General Medical · Health

Breast Health: Breast Cancer Prevention and Early Detection Both Save Lives

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Ductal Carcinoma-in-situ (DCIS): One Breast Surgeon’s Perspective on the Latest in Research and Treatment (Published October 26, 2015)

New Gen Breast Cancer Book coverThe breast cancer cure rate is at an all-time high, and so is the information — and misinformation — available to patients and their families. Online searches can lead to unreliable sources, leaving even the most resilient patient feeling uneasy and uncertain about her diagnosis, treatment options, doctors, side effects and recovery. Elisa Port offers a valuable perspective on how to approach reports of new developments on screening, diagnosis, prognosis and treatment. In her book, The New Generation Breast Cancer Book: How to Navigate Your Diagnosis and Treatment Options—and Remain Optimistic—in an Age of Information Overload, she describes every possible test and every type of doctor visit, providing a comprehensive, empathetic guide that a newly diagnosed woman (and her family) will want to have at her side. —Ed.

Whenever big news in breast cancer is reported, those of us who are in the thick of it, the physicians actually taking care of women with breast cancer, brace ourselves for the flurry of phone calls, emails and texts from our patients wanting to know one thing: “How does this new development apply to me?”

The JAMA study released a few months ago, which was covered extensively in the media (The New York Times, Aug. 20, 2015) and the TIME magazine cover story were no exceptions. Both the study and the story involved patients with DCIS (ductal carcinoma-in-situ), the earliest form of breast cancer. The take-home message from reading both the study and these articles should be that for women with DCIS the overall long-term survival rate is excellent: 97 percent to 98 percent. This is good news, and all women with DCIS should keep this in mind.

And there is more good news. Because there have been so many advances in the care and treatment of breast cancer in general, not just DCIS, there are more options than ever before. As a result there is no place anymore for the “one size fits all” approach in taking care of women with breast cancer. It’s critical to know that not all women will have all options, and that in each particular case, surgery and additional treatments are tailored and offered based on different factors specific to each individual case. As surgeons and oncologists, our job is to decide which options are medically appropriate, and then among the viable options in each case, help a patient decide which is best for her as an individual: Lumpectomy or mastectomy? Mastectomy or bilateral mastectomy? Chemotherapy or hormonal therapy? Or both?

RELATED: On Mammograms and their Value: A Breast Surgeon Weighs In

Some of the factors that contribute to decision making about treatment on an individual basis include: age, overall health status, the amount of cancer in the breast, whether or not there is a concern for spread, and of course, what does the patient herself want? It’s not easy to navigate these pathways for any woman with a new diagnosis, but with the right guidance and the right team of doctors, the outcomes are usually very good, and the results from the JAMA study verify this fact.

But in reading these studies and the associated media coverage, many of the women who called my office recently did not get this message of optimism. Mostly, there was confusion and anxiety. I heard two specific concerns over and over again, and I believe they should be addressed with clear answers.  Read More »

Next Page: I had a mastectomy for DCIS. Does that mean I was “overtreated” and would have had the same outcome with lumpectomy?

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  • Ricel February 2, 2016 at 5:33 pm

    Hi Dr. Elisa Rush Port,

    Thank you so much for this post. I never thought that being obese is also one of the risk factors for breast cancer. Everyone especially women must keep being physically fit and healthy to avoid this risk.

    This article is such a wakeup call for everyone. I find it very insightful. Thanks for sharing!

    Reply