Habits that May Lead to Breast Cancer

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Around the globe, breast cancer affects millions of women. One in eight women is predicted to have breast cancer during their lifetime in the United States alone. While there are several risk factors that you can’t control, such as a family history of breast cancer or dense breast tissue, there are certain behaviors and lifestyle choices that may have a significant impact on lessening your risk. Eliminating the habits that you can control can help decrease your risk of developing breast cancer.

Poor Diet

About 30 to 40 percent of all malignancies are considered to have some connection to diet. You cannot avoid developing breast cancer with diet or food alone. However, certain meals may improve your body’s health, strengthen your immune system, and lower your chance of breast cancer. According to research, eating a range of foods that are high in nutrients, including fruits, vegetables, legumes, and whole grains, may help you feel your best and provide your body with the energy it needs. Animal studies suggest eating food cultivated without pesticides may help prevent the unfavorable cell alterations linked to pesticide usage.

In nations where the traditional diet is plant-based and low in total fat, breast cancer is less prevalent. However, studies on American adult women haven’t shown a link between dietary fat consumption and a woman developing breast cancer. A high-fat diet throughout adolescence, however, may increase a girl’s risk of developing breast cancer later in life, even if she doesn’t go on to gain weight or become obese.

Further study is required to fully comprehend how nutrition affects the risk of breast cancer. However, it is undeniable that calories do matter, and fat is a significant source of calories. Being overweight or obese, which are breast cancer risk factors, may be brought on by high-fat diets. Because excess fat cells produce estrogen, which may promote the development of extra breast cells, overweight women are considered to have a greater chance of developing breast cancer. Breast cancer risk is increased by this additional growth.

Lack of Exercise

Regular exercise benefits your health in a variety of ways, one of which is a decreased risk of breast cancer. Over the last 20 years, several studies have consistently shown a relationship between increased physical activity and a decreased risk of breast cancer.

It is unclear exactly how exercise reduces the chance of developing breast cancer. It is believed that exercise controls estrogen and insulin, two substances that may promote the development of breast cancer. Regular exercise also aids women in maintaining a healthy weight, which supports hormone regulation and immune system health.

Unfortunately, there is no magic number of hours a woman should exercise each week to prevent breast cancer. We do know that more is preferable to less, and that some is better than none. Additionally, more intense exercise is more productive than less intense exercise. All people should exercise for at least 150 minutes per week of moderate effort or 75 minutes per week of vigorous intensity, ideally spaced out over the course of the week, according to the American Cancer Society.

Brisk strolling, dancing, leisurely biking, yoga, golfing, softball, doubles tennis, and routine yard and garden upkeep are some examples of moderate-intensity exercises. Jogging, running, rapid cycling, swimming, aerobic dancing, soccer, singles tennis, and basketball are some examples of high-intensity exercises. Along with your regular daily activities at home and at work, all of these extracurricular activities include stair climbing and walking from your vehicle to the garage.

Exercise has the additional benefit that it keeps you from merely sitting around. The probability of acquiring breast cancer and several other forms of cancer, as well as obesity, type 2 diabetes, and heart disease rises with sitting time, regardless of how much exercise you receive when you’re not sitting, according to an increasing body of research. Many of us spend most of our workdays seated at a desk. Because of this, it’s even more crucial to include activity throughout your day.

Certain Types of Birth Control

There is a small increase in the risk of breast cancer associated with the current or recent usage of oral contraceptives. According to studies, women’s breast cancer risk is 20–30% greater while using birth control pills (and immediately after) than the risk for women who have never used the pill. However, since the absolute risk of breast cancer for the majority of young women is low, this additional risk has only a little effect.

Women’s chances of developing breast cancer start to decrease after they quit using oral contraceptives. The risk eventually drops to the same amount as women who have never used the pill. Despite the increased risk of breast cancer , birth control pills also lower the risk of uterine and ovarian cancer in addition to preventing pregnancy. Just like with previous, higher-dose versions of the drug, modern, lower-dose tablets have been associated with an increased risk of breast cancer.

Some alternative contraceptives contain (or release) hormones, just like birth control pills do. Depo Provera users who have been using it for extended periods of time may be at a higher risk for breast cancer than women who have never used it.

Research on IUDs that release hormones and breast cancer research have conflicting results. IUDs don’t increase the risk of breast cancer, according to some research. According to other studies, women who use hormone-releasing IUDs may have a 20% greater chance of developing breast cancer (similar to birth control pills). According to other research, women who previously used hormone-releasing IUDs may be more likely to develop breast cancer after menopause.

Discuss the advantages and disadvantages of any contraceptive pill with your doctor before using it (or if you already are and haven’t done so).

Not Getting Routine Mammograms

Low-dose x-rays of the breast are called mammograms and can help doctors identify a breast cancer diagnosis. Regular mammograms are one of the best breast cancer screenings that may assist in detecting early stage breast cancer, when treatment has the best chance of being effective. Years before physical breast cancer symptoms appear, a mammogram may often detect breast abnormalities that might be cancer. Results from decades of research definitively demonstrate that women who receive routine mammograms are more likely to have breast cancer discovered earlier, are less likely to require an invasive breast cancer treatment like chemotherapy and surgery to remove the entire breast (mastectomy), and are more likely to recover from the disease.

Mammography is not flawless at detecting breast cancer cells. Dense breast tissue can make it harder for radiologists to see breast cancer on mammograms. Although most breast cancers will be detected, some will be missed. A woman will probably need more testing (such as additional mammograms or a breast ultrasound) in order to determine if anything seen on a screening mammogram is cancer. Additionally, there is a slight possibility of receiving a cancer diagnosis that, if not discovered during screening, would never have given rise to any issues.  It’s crucial that women undergoing mammograms be aware of what to anticipate and the advantages and limitations of screening. As you age, your risk of developing breast cancer increases. Breast cancer screening through mammography is vital for women over age 40.

Use of Tobacco Products

According to research, smoking may significantly increase the chance of developing breast cancer, particularly in women who began smoking as adolescents or who had a family history of breast cancer. Smoking might increase one’s chance of developing breast cancer because specific chemicals in tobacco products may cause out-of-control cell proliferation in the body. Smoking is associated with an increased risk of breast cancer in certain women, despite the fact that it is not thought to be a direct cause. In addition, smoking may make treating breast cancer more difficult and lead to complications from breast cancer surgery. Avoiding tobacco products is an important factor in breast cancer prevention.

Excessive Use of Alcohol

Many studies reveal women who consume alcohol have an increased risk of breast cancer. According to research, the relative risk of breast cancer rose by roughly 7% for every alcoholic beverage taken daily. Compared to women who didn’t consume alcohol, women who had 2-3 alcoholic drinks per day had a 20% increased chance of developing breast cancer.

Alcohol may alter how a woman’s body processes estrogen. Blood estrogen levels may increase as a result of this. Women who drink alcohol have greater amounts of estrogen than non-drinkers do. As a consequence, higher estrogen levels are related to a higher risk of breast cancer. Alcohol and cancer risk can be controlled by limiting the amount you consume.

Hormone Replacement Therapy

Breast cancer risk is elevated by the majority of hormone replacement therapy (HRT) types. However, individuals who take combination hormone replacement therapy (HRT), which combines both estrogen and progesterone, are at a greater risk.

Breast cancer risk is only modestly elevated when HRT is used for less than a year. However, the hazards become more severe and continue longer the longer you use HRT.

HRT-related breast cancer risk varies from individual to individual. The risk may vary depending on your age when you start HRT, any medications you may be on, and overall health.

Breast cancer risk factors are greater for people who take HRT before or shortly after menopause as compared to those who start it later.

Even though there are several potential causes of breast cancer, some behaviors and lifestyle choices may have a big impact. These lifestyle choices, including smoking, drinking alcohol, and eating poorly may all raise your risk. Regular physical activity and maintaining a healthy weight are effective methods to lower your risk. This disease may also arise as a result of certain birth control methods and hormone replacement therapy. If you have any of these risk factors, it’s important to speak to your doctor about them.

Dr. Valerie Gorman Faculty for Women in Breast Surgery

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Hologic’s women in breast surgery conference

Dr. Valerie Gorman, MD, FACS, a Waxahachie-based breast surgeon specializing in surgical oncology and surgical diseases of the breast, was selected for faculty at the prestigious Women in Breast Surgery conference. The Tampa, Florida-based conference was sponsored by Hologic, a groundbreaking enterprise designed to support women’s health by providing effective, state-of-the-art technology to healthcare professionals. Hologic constructed this two-day conference around the personal and professional development of women breast cancer surgeons.

Four renowned female surgeons, including Dr. Gorman, led the courses, merging the medical field and the business world through incorporating topics such as improving workflow efficiency, leadership and a seat at the table, getting the word out to build your brand, and offering a negotiation workshop. Dr. Gorman and her peers, who came from all over the United States, provided new breast surgeons and breast fellows (the medical community’s term for surgery residents and breast fellowships) with leadership and marketing tactics. “It was an honor to be a part of this,” said Dr. Gorman, “and to provide the tips and tricks I wish I had known when I was starting in the field rather than learning these strategies the hard way. This is really exciting work for the breast surgeon community.”

Educating the medical community on breast cancer surgery practices

Breast cancer technology

Gorman’s practice, Texas Breast Center, is considered a center of excellence for training among medical personnel. The conference’s sponsor, Hologic, sends its representatives and other physicians to be trained by Dr. Gorman and her team on the technology of the BioZorb, a marker device used for stereotactic body radiation targeted therapy, and the wireless technology she employs. Dr. Gorman is grateful for the opportunity to train other physicians and industry persons on breast cancer treatment and care advancements. “Bringing them into the process of these surgical techniques and utilization of the BioZorb to gain a first-person understanding of the tools they are selling or using is essential to promoting healing and recovery for patients; education is key,” emphasizes Dr. Gorman. Her desire to raise awareness and educate others in the field led her to present at the Women in Surgery conference.

Strategies for breast surgeons

Dr. Gorman emphasizes the importance of empowering women, physicians and patients alike, through education. Her presentations at this conference aimed to help women claim their spot at the table among the leading breast cancer surgeons by providing insight into the business side of surgery, an aspect that is often neglected within the medical field. Additionally, effective business tactics would lead to larger public exposure of surgeons and, thus, more conversations surrounding breast cancer and breast care in general. Through a nationwide increase of young women entering the field with successful business strategies and tailored care for patients enduring breast cancer surgery, Dr. Gorman hopes this will lead to greater self-awareness and detection of early-stage breast cancer among the public.

Why is breast cancer awareness critical?

Breast cancer is one of the most common cancers detected in females, ranking second only under skin cancer. This means that, statistically, most women will either be diagnosed or know someone who has been diagnosed with breast cancer. Awareness helps us begin to topple this statistic. It leads to more women participating in self-checks, earlier detection, and an understanding of the risk factors that may indicate breast cancer. Opening the door for these actions to become regular practices starts with preparing and enabling newer breast cancer surgeons with the information surrounding strong business tactics and state-of-the-art care for patients and their communities. The Hologic Conference on Women in Breast Surgery sought to jumpstart these efforts, aligning with Dr. Gorman’s mission.

Dr. Gorman was also selected to present at the 20th Annual Meeting of the American Society of Breast Surgeons.

 

 

Breast Cancer Awareness: A History

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March is officially known as Women’s History Month! To celebrate women, the incredible things they have endured throughout history, and to highlight the value of their wellbeing, let’s examine breast cancer awareness throughout history. You are likely to see an influx of this information during October, but Dr. Valerie Gorman of Texas Breast Center emphasizes the importance of breast cancer awareness year-round. Doctors and breast care specialists universally agree that awareness of the realities and risk factors is critical in conquering breast cancer’s devastation.

While the history of breast cancers presumably goes back to the early days of humanity, widespread advocacy for the cancer community and dispelling the shame around breast cancer has had a much shorter timeline. Not only that, but common awareness of this cancer and its symptoms has just become prevalent within the last 50-75 years. Texas Breast Center wants to highlight the journey of awareness for breast cancer and, through doing so, encourage people to check their own breasts and to spread knowledge of both prevention and risks of breast cancer in their communities.

The Origins of Breast Cancer Awareness

When did breast cancer awareness begin?

Women have been at the forefront from the beginning of cancer research initiatives. Early forms of the American Cancer Society founded the Women’s Field Army, giving thousands of women the chance to instigate fundraising and promote research during a time when society handed them few other privileges.1 Despite the advancement of fundraising efforts beginning in 1913, discussing cancer was taboo and deemed unfit for conversations far into the 1900s. Particularly regarding breast cancer, public discourse would identify it solely as a “prolonged women’s disease.”2

Only in the 20th century did breast cancer finally reach public notice. This shift can largely be attributed to former First Lady Betty Ford. She opted for total transparency in her battle against breast cancer during the 1970s, a time when stigmas surrounding breast cancer were a crippling concern for many women. Using her platform, Betty Ford shared the importance of screenings, breast cancer treatment, and solidarity for other American women affected by cancer. This instigated a dramatic reformation in culture surrounding breast cancer, both in the societal support of breast cancer patients and in prioritizing regular doctor exams.

When did widespread breast cancer initiatives arise?

Recognition of the disease began at an individual level first, with women such as Betty Ford speaking candidly about their experiences. From this stemmed the opportunity for structural and organizational levels of awareness to be formed. The best-known cancer charity initiative is the internationally recognized Breast Cancer Awareness Month, taking place annually in October. In 1985, Imperial Chemical Industries and the American Society for the Control of Cancer partnered to create the first national week-long breast cancer awareness event. The initial intent of this was to encourage women to get regular mammograms, a form of breast imaging used to screen for breast cancer. This week later transitioned into a month-long observance of breast cancer survivors and patients.

Nowadays, it is incredibly common for a non-profit organization or a corporation to take part in the annual commemoration. From the NFL to cosmetic companies like Estee Lauder to The White House, public awareness campaigns, donation drives, and stories are spread to raise money and support systems for women who have been diagnosed with this disease. Estee Lauder created one avenue of this in 1992, seven years after the first awareness event, with the pink ribbon, and gave out over a million to initiate a tangible representation of the month’s efforts.3 This image is still easily identified today, commonly known as a symbol of support for patients.

The Importance of Breast Cancer Awareness

Why is breast cancer awareness so important?

Breast cancer awareness is crucial because of the approximate 13% chance of women receiving this diagnosis. (1 out of 8 women in America develop breast cancer at some point in life, with the likeliness increasing with age.) Knowing the statistics surrounding developing breast cancer, keeping watch over the risk factors, and seeking transparent, expert education on the latest prevention methods can help one improve their chances of keeping a late diagnosis at bay.

What are the achievements of the breast cancer movement?

Breast cancer research

An increase in awareness has led to a greater emphasis on research to cure breast cancer throughout recent history. Following individual concerns, support groups were created, leading to lobbyists and activists pushing for greater research and education on the disease. The Journal of Women’s Health provides one example of this through the seven-year project on environmental toxins and impact conducted by the Breast Cancer and Environment Research Centers (BCERC).4 This program was an influential precedent, as it was the first National Cancer Institute funded initiative to incorporate activists into the scientific research council. In this, those involved in pushing to raise awareness had a direct impact on the focus of the studies. This 2003-2010 project is simply one of many historical examples where voices in the community resulted in an incredible impact on cancer research. What proof that individuals’ involvement matters!

What is the aim of breast cancer awareness?

You Can Help Save Lives

Breast cancer is the second most common cancer in women. This means the odds of you or a loved one needing to be treated are high. Awareness aims to help eradicate this statistic, and you can play a tremendous role in this by educating yourself and your community on the risks. Being informed is crucial for many reasons, mainly because it teaches people about the necessary aspects of breast care. These are measures such as routinely scheduled mammograms, conducting self-examinations, maintaining a healthy weight, limiting alcohol consumption, pumping your own breast milk, extensively researching birth control pills and medicine, and staying active to the best of one’s abilities. Each of these factors can lead to a lower risk for women of developing breast cancer, or, if one is to get cancer despite a lowered risk, to an early diagnosis, which has proven to yield better outcomes.

Additionally, in creating ordinary spaces for conversations about the realities of breast cancer to occur, the perception of those whose lives have been affected by this disease will change for the better. Increasing knowledge in your community can breed hope and support for women with breast cancer. This acceptance can also lead to a society that encourages scheduling screening mammograms regularly, producing more cases of early detection, which can save lives.

Support for You

As research increases, so do the success rates of treatment. Even with improving science, we understand that a breast cancer diagnosis can still feel overwhelming. Texas Breast Center is committed to being with you every step of the way. The team aims to connect with you to provide hope through a personalized, targeted treatment plan and support that goes beyond your initial treatments. Valerie J. Gorman, MD, FACS, is a breast surgeon specializing in surgical oncology and surgical diseases of the breast. Under her care, you will find a broad spectrum of treatment options, such as hormone therapy, and a treatment program designed to benefit your exact case of breast cancer.

 

  1. Lerner B. Inventing a curable disease: breast cancer control after World War II. In: Lerner B, editor. The Breast Cancer Wars: Fear, Hope, and the Pursuit of a Cure in Twentieth-Century America. Oxford: Oxford University Press, Inc.; 2001. pp. 41–68.
  2. Ross W. Transformation. In: Ross W, editor. Crusade: The Official History of the American Cancer Society. New York: Arbor House; 1987. p. 33.
  3. https://www.elcompanies.com/en/our-commitments/the-breast-cancer-campaign
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298674/

Black Women and Breast Cancer

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Black History Month

Officially recognized in 1976, February is dedicated as Black History Month in the United States of America. Commemorating the victories and legacies of African Americans and recognizing the hardships they have faced throughout our history, it is a pinnacle time of awareness and memorialization in the lives of American citizens. In honor of this past month’s observations, we wanted to provide information on women’s health surrounding the realities of breast cancer for black women.

Black Women and Breast Cancer

According to the American Cancer Society, breast cancer is the most commonly diagnosed cancer for black women. Falling second to lung cancer, breast cancer is also a top cause of cancer-related mortality. It is crucial for black women to understand the likelihood of a diagnosis, the risks surrounding breast cancer, and ways to routinely check for potential breast tumors. There are many questions surrounding the truth on breast cancer statistics, particularly pertaining to black women. Educating people on the realities of breast cancer plays a key role in women knowing what to watch for regarding their breasts and in changing some of the socially constructed elements surrounding medical and breast care for black women.

What is breast cancer?

Essentially, breast cancer is the uncontrolled development of breast cells. This is why it is recommended that women examine their breasts regularly for evidence of changes to the breast such as puckering or discoloration, as they are often the first symptoms to appear.

What would lead to a breast cancer diagnosis?

Although there are many different varieties of cancer, tumor biology at its base level remains consistent, and they all have similar characteristics. The genes in the human body regulate and control cell proliferation. The job of genes, which are found in the nucleus of cells, is to ensure that as old cells die, they are replaced by new cells. Mutations can develop, causing this process to be disrupted. This change can significantly affect the regeneration process, removing control from the genes and allowing the cells to continue making new cells without restriction. The production of additional cells can lead to the formation of a tumor. The emergence of a malignant tumor (which is an aggressive form of cells and can spread to other areas of the body via the blood and lymph systems) is what typically generates a breast cancer diagnosis.

Breast Cancer Risk for Black Women

Age, ancestry, family history, and type of diagnosis affect the severity and likeliness of breast cancer.

Who has the highest risk of breast cancer?

Despite a lower incidence of breast cancer development, black women’s lives are approximately 40% more likely result in breast cancer death. Women of a younger age, meaning below the age of 45, also tend to have the highest risk. There is no simple answer to this disproportion, as these starkly contrasting numbers seem to arise from a combination of factors, including both sociological conditions and genetic factors.

Disparities of Breast Cancer and Race

In recent years, there have been increasing conversations surrounding the tragic breast cancer disparities of medical care and attention for people of color. These risks and realities prove particularly tangled and problematic in the world of health care and surgical access. While this is true, Dr. Gorman of Texas Breast Center is eager to dismantle this problem through targeted, attentive care for each person who comes under her expert care.

The prevalence of breast cancer is still far greater than we like to see, which is why Dr. Gorman and her team at Texas Breast Center fight endlessly to see these numbers decrease. Particularly among black women, the statistics of more aggressive forms of breast cancer diagnoses, such as triple-negative breast cancer, are astronomically higher.

What is triple-negative breast cancer?

Triple-negative breast cancer is a form of breast cancer that tests negative for all three receptors: estrogen, progesterone, and HER-2. This kind of breast cancer is one of the more aggressive and invasive breast cancer types, with high spread and growth rates. Both age and race play into the likeliness of this diagnosis, as it is most common in women under forty and in black women.

Not all black women are at the same risk of developing triple-negative breast cancer. Research shows that particularly those born in Western Africa and the United States are at an increased risk for triple negative breast cancer in comparison to those born in East Africa. This difference is especially notable when compared to white women or women of other races. According to the American Cancer Society, black women in the United States are actually twice as likely as white women to receive this diagnosis. This may be a reason for the lower rate of survival among black breast cancer patients. Educating oneself on the risks of breast cancer can help black women act in anticipation and preparation and increase the chances of survival through early detection.

Dr. Gorman at Texas Breast Center

While statistics surrounding breast cancer can seem overwhelming and may evoke fear, Dr. Valerie Gorman combats this with the truth that “treatment for breast cancer has improved significantly over the last few years, and success rates continue to rise.” Breast cancer outcomes and treatments have never seemed more optimistic.

Dr. Gorman and her team at Texas Breast Center, located in Waxahachie, are devoted to caring for every patient in a manner tailored to their unique case, conducting each interaction with expert care, attention, and skill. Providing honest, advanced information on the risk factors of breast cancer and the leading treatment options is a top priority of this Texas-based breast surgeon. She dedicates herself to the wellbeing of every single patient and, in doing so, aims to topple the disparities that black women diagnosed with breast cancer face and help reduce the rates of breast cancer mortality, one case at a time.

Staying informed

As a leading surgeon, Dr. Gorman advocates for preventative measures and staying on top of breast health. Regular self-breast checks, mammography screening, a regular clinical breast exam, assessing controllable risk factors, and remaining informed on the latest news surrounding breast care are all steps that can increase the chances of detecting breast cancer while it is still in the early stages.

If you have any questions surrounding breast cancer or breast cancer risk factors, don’t hesitate to contact Dr. Gorman and her team at Texas Breast Cancer.

 

https://www.cancer.org/research/cancer-facts-statistics/cancer-facts-figures-for-african-americans.html

https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.32293?referrer_access_token=tNmZThNQBcGMkZz0Mw1KaU4keas67K9QMdWULTWMo8PjlxlDClmn9SMF_cvVV7b6CVxSyInTq9HeXJidKb9BxMA8NsR

How Breast Cancer is Diagnosed

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No one is excited to get a mammogram or go through other breast cancer screening tests. However, keeping on top of breast health and regular screening can be life-saving. The sooner breast cancer is diagnosed, the better the outcome is more likely to be.

First Steps

Keeping on top of regular breast self-checks, yearly mammograms, and annual physicals can help increase the chances of finding breast cancer in the early stages. That is to say, mammograms and self-checks will not increase the chances of a diagnosis but of early detection of the disease should it occur. These are three possible first steps in a potential breast cancer diagnosis.

Self Breast Check

A self breast-check, also known as breast self-exams, is a method used to keep yourself informed and aware of your own breasts and breast tissue. They should be done monthly, if possible, and especially if you meet a high number of risk factors, and they do not take long. But if performed regularly, they can keep you very familiar with the feel and appearance of the breasts, meaning any change is sure to stand out.

The process is relatively simple:

  • Start by looking at your breasts, both looking down and checking them in a mirror. Check for any changes in color, size, or shape. Signs of cancer or other infection are swelling, redness, dimpling, puckering, or discoloration. Especially check the nipple for inversion, pain, or unexpected or bloody discharge.
  • Raise your arms and reexamine. Having your arms up may shift the positions of the breasts to reveal something you may have missed otherwise.
  • Use the pads of a few fingers to carefully feel over the entire breast. Use consistent, small, circular motions to move across, up, and down the whole breast, covering the collarbone to the top of the rib cage and cleavage to the armpit
  • . Use enough pressure to feel deep tissue but not enough to hurt yourself.
  • Lay down and repeat the process.

Keeping up with regular breast self-exams will make it easier to notice any changes. If you find anything of concern, speak with your physician to discuss options and further screening.

Clinical Breast Exam

A clinical breast exam is part of the standard physical. It is a breast exam performed by your doctor, in which they will physically examine and feel each breast to feel for any changes or lumps in the tissue. The clinical breast exam becomes particularly relevant if you are at high risk of breast cancer or have noticed changes in your breasts during a breast self-examination. Raise any concerns with your physician so they can help you and discuss any necessary next steps.

It is not as simple as finding a lump and having doctors diagnose breast cancer. Should something be found during these exams, your doctor will likely send you to get a mammogram or ultrasound.

Schedule your appointment for a clinical exam today!

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Breast Imaging Tests

Mammograms

Another way to keep on top of your breast cancer risk and status is to receive regular mammograms. A screening mammogram, or mammography, is an X-ray of the breast using a low dose of radiation. Two plates will compress the breast at different angles to get multiple digital images, which a radiologist can examine for signs of breast disease or any other possible abnormality.

However, those who have particularly dense breast tissue or scar tissue in the breast are likely to have false positives in a mammogram. Breast cancer, dense tissue, and even cysts (fluid-filled sacs) appear white on x-rays, with limited ways to distinguish between them. For this reason, a potential positive from a diagnostic mammogram is not considered conclusively positive. Additional tests or a biopsy should be taken to confirm accuracy.

Ultrasound

A breast ultrasound uses sound waves to form a picture of the breast tissue. This is a good alternative to a mammogram if you’re pregnant and shouldn’t be exposed to x-rays. While ultrasounds are not generally used for cancer screening, they work well at differentiating a fluid-filled cyst from more solid masses. It can also give locations of tumors to help doctors, should they need to perform a biopsy or further investigation. Some surgical oncologists will use ultrasound during lumpectomies to establish the boundaries of the breast cancer before they begin removal.

MRI Scan

MRIs, or Magnetic Resonance Imaging tests, use magnetic fields to produce images of the breast’s interior. A contrast dye is injected before the screening, revealing where any blockages are. MRIs are not often used to diagnose breast cancer but instead used after an initial diagnosis to see how far cancer has spread. However, it can be used in combination with a mammogram to screen if:

  • there is a strong family history of breast cancer or ovarian cancer
  • the breasts are particularly dense (primarily ducts, fibrous tissue, and glands, with little fatty tissue), so any signs of breast cancer would be difficult to spot on a mammogram alone
  • the BRCA1 or BRCA2 gene mutation or other genetic mutations are present
  • radiation treatments have been applied to the chest before age 30

These traits can potentially lead to a high risk of breast cancer or, in the case of the dense tissue, an increased risk of missing early-stage breast cancer.

Metastatic Breast Cancer Detection

Specific imaging tests can detect metastasis once breast cancer has already been diagnosed. Biopsies can be performed by interventional radiologists, doctors whose primary focus is minimally invasive and targeted therapy.

Biopsy Sample

There are multiple kinds of biopsies, each serving their own purposes, though generally speaking, a biopsy is used to confirm or rule out a breast cancer diagnosis. Put simply, a biopsy takes a small amount of cells or tissue from an area of concern to examine under a microscope to establish whether these cells are cancerous or not. A pathologist–a doctor specialized in interpreting lab data and evaluating and diagnosing based on cells and tissues–will create a pathology report to explain what was found and discuss potential treatment options.

Fine Needle Aspiration Biopsy

The tissue or cell sample is removed using a thin needle.

Core Needle Biopsy

Like the fine needle aspiration method, the core needle biopsy uses a needle to remove the needed sample. However, the needle gets a core of tissue, so it collects a larger sample. This is generally the preferred technique for getting breast cancer diagnosed once an abnormality has been found in the breast, whether through physical examination or imaging tests. A pathologist will examine the sample to establish whether they are invasive cancer cells and identify any cancer biomarkers. Local anesthesia is commonly used to minimize discomfort during the procedure.

Image-Guided Biopsy

Image-guided biopsies are a form of core needle biopsy that map the area and guide the needle to the correct area of calcifications or mass through the use of imaging devices, such as ultrasound, mammography, or MRI. Usually, a marker is left behind–a small metal clip, usually titanium–to mark where the sample was taken.

Surgical Biopsy

Surgical biopsies are usually performed after a diagnosis has already been given, so they are rarely used as diagnostic tests. Most potential breast cancer patients will be given a form of needle biopsy to avoid unnecessary surgery. However, surgical biopsy does yield the largest amount of tissue.

Sentinel Lymph Node Biopsy

Breast cancer will sometimes spread into the local lymphatic system. The lymph nodes the breast cancer cells reach first are referred to as the sentinel lymph nodes and are usually the axillary lymph nodes (found under the arms). The sentinel lymph node biopsy removes 1-3 lymph nodes to avoid needing to remove more lymph nodes later.

Staging Breast Cancer

Once a breast cancer diagnosis has been established, your doctor will establish its severity in one of the breast cancer stages. The stage helps determine your prognosis and the best treatment options to take moving forward.

Some procedures that may be used to establish the breast cancer’s stage are:

  • Mammogram
  • Breast MRI
  • Blood tests
  • Bone scan
  • PET scan
  • CT scan

The stages ran from 0–meaning noninvasive and relatively contained–to IV–also called metastatic, meaning it has spread to other parts of the body.

Treatment Options

A patient’s treatment plan will be determined based on their breast cancer stage, health, and other factors. Dr. Gorman at the Texas Breast Center always ensures that each patient receives a personalized and targeted approach to breast cancer treatment to best meet their needs.

Breast Cancer Recurrence: New Data in 2022

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In layman’s terms, breast cancer recurrence happens when cancer has come back after treatment. When a number of breast cancer cells evade initial treatment and later aggregate, they cause the cancer to return despite months or even years of remission. It is important to note that a minimum of a year must pass between the execution of cancer therapy and the appearance of growing cancer cells for the growth to be deemed a recurrence, rather than treatment failure or progression of cancer.

Every survivor of breast cancer faces a chance of recurrence, so it is essential to understand what to look for and how to take proactive measures. We have written a previous article that details risk factors of breast cancer recurrence and many of the prevention and treatment methods used to fight the growth of cancer cells. However, new data has arisen, giving us an even greater insight into the ins and outs of breast cancer recurrence.

New Data

Initially, recurrence was thought to happen within the first five years after treatment. Risk is greatest during these beginning years, but up-to-date studies reveal that the risk of recurrence lasts more than thirty years. Cancer cells can lay dormant, causing them to be undetectable for long periods, leading to a recent notable concern of the risks of late recurrence. The growing concern is attributed to a high cumulative incidence increase (which is an estimate of the risk that one may experience an event within a specific period). This means that more patients are at risk for late recurrence due to an increased number of long-term breast cancer survivors.

While this information seems alarming, and certain factors make recurrence more likely, thankfully, those who have a recurrence are not in the majority, and research has allowed us to identify the most prominent contributors to recurrences. The study also notes that because of the allotted time between the research participants’ first diagnoses and present day, as well as the study’s focus on late recurrence (requiring an extended follow-up), there have been significant changes and improvements in treatment procedures and technology since the participants’ initial treatment. Therefore, the study results are uncertain in association with today’s regimens. Because of this, such studies are paramount and must be completed repetitively to find continual up-to-date results.

Recurrent Breast Cancer

While the chances of a recurrence are not common, it is still valuable to consider the risk factors and to understand the realities of the different types of recurrences.

Types of Recurrence

If a recurrence does occur, a breast surgeon will categorize it by its appearance in proximity to the initial breast cancer. The three forms are:

Local recurrence

  • This refers to when the breast cancer returns to the same chest area as the original tumor.
  • Changes in appearance or feel (such as thickening of the skin or new lumps) are typical indicators of a local recurrence.

Regional recurrence

  • It is deemed regional recurrence if cancer cells show growth in nearby lymph nodes (found in the armpit or collarbone) to the initial cancer area.
  • Regional recurrence is differentiated from local recurrence solely because of the involvement of lymph nodes.
  • Symptoms of regional recurrence may involve newfound pain or lumps in the arm attached to the side of the body with the original breast cancer.

Distant recurrence

  • When cancer has traveled to different parts of the body (such as bone or organs), it is considered a distant recurrence.
  • Another name for this is metastatic breast cancer.
  • Bone pain, weakness, and extreme fatigue may point to metastatic breast cancer.
  • It is considered stage IV cancer, as the cancer has extended to other parts of the body.

Which breast cancer is most likely to recur?

The initial diagnosis is a significant indicator of the chance of recurrence. Recurrent breast cancer is most likely to appear in patients who had an original tumor with more than three positive lymph nodes.

What are the chances of recurrence of breast cancer?

The cumulative incidence of recurrence is between 8.5-16.6% for fifteen to thirty-two years after a primary diagnosis. Chances of late recurrence are typically higher for those whose initial breast cancer was found in the lymph nodes and resulted in tumors over 2o millimeters. The chances are higher for women who were 35 or younger during their primary diagnosis. According to the recent data, 2,595 of the 20,315 women involved in the research study were diagnosed with a recurrence more than ten years following their initial bout with breast cancer.

Is recurrent breast cancer worse?

Recurrent breast cancer may prove more challenging to manage, and the therapy used in your initial treatment may no longer be effective in your specific case. Metastatic cancer may also require more aggressive treatment, as the cancer has spread to more than just one part of your body. Recurrent breast cancer should not automatically be considered worse than the primary diagnosis, but it will often require different methods of treatment or therapy.

Treatment

Even simple cells can become tumors if not adequately treated. It is impossible to guarantee a 100% chance of freedom from cancer recurrence. Still, treatment may be able to halt the growth of undetected cells for many years, and there are methods of prevention that the doctor-patient duo can take to reduce your risk of recurrence.

While a breast cancer diagnosis can seem bleak, both Dr. Gorman and the researchers of this recent study recognize the significant evolution of modern-day regimens and their success rate. If your breast cancer comes back, treatment is available. Depending on the type of breast cancer, treatment may entail surgical treatment and radiation therapy. More aggressive treatment regimens and therapy approaches may be merited for those at a higher risk of late recurrence. Survivors are also encouraged to stay under extended surveillance by making regular check-ins with their doctors and surgeons.

Risk Factors and Therapy

The chances of recurrence are significantly lowered by the proactive utilization of hormone, chemo, or radiation therapy following the initial removal of cancer cells. You can play a role in lowering the recurrence risk factors by opting for therapy options (such as radiation treatment or endocrine therapy) recommended by your oncologist. Such regimens may attempt to prevent breast cancer recurrence or aid in reducing the potential of recurrence. Exercise and a healthy diet are also easy, proactive measures to implement for holistic well-being and to reduce the risks of recurrence.

Dr. Gorman and Texas Breast Center

Remember that recurrent breast cancer is not your fault. Though a breast cancer diagnosis can be alarming or dismaying, Dr. Gorman holds fast to the fact that “treatment for breast cancer has improved significantly over the last few years, and success rates continue to rise.” There is great hope. Dr. Gorman understands the significant emotional and physical impact a breast cancer diagnosis can play in one’s life. Her team at Texas Breast Center is dedicated to offering patients personalized, advanced care in the treatment of breast cancer recurrence and the prevention of recurrence, as well as support that lasts long after your treatment regimen.

Our previous article: https://www.texasbreastcenter.com/breast-cancer/breast-cancer-recurrence-what-and-why

New Data: https://www.medscape.com/viewarticle/963031?uac=390358FV&faf=1&sso=true&impID=3870849&src=mkm_ret_211213_mscpmrk_BC_Monthly

 

History of Breast Cancer

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March is Women’s History Month. The history of women and the history of breast cancer go hand in hand. But how far back does the history of breast cancer go? How long have we known about it, and how long have we been able to treat it? This article will discuss treatments and diagnoses of breast cancer since antiquity.

Who first discovered breast cancer?

When did breast cancer start?

Breast cancer, and cancer as a whole, has likely been around as long as humanity has. Evidence of prostate cancer has been found on skeletons of both a Russian king (approximately 2,700 years old) and an Egyptian mummy (about 2,200 years old). But the earliest record we have of breast cancer can be found on the Edwin Smith Surgical Papyrus, an Egyptian papyrus dating back to 3000-2500 BC. While the papyrus does not offer much in the way of treatment options, it does give a way to identify an incurable disease as “cool to touch, bulging and spread all over the breast.”

Ancient Greece, around 460 BC, gave us the term carcinoma (karkinoma). Carcinoma is a cancer that starts in skin or organ tissue cells rather than in structures like blood vessels or bones. However, breast cancer treatment was still relatively unsuccessful as it was believed that disease was caused by imbalances of the four humours, phlegm, yellow bile, black bile, and blood. To treat illnesses, one had to remove or increase the humours within the body. Galen, a well-known Greek physician from around 168 BC, claimed that breast cancer was caused by too much black bile and began to treat the condition with surgery to remove the tumor, though he let the incisions bleed to continue removing excess bile.

While the surgery that Galen performed spread throughout Greece, the increase in religious philosophies and medical approaches prevented the practice from going much further. Early Christianity believed surgery to be more barbaric than their faith healing preference, a tradition that persisted through much of the world between 476 and 1500 AD. However, between the 10th and 15th centuries, Abu Al-Qasim Al-Zahrawl and Ibn Sina, a pair of Islamic physicians, revived the Greek practices, including surgery, and wrote many medical texts. Their ideas and practices spread throughout Europe.

The 16th, 17th, and 18th centuries, known more commonly as the Renaissance period, saw a growth in surgical practice. Where once ‘surgeon’ was simply a title tagged onto the end of ‘barber’, and a procedure could be performed after a haircut, surgeons now had their own trade. John Hunter, a Scottish surgeon, proposes the first idea of breast cancer in stages. While not as clearly defined as those we have today, there were some stages where surgery was necessary, while others were not. This was also a time of no anesthesia, so these early lumpectomies and mastectomies had to be performed quickly and accurately.

As the 19th century rolled around, significant improvements were made to the safety of surgery. With the introduction of hygiene to medical practices (albeit slowly), disinfection and surgical garments became more common. Anesthesia was also developed, helping prevent patient shock and give the doctors more time to perform the breast cancer surgery. William Halsted, an American surgeon, developed the radical mastectomy procedure in 1894. This procedure removes the entire tumor in a single piece together with the breast, the axillary lymph nodes, lymphatic vessels, and pectoral muscles. This was the first time breast cancer was considered treatable and even curable. Two years later, Thomas Beatson, a British surgeon, announces that oophorectomies–operations to remove one or both ovaries– can reduce tumors in advance breast cancer.

Modern Breast Cancer Treatments

The 20th century brought vast change to breast cancer treatment. Tumors were shrunk using radiation. Chemotherapy was introduced in the 1940s, and Robert Egan introduced mammography as a breast cancer detection option in 1962. The first modern autologous breast reconstruction was performed in 1979, allowing for more natural feeling breasts. More medications, procedures, and treatments for breast cancer have been researched and implemented, as well as potential causes and risk factors. The BRCA1 and BRCA2 genes–commonly known as the breast cancer gene– were discovered in 1995. A few years later, new breast cancer subtypes–HER2 positive, triple-negative, progesterone receptor-positive, and estrogen receptor-positive–were classified in 2000.

Even today, new research is still being performed to improve upon the surgeries, treatments, and post-op for breast cancer patients to have the best possible results. Dr. Gorman was involved in a study using the Biozorb implantable marker that helps target radiation therapy as well as post-operation imaging. She also contributes to the study on Accelerated Partial Breast Irradiation, or APBI, a method that shortens the amount of time the patient needs to spend getting radiation therapy and uses a higher dose of radiation in a more targeted beam–assisted by the Biozorb marker. She also uses oncoplastic techniques which help with postoperative cosmesis.

Breast Cancer Treatment Today

With today’s understanding of the disease, treatment is far more effective than it has been in the past. One primary reason for this is the improved breast cancer screening guidelines and understanding of breast cancer risk factors such as family history or having the so-called ‘breast cancer genes’. Knowledge of these risk factors can help set up specific screening procedures for those with a higher risk of breast cancer while still having a standard screening arrangement for those with lower risk. Getting a regular mammogram and breast self exam are easy steps to keep an eye out for early potential signs and symptoms. The sooner breast cancer is caught, the easier it is to treat.

Once a breast cancer diagnosis is reached, a treatment plan is agreed upon; no patient’s treatment plan and recovery are exactly alike. Treatment plans can–but do not necessarily–include breast surgery, radiation therapy, chemotherapy, hormone therapy, targeted medical therapy, as well as cosmetic surgery to aid in the patient’s self-image after an oncological procedure. Each of these treatment options has benefits and downsides and side effects and is more useful in some situations than others. The different surgical approaches can be applied depending on the tumor’s size and how far the breast cancer cells have spread. There are options to save more of the breast tissue and chest muscles if the breast cancer is caught early enough.

Combination treatments–surgery accompanied by radiation therapy or chemotherapy alongside medical therapy, for example–can help by approaching the breast cancer from different angles, ensuring thorough results with no cancer cells left behind and decreasing recurrence. With a combined effort from a full oncological team, the survival and recovery rates have increased exponentially since the days of the Edwin Smith Surgical Papyrus.

Dr. Gorman and her team at the Texas Breast Center work together to treat breast cancer from all angles. Dr. Gorman focuses on treating from the surgical side and works closely with medical and radiation oncologists to form a personalized treatment plan best suited to each patient. She also looks to the future of treatment by keeping aware of current and ongoing breast cancer research to best treat her patients. If you have questions or are ready to find your next steps in treatment, reach out to the Texas Breast Center. The team is prepared to help.

Breast Cancer Screening

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An essential part of breast cancer awareness and breast cancer prevention is breast cancer screening. Screening takes many forms, from the self-breast check to the breast MRI, but all play their part. These screening examinations provide an opportunity to catch signs and symptoms of breast cancer, as well as lumps, early so that treatment options can be less extreme. Here is some information on the basics of different tests, when and how they are taken, and the decision-making process behind them.

When should I start breast cancer screening?

While any person with breasts should start a regular breast self-exam as their breasts start to develop, clinical screening does not need to begin so early. Different organizations vary in their breast cancer screening recommendations, especially as it comes to when exactly you should begin your breast cancer screening. Your particular risk and family history can play a part in your timeline.

When should I get screened for breast cancer?

The general timeline recommends:

  • Ages 25-39: Self breast exam monthly; annual clinical breast exam; mammogram for high-risk patients (annually, starting 10 years before youngest family member diagnosed with breast cancer)
  • Ages 40-54: At age 40, patients with normal risk start annual screening mammogram.
  • Ages 55+: It is recommended that screening continues for as long as the patient is still living a healthy life and is expected to do so for at least ten more years. According to the U.S. Department of Health and Human Services, women between 40-74 with screened mammograms have a decreased chance of dying from breast cancer.

As with any medical concerns or tests, ask your doctor the best time to start your breast cancer screening and how often you should go.

What are the screening tests for breast cancer?

There are a handful of different kinds of breast cancer screening tests, each with its own purpose and use, as well as benefits and risks.

What are Clinical Breast Exams?

A clinical breast exam is an exam performed in a doctor’s office by a doctor or other health professional. They will use their hands to feel and check for any physical abnormalities, signs, or symptoms of breast cancer in the breast and surrounding areas. These include lumps, irritated or puckered skin, and swelling.

The doctor will also ask for any relevant information such pregnancy history or the date of the patient’s last period. These can affect a patient’s risk of developing breast cancer and the current state of their breast. It is always best to be familiar with your own breasts look and feel so you can note any changes to your doctor straight away.

Most often, when a woman finds a lump or other sign or symptom, it tends to be during dressing, bathing, or other regular activities. However, doing these regular physical and visual checks, especially self-checks, keeps you familiar with your breasts’ regular state, so you are more likely to notice a change.

What is a mammogram?

A mammogram is the most common method of breast cancer screening in women ages 25 and above. It is a low dose x-ray exam that provides internal images of the breast. Mammography is an integral part of early detection because it can find small changes within the breast before these changes can be felt or seen by the patient or their doctor. Ductal Carcinoma in Situ (DCIS) can also be found early in mammograms. DCIS is a collection of abnormal and/or pre-cancerous cells in the milk ducts of the breasts. The sooner breast cancer is found and treated, the better, as it is usually much easier to treat in early stages.

As with any medical test, there are some risks. Because it is an x-ray, there is radiation involved. However, it is such a low dose, and such a brief exposure, that no radiation is left in the body after the examination. These risks also include the chance of a false-positive in the test results. A false positive can be caused by particularly dense breast tissue, scar tissue, or other factors. However, most doctors will not give a positive diagnosis purely based on just the mammogram due to the risk of false positives. They will recommend another form of test to compare results. There is also a 10-15% risk of a false-negative test result from a mammogram.

Another form of this test is digital mammography, also known as 3D mammography or tomosynthesis, which is particularly helpful for women with dense breast tissue or other factors that might cause a false positive on a typical mammogram. This screening exam can improve the chances of finding small cancers while reducing the need for additional testing to confirm false positives. 3D mammography does give a clearer picture of the breast tissue.

Other Breast Cancer Screening Tests

A few other types of breast cancer screening tests are used less commonly, though each has its purpose. These screening tests are generally used for women or patients with many risk factors, such as a family history of breast cancer or a genetic predisposition for breast cancer, or potential positives in previous mammograms.

  • Breast MRI Screening–MRI, or Magnetic Resonance Imaging, uses radio waves and magnets to collect detailed images of the body. This is often used for high-risk patients and those with a genetic mutation that increases their risk of breast cancer. This may actually start prior to mammogram on these high-risk patients.
  • Breast Ultrasound–An ultrasound of the breast can be used when a woman cannot undergo an MRI or x-ray screening (for example, if they are pregnant). Ultrasounds are particularly useful on dense breast tissue, containing more glands or ducts than fat. The ultrasound can differentiate the dense tissue and breast cancers better than traditional mammography. If there is no contraindication, however, a patient also needs a mammogram.
  • Thermography– Thermography uses a heat-sensing camera to observe and record the temperature of the breast’s skin. Because some tumors cause temperature changes, the thermogram may detect the presence of these tumors. However, there have not yet been any randomized clinical trials of this test to determine its validity. This may be additional information for your physician but does not replace annual mammograms.

What is the most accurate test for breast cancer?

Each test used to screen for breast cancer, from the breast self-exam to the breast ultrasound, has benefits and risks. Mammography is the easiest screening test to access and has been found to to find DCIS and other breast cancer tumors reliably, and is best for average-risk women. However, 5-15% of mammograms need a follow-up by another test for clarification. Ultrasounds can add diagnostic information on a painting and can help give a clearer picture than a mammogram, especially for women with dense breasts. MRIs are also helpful diagnostic tools for women with dense breasts and can sometimes find cancers that were even missed by the ultrasound. MRI cannot be used by those who have metal implants or are allergic to the contrast.

Each of these types of cancer screening exams works uniquely to collect different results. Ask your doctor for their recommendation based on your personal risk factors and concerns.

Does screening for breast cancer really work?

No one breast cancer screening exam is going to find 100% of breast cancer. However, between regular screening and breast self-checks, the chance to find breast cancer while it is still in the early stages increases dramatically. The sooner breast cancer can be detected, the easier it is to treat, and therefore the easier treatment will be on the cancer patients.

Remember, you can speak to your doctor or healthcare provider about your risk factors and determine your best method and pacing for screening. Dr. Gorman and her team at the Texas Breast Center are always happy to speak with you about breast cancer and any next steps in treatment plans.

See the article on Breast Cancer Diagnosis.

Breast Cancer Risk Factors

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What is a Risk Factor?

A breast cancer diagnosis can seemingly come out of nowhere for many patients. However, many things that could have made this diagnosis (or any potential diagnosis) far more likely for some patients than others. These little details in lives are known as risk factors. Some factors are a part of your lifestyle and can be controlled in your day to day life. Others are beyond a given person’s control, like things built into the DNA. It’s important to note that none of these factors will cause breast cancer. Any one of these risk factors is not a cause for breast cancer. They will only bring about higher risk.

Risk Factors You Can Affect

  • Taking hormones–Some forms of hormone replacement therapy (HRT), including estrogen and progesterone, in menopause can increase the breast cancer risk.
  • Using oral contraceptives–Some birth control pills have been found to raise breast cancer risk.
  • Reproductive history–A few factors relating to childbirth can vary your risk level. Having your first pregnancy after the age of 30, not having children, never having a full-term pregnancy, or not breastfeeding can increasing your breast cancer risk.
  • Being physically active–Women who are more active will decrease their risk of getting breast cancer.
  • Being overweight after menopause–Older women with obesity have an increased risk as opposed to those at a healthier weight.
  • Alcohol–The more alcohol someone drinks, the higher the risk of breast cancer. For example, a woman who has 2-3 alcoholic drinks a day will have a 20% higher risk than a woman who does not drink.
  • Diet–There is some debate about what diets increase or decrease the risk of breast cancer. However, a healthy diet with plenty of fruits and vegetables and minimizing animal fats has many health benefits.
  • Smoking–Smoking can increase a person’s risk of breast cancer.
  • Night shift/light at night–Routinely working night shifts can bring about a higher risk of breast cancer, possibly due to light exposure at night.

Risk Factors You Cannot Affect

  • Sex–A woman is far more likely to get breast cancer than a man due to the increased exposure to estrogen and progesterone. Because these are the hormones used in hormone replacement therapy for transgender women, this increased risk includes them. While men can certainly get breast cancer, the risk is not as high.
  • Race–White and black women are most likely to develop breast cancer. Black women tend to have the highest risk before 45 and are more likely to die from the disease.
  • Ashkenazi Jewish heritage–Jewish women also have a higher risk of breast cancer, likely due to a high occurrence of the BRCA1 and BRCA2 gene mutations in those of Ashkenazi Jewish descent.
  • Inherited genes–Several genes that can act as risk factors for breast cancer.
    • BRCA1 and BRCA2
    • ATM
    • BARD1
    • BRIP1
    • CDH1
    • CHEK2
    • NBN
    • NF1
    • PALB2
    • PTEN
    • RAD51C and RAD51D
    • STK11
    • TP53
  • Age–As you get older, your risk of breast cancer increases. Most diagnoses occur after the age of 50, and by the time a person is 60, the risk of breast cancer is 1 in 29.
    Breast History–If someone has previously been diagnosed with breast cancer or another breast disease like lobular carcinoma in situ or atypical hyperplasia, they have a much higher risk of breast cancer in the future.
  • Family History–Women who have a family history of breast cancer, especially when it is a first-degree relative (mother, sister, daughter) previously diagnosed. The risk of breast cancer also increases with multiple family members diagnosed, and a family history of ovarian cancer can also indicate an increased risk.
  • Radiation Exposure–Previous exposure to ionizing radiation in the chest area is a risk factor for breast cancer. Radiation is often used for treating Hodgkin’s disease. The risk is greater if the radiation was applied as a child.
  • Age at First Period–Starting menstruation early, before ages 11 or 12, can raise the breast cancer risk factor by bout 15-20% over those who started to get their periods at 15 or older. This is due to more prolonged exposure to estrogen and progesterone, which, as mentioned above, increases risk.
  • Age Starting Menopause–Women who start menopause after 55 have an increased risk of breast cancer by approximately 40% compared to those who start at age 45 or younger. Like with the earlier start of menstruation, this is due to more prolonged exposure to progesterone and estrogen.
  • Breast Density–Breast density comes from having more connective tissue than fatty tissue. This denser tissue can make it very difficult to read a mammogram accurately, sometimes increasing the risk of missing a potential diagnosis. Breast density can come from high estrogen levels, indicative of a risk factor rather than one on its own.
  • History of Diethylstilbestrol (DES)–DES was a drug given to some pregnant woman between the 1940s-1950s to prevent miscarriage. Those women and those whose mothers took it all have a high risk of breast cancer.
  • Birth Weight–Women born with a higher birth weight have an increased risk of breast cancer, particularly before menopause.
  • Blood Androgen–Androgens are hormones important to sexual development (including testosterone). An increased amount of androgens in a woman’s blood can increase her breast cancer risk.
  • Bone Density–High bone density can be a breast cancer risk factor. Someone with high bone density can have up to 60-80% higher risk than those with lower density.

    For a deeper look at Breast Cancer Risks, read our Causes series, starting with this article on Family History Risks.

Reducing Risk

  • Breast Cancer Screening–Go for regular breast screening to keep an eye on your breast health. For most, a mammogram is sufficient for checking breast health. A Breast MRI (Magnetic Resonance Imaging) may be better for those of higher risk. Speak with your doctor to establish the best course of action for the frequency and type of screening for you.
  •  Breast Self-Exam–Monthly, you should check your own breast health. While it won’t necessarily catch every sign of breast cancer, it can find many, and it is an excellent way to keep yourself familiar with your breasts. By checking your breasts’ appearance, feel, and textures regularly, you will be more likely to notice any changes should they come. If anything does change, bring it to the attention of your doctor.
  • Breast Feeding–Breastfeeding can help reduce the risk of breast cancer, particularly in those pre-menopause.
  • Lifestyle Changes–As mentioned above, some breast cancer risk factors that can be reduced through your own lifestyle choices. By doing what you can to handle these risk factors, such as alcohol intake and physical activity, one can reduce their risk of breast cancer by a great deal while also keeping themself healthy in general.

Speak With Your Doctor

If you are ever concerned about your risk of breast cancer, you can speak with your doctor. While some risk factors are easy to determine for yourself, some must be tested for–blood androgen levels, inherited genes, etc.–which your doctor can help you get access to and understand. Once you and your doctor are familiar with your breast cancer risk level, you can set up a plan for your next steps. These will include recommendations for breast cancer screening–how often and what type–as well as possible medical preventative steps if your risk of breast cancer is high enough.

Dr. Gorman at Texas Breast Cancer is always available to help with any questions about breast cancer risk, preventative steps, and the process should a breast cancer diagnosis be given. She is an advocate for the informed patient, always providing her patients and those who could potentially become patients with the information they need.

If you have any questions about breast cancer or breast cancer risk factors, please feel free to contact Dr. Gorman or her team at Texas Breast Cancer.

 

Breast Cancer Recurrence: What and Why?

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When breast cancer comes backs, it is called recurrence. While those who have a recurrence are not in the majority, they are certainly not a rarity or an impossibility. Recurrences typically happen within the first five years after treatment but can occur at any time and have a few ways of returning. To help ease some of the worries of these first few cancer-free years, we want to give some clarity and explanation into what breast cancer recurrence is and what to look for.

See updated data from 2022 on the recurrence of breast cancer.

Causes

Breast cancer recurrence occurs when cells from your original breast cancer manage to escape being treated and begin growing again. This process can sometimes take years. The cancer cells will lay dormant until something kick starts them into growing again.

Risks

Many of the recurrence risk factors are determined by the original tumor and cancer, though the patient determines some. These risk factors include:

  • A large tumor–A larger tumor increases the risk of cells being left behind.
  • Close or positive tumor margins–During surgery, when the surgeon removes the cancer, they will remove a small amount of healthy tissue around it. The tissue is then examined with a microscope. If it is clear of cancer, the margin is considered negative. However, if there are any cells left (considered a positive margin), risk or recurrence increases.
  • Lymph node infection–The risk of recurrence increases if cancer was found in lymph nodes at your original diagnosis.
  • No radiation treatment post-surgery–While most who undergo a lumpectomy choose to receive radiation therapy in the area of cancer afterward to reduce the risk of recurrence, some do not.
  • Inflammatory breast cancer–This type of breast cancer increases the risk of a local recurrence.
  • Specific cancer cell characteristics–Having triple-negative breast cancer or cancer resistant to hormone therapy can increase your risk.
  • No endocrine therapy–For certain types of breast cancer, not receiving endocrine therapy can raise the risk of recurrence in cancer patients.
  • Younger age–Those of a younger age during their initial breast cancer diagnosis, specifically under 35, have a higher risk of their cancer returning, despite generally older generally being a risk factor of cancer in general.
  • Obesity–Increased body mass index increases the risk of breast cancer coming back.

Prevention

There are methods and steps you can take to reduce your risk of recurrence of breast cancer, many in your initial treatment.

  • Chemotherapy–Those with an increased chance of recurrent breast cancer have been shown to have a decreased risk when treated with chemo.
  • Hormone therapy–If you have receptor-positive breast cancer, taking hormone therapy in your initial treatment can reduce your risk. This treatment method can sometimes continue for five or more years.
  • Targeted therapy–If your cancer produced additional HER2 proteins, targeted drug and treatment might reduce your risk.
  • Radiation therapy–A previous breast cancer patient with a large tumor, a breast-sparing operation, or inflammatory cancer would have reduced risk if treated with radiation treatment.
  • Bone-Building–Bone building medications can reduce the risk of recurrence taking place in bones, otherwise known as bone metastasis, for those with a high risk.
  • Healthy Diet–To decrease your risk of breast cancer recurrence, be sure to include plenty of fruits, vegetables, and whole grains in your diet, as well as limiting alcohol to one drink a day.
  • Exercising–Exercising regularly may help reduce your risk.

Kinds of Recurrence

Recurrent breast cancer can take one of three forms, defined by where it appears in reference to the primary cancer and treatment. The three types are local, regional, and distant recurrence.

Local

A local recurrence occurs when cancer cells grow in the same area as your previous cancer. If a lumpectomy was used for treatment (rather than a full mastectomy), cancer might start to regrow in the breast tissue that remains. If a complete mastectomy were performed, the tissue along the skin or chest wall would hold the recurring breast cancer.

Some signs that local recurrence is occurring are:

  • One or more painless lumps, nodules, or irregular areas of firmness under the skin
  • Newly thickened areas along mastectomy scars
  • Changes to the skin (inflammation, redness, changes in texture)
  • Nipple discharge

Many of the signs of a local recurrence are similar to those of initial breast cancer. After treatment, it does not hurt and may help to continue self-breast exams to keep an eye out for any changes, just in case.

Regional

Regional recurrence also happens rather close to the original site of infection. However, the difference between regional and local recurrence is a matter of lymph nodes. In regional recurrence, the local lymph nodes, such as those under the arm, will be infected with cancer.

Signs of regional recurrence cancer may include a lump or swelling in lymph nodes, so continue your self-checks in these areas:

  • Under the arm
  • Along the neck
  • Near and in the groove above the collarbone

This kind of recurrent breast cancer can almost be considered a subset of local recurrence and can many times be found by being familiar with your own body. Regular self-breast checks are just as necessary after breast cancer treatments as they are before.

Distant

Distant recurrence is when cancer recurred somewhere in the body away from the original site. This can include other organs such as the lungs or even bones. In this case, the patient is generally treated much in the same way as those diagnosed with stage IV breast cancer. However, treatment can vary from standard stage IV treatment based on the responses to previous treatments.

Treatment

Treatment, many times, is determined by the kind of breast cancer recurrence found. Local will be treated differently from regional will be treated differently from different.

Local Treatment

Local breast cancer recurrence is, if possible, treated with surgical treatment. If a lumpectomy and radiation were used previously, then a mastectomy would be the first choice treatment. If a mastectomy was performed prior, the tumor would be removed, and the patient will be treated with radiation therapy if not already received.

Either way, both of these plans are likely to be accompanied by chemotherapy, targeted therapy, hormone therapy, or some combination to ensure a full recovery.

Regional Treatment

Sometimes breast cancer will come back in the lymph nodes. This can be treated by removing the lymph nodes themselves, followed by radiation in the surrounding area, if not already received. Systemic (targeted, hormone, or chemotherapy) treatment after surgery may be discussed on a case-by-case basis to ensure that any remaining cancer cells are eliminated.

Distant Treatment

The primary treatment for distant recurrent breast cancer will be a form of system treatment (hormone, targeted, or chemotherapy) based on how your cancer has responded before. You and your doctor can create a treatment plan that serves you well, knowing what has worked with these breast cancer cells previously and what has not.

Dr. Gorman

Dr. Valerie Gorman and the Texas Breast Center are aware of the risks of recurrent breast cancer and the chances that your breast cancer may come back. This is why she and her team stay with you through your personalized treatment and long after to make sure you know that you always have a support system, whether you need it or not.

Dr. Gorman specializes in surgical oncology and surgical diseases of the breast. She serves as the Medical Director of Surgical Services at Baylor Scott & White Medical Center as well as the Chief of Surgery.

Breast Density FAQs

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After a mammogram, some women find out they have dense breasts. They come to me with questions about what that means, how it affects their risk for breast cancer, and what they should do differently. Here’s how I answer the questions I hear most often.

 

What does it mean to have dense breasts?

It’s common for women to have dense breasts. Your breasts are made of fatty tissue, which is not dense, and supportive tissue, milk glands, and milk ducts, which is. The parts of your breast made up of dense tissue show up as white on a mammogram, so it can be harder to spot signs of breast cancer in those areas.

 

How do I know if I have dense breasts?

The radiologist who reviews your mammogram assigns a grade to your breast density based on how much of your breast tissue is dense. You might see something on your mammogram report called Breast Imaging Reporting and Data System (BI-RADS). There are four levels of breast density:

  • A is almost all fatty tissue, found in about 10 percent of women
  • B is more nondense than dense, found in about 40 percent of women
  • C is more dense than nondense, found in about 40 percent of women
  • D is almost all dense, found in about 10 percent of women

If you fall into the C or D categories, your mammogram report may indicate that you have dense breasts. If it doesn’t say, ask your doctor.

As you can see, about half of all women have dense breasts. You’re more likely to have dense breasts if you are younger, have less body fat, and/or take hormone therapy for menopause.

 

How does my breast density affect my risk for breast cancer?

Since it’s harder to spot breast cancer on dense breasts, you have a higher chance of cancer not being detected on a mammogram. Separately from that, women with dense breasts also have a higher risk of breast cancer.

 

What should I do differently if I have dense breasts?

You should talk to your doctor about your other risk factors for breast cancer and work together to come up with a breast cancer screening schedule that works for you. For my patients with dense breasts but no additional risk for breast cancer, I recommend an annual mammogram beginning at age 40. Depending on other risk factors for breast cancer, I might also recommend:

  • A breast MRI, which uses magnetic forces to image your breast
  • A 3D mammogram, which combines images of your breast taken from different angles
  • Breast ultrasound, which uses sound waves to investigate areas of your breast that might be concerning
  • Molecular breast imaging, which uses a radioactive tracer to look for cancerous areas

The Cost of Breast Cancer Treatment: What are the Contributing Factors?

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In a recent survey of patients diagnosed with early-stage breast cancer, 38% said they were worried about finances due to their treatment. 14% said that their breast cancer cost them at least 10% of their household income. 17% said that they had spent even more than that 10% on out-of-pocket medical expenses.

When doctors, surgeons, and radiation oncologists were asked about how their offices handle financial discussions with their patients, 50% of medical oncologists reported that someone in their practice “often or always discusses financial burden” with their patients. 43% of radiation oncologists said they did as well. Only 16% of surgeons reported the same.

Furthermore, no one seems to know, going in, just how far a diagnosis of breast cancer is going to set them back financially. It is difficult to find answers about the cost of treatment, whether for surgery, radiation, or other medications. We are taking this chance to clear the air between doctors and patients; we can give the answers that so many have been looking for and help to start the conversation so you can be prepared should this diagnosis ever come your way.

Total Costs

In 2010, breast cancer was the highest-costing cancer in the United States. Nationwide, it cost a total of $16.5 billion. By 2020, this is expected to increase to $20.5 billion. The American Cancer Society estimates that over $180 billion is spent on health care expenses and lost productivity every year due to cancer.

How Much Does Breast Cancer Surgery Cost?

Of course, each person’s case is unique. Their access to insurance must be taken into consideration. Different stages of cancer are harder to treat than others, which can affect overall treatment costs. Not to mention that disease takes root differently in each person, so it must be treated differently. And with no one-size-fits-all treatment, there is no one-size-fits-all price tag. All of these factors must be considered.

Stages

The stage at which a patient’s breast cancer is discovered significantly affects how difficult it is to treat. A study was done recently and published in The American Health and Drug Benefits1 on the cost and frequency of some treatments based on the cancer stage and how long it had been since the diagnosis.

It was not much of a surprise to find that those patients with more advanced stages of breast cancer spent more on treatments. For those with stage 0 cancer, the average cost of treatment at twelve months after diagnosis was $60, 637. After twenty-four months, the price had jumped to $71, 909 per patient overall.

For those whose cancer had advanced to stages I-II, their medical costs were approximately $82,121 in the first twelve months of treatment. In the second twelve months, each patient still in the study brought the total average to $97, 066.

With breast cancer in stage III, the average cost in the first twelve months continued to rise to $129,387. After a full twenty-four months, the study reported that patients spent an average of $159,442.

At stage IV, the most difficult to treat, the average treatment costs were $134,682 at twelve months and $182,655 at twenty-four.

According to the study, patients were paying an average of $85,772 within the first twelve months of being diagnosed with breast cancer, despite their cancer stage. And within the first two years of their diagnosis, the study reported their treatment costs averaging $103,735.

Treatments

Another major factor that will contribute to the overall cost of breast cancer treatment is the kind of treatment a patient is receiving. Which treatment you receive depends on the location, cancer stage, and extent to which the disease has spread. Sometimes the procedures are combined to get the best results and return you to health quicker and more effectively. The same study mentioned above also explored the average amount spent on categories of treatments, and how common these kinds of treatments were within the given periods.

Surgery

Surgery is a standard treatment for a breast cancer diagnosis. If applicable, it is a way to remove cancer physically from where it has taken root. Altogether, surgical treatment accounts for an average of 20% of the cost of breast cancer care treatments within the first year after diagnosis, and 4% in the second year.

  • Inpatient breast cancer surgery accounts for 6% of the cost treatment in the first year, and 2% in the second year. In the first year of treatment, the cost of breast cancer surgery is, on average, $4,762, while in the second year after diagnosis, the cost is approximately $347.
  • Outpatient breast cancer surgery accounts for approximately 14% of the price of breast cancer treatment in the first twelve months, and 2% in the second. The cost of outpatient surgery in the first and second years were found to be, on average, $11,691 and $389 respectively.

Chemotherapy

Chemotherapy is another well-known treatment of cancer. It accounts for approximately 19% of breast cancer treatment in both the first and second year after diagnosis.

  • For general chemotherapy, the average cost (including all costs on the day of the treatment) in the first year is $15,113. As this accounts for 18% of the payment for treatment for breast cancer, this is particularly significant. In the second year post-diagnosis, the average cost for this treatment is $3,625. This makes up 16% of all breast cancer treatment costs.
  • Oral chemotherapy is far less conventional. It only accounts for approximately 1% of the costs of first-year treatment, and 3% in the second year. Patients are usually paying $432 in their first year and $636 in their second year for this treatment.

Radiation

Radiation is used to kill the tumors by damaging cancer cells’ DNA. It is often used in combination with surgery. It makes up 18% of diagnosis treatment costs in the first year and 3% in the second year. In the first year, it costs an average of $15,455, while in the second year, patients pay $638.

Medication

Hand in hand with these major treatments come medications. Medications make up for 3% of the first year’s medical payments, and 7% of the second year. That equates to approximately $2,258 and $1,510, respectively.

Other Treatments

There are, of course, other treatments. Smaller subcategories that don’t quite fit these above, including hormone therapy, additional inpatient or outpatient care, or professional or specialist care. They make up about 42% of potential treatment costs in the first year and 67% of costs in the second year. That equates to $35,762 in the first twelve months and $14,980 in the second.

Health Insurance

Another factor that contributes to the overall cost of breast cancer treatment is health insurance. Healthcare, the amount of coverage you have, and the type of coverage you have, are all essential to discuss with your doctor, oncologist, and surgical team to make sure you understand where you stand.

Researchers in North Carolina found that patients who received a cancer diagnosis and did not have insurance or Medicare paid $6,711 for medication, while those with insurance paid $3,616 and those with Medicare paid $3,090 simply because they do not have the means to negotiate for a lower price.

Often, clinical appointments are more costly, as well. Where an insured patient might pay approximately $65-246, a patient without insurance coverage would pay around $129-391.

Ask Questions/Dr. Gorman

Getting a diagnosis of breast cancer is near impossible to imagine, and even harder to plan for. But if you ever find yourself in that place, you have a little more knowledge about what to expect. One should always be prepared for the unexpected, and it never hurts to have a little money saved up for emergencies. But breast cancer treatment costs will require more than just a bit of your savings. However, with communication with your team and laying out your healthcare terms and concerns as you discuss your health plan, everyone can be on the same page and do what they can to work within your needs.

Dr. Valerie Gorman knows about the financial burden that comes with breast cancer. She is dedicated to offering her patients a personalized approach to breast surgery and the treatment of breast cancer. She and her team will help to create a treatment plan that best meets your needs, and most fits your lifestyle. Because of the experience and breadth of our specialists, a multitude of treatment options exists which can be tailored to your situation.

There is no need to panic when you hear the word cancer. We have walked alongside many people who have been diagnosed and understand your fears and concerns. It is our privilege to walk with you and help you through this difficult process.

 

 

 

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822976/#idm139828318640480title

 

 

FAQs About Mastectomy

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What are the types of mastectomy?

 

  • Simple/Total Mastectomy–The entire breast is removed; lymph nodes and muscle are not removed.
  • Radical Mastectomy–The entire breast is removed, this time including the pectoral muscles and lymph nodes extending under the arm. This is rarely done today.
  • Modified Radical Mastectomy–Removes the entire breast including the lymph nodes;
  • Double Mastectomy–Both breasts are removed.
  • Lumpectomy/Partial Mastectomy–Part of the breast is removed, namely abnormal tissue or cancer, rather than the whole breast, just removing the lump.
  • Nipple-Sparing Mastectomy–The breast tissue is removed, but the nipple and skin are left unscathed.
  • Skin-Sparing Mastectomy–The skin is left intact while the breast tissue, areola, and nipple are removed.

 

Mastectomies are recommended for those who have large tumors or tumors that affect multiple areas of the breast. They can also be used as a preventative measure for those who carry the BRCA1 or BRCA2 gene or other genetic mutations that increase your risk of breast cancer. The skin- and nipple-sparing mastectomies are newer surgeries. These are optimal for minimal scarring and reconstruction.

What is recovery like for a mastectomy?

Your stay in the hospital after a mastectomy will vary depending on the kind of mastectomy you had, your reactions to the anesthesia, and whether or not you had reconstruction done at the time. However, it can be guaranteed that after surgery, you will be taken to a recovery room until the nurses are sure you are stable and (mostly) alert. At this point, you will be wheeled along to your hospital room where you will stay approximately 1-2 days.

Then, once you are home, you must keep the incisions clean. Your surgeon will give you instructions on how to do so, as well as how to care for your drainage tube, which you will only have with you until your follow up exam.

Your doctor should prescribe you medication for your pain, though the levels vary depending on the location, type of mastectomy, and amount of tissue taken. Follow your doctor’s instructions for approved medication intake.

It usually only takes a few weeks to be back to normal activities, though anything that uses your arms a lot or seems strenuous to your body should be approached cautiously for a while. If you’re ever unsure, you can always check with your doctor. It’s better to be safe than sorry. But soon enough you’ll be back on your feet and facing the world again.

What are mastectomy recovery tools?

While you are recovering, there will be many things you will have directly on your mind. There will be drains to empty and keep untangled, pain medications and antibiotics to keep track of, what will be waiting at home after your stay in the hospital, and your life at large to consider. But there are some tools to help you stay comfortable while you heal. And some people have been patients before you. They have tips to recommend based on their experience.

Some tools that many find helpful are drain belts or robes and mastectomy pillows. There are variations on both of these tools, but both offer support and work to simplify your recovery.

After the mastectomy, drains are left in the area to allow any access fluid to leave the body rather than pooling. The fluid follows a tube to a bulb that you empty regularly and record the amount in them. However, the tubes can quickly become an inconvenience with a risk of snagging. The easiest solution is to attach the drains to your clothes with the velcro attachment or clip them onto a lanyard. But other people have come up with more comfortable and convenient solutions. There are now drain belts, which are comfortable belts with holster-like pockets in which the bulbs can sit. There are drain robes that have pockets to keep the drains out of your way. And some companies produce adhesive pockets that will attach to whatever clothes you wear, making your pajamas into drain holders. Dr. Gorman’s surgical team will provide a bra for you post-operatively that includes rings to which you can attach your drains.

Mastectomy pillows are pillows that are shaped or placed in a way to help support you after your surgery. This can be anything from a regular pillow that is placed under your knees to raise your legs and increase blood flow to the armpit pillow–a rectangular pillow that lays over your chest with notches cut out for your arms. Some provide support for both breasts, while others go between the breast tissue of one breast and the other. Find the pillow that minimizes pain and discomfort and offers the support and comfort you will need. Volunteers in our community sew rectangular post-op pillows for Dr. Gorman’s patients. Each of Dr. Gorman’s patients receives one of these pillows in recovery immediately after surgery.

Previous breast cancer patients have made suggestions to make your recovery as easy as possible. First, stock up on food—at least two weeks’ worth–before your surgery. You will not want to go shopping while you are healing. And while you may not want to eat right away, you should try to find something light on the stomach so you can take it with your pain medication, such as yogurt or pudding.

When you take your first shower about two days after your surgery—or when Dr. Gorman clears you to do so—it’s generally best to do so sitting in a shower chair. You have been off of your feet and on medication since your mastectomy. It’s safest to sit while you clean yourself off.

Avoid housework. Think of this as an excuse to avoid your chores for as long as you can. You need to heal before you start expending that kind of effort. Similarly, don’t try to rush back to work. Many women recommend waiting at least three weeks before returning to your job. Returning too quickly could not only tire you out but could potentially cause complications. This advice is especially relevant to those who have reconstruction surgery, as well.

Dr. Gorman’s team provides a one-on-one education time for each patient that covers all of this information and more prior to a mastectomy.

What will my mastectomy scars look like?

The type or amount of scarring will differ based on the type of mastectomy you are having done. The total, radical, and modified radical mastectomies will leave a visibly large scar as a large amount of tissue/skin is removed. However, with partial/lumpectomies, skin-sparing, and nipple-sparing mastectomies, the scars are less noticeable. Skin-sparing mastectomies tend to leave behind a scar that is usually where the nipple was previously. The scar of the lumpectomy is small and linear and tends to be hidden away in the crease or around the nipple to avoid detection. Lastly, the nipple-sparing mastectomy generally leaves a scar under the breast, where it can be tucked away in the bra-line to avoid visibility.

The Texas Breast Center utilizes Hidden Scar™ Breast Cancer Surgery to help minimalize scarring in patients. Dr. Gorman works with each patient to make the right decision for them on the right kind of mastectomy, and from there to ensure the scarring will be minimal and where it will as minimally intrusive as possible.

How does breast reconstruction work?

Not everyone has breast reconstruction after a mastectomy. For example, those having lumpectomies do not necessarily need one, because a majority of the breast tissue is left alone in the breast. With a mastectomy, reconstruction is more likely as all the tissue was removed. However, it really is up to the patient. Talk to your surgeon about your preferences so that they can be informed when discussing your options with you

What are the risks of a mastectomy?

A mastectomy, like any other surgery, has its risks. There will be swelling in the area, as well as bruising for a while after the surgery. The breast will be sore and scar tissue will form and likely harden. Some patients experience phantom pain in removed breasts. More seriously, however, the incisions could bleed or become infected, or, more rarely, skin necrosis. There is a risk of lymphedema or swelling in the arm where lymph nodes were removed. Seromas (fluid filling the now-empty breast) can form. And not the least of the risks can be a change in self-confidence.

Dr. Gorman is aware of these risks and is there to help prevent them. If they can’t be avoided, she will support you through them and work with you on a plan to improve, step by step.

Should I have radiation or chemo with my mastectomy?

Chemotherapy is not used in all cases of breast cancer. And, if it is used, it is not always used in the same way. There are two primary ways it is used concerning surgery.

Some kinds of chemotherapy–neoadjuvant chemotherapy–is used before surgery as an attempt to shrink the tumor to a more manageable size that requires less extensive surgery. Adjuvant chemotherapy is given after surgery to kill any possible remaining circulating cells that may have been left behind to prevent more tumor growth.

Radiation is often recommended after a mastectomy as a tool to prevent the recurrence of cancerous growth. Traditionally, radiation is administered for five to six weeks, up to five days a week. However, Dr. Gorman has experience with a method that only takes five days, with less waiting period between surgery and the radiation beginning for post-lumpectomy patients.

Can men get a mastectomy?

Breast cancer in men may be rare, but it is still very possible. Only 1% of breast cancer diagnoses are in men, but that still accounts for 1 in every 1,000 men. Invasive Ductal Carcinoma is the most common form of breast cancer found in men. Like in women, black men have a higher risk of getting breast cancer than those of other races. Take precautions and familiarize yourself with the breast area by firmly feeling over the breast tissue in the area for anything unusual.

If a man receives a diagnosis for breast cancer, there is a high chance surgery will be involved in treatment. The operation could be used to establish how far into the lymph nodes the cancer has spread (a sentinel lymph node biopsy, for example), to relieve symptoms of advanced cancer, or to remove as much of the tumor itself as possible (a mastectomy).

All of these and a few more can be performed on a man to help treat him for breast cancer. It is not just women who get this disease, and today’s treatments reflect that.

How do I take blood pressure after a mastectomy?

There is some question about where to have blood pressure taken and blood drawn from post-mastectomy; more specifically, patients ask whether it is safe to do these things on the same side of the body as the mastectomy. While you can have your blood pressure tested from either arm without causing any trouble to your healing process, there could be a (minimal) risk when it comes to drawing blood after breast cancer surgery.

After certain types of mastectomies–radical mastectomy, modified radical mastectomy, sentinel lymph biopsy, or any procedure when the lymph nodes are removed–there is a risk of lymphedema. Lymphedema is a swelling of the arm and usually stems from an infection of the arm. Because having blood drawn in a medical facility is done in a clinical environment with sterile equipment, the already small risk of infection becomes minimal. However, it is still recommended to take the ‘better safe than sorry’ route and instead have your blood drawn from the arm opposite your operation.

The same goes for vaccines and other injections. While the medication won’t cause any complications, it’s best to reduce the chances of introducing possible infections to the area soon after your breast surgery or years later.

What do I ask my surgeon?

You should always prepare a few questions when going into a procedure like this. Likely, a number of them will get answered simply through the surgeon’s explanation of the process, but it never hurts to be prepared. Here a few to get you started:

 

  • What are the risks of my type of mastectomy?
  • Will I need reconstruction? Can it be done in the same procedure?
  • How can I prepare my home for my recovery before the procedure?
  • How can I emotionally prepare for this?
  • What medicines/foods should I or shouldn’t I take on the day of the procedure?
  • Who will perform my breast reconstruction surgery?
  • How much breast tissue will be removed in my mastectomy?
  • Will I need radiation therapy?
  • How long will I stay in the hospital?
  • Will I need to return for additional surgery?

And remember, there really are no stupid questions. None. This is your surgery, you deserve to know about it, and Dr. Gorman is here to help you understand. Ask away and she will do her best to answer. She will help with your before questions, your after questions, and your it’s-been-a-while-but-this-just-occurred-to-me questions. Being informed is something she wants for all of her patients, and something she will do her best to ensure as she walks with you every step of the way.

Who performs a mastectomy?

A breast cancer surgeon will perform your mastectomy, and a plastic surgeon will perform your breast reconstruction should you have that done. When choosing your surgeon, Johns Hopkins recommends a surgeon who:

  • Specializes in breast cancer
  • Is recognized as a breast surgical oncologist
  • Performs many breast cancer surgeries each year

 

Looking at these qualifications, Dr. Valerie Gorman at the Texas Breast Center can be your breast cancer surgeon, and of course, is always ready to help. Her specialty is breast cancer surgery and its related topics. Her residency was in general surgery, though with a focus on detecting and treating breast cancer. She is also currently serving as the Chief of Surgery and Medical Director of Surgical Services at Baylor Scott & White Medical Center, as well as board-certified by the American Board of Surgery.

At the Texas Breast Center, mastectomies and other breast cancer surgeries are what Dr. Gorman is known for, and she performs them year-round.