Our Expert is Elisa Port, MD, FACS, Co-Director of the Dubin Breast Center and Chief of Breast Surgery. She spoke at the April Women’s Health 2015: the 23rd Annual Congress.

If there is a medical topic you would like to see explored here, please let me know!

 

Very best,
Mitzi Perdue
Mperdue@liebertpub.com

WITH BREAST CANCER THERE IS NEW REASON FOR OPTIMISM

More than two million American women will develop breast cancer in their lifetimes and 39,000 of them will die from it every year. However, even though women who are newly diagnosed may understandably have feelings of doom and gloom, there are good reasons for optimism. The overall survival rate is about 90%, an all-time high. Treatments have improved dramatically, not just in the last ten years, but with each year comes new advances through research, and improvements in outcomes.

HELP YOUR PATIENTS TO TUNE OUT THE BACKGROUND NOISE

She may not have a realistic view of how she’s doing because there’s a lot of breast cancer misinformation around. Between the Internet and social media and also the fact that breast cancer is so common that almost everyone knows something about it, your patient may come across a lot of unreliable information or information that doesn’t apply to her. I advise patients to use the internet with caution and to try not to become overwhelmed by researching the disease online. Each patient’s situation is unique and should be reviewed by a doctor who knows the individual and her unique situation.

BREAST CANCER SHOULD BE TREATED BY SPECIALISTS

Encourage your patients to seek breast cancer specialists for their care. Experts who devote all their time and energy to the care and treatment of breast cancer will be familiar with the latest medical breakthroughs. In addition, their experience counts for a lot; a general surgeon who is doing gall bladder one day and appendixes the next can’t know as much about, for example, about the nuances of breast cancer surgery as the specialist who is dealing with breast cancer care every day.

MORE SURGERY DOESN’T MEAN A BETTER OUTCOME

To me, one of the biggest challenges we have is making sure our patients are making the right decisions for the right reasons. A newly diagnosed breast cancer patient, given that she’s vulnerable and nervous, may feel that it’s intuitively obvious that more surgery is better. For instance, she may choose a bilateral mastectomy in the belief that this improves her chances of survival. Actually, this is far from the truth. Today we are often able to deliver the same results while doing less and less surgically. In spite of our successes in this, there’s been a disturbing trend in the last few years of women choosing more aggressive surgery, such as having mastectomies or having all their lymph nodes removed when less aggressive procedures would have served them at least as well. We need to educate our patients that for many patients, more surgery doesn’t necessarily lead to a better outcome.

LIFESTYLE FACTORS THAT DO AND DO NOT AFFECT BREAST CANCER

Obesity increases the risk of developing breast cancer, and increases risk of recurrence for those who already have been diagnosed. I’m sympathetic with the woman who is overworked, and has trouble making time for physical activity, and who would rather stay indoors when the weather is bad. But even so, exercise and having a healthy body weight is one of the keys to all of health and in spite of the obstacles, she needs to make exercise and a healthy body weight a priority. Another lifestyle risk she needs to keep in mind is alcohol consumption. Drinking more than one or two alcoholic beverages a day increases her risk, and a habit of having seven or more drinks a week will also increase her risk .

Surprisingly, stress does not seem to impose a higher risk of breast cancer. There have been many studies involving very significant stressors, such as being a prisoner of war or a holocaust survivor. These women did not have a higher risk of breast cancer.