Definitely, you should always
discuss your personal preferences in
terms of your goals for
treatment with your health care team.
This will help your team come up with
the best treatment plan for you.
We need to know whether you
have limited time off work.
We need to know whether
it's more important for
you that everything is accomplished
at one operation,
or whether you're open to
having two operations in
order to have the best
long-term cosmetic outcome.
All of these nuances in
terms of travel distance,
your fears about radiation,
your fears about chemotherapy,
your fears about surgery are important so that
your health care team can put
your mind at rest and can also
dispel any potential myths
that you may have that may be inaccurate.
This is a very common question that I get.
And essentially the answer
is no. Cancer does not
spread or jump from
one breast to the other breast.
If a patient with breast cancer develops
a subsequent breast cancer on
the contralateral side or on the other side.
This is usually a "de novo"
or a new primary breast cancer,
and it's very unlikely for
a single breast cancer to
spread from one side to the other.
No, the needle biopsy
is commonly performed and this
does not increase the chance
of spreading of the breast cancer.
Well, there have been a lot of advances in
both breast surgical options and
reconstructive options.
In terms of breast surgery,
increasingly, women have the option
of breast-conserving surgery,
allowing them to maintain
their normal breast. For
those women who do need
to undergo mastectomy,
we now have more options in
terms of how that mastectomy is performed.
And for some women, we are
able to preserve the nipple and
areola complex at the time of
their mastectomy
so that their reconstructed
breast mound has their normal skin
and their normal nipple and areola complex.
In terms of breast reconstruction,
increasingly that reconstruction is
performed in front of the muscle,
minimizing the muscle spasm
and some of the pain
associated with that
after reconstructive surgery.
Well, here at Mayo Clinic,
we have a strong multidisciplinary team.
Usually your first portal of
entry is our breast clinic.
This is a group of internal medicine
boarded physicians
specializing in breast care.
And they can see you, evaluate
your imaging and pathology and
discuss all of the findings with you
before they then refer
you on to breast surgery,
breast medical oncology and
breast radiation. For patients
with more advanced disease,
where upfront medical therapy
prior to surgery is likely to be recommended,
you'll be seen as part of
our multidisciplinary team, where
you'll meet with both the surgeon,
the medical oncologist, and
the radiation oncologist on the same day.
In terms of surgery,
we have strong support from
our pathologists with our
frozen section pathology.
This means, for women undergoing
breast-conserving surgery,
where we are removing
just the breast cancer or the lump,
also called a lumpectomy,
our pathologists will actually evaluate
the edges of that lumpectomy during surgery.
And if there's any disease
at an edge then we will re-excise that
edge or that margin
during that same operation.
This means that the chances of needing
a second operation to clear
those margins is as low as about 3%,
as in fact has been shown to be four-fold
lower than any other institution.
The best way to partner with
your medical team is to be completely
honest about everything that you're taking or
doing and your own personal preferences.
Many people are often drinking alcohol or
smoking and
even the use of herbal supplements.
And it's really important that
your health care team is
aware of all of these behaviors.
Smoking can definitely impact some of
the potential options
in terms of reconstruction,
if you choose a mastectomy.
And even herbal supplements can
sometimes interact with some
of the medical therapies.
So be transparent and discuss
everything openly with your medical team,
so that together you can come
up with the best treatment plan.
I recommend working closely with
a multidisciplinary team specialized
in the care of breast cancer.
Look at all of the treatment options
and plan your journey
with your multidisciplinary team
and include your family and friends.
And remember, as you embark on
this journey and go through this journey,
there are thousands of women out
there that have successfully
completed this journey,
decades out from their breast cancer diagnosis,
living full lives.