patient faces after receiving her diagnosis.
With so many medical advancements and earlier detection of the disease, treating breast cancer today also means making a lot of decisions. A crucial part of your treatment is to better understand what to ask your doctor, what choices you have and what sources to reach for if you want to conduct your own research to answer your breast cancer questions.
Michelle’s Place Breast Cancer Questions Forum
That’s why about 30 individuals packed the room at Michelle’s Place Breast Cancer Resource Center in Temecula one recent evening to listen to presentations from Dr. Ryan Wong, our plastic surgeon, Dr. Tchaiko Parris, our radiologist and director of breast imaging, and me.
During the nearly two-hour seminar, we went over all the stages of breast cancer, from diagnosis and treatment to recovery and follow-ups. For many patients, it’s difficult to see past the initial shock of the diagnosis and often they need to process the information before dealing with the decision-making journey.
After Dr. Parris discussed the survival rates of breast cancer today – one in eight women are diagnosed with the disease, but there are more women living as survivors than dying from it – she also addressed the risk factors and how much control we have over them.
The number one risk factor is being a woman “and many of us in here can’t change that,” she said to laughter, as she looked out at the vastly female crowd.
Dr. Wong explained that thanks to the Women’s Health and Cancer Right Act of 1998, insurance companies are now required to cover breast reconstruction. Just deciding whether a patient wants reconstruction is yet another decision. And once that choice is made, women are faced with a multitude of others: immediate or delayed reconstruction, type of implants or reconstruction using their own tissue, to name a few.
My presentation was filled with a lot of visuals, as I wanted to show these women the results of the surgery many of them will undergo. I explained that today, depending on variable factors, we can do nipple sparing mastectomies and breast conserving surgery.
The survival rates are not affected by the patient’s choice of a lumpectomy or a mastectomy, but more by the possibility of local recurrence, whether the cancer will return in that breast in the future.
Many of my patients’ initial, passionate reaction, is to remove both breasts. Women have their own reasons, many are younger and are worried about recurrence. After explaining the risks associated with a double mastectomy, some still choose that route while others choose breast-conserving surgery.
Ultimately, the decision, as with all the decisions you make from diagnosis to post-cancer, are the patient’s to make.
Breast Cancer Questions?
Some of the questions asked during our April 22 seminar at Michelle’s Place include:
Audience: After a double-mastectomy how often do you need to go in for a follow-up appointment?
Dr. Bremner: Once every year for a clinical breast exam.
Audience: What do they do at the follow-up appointments? Ultrasound?
Dr. Bremner: A breast exam. If the doctor feels something they will move forward with other tests.
Audience: Is it better for the patient to see the plastic surgeon before surgery?
Dr. Wong: Not necessarily, I want the patient to focus on taking care of the cancer.
Additionally, Dr. Tara Washington and I discussed new advancements in Breast Radiation, specifically Intraoperative Radiation Therapy or IORT, at another recent seminar. IORT is a relatively new approach to deliver radiotherapy that is used in conjunction with a lumpectomy. During the surgical procedure, and after removal of the identified breast cancer, an individualized dose of radiation therapy is specifically targeted to the immediate area where the cancer was located.
Stay tuned for our next educational seminar. I hope to see you there.