Awareness – Breast Cancer

You’re probably aware that October is National Breast Cancer Awareness Month, and that breast cancer touches the lives of most people at some point in time, either directly or indirectly.  I thought it would be a good time to share with you some information on the subject from Dr. Alissa Shulman, a board-certified plastic surgeon who practices here in Sarasota, Florida (now Chief of the Surgery at Sarasota Memorial Hospital). One of her areas of specialization is reconstructive surgery for patients who have had a mastectomy.  Dr. Shulman is a recognized expert – and we all can use some information and advice on this topic from a well-respected professional.

Most women dealing with breast cancer meet with me “somewhere into the process.”  However, since I am one of the physicians they spend a great deal of time with, I get to know “the whole story.”

Hopefully, every woman is getting her routine mammograms and doing her monthly self-examination.  If you feel a lump, please be sure to have it checked out by a professional.  We never expect a woman to diagnose her own breast cancer, but do point out if something feels different.  It’s usually best to start with your primary care MD or GYN.

If something abnormal is noted, then further exams need to be done – either more views on a mammogram, an ultrasound, and/or an MRI.  If need be, someone (PMD, GYN, radiologist, or general surgeon) will request and obtain a biopsy – a sample of the breast tissue in question.

If the diagnosis is breast cancer, then you will see a general surgeon, one with experience in breast cancer.  Depending on the size, location in the breast and stage (if known from the biopsy) of the cancer, the general surgeon will review your options.  Factors that need to be taken into consideration include: your health and medical history, family history, breast size, etc.  At some point, the options of breast conservation (lumpectomy and radiation) versus mastectomy (removal of “entire” breast) are discussed.  Some general factors to be considered are:  size of cancer/size of breast, ability to remove “all” the cancer in one excision, the need for other treatments, etc.  These are all individual factors and decisions, and everyone’s pre-existing ideas will be different – including the patient, family members and friends.

If the option selected is mastectomy, it should lead to a discussion on reconstruction.  This is the point at which I generally become involved in the treatment, but sometimes people get a diagnosis and “jump ahead” to reconstruction.  Truly, one is best served by gathering all the information and “digesting” everything “slowly” – although it is difficult to see it this way.  Most breast cancers are slow growing, and a week or two will not make a difference (in the big picture).  The time giving every option careful consideration will be well spent.

In this process of seeing doctors and learning about the patient’s condition and options, one is best armed with a note pad and a second set of ears (spouse, relative, friend – somebody).  There will be a lot of information discussed, although generally, anything really important will be repeated several times and in multiple settings.  I meet with my reconstructive patients at least 2 to 3 times before the actual surgery.

Even at my office, I try to make sure a patient understands all of her options.  Sometimes a lumpectomy and radiation is truly the best option, and I try to present each patient with advice about the best option and WHY I feel it is the best choice.

So…Darla says, be sure that you pay attention to your breast health. And please help raise awareness and breast cancer research funds whenever you can.

Hope to see you soon.