Breast Cancer Experts Report Good News: “We’re Winning”
A panel of four breast cancer specialists presented current facts about breast cancer, along with the good news that breast cancer survival rates are increasing, at a special Breast Cancer “Lunch and Learn” event sponsored by Memorial Hospital and Manor. More than 75 women and a few men attended the annual event at the Kirbo Regional Center on October 16th to hear Dr. Don Robinson, Dr. Charles Walker, Dr. Richard Zlotnik, and Dr. Steve Johnson give expert advice about how to prevent, detect, and treat breast cancer.
All of the doctors agreed that the most important takeaways from their presentations were for women to (1) do self-breast exams each month, (2) get annual mammograms, (3) have an annual physical with their healthcare provider, including clinical breast exams, and (4) see their healthcare provider if they notice any change in their breast appearance or feeling.
Don Robinson, M.D., a Board Certified Obstetrician and Gynecologist at Memorial Hospital and Manor, said women should make healthy lifestyle choices to lower their risk of getting breast cancer. Recommendations include maintaining a healthy weight, adding moderate exercise to daily routine, limiting alcohol intake, limiting postmenopausal hormone use, and breastfeeding, when possible.
Dr. Robinson said that women should look for any changes in their breasts such as unusual (or different) size, shape, or color; breasts that have dimpling, puckering or bulging of the skin; a nipple that has changed position or an invented nipple; or redness, soreness, rash or swelling. Women should call their doctors when they find a knot or lump that feels different, or if they have bloody nipple discharge, or any change in appearance. Robinson said that the recommended ages for women to get mammograms are from age 40-50 (annually or biennially) and age 50 and older (annually). High-risk patients, such as those with a family history of breast cancer, should talk with their health care provider about having mammograms and clinical exams more often.
Richard Zlotnik, M.D., a new Board Certified General Surgeon in Bainbridge, talked about how annual mammograms help detect changes in the breast from year to year, often before a lump is felt. He said that ultrasound testing is also useful in detecting and locating breast lumps. Zlotnik added that women are faced with individual decisions about having surgery to remove breast lumps, but their physician is always available to guide them and help them understand the process.
Charles Walker, M.D., also Board Certified in General Surgery, said that several treatment options are available if a lump is found. He said a biopsy is a procedure to remove a small sample of breast tissue for laboratory testing to determine if it is cancerous. There are several types of breast biopsy procedures, including needle biopsy, excisional biopsy (ultrasound guided), and stereotactic biopsy.
If a laboratory analysis concludes that the lump is malignant (cancerous), a lumpectomy or a modified radical mastectomy are the two most common surgical options. A Lumpectomy is a treatment option for some women with early-stage breast cancer. Lumpectomy is always followed by radiation therapy to reduce the chances of cancer recurring.
Lumpectomy is also called breast-conserving surgery because only a portion of the breast is removed. It is also referred to as a wide excision surgery. During lumpectomy, a small amount of normal tissue around the lump (clean margins) is taken to help ensure that all the cancer or other abnormal tissue is removed.
For most invasive breast cancers, a modified radical mastectomy is performed to remove the entire breast — including the breast tissue, skin, areola and nipple — and most of the underarm (axillary) lymph nodes. Sentinel node biopsy eliminates the need to remove all the axillary lymph nodes by removing the first lymph node (the sentinel node) to which cancer cells are most likely to spread from a primary tumor. Removing and examining the lymph nodes helps to identify whether cancer cells may have spread beyond the breast to other parts of the body through the lymphatic system. Plastic surgery for reconstruction of the breast after mastectomy gives women another option to preserve the look of their natural breast.
Steven Johnson, M.D., a Board Certified Radiation Oncologist with the Singletary Oncology Center in Thomasville, spoke about the progress made in breast cancer treatment in recent years. He said that 1 in 8 women will have breast cancer in her lifetime, and there will be about 230,000 new cases of invasive cancer yearly. Over 2000 men are diagnosed each year with breast cancer, as well.
According to Dr. Johnson, the good news is that “We’re winning.” There has been about a 2% decrease each year from 1999-2005 in the number of women over age 50 diagnosed with breast cancer. Death rates have steadily declined since 1990, due to early detection, treatment advances, and awareness. The decline may be attributed, in part, to the decreased use of Hormone Replacement Therapy. Hormone Replacement Therapy increases the risk of breast cancer by as much as 24% after 5 years of use.
Dr. Johnson said that 15% of breast cancers are in women with a family history of the disease, and 5-10% have the BRCA or BRCA2 breast cancer gene. Although family history puts a woman at a higher risk, 85% of all women with breast cancer have no family history.
Breast cancer patients are usually referred to Oncologists for Chemotherapy and/or Radiation Therapy after surgery; however, some patients benefit from Chemotherapy before surgery, followed by Radiation after surgery. Oncologists specialize in treating cancer and recommend a treatment plan in the best interest of the patient.
All four physicians agreed that the key to fighting breast cancer is for each individual to take responsibility for her own health: (1) Do monthly self-breast exams, (2) get annual mammograms, with a baseline mammogram at age 35, (3) get annual physical exams, including clinical breast exams, and (4) learn your options by getting information from reliable sources. They all agreed that no one knows your body better than you do, so make sure you contact your healthcare provider if you notice any questionable changes. Treatment is much simpler when cancer is detected early.
American Cancer Society
National Cancer Institute
National Institute of Health
American Dietetic Association
Centers for Disease Control
Five Steps to Safer Health Care
1. Ask Questions
Speak up if you have concerns, ask questions, and expect answers you can understand.
Choose a doctor with whom you feel comfortable to discuss your health and treatment.
Take a relative or friend with you if this will help you ask questions and understand the answers.
2. Your Medications
Keep a list of all medicines you take.
Tell your doctor and pharmacist about all the medicines you take, including over-the-counter medicines such as aspirin, ibuprofen, vitamins and herbals. Be sure to report any drug allergies you have.
Additional Medication Issues:
Ask the pharmacist about side effects and what foods or other things to avoid while taking the medication.
Read the label, including warnings. Make sure it's the medication your doctor ordered and you know how to use it.
If the medication looks different than you expected, ask the pharmacist about it.
3. Test Results
Make sure you get the results of all tests and procedures.
Ask the doctor or nurse when and how you will get the results.
Call your doctor and ask what the results mean.
Make sure you understand what will happen if you need surgery. You, your doctor and surgeon should discuss what will be done during the operation. Tell the surgeon, anesthesiologist and nurses if you have allergies or ever had a bad reaction to anesthesia.