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Breast Density: Higher Risk & New Screening Options
 
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We teach you how breast density is a risk factor for developing cancer and share new tools and technologies to better screen women with dense breasts. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ____________________________________ Questions for your Physicians or Breast Surgeon: 1. Do I have significantly dense breasts on my mammogram? 2. Shouldn’t I have a 3D mammogram? 3. What is my mammogram “BI-RADS density score?” 4. Should I see a breast surgeon to discuss this? What is mammographic breast density? Breast density is a term used to describe how much breast tissue is made up of glands and supportive tissue. Dense breasts have more of this “thicker” tissue, which appears white on mammograms. Mammograms in women with very dense breasts can be more challenging to interpret by breast radiologists. Up to 40 percent of women have significantly dense breasts. Why does breast density matter? We have learned over time that women with dense breasts have a higher risk of developing breast cancer in their lifetime. Studies have yet to narrow down exactly how much of an increased risk, but the best “calculator” is the BCSC Calculator outlined in detail below. Dense breasts also make it more difficult for radiologists to see a small breast cancer because these growths can be overshadowed by the dense or white appearing tissue on a mammogram. So dense breasts pose a “double-whammy” of increased risk and decreased ability to find breast cancers on mammograms. The take-home message for those with dense breasts is to get regular mammograms, and ask for 3D mammograms if they are available to you. This best applies to those who have high BI-RADS Density scores of 3 and 4 (see below). What is my “BI-RADS” Density Score on my mammogram report? This scoring system is the radiologist’s estimate of breast density. The BI-RADS scores for low density are 1 and 2. High density are 3 and 4. The images below are examples of low to high density from left to right. The “terms” used to describe density in the figure below correspond to the BI-RADS scores 1 – 4. LOWER DENSITY terms used on every mammogram report: BI-RADS 1 or “A” or “Almost Entirely Fatty Tissue” BI-RADS 2 or “B” or “Scattered Fibroglandular Tissue” HIGHER DENSITY terms used on every mammogram report: BI-RADS 3 or “C” or “Heterogeneously Dense” BI-RADS 4 or “D” or “Extremely Dense” Should I see a breast surgeon for density? Seeing a breast surgeon is not generally necessary just for dense breasts. However, if you have multiple other “high risk” factors, or are at risk for carrying the BRCA mutation, ask for a breast surgeon consultation. Calculate your risk for breast cancer The new, online Breast Cancer Surveillance Consortium (BCSC) Risk Calculator (link on our website) calculates your 5-year and 10-year risk of developing invasive breast cancer. It is the only “risk calculator” that includes breast density as a risk factor. It is designed for physicians, but you are free to use it also. We suggest you take a printout of “your calculated risk” to your physician to engage them in a discussion about your personal risk for developing breast cancer. Share this calculator with your physician in case they aren’t aware of this new tool. To calculate your breast cancer risk online you will need a copy of your most recent mammogram report from your physician to complete the questions. Most radiologists will list a “BI-RADS” breast density score (1,2,3, or 4) or a description of the level of density as described above. Enter this “level” into the calculator in addition to the other information that is requested. The Breast Cancer Surveillance Consortium (BCSC) is a group of organizations that work together to advance breast cancer research. Automated Whole Breast Ultrasound (ABUS) Whole breast ultrasound was designed to screen women with dense breasts to improve the chance of finding a cancer that might be missed by mammography. It is not a replacement for mammograms. Mammograms are still essential to screen women with dense breasts. This type of ultrasound is designed to be used in addition to annual mammograms. When ABUS is added to mammographic screening, breast cancer detection can be improved by up to 50 percent. The GE Healthcare Invenia ABUS system is the first FDA-approved device and is becoming more widely available in the community. Click (here) to find a facility near you that offers this ABUS service. More information about breast density and ABUS by GE Healthcare is located (here).
Просмотров: 20911 Breast Cancer School for Patients
Triple Negative Breast Cancer: What you need to know
 
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We teach you why Triple Negative Breast Cancer is threatening. Learn how it is treated, and it's link to the BRCA genetic mutation. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _________________________ Questions for your Breast Surgeon and Medical Oncologist: 1. What exactly is triple negative breast cancer? 2. Will I need Chemotherapy? 3. What are the benefits of Neoadjuvant Chemo? 4. Isn’t Neoadjuvant Chemo recommended more now? 5. Do I qualify for BRCA genetic testing? 6. Should I consider a Clinical Trial? 7. What is “Triple Negative” breast cancer? “Triple Negative” breast cancers are fast growing tumors that more frequently spread beyond the breast to other parts of the body. Because of this, they are a bigger threat to your life than most other types of cancers of similar size with a different receptor pattern. These cancers are called “triple negative” because the three most important breast cancer “receptors” on the surface of the cells are not present (negative). When present, these receptors are used as targets to attack the cancer with medications. When absent, the main medical therapy is chemotherapy. Your Breast Surgeon will know your “receptor pattern” within days after your initial breast biopsy. These results are often not communicated to you early on in your decision process. Although only 15% of breast cancers are “triple negative,” it is imperative that you specifically ask your surgeon immediately, and well before surgery, “What are my receptor results?” “Triple Negative” is treated with Chemotherapy These cancers are often sensitive to chemotherapy and it is offered to almost everyone healthy enough to tolerate it. Chemotherapy is obviously a more intense cancer treatment than hormonal therapy (pills). But unfortunately, since triple negative cancers do not have “Estrogen receptors” (ER negative), hormonal therapy is not helpful at all. The time to cure triple negative cancer is now, not when it recurs later. Chemotherapy and surgery is the standard for treating triple negative breast cancer. Ask about the benefits of “Neoadjuvant Chemo” What is often overlooked are the benefits of offering neoadjuvant chemotherapy for patients with triple negative, “Early-Stage” (I & II) breast cancer. There may be distinct advantages (listed below) to having chemotherapy before surgery, not after surgery if you have a triple negative tumor. The decision to consider neoadjuvant chemotherapy always begins with your breast surgeon. You must address this “cutting edge” treatment option well before surgery to benefit from neoadjuvant chemotherapy. Do not be afraid to ask. This is a very important question. The Potential Benefits of Neoadjuvant Chemo: *Begin life-saving chemotherapy earlier *Reduce the need for a mastectomy *Improve cosmetic outcomes with a lumpectomy *Reduce the need for an “Axillary Dissection” *Allows more time for BRCA genetic testing *More time to think about “lumpectomy vs. mastectomy” *Shows your cancer team if the chemo is working *Can sometimes eliminate all cancer cells before surgery *May reduce the need for radiation after a mastectomy Ask for BRCA Genetic Testing Triple negative breast cancers can be associated with inherited genetic mutations. Any woman who has ever been diagnosed with a triple negative breast cancer at age 60 or younger is at a high risk for carrying the BRCA mutation. If you also have a strong family history of breast or ovarian cancer you are at an even higher risk. Unfortunately, genetic testing is often not offered for triple negative breast cancer patients. It is important to ask for BRCA Genetic Testing in this situation. The BRCA (Breast Cancer) gene is commonly referred to as “The Breast Cancer Gene.” If someone inherits a broken version (mutation) of this gene at conception, they carry a very high lifetime risk of breast cancer and ovarian cancer. African Americans are a higher risk for Triple Negative African American and women of West African descent are at a higher risk of developing triple negative breast cancers than most other ethnic groups. Thirty percent (30%) of all breast cancers in this group are triple negative. Younger women are at a higher risk for Triple Negative Women diagnosed with invasive breast cancer before 40 are at a higher risk for having triple negative disease when compared to older women. Any women diagnosed before the age of 50 qualifies for genetic testing and should consider genetic counseling. Ask if you would benefit from a Clinical Trial New therapies must be studied in clinical trials to make sure they are safe and effective at treating breast cancer. Ask your medical oncologist if they offer or recommend you participate in a clinical trial.
Просмотров: 5788 Breast Cancer School for Patients
Will I Survive Breast Cancer? Learn About Your Risk
 
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We teach you how to understand the risk to your life from your breast cancer. Ask your breast cancer specialists about the specific threat for your unique cancer situation. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ______________________________________ Questions for your Breast Cancer Specialists: 1. Am I going to die of breast cancer? 2. What is the percentage chance I could die in the next 5 years? 3. Do factors like “triple negative receptors” or “HER2-positive receptors” or “my youth” make my chance of dying higher than the average statistics? 4. Will I die of breast cancer? This is a difficult question to answer early in your cancer care but it is still worth asking. Many people just diagnosed with cancer have no idea how much of a risk to their life their unique situation poses. Most breast cancers carry a low risk of recurrence, especially early stage cancers. The answer is usually reassuring. What is the chance I could die in the next 5 years? The average 5-year survival rate for all people with breast cancer is 89%. The 10-year rate is 83%; and the 15-year rate is 78%. If the cancer is located only in the breast (Stage I), the 5-year survival rate is 99%. More than 70% of breast cancers are diagnosed at an Early Stage. All survival statistics are primarily based on the stage of breast cancer when diagnosed. Some of the other important factors are also listed below that affect survival. Breast Cancer Stage is important: Non-invasive breast cancer Stage 0 breast cancer can be also described as a “pre-cancer.” If you have DCIS (Ductal Carcinoma In-situ) you can be quite confident you will do well. DCIS does not spread to other organs. What can be concerning is when an invasive cancer grows back in the area of a prior lumpectomy for DCIS. This type of local recurrence does carry a risk to your life. Luckily, this does not happen frequently. Also, be aware that those who have had DCIS in the past are at a higher risk for developing an entirely new, invasive breast cancer. Take our video lesson on “Non-Invasive DCIS“ (here) to learn more. Early Stage “Invasive breast cancer“ Stage I invasive breast cancer has an excellent survival rate. The chance of dying of Stage I breast cancer within five years of diagnosis is 1 to 5% if you pursue recommended treatments. Stage II breast cancer is also considered an early stage breast cancer. There is a slightly increased risk to your life versus a Stage I breast cancer. Altogether, the risk of Stage II breast cancer threatening your life in the next 5 years is about 15%. Later-Stage breast cancer (more advanced cancer) Stage III breast cancer has a higher risk to your life, with a 72% survival at 5 years. There are many individual and tumor specific factors that can change this survival rate. Inflammatory breast cancer is a more worrisome Stage III breast cancer. Overall, the 5-year survival rate for inflammatory breast cancer is about 50%. Stage IV breast cancer means that the cancer has spread beyond the breast to other organs or parts of the body. These metastases are not viewed in general to be curable. The treatment is aimed at helping people live longer with their cancer. This is the type of cancer carries up to 75 to 80% risk of dying within five years. What tumor factors threaten my life more? There are important “tumor biology” factors not well reflected in survival statistics by breast cancer “stage.” Below we list a few important factors that carry a higher risk to life beyond just the stage of cancer. “Triple Negative Receptor” breast cancer Triple negative breast cancer is considered a more aggressive breast cancer. Invariably it does require chemotherapy. If you have a triple negative breast cancer the risk of dying is higher than the standard statistics usually quoted for a particular stage of breast cancer (Stage I – IV). Learn more about “Triple Negative Breast Cancer“ with our video lesson (here) “HER2-Positive” breast cancer HER2-positive breast cancers are also more aggressive tumors. But the good news is that we now have incredibly effective, targeted chemotherapy and immunotherapy for HER2-positive cancers. Our video lesson covers “HER2-Positive Breast Cancer“ in more detail (here). Untreated breast cancer Untreated breast cancer obviously carries a higher risk of death than those who undergoing treatment. All survival statistics are based on breast cancer that underwent recommended treatment such as surgery, endocrine therapy, chemotherapy and radiation therapy. If you elect to not undergo standard treatment options, your chance of survival will be lower than the standard statistics for survival by stage.
Просмотров: 9244 Breast Cancer School for Patients
HER2 Positive Breast Cancer: Everything You Must Know
 
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We teach you why HER2-positive breast cancers are more threatening and educate you about new therapies such as targeted immunotherapy and neoadjuvant chemotherapy. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________ Questions for your Breast Surgeon and Medical Oncologist: 1. What is HER2-Positive breast cancer? 2. Will I need Chemo and Targeted Therapy? 3. What are the benefits of Neoadjuvant Chemo? 4. Isn’t Neoadjuvant Chemo recommended more now? 5. Should I consider a Clinical Trial? 6. What is “HER2-Positive” breast cancer? “HER2-Positive” breast cancers are fast growing tumors that more frequently spread beyond the breast to other parts of the body. Because of this, they are a bigger threat to your life than most other types of cancers with different receptor patterns. These cancers are called “HER2-positive” because they have too many HER2 protein receptors on their surface. These tiny proteins act like “light switches” to turn cancer cell growth “on.” Chemotherapy, combined with new, “targeted” drugs, are very effective against HER2-positive breast cancer and are a leap forward in breast cancer care. Your Breast Surgeon will know your “receptor pattern” within days after your initial breast biopsy. These results are often not communicated to you early on in your decision process. Although only 20% of breast cancers are “HER2-positive,” it is imperative that you specifically ask your surgeon immediately, and well before surgery, “What are my receptor results?” Take our lesson on “My Tumor Receptors” to learn more. Treated with Chemo and “Targeted Therapy” HER2 Receptor Positive (HER2+) tumors are incredibly responsive to chemotherapy when paired with new breakthrough drugs that target these cancers, such as Herceptin and Perjeta. The same holds true if a HER2+ tumor is also Estrogen Receptor positive (ER+). HER2+ tumors are more aggressive cancers, but we now can treat them more effectively, than in the past, with chemotherapy and “targeted immunotherapy” drugs that are designed to destroy them. Everyone with a HER2+ tumor larger than 5mm (1/4 inch) and in good health is considered for chemotherapy and targeted therapy. Unfortunately, studies have shown that many patients are not offered these standard of care, life-saving “targeted drugs” along with chemotherapy. You will make better treatment choices when you are well informed about HER2 therapies before meeting with your medical oncologist. You must inquire about Herceptin, Perjeta, and other “anti-HER2 drugs” that may be of benefit to you. Ask about the benefits of “Neoadjuvant Chemo” What is often overlooked are the benefits of offering neoadjuvant chemotherapy for patients with HER2-Positive, “Early-Stage” (1 & 2) breast cancers. There are distinct advantages (listed below) to having chemotherapy before surgery instead of afterwards. The decision to consider neoadjuvant chemotherapy always begins with your breast surgeon. Breast surgeons choose the initial direction of your entire breast cancer treatment plan. You must address this “cutting edge” treatment option well before surgery to benefit from neoadjuvant chemotherapy. Do not be afraid to ask. This is a very important question. Learn more about “Neoadjuvant Chemotherapy“ by taking our video lesson on the topic. The Potential Benefits of Neoadjuvant Chemo: *Begin life-saving chemotherapy earlier *Reduce the need for a mastectomy *Improve lumpectomy cosmetic outcomes *Reduce the need for an “Axillary Dissection” *Allows more time for BRCA genetic testing *More time to think about “lumpectomy vs. mastectomy” *Shows your cancer team if the chemo is working *Can possibly eliminate all cancer cells before surgery *Reduces the need for radiation after a mastectomy Ask if you might benefit from a Clinical Trial. New therapies must be studied in clinical trials to make sure they are safe and effective at treating breast cancer. HER2-positive breast cancers are currently the focus of intense clinical research. New drug treatments are rapidly being developed for this aggressive cancer. Less than 5% of all patients with breast cancer participate in clinical trials. Patients with cancer willing to participate in clinical trials are essential for the advancement of breast cancer care. Ask your medical oncologist if they offer or recommend you participate in a clinical trial for your unique breast cancer situation. Learn more about “Clinicial Trials“ at the Breast Cancer School for Patients.
Просмотров: 12247 Breast Cancer School for Patients
Less Chemotherapy for Breast Cancer: The TAILORx Results
 
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We teach you about the TAILORx clinical trial results and how this information may save many women in the future from chemotherapy. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _________________________________ Questions for your Breast Surgeon and Medical Oncologist: *Do I qualify for an Oncotype DX genomic test? *If so, will you order genomic testing for me? *What if I have an "Intermediate" result? *Do you follow the "TAILORx" trial recommendations? *Would you order a genomic test before I see a medical oncologist? What does the TAILORx Clinical Trial results mean to me? On June 3rd, 2018 the results of the largest breast cancer trial reported results that help us better determine who MAY benefit or MAY NOT benefit from chemotherapy in early stage, favorable breast cancers. The results help patients and physicians better interpret the results from the genomic assay, Oncotype DX, which is commonly used in the United States. The trial concludes that most patients with an "Intermediate Recurrence Score" result may avoid chemotherapy. The results were also released for publication by the New England Journal of Medicine. Journal Article Link: https://www.nejm.org/doi/full/10.1056/NEJMoa1804710 Video Outlining the TAILORx Clinical Trial: https://www.youtube.com/watch?v=orwPgT0ZP_0&t=14s What is a genomic test? These sophisticated tests are performed on a small sample of cancer tissue in appropriate patients with early stage breast cancer. Genomic tests are usually ordered after surgery when the pathology report is finalized. It measures unique aspects of the tumor to determine if a patient will benefit from chemotherapy in addition to hormonal therapy. Such “genomic assays” developed over the last decade are a dramatic advance in breast cancer care. The Oncotype DX assay by Genomic Health Inc. is the most utilized genomic assay of those available in the United States. Who should consider a genomic test? Patients who have small “Estrogen receptor positive” (ER+) and “HER2 receptor negative” (HER2-) tumors and no evidence of cancer in their lymph nodes may benefit from an Oncotype DX assay. The purpose of this test is to better identify people who do and do not benefit from chemotherapy. The decision to undergo chemotherapy is a complicated one. Your medical oncologist will examine multiple factors to help determine if you will benefit from chemotherapy. The NCCN Guidelines, listed in the website links below, outline in much greater detail recommendations for the use of genomic tests. An Oncotype DX test can be instrumental in this decision for many patients. You may qualify for a Genomic Assay if… You have early stage cancer (Stage I or II) Your tumor is Estrogen receptor positive (ER+) Your tumor is Her2 receptor negative (HER2-) No cancer was found in your lymph nodes You are willing to consider having chemotherapy You are healthy enough to undergo chemotherapy How is chemotherapy tailored to patients? Genomic breast cancer tests are a leap forward in our ability to “look inside” breast cancer cells. Sophisticated breast cancer care is based upon the principle of providing maximal benefit from the least toxic therapy. Newly diagnosed breast cancer patients deserve the best information available to decide whether they need chemotherapy. Take our video lesson on “Will I Need Chemotherapy?“ (here) to understand the general concepts. Genomics is a promising and rapidly developing field. Take Home Message: Make sure to ask both your breast surgeon and medical oncologist if a genomic assay might play a role in your treatment decisions. For appropriate patients, these tests should be considered only one piece of the many “pieces of the puzzle” in deciding treatment decisions about chemotherapy and hormonal therapy.
Просмотров: 21523 Breast Cancer School for Patients
Breast Cancer Type and Stage: What You Need to Know
 
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We teach you how "stage" and "type of breast cancer" is determined. Learn how stage can guide treatment decisions. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________________ Questions for your Breast Cancer Specialists: 1. What type of breast cancer do I have? 2. Can you explain my breast cancer stage and what it means? 3. How much of a threat to my life is my stage of cancer? Breast Cancer Type: Breast cancer “type” is a general reference to the unique features of breast cancer cells. Most important is if the tumor is considered invasive or non-invasive. “Cell type” and “receptors” are also important. These are some of the puzzle pieces that you and your breast specialists must put together to fully understand your breast cancer and how to best treat it. Invasive breast cancer: Invasive breast cancer cells may have the ability to spread beyond the breast to the lymph nodes and other organs of the body. Although this is the type of cancer that can threaten one’s life, 90% of all invasive breast cancers are cured by modern day cancer treatment. “Invasive Breast Cancer“ is covered in great detail with our video lesson (here). The two most common “cell types” of invasive breast cancer are Infiltrating Ductal Carcinoma (IDC) (70%) and Infiltrating Lobular Carcinoma (ILC) (20%). They both are treated in almost the same fashion with a combination of surgery, possibly chemotherapy, hormonal therapy, and radiation therapy. There are other less common cell types of invasive breast cancer which are not covered in this course. These include papillary, mucinous, colloid, tubular, and phyllodes to name a few. Non-invasive breast cancer: Non-invasive breast cancer is generally defined as DCIS (Ductal Carcinoma In-Situ). It does not spread to the lymph nodes or beyond. Think of DCIS as a “pre-cancerous” area of the breast. An invasive cancer may evolve from an area of DCIS over time if it is untreated and left in the body to grow. Learn more about “Non-Invasive DCIS“ with our video lesson (here). Breast Cancer Stage: Stage is a way of estimating how life-threatening a cancer is based on the “size” of the tumor, if cancer involves the lymph nodes, and if it has spread to other parts of the body. There are many other important cancer factors beyond stage that determine how a breast cancer should be treated. The term “stage” is often confused with tumor “grade.” Tumor grade is a reference to how abnormal the cancer cells appear under the microscope. Stage of cancer is a reference to how extensive the breast cancer was at the time of diagnosis. Non-Invasive Breast Cancer: (Stage 0) This refers to the presence of DCIS without evidence of invasive breast cancer. The size of the tumor can be small or large. A lumpectomy, followed by radiation to the breast, is the most common treatment approach. A mastectomy may be required to remove a large area of DCIS in some situations. Surgery is the first treatment for Stage 0 breast cancer. Early Stage Invasive Breast Cancer: (Stage I) The invasive cancer tumor is smaller than 2 cm and there is no evidence that cancer has spread to the axillary lymph nodes. Surgery is usually the first treatment. Infrequently, chemotherapy before or after surgery is sometimes needed. (Stage II) The most common scenario is that the tumor is larger than 2 cm but smaller than 5 cm without evidence of spread to the axillary lymph nodes. Another scenario is that the tumor is less than 5 cm in size and there is evidence of cancer in a few axillary lymph nodes. Surgery or chemotherapy are often the first treatment options. Later Stage Breast Cancer: (Stage III) These cancers are generally much larger tumors and in a few situations have grown into the skin or the chest wall. Many have already spread to the axillary lymph nodes. The cancer can grow in a way that involves other tissue around the tumor that makes it difficult to remove surgically. Stage III cancer also includes “inflammatory breast cancer.” There is no evidence of cancer spreading to other body sites yet in Stage III breast cancer. Chemotherapy is usually the first treatment. (Stage IV) Any breast cancer that is found to have spread to other parts of the body (distant metastasis) is Stage IV. The size of the tumor and involvement of the lymph nodes is still important information for treatment decisions. The fact that cancer has spread elsewhere reflects the life-threatening nature of Stage IV breast cancer. Chemotherapy or hormonal therapy is usually the first treatment.
Просмотров: 25522 Breast Cancer School for Patients
Breast Cancer Receptors: Learn What You Need to Know
 
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We teach you to about breast cancer tumor receptors and why they are important in your breast cancer treatment. Chemotherapy and hormonal therapy are based on your receptor pattern. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _________________________________ Questions for your Breast Surgeon and Medical Oncologist: 1. What receptors do my tumor have? 2. What type of treatment do they suggest I will need? 3. May I have a copy of all my pathology reports? 4. Do my receptors already suggest I need chemotherapy? 5. Do my receptors show I will need hormonal therapy? 6. Would I benefit from neoadjuvant chemotherapy? What are Breast Cancer Receptors? Once a breast biopsy is determined to be an invasive by a pathologist under the microscope, they will automatically run at least three more tests on the same tissue to determine what “receptors” are present. Receptors are tiny proteins on the surface of the cells that act like “light switches” that can turn cancer cell growth “on” or “off.” The Estrogen receptor (ER), Progesterone receptor (PR), and HER2 receptor results are incredibly important for you to know and understand. Receptors are different than “grade” and “stage” as outlined in the diagram below. All are different pieces of the breast cancer puzzle that your physicians will assemble to determine the best therapy for you. In the case of receptors, these are key determinants as to whether you will or will not benefit from hormonal therapy (pills) or chemotherapy. The receptors involving a precancerous lesion such as DCIS have different implications and are addressed in our DCIS course. Receptors that suggest Hormonal Therapy Estrogen Receptor Positive (ER+) tumors are always treated with hormonal therapy. Usually these types of medications (pills) are taken for a total of 5 to 10 years. It is still possible that one may need chemotherapy in addition to hormonal therapy. If you are Progesterone Receptor Positive (PR+) then you will likely need hormonal therapy, even if you are ER-. The Estrogen Receptor plays a much more important role in cancer care than the Progesterone Receptor. Receptors that suggest Chemotherapy Determining if you need chemotherapy is a very complex decision process and is primarily driven by your medical oncologist. Your “receptor pattern” is a key piece of information that is known early in your breast cancer journey. In about 30% of patients with an invasive breast cancer, the receptor pattern alone can strongly suggest that chemotherapy will be needed, regardless of what is found at surgery. We list a few of the more common “chemotherapy receptor patterns” below. Many factors, including a large cancer and cancer that is present in the lymph nodes, also point someone towards chemotherapy. Take our video lesson on “Will I Need Chemotherapy“ (here). Often if someone needs chemotherapy, they will likely benefit also from hormonal therapy after chemotherapy if their estrogen receptor is positive. Estrogen Receptor Negative (ER-) tumors do not respond to anti-estrogen oral medications that are essential for treating estrogen receptor positive (ER+) tumors. Quite simply, patients with ER negative tumors will benefit from chemotherapy if they are healthy enough to tolerate it. ER negative tumors are more aggressive cancers, but respond very well to chemotherapy. This includes “triple negative” breast cancers. Progesterone Receptors (PR) play a much smaller role than estrogen or HER2 receptors and are not addressed here. HER2 Receptor Positive (HER2+) tumors are very responsive to chemotherapy when paired with new breakthrough drugs that target these tumors, such as Herceptin and Perjeta. The same holds true if a HER2-positive tumor is also ER positive. Take our “HER2-Positive“ video lesson to learn more (here). HER2-positive tumors are more aggressive cancers, but we now can treat them more effectively with chemotherapy and “targeted immunotherapy” drugs that are designed to destroy HER2-positive cancers. “Triple Negative” (ER-)(PR-)(HER2-) tumors are also fast growing tumors that are usually treated with a specific chemotherapy regimen. These tumors are not responsive to hormonal therapy at all, but are sensitive to chemotherapy. If you have “Triple Negative Breast Cancer“ review our video lesson (here). Take home message: Make sure to ask for a copy of the pathology report from your biopsy. Ask your breast surgeon and medical oncologist to explain to you what your receptors mean regarding your treatment. Sometimes the HER2 receptor results can take up to two weeks to become finalized. Inquire early on with your physicians about your benefit from hormonal therapy and/or chemotherapy.
Просмотров: 1804 Breast Cancer School for Patients
Invasive Breast Cancer: We Teach You The Essentials
 
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We teach you how invasive breast cancer can threaten your life and guide you to the key information you need to know to get the best possible treatment. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________ Questions for your Breast Cancer Specialists: 1. What is invasive breast cancer? 2. What type of breast cancer do I have? 3. What is the chance I will die of my breast cancer? 4. What are my receptor results? 5. May I have a copy of my pathology report? 6. Do I qualify for genetic testing? 7. What is invasive breast cancer? Invasive breast cancer is defined by breast cells that grow abnormally fast and have developed the ability to spread beyond the breast to other parts of the body. It can take years for breast cells to slowly develop the genetic changes (mutations) to change from a normal cell to an invasive cancer cell. But once they do, some spread more rapidly and others grow very slowly and may not spread at all beyond the breast. Invasive breast cancer can threaten your life. “Non-invasive” breast cancer are cells that also grow abnormally fast, but cannot yet spread beyond the breast to threaten someone’s life. Ductal Carcinoma In-Situ (DCIS) is an example of non-invasive breast cancer and is generally categorized under “breast cancer” by most organizations. It is covered in our “Non-invasive DCIS” lesson and is more of a “pre-cancerous” condition. Important facts if you have an Invasive Breast Cancer: Treatments can cure 90% of all women with breast cancer The majority of all patients are diagnosed at an early stage Surgery, hormonal therapy, chemotherapy, and radiation are treatment options You have time before choosing a treatment pathway You may qualify for genetic testing Types of invasive breast cancer: Infiltrating Ductal Carcinoma is the most common (70%) type of invasive breast cancer. It is called “ductal” because the cancer cells originate from the cells lining the milk ducts. There are many other factors beyond “type” of cancer that are important. Infiltrating Lobular Carcinoma occurs in less than 20% of patients. It is called “lobular” because the cells originate from the “lobules” of the milk ducts. Lobular cancers are no worse or better than invasive ductal cancers from a survival perspective. There are some unique features of lobular cancers that can affect diagnosis and treatment. Ask you physician how an invasive lobular carcinoma is different from an invasive ductal carcinoma. Other types: Inflammatory Breast Cancer (5%) is a very aggressive cancer. Colloid and Mucinous (3%) are considered less aggressive breast cancers and carry a lower risk to one’s health. There are other less common types of invasive breast cancer that we have not covered. What is the chance I will die of my cancer? Most women just diagnosed with breast cancer have no idea how much of a risk to their life their unique situation poses. Any invasive breast cancer does impart some level of risk to your life. However, this risk is usually less than you would assume. Why are “receptors” important? Receptors are tiny proteins on the surface of the cells that act like “light switches” that can turn on and off cancer cell growth. The Estrogen receptor (ER), Progesterone receptor (PR) and HER2 receptor results are incredibly important for you to know and understand. Take our lesson on “My Tumor Receptors” to learn the essentials. How do you treat invasive breast cancer? The most common first treatment for early stage invasive breast cancer is surgery, possibly followed by chemotherapy, radiation therapy, and then hormonal therapy. Breast cancer treatment is incredibly complex and there can be many different approaches to the same type of breast cancer. There are some situations that are better treated by “neoadjuvant chemotherapy” as a first treatment rather than surgery. The Breast Cancer School for Patients was created to help you to make the best treatment decisions with your breast specialists in your community. You may qualify for genetic testing Invasive breast cancer is known to be associated with the BRCA gene mutation. The BRCA (Breast Cancer) gene is commonly referred to as “The Breast Cancer Gene.” If someone inherits a broken version (mutation) of this gene at conception, they carry a very high lifetime risk of breast cancer and ovarian cancer. Most breast cancers are not the result of the BRCA mutation. In fact, it is estimated that the BRCA and similar genetic mutations cause only 10 to 15% of all breast cancers. It is important to ask your physicians if you meet the guidelines for genetic counseling and testing. Take our “BRCA Genetic Testing” lesson to learn more.
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BRCA Genetic Testing: What to Know & Why Its Important
 
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We teach how to identify if you are at risk for the BRCA genetic mutation. If you carry this “breast cancer gene mutation” you are at an increased risk for breast and other certain types of cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________________ Questions for your Breast Surgeon and Medical Oncologist: 1. Do I qualify for BRCA genetic testing? 2. If so, will you order genetic testing for me? 3. Would genetic testing before surgery change our plans? 4. What is the downside of BRCA testing? 5. Will you also order “Multi-Gene Panel”? 6. What is “The Breast Cancer Gene?” The BRCA (Breast Cancer) gene is commonly referred to as “The Breast Cancer Gene.” If someone inherits a broken version of this gene (known as a “mutation”) at conception, they carry a significantly increased lifetime risk of breast cancer and ovarian cancer. This gene “mutation” can come from either their mother or father. Most breast cancers are not the result of BRCA mutations. In fact, it is estimated that BRCA and similar genetic mutations cause only 5 to 10% of all breast cancers. If you are a woman and test “positive” for a BRCA mutation, your physicians can advise you how to reduce your risk of developing breast and ovarian cancer in the future. There are excellent prevention strategies to lessen your cancer risk. There are also enhanced screening options to detect cancers earlier when they are more curable. You must be your own advocate to find out if you are a candidate for genetic testing. This is the condition that was widely reported in the media when celebrity Angelina Jolie announced that she had mastectomies and reconstruction of both her breasts to reduce her personal risk of developing breast cancer. Although she did not have breast cancer, she tested positive for the BRCA mutation. She underwent testing because she had a strong history of breast and ovarian cancer in her family. Should I ask about BRCA testing before surgery? You need to ask yourself this question, “If I have cancer and carry a BRCA mutation, would I change my mind about surgery and have both breasts removed to reduce my risk of having another new breast cancer in the future?” If the answer is yes or maybe, you should consider undergoing the testing before your recommended surgery. If the answer is no, you can undergo testing after surgery, if desired. Both men and women are at equal risk for carrying the BRCA mutation. Women are more commonly identified as “High Risk” for BRCA mutations because they may have been diagnosed with breast or ovarian cancer and are more often asked if they have a family history of these cancers. But it is important that men also learn if they are at high risk for cancer causing mutations and pursue genetic counseling. You may qualify for BRCA genetic testing if you have: Below is a very simplified list of the most common qualifying risk factors. *Breast cancer diagnosed at 50 or younger *Ovarian cancer at any age *A family member with a “BRCA mutation” *A strong family history of breast, ovarian, prostate or pancreatic cancer *Breast cancer in both breasts *Male breast cancer at any age *“Triple negative” breast cancer before age 60 *Ashkenazi Jewish ancestry and breast or pancreatic cancer We list detailed references and links on our website, www.breastcancercourse.org to several national guidelines. Always obtain formal genetic counseling with a qualified physician or certified genetic counselor before undergoing BRCA and genetic testing.. Multi-Gene Panel Testing Although the majority of “hereditary” breast cancer is likely due to the BRCA genes, other gene mutations could be present that also cause an increased risk for breast and other types of cancers. “Multi-Gene Panel Tests” evaluate multiple other cancer-causing genes at the same time as BRCA testing. We recommend considering “Panel Testing” be included with BRCA testing. There is usually no additional cost for adding this test to BRCA genetic screening. What are the downsides to genetic testing? It is important to note that if someone carries the BRCA mutation, that does not mean they will develop cancer. Genetic testing can open a “Pandora’s Box” of unanswerable questions. Everyone has a unique philosophy of life and belief system. Many decline genetic testing for personal reasons. Unfortunately, too many men and women at risk for genetic mutations are never offered genetic counselling. A recent study in the Journal of the American Medical Association found that many women with newly diagnosed breast cancer and at a high risk for genetic mutations are not offered genetic counseling.
Просмотров: 28843 Breast Cancer School for Patients
Breast Cancer Pathology Reports: What You Need to Know
 
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We teach you why it is important to get copies of your breast pathology reports and how to understand the information they contain about your cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________ Questions for your Breast Surgeon and Medical Oncologist: 1. Will you give me a copy of my “breast biopsy pathology report?” 2. What do my receptors mean? 3. Will you give me a copy of my “surgical pathology report?” 4. What stage is my breast cancer? 5. May I have a copy of my “Operative Report” and “History and Physical?” 6. Two Types of Pathology Reports: Breast Biopsy Report: The first report you will encounter is your breast biopsy report. This identifies whether or not you have a breast cancer. The initial report only tells you the type of breast cancer and is available 1 to 3 days after a needle biopsy is performed. Over the next week, the receptor results are reported and amended to the initial report. Make sure to get a final copy of your breast biopsy report from your surgeon that includes the receptor information. It is critical information for you to know and keep as a record of your cancer for the future. The “type” of cancer sets the direction of your cancer treatment. Breast cancer is classified into invasive or non-invasive disease and also are given names based on their “cell type.” The Estrogen receptor (ER), Progesterone receptor (PR) and HER2 receptor results are also incredibly important for you to understand. Ask both your surgeon and medical oncologist if the receptors mean you will ultimately need chemotherapy. The receptor results from your biopsy report can often tell you early on in your journey that you may benefit from chemotherapy, even before surgery. Review our lesson “My Tumor Receptors” to better understand what this means to your care and prognosis. Surgical Pathology Report: The second pathology report is the surgical pathology report. It is available about 3 to 5 days after your surgery. This is a detailed examination of the tumor size, margins, and possibly lymph node involvement. Your final stage of cancer should be included in this report. If it is not, ask your doctor to tell you if you have a Stage O, I, II, III, or IV breast cancer. Ask your medical oncologist what your stage of cancer means for your 5 and 10-year survival. Always ask for a copy of this report when you see your breast surgeon about a week after your breast surgery. Your Surgeon’s “Operative” and “History & Physical” notes: Also ask for a copy of your surgeon’s “Operative note” and “History and Physical” note. These documents provide an excellent summary of your breast cancer care. Keep for your own health records and share this information with new physicians in the future. You will likely not remember all of the details of your care years later. As time passes, these records are difficult to obtain from retired physicians or cumbersome hospital medical record departments. Patient-Friendly References: breastcancer.org Download this booklet (here) on "Your Guide to the Breast Pathology Report.” On page 45-46 of this booklet, there is a list of “Key Questions” and a “Checklist” of key items in your report. This non-profit organization provides excellent online and printable patient resources about breast cancer. www.komen.org This outline (here) “What is a Pathology Report?” explains why it is important to have copies of your pathology report. The Susan G. Komen organization is a leading advocacy group dedicated to assisting patients, funding research, and ensuring quality breast cancer care. www.breast360.org Review their page “Interpreting Your Initial Pathology Report” (here) to better understand your breast biopsy report. This site was created for patients by the American Society of Breast Surgeons. www.lbbc.org Their page (here) on “Your Pathology Report” has information about the specifics of tumor type, receptors, and other important information. Living Beyond Breast Cancer is a non-profit organization dedicated to providing quality information about breast cancer to patients. More Detailed References: NCCN Breast Cancer Clinical Practice Guidelines nccn.org If you want to get deep into the details, this free 200-page pdf document has guidelines to help clinicians to make treatment recommendations about nearly all aspects of breast cancer. You can easily register (here) as a non-professional to get access.
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Hormonal Therapy for Breast Cancer: We Teach You
 
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We teach you about hormonal therapy for breast cancer. Drugs such as tamoxifen and aromatase inhibitors are key treatment options for most breast cancers. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________ Questions for your Medical Oncologist: 1. What type of hormonal therapy do you recommend? 2. Will I also benefit from chemotherapy? 3. What are the side effects of hormonal therapy? 4. Will I need 5 or 10 years of these medications? 5. Would the genomic assay Oncotype DX be helpful? 6. What is Hormonal Therapy? Anti-estrogen (estrogen-blocking) medications, prescribed as pills, are incredibly effective at treating certain types of breast cancer. Hormonal therapy is given to about 70 to 80% of women with breast cancer. Chemotherapy, on the other hand, is a more intense cancer treatment that is generally administered intravenously. Most patients will not need chemotherapy. Many women that do need chemotherapy will also benefit from hormonal therapy. These treatment decisions are complex ones with your medical oncologist. You will make better choices when you are well informed before meeting with your medical oncologist. Do my “Receptors” suggest Hormonal Therapy? When the estrogen circulating in your blood stream interacts with a breast cancer that has “Estrogen Receptors” (ER) present on its surface, it tends to flip the ER switch to the “on” or “grow” position for ER Positive tumors. The same can be said to a lesser extent for the “Progesterone Receptor,” if your cancer is found to also be PR positive. Patients with ER+ breast cancers almost always benefit from the anti-estrogen effects of hormonal therapy. These medications can make cancer cells die, or slow down their growth. If a few cancer cells have already spread to other parts of the body, these medications are incredibly effective at preventing these cells from growing and threatening your life in the future. In other words, those who take hormonal therapy for ER+ tumors have a more successful chance at long-term survival when compared to those who do not. About 80% of all breast cancers are ER+. Even if your medical oncologist recommends chemotherapy for you, if your tumor is ER+ you will also benefit from up to 10 years of hormonal therapy after chemotherapy. Hormonal therapy is never given during chemotherapy nor during radiation therapy. What is “Tamoxifen?” Tamoxifen is an anti-estrogen medication (pills) that has been used with great success with ER+ cancers for three decades. It is now the primary hormonal therapy for younger, pre-menopausal women. It is also the primary drug for men with breast cancer. It is used for some post-menopausal women. What are “Aromatase Inhibitors?” Aromatase inhibitors (AIs) are a class of anti-estrogen medications (pills) that have proven to be slightly more effective than Tamoxifen for post-menopausal women. It is not recommended for younger, pre-menopausal women, except in certain circumstances. The three most common versions are Anastrozole (Arimidex), Letrozole (Femara), and Exemestane (Aromasin). What are the side effects of Hormonal Therapy? Side effects vary greatly from one person to the next for both types of hormonal medications. Some have no symptoms at all. Most have very tolerable side effects. Some patients will need to change hormonal therapy medications to find the best balance of cancer benefit versus side effects. Several side effects that are rather common for both tamoxifen and aromatase inhibitors are hot flashes, night sweats, joint pain, and vaginal dryness. Below, we list some of the other specific side effects for both drugs. Tamoxifen Side Effects: Increased risk of uterine (endometrial) cancer Increased risk of developing blood clots Slows normal bone loss in most women (a “good” side effect) Cannot be taken during pregnancy because of risk of birth defects or fetal death Can temporarily induce menopause in pre-menopausal women. Aromatase Inhibitor Side Effects: Can worsen bone loss (osteoporosis) in women Muscle and joint aches and pains Would an “Oncotype DX” assay help me? Patients who have a small, estrogen receptor positive, HER2 receptor negative tumor, and no evidence of cancer in their lymph nodes may benefit from an Oncotype DX genomic assay. This cutting-edge test looks deeper into your cancer cells to better identify people who may also benefit from chemotherapy with ER+ breast cancers. The decision to undergo chemotherapy, in addition to hormonal therapy, is a complicated one. Your medical oncologist uses many factors to help decide if you will benefit from chemotherapy. An Oncotype DX analysis of a portion of your breast cancer tissue can be instrumental in this decision.
Просмотров: 5251 Breast Cancer School for Patients
Breast Cancer Radiation: Will I Need Radiation?
 
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We teach you about the indications for, and benefits of breast radiation after a lumpectomy or mastectomy. Learn about the criteria to possibly avoid radiation after a lumpectomy. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________________ Questions for your Surgeon and Radiation Oncologist: Will I need radiation if I have a lumpectomy? Will I need radiation if I have a mastectomy? How can I avoid radiation for my cancer? Will I need radiation if I have a lumpectomy? The answer is most likely, YES. For those diagnosed with a small, Early-Stage breast cancer, a lumpectomy followed by radiation is just as effective at curing your cancer as a mastectomy without radiation. Whenever the term “lumpectomy” is mentioned, it is assumed that “radiation” will follow the surgery in order to keep the chance of a breast cancer local recurrence to an acceptably low rate. There are some instances where a lumpectomy without radiation may be an option for those with very favorable breast cancers. Review our lesson on “Breast Cancer Recurrence” to learn about the threat to your life from “local and regional recurrence.” Why is radiation often needed after surgery? Quite simply, radiation reduces the chance of cancer growing back in the area where the tumor was surgically removed. When a lumpectomy is performed, the surgeon removes a normal layer of breast tissue around the cancer, called margins. Even if the margins are “clear” and uninvolved with cancer, there is still a small chance cancer cells can be left behind in that area of the breast. In the future, these cells can grow to become a “local recurrence” of cancer in the same area of the surgery. Without radiation, the chance of local recurrence after a lumpectomy is about 15 to 25% over a period of 10 years. Radiation reduces this risk to about 5 to 8%. Will I need radiation after a mastectomy? The answer is most likely, no. Post Mastectomy Radiation Therapy (PMRT) is the term for applying radiation to the area of the chest wall after a mastectomy, usually performed about 4 weeks after surgery or after both surgery and chemotherapy are completed. PMRT is generally recommended for those with a high risk of local recurrence. If you or your surgeon. before surgery, think you might need PMRT it is essential to see your radiation oncologist before you have mastectomy surgery. This way, your radiation oncologist will better understand the size, shape, and extent of your breast tumor before it is removed by surgery or has shrunk away with neoadjuvant chemotherapy. Radiation oncologists have a unique insight into breast cancer treatment options that can assist your surgeon in planning the direction of your cancer care. The decision to undergo Post Mastectomy Radiation Therapy is complicated. Patients should insist on a multidisciplinary team approach to get the best treatment recommendations for high risk breast cancer situations. When your breast surgeon works closely with your radiation oncologist and medical oncologist, you will be offered the best treatment options. Below is a general outline to help you understand when radiation after a mastectomy is needed. How can I avoid radiation for my cancer? Your surgical choice: Lumpectomy vs Mastectomy: Lumpectomy with radiation is just as effective as a mastectomy without radiation for most early stage breast cancers. This is a choice made with your breast surgeon and is obviously a difficult one. The decision is also a personal one. Usually, you can avoid radiation if a mastectomy is performed for favorable cancers. Review our lesson on "Lumpectomy vs. Mastectomy" to learn the questions to ask your surgeon to be better informed about the risk and benefits of each surgical approach. Advanced age or poor health: If you are older than 70 and have a favorable, small tumor with no lymph nodes involved, you can consider having a lumpectomy and withholding radiation. This approach is only possible when you take a 5 to 10-year course of hormonal therapy. There are specific criteria for this “lumpectomy only” approach. Make sure to ask your radiation oncologist about the risks and benefits of radiation and no radiation in this situation. The same approach can apply if someone is more advanced in age or those with a fragile health status. In these situations, the risks of radiation can sometime outweigh the benefits of post-lumpectomy radiation. Neoadjuvant Chemotherapy: Chemotherapy before surgery for well selected patients can sometimes destroy all of the cancer cells in the breast and the lymph nodes. When surgery reveals that the tissue has no residual cancer cells after completing chemotherapy, this is called a Pathologic Complete Response (pCR).
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Sentinel Node Biopsy: Breast Cancer Lymph Node Surgery
 
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We teach you why lymph nodes are important in breast cancer treatment. A sentinel node biopsy is the most common surgery performed to assess if cancer has spread to the axillary lymph nodes. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________________ Questions for your Breast Surgeon: 1. Am I a candidate for a “sentinel lymph node biopsy?” 2. If I have a “positive node” how will that change my treatment plan? 3. Under what situations might I need an “axillary dissection?” 4. What will you do if you find one or two nodes with cancer? 5. What are the side effects of the biopsy? 6. Can I avoid lymph node surgery altogether? Knowing your “lymph node status” helps determine which combination of therapies are best for treating your unique cancer. Only about 30% of all patients diagnosed with invasive breast cancer are found to have cancer in their lymph nodes. If cancer travels to the lymph nodes, these cells typically go to the axillary lymph nodes under the arm on the same side of the newly diagnosed breast cancer. These cells usually lodge in the first 1, 2, or 3 lymph nodes (known as “sentinel nodes”) and grow there. Research suggests that cancer typically spreads to the sentinel nodes before the other 10 to 20 axillary nodes everyone has under the arm. If you are found to have cancer in your lymph nodes, you will likely be offered chemotherapy if you can tolerate it. It is less likely you will need chemotherapy if your lymph nodes are “negative.” Your lymph node status is one of many factors in deciding your treatment options. “Sentinel Node Biopsy” vs. “Axillary Dissection” A sentinel lymph node biopsy has replaced the more extensive “axillary dissection” for most early stage breast cancer surgeries. A sentinel node biopsy is easier to perform, is just as accurate, and causes fewer side effects than an axillary dissection. An axillary dissection is a more extensive surgery that removes all of the axillary lymph nodes and results in more armpit sensation loss and an increased risk of lymphedema than the less invasive sentinel node biopsy. There are some situations where an axillary dissection is still clearly needed. Having detected cancer in the lymph nodes before surgery is usually an indication for an axillary dissection. In some instances, if you are found to have cancer present in the sentinel nodes, you might need an axillary dissection. Our goal with this course is to give you an outline on axillary surgery so you can better make these decisions with your breast surgeon. How is a sentinel lymph node biopsy performed? Hours before your breast surgery, you will likely undergo a small injection into the skin of your breast of a mildly radioactive “tracer.” This tracer slowly filters through the lymphatic system of the breast to the first one or two axillary lymph nodes (sentinel nodes) under your arm. These are the same lymph nodes that breast cancer cells would first travel to from the breast. A blue dye injection is also commonly used in addition to the radioactive tracer. Your surgeon will use a small probe (similar to a Geiger counter) during surgery to find your sentinel nodes. The dye can also turn the same sentinel nodes blue in color, assisting your surgeon in finding them. The term “biopsy” implies taking just a piece of these nodes. In fact, these “sentinel nodes” are removed intact. The average number of sentinel nodes removed is only about three of the 10 – 20 lymph nodes normally present under the arm. Are there side effects of a sentinel node biopsy? Sentinel node surgery is a much less invasive procedure than an axillary dissection. The risks do include pain and discomfort in the armpit that does improve over time. You may have some permanent, partial sensation loss in the armpit and upper, inner arm. There is a slight risk of mild lymphedema. If your surgeon uses “blue dye” during the surgery to help find the sentinel nodes, there is a 1 to 2 % chance of having an allergic reaction to the dye. Does a “positive” sentinel node mean an axillary dissection? Until recently, surgeons would remove the sentinel lymph nodes and immediately have a pathologist evaluate the nodes under the microscope to see if cancer was present. For years, if any cancer was found in a sentinel node, surgeons would go ahead and remove all the nodes during the same surgery. This “axillary dissection” results in more long-term side effects than a sentinel node biopsy surgery. In 2011, the ACOSOG Z00011 clinical trial showed that carefully selected women with early stage cancer undergoing a lumpectomy can now avoid an axillary dissection if only one or two sentinel nodes are found to be involved with a small amount of cancer.
Просмотров: 3655 Breast Cancer School for Patients
Lumpectomy or Mastectomy? It's Your Decision to Make
 
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We teach you about the surgical options available for treating breast cancer. There are distinct advantages and disadvantages with lumpectomy and mastectomy surgeries. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _______________________________ Questions for your Breast Surgeon: 1. What are my surgical options? 2. What surgery do you recommend for me? 3. What is the difference in recovery? 4. How do the “local recurrence” rates differ? 5. Can you outline the possible complications of both surgeries? 6. Should I do “Genetic Testing” before surgery? 7. Lumpectomy vs. Mastectomy surgery options A Lumpectomy (followed by radiation) for early stage breast cancer is generally considered the optimal choice because it is less invasive and has the same cure rates as a mastectomy. At surgery, the breast cancer “lump” is removed with a margin of normal tissue around it. You are able to keep your breast with a lumpectomy, but you will likely benefit from a course of radiation to that breast to lessen the risk of developing a recurrence of cancer in the lumpectomy area of the breast in the future. It is important to note that some may not be good candidates for a lumpectomy. A Mastectomy (usually without radiation) for early stage breast cancer is a more involved surgery especially if breast reconstruction is performed. It is important to understand that multiple surgeries are often needed by a plastic surgeon to ultimately achieve a symmetric, cosmetic outcome. “Nipple-sparing” and “skin-sparing” mastectomy techniques can now achieve better cosmetic outcomes than in the past. One advantage is that you can generally avoid radiation for early stage breast cancer. A mastectomy does not generally improve survival rates compared to lumpectomy for early stage breast cancer. Why is breast surgery a complex decision? Every patient presents with a unique breast cancer situation. Your breast surgeon is the key person to understand what surgical options will serve you the best. Multiple cancer factors play into these options. This is a complex decision and recommendations may differ amongst surgeons. Most importantly, it is up to you to make a well-informed decision that suits you as a person and a patient. Do I have time to decide what surgery is best? This is a difficult time and one of information overload. You have plenty of time to learn more about your breast cancer and discuss your options with your breast surgeon. Taking a few weeks to make a decision has not been shown to have an effect on your cancer outcome. Early stage breast cancer usually can be managed with either a lumpectomy followed by radiation or a mastectomy alone. There are distinct advantages and disadvantages to both approaches. When you are well educated about your options, you will be better prepared to work with your breast surgeon to decide what surgery is best for you. Myths and Facts about surgery and early stage cancer: A mastectomy does not reduce the need for chemotherapy Lumpectomy is an outpatient surgery It generally takes 3 to 6 weeks to schedule a mastectomy with reconstruction Genetic testing before surgery can sometimes alter your decisions Breast radiation after a lumpectomy usually takes 4 to 6 weeks Does a mastectomy increase my odds of survival? A mastectomy does not increase your odds of survival for early stage breast cancer. This question has been studied in detail. If you have a lumpectomy and radiation, your chance of being alive ten years later is exactly the same as if you had a mastectomy without radiation. “Survival” is the most important cancer outcome we measure. It is the same for both treatment approaches for early stage cancer. Why do some choose a mastectomy over a lumpectomy? Most of the time this choice is a personal one for a variety of reasons. There are legitimate differences between the two surgical approaches involving recovery, side effects, complications, and costs. It is important to realize that everyone has different goals, unique personal situations, and their own reasons as to how they manage their health issues. “Patient autonomy” is essential to a great “doctor-patient” relationship. The more informed you become, the better decisions you will make for your own cancer situation. Ask about BRCA Genetic testing before surgery. You need to ask yourself this question, “If I have cancer and carry the BRCA mutation, would I change my mind about surgery and have both breasts removed to reduce my risks of having another new breast cancer in the future?” If the answer is yes or maybe, you should consider undergoing genetic testing before your recommended surgery. If the answer is no, then you can undergo testing after surgery.
Просмотров: 1407 Breast Cancer School for Patients
Will I need Chemotherapy for My Breast Cancer?
 
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We teach you how your tumor receptors, lymph nodes, genomic assays, and breast cancer stage indicates if you would benefit from chemotherapy. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ____________________________________ Questions for your Medical Oncologist and Breast Surgeon: 1. Would I benefit from chemotherapy? 2. What factors suggest I will benefit from chemotherapy? 3. What is the risk to my life if I do not undergo chemotherapy? 4. What are the advantages of “Neoadjuvant Chemo” before surgery? 5. Would a “Genomic Assay” help determine if I need chemotherapy? 6. What is chemotherapy? Chemotherapy is the use of certain medications to treat cancer systemically, meaning throughout the whole body. If needed, chemotherapy is usually given after surgery for invasive breast cancer. It is a more intense cancer treatment than hormonal therapy (usually pills). Only a minority of breast cancer patients will ever need it. These complex decisions are ones you will make with your medical oncologist. You will make better treatment choices when you are informed about chemotherapy and hormonal therapy before meeting with your medical oncologist. General indications for chemotherapy We outline below some of the more common indications for needing chemotherapy. The decision to undergo chemotherapy also involves being healthy enough to tolerate the treatment. Deciding who needs chemotherapy and what type of chemotherapy to administer is one of the most difficult decisions made in medicine. Your medical oncologist will guide you. Do my “receptors” suggest I need chemotherapy? Once a breast biopsy is found to be cancerous, the pathologists will automatically run more tests on the same tissue to determine what “receptors” are expressed. Your receptor pattern is a key piece of information that comes early in your breast cancer journey. In about 30% of patients with an invasive breast cancer, the receptor pattern alone can strongly suggest that chemotherapy will be needed regardless of what is found at surgery. The key points regarding receptors are outlined below. Estrogen Receptor Negative (ER -) tumors (20%) do not respond to anti-estrogen oral medications that are essential in treating estrogen receptor positive (ER +) tumors. Quite simply, patients with ER negative tumors will benefit from chemotherapy if they are healthy enough to tolerate it. ER negative tumors are more aggressive cancers, but respond more favorably to chemotherapy than ER positive breast cancers. HER2 Receptor Positive (HER2+) tumors (20%) are very responsive to chemotherapy when paired with new breakthrough drugs that target these tumors, such as Herceptin and Perjeta. The same holds true even if a HER2-positive tumor is also Estrogen Receptor positive (ER+). HER2+ tumors are more aggressive cancers, but we now can treat them more effectively with chemotherapy and new drugs that are “targeted” to destroy HER2-positive cancers. “Triple Negative” (ER-)(PR-)(HER2-) tumors are fast growing tumors that are usually treated with a specific chemotherapy regimen. These tumors are not responsive to hormonal therapy at all, but may be sensitive to chemotherapy. What if cancer is detected in the lymph nodes? If you have “lymph node positive” breast cancer, it is likely you will be offered chemotherapy. Premenopausal women and those with multiple “positive” lymph nodes generally benefit from chemotherapy. If your breast surgeon detects cancer in your lymph nodes before surgery, there may be specific advantages to undergoing “neoadjuvant chemotherapy.” “Inflammatory Breast Cancer” requires chemotherapy If you have been diagnosed with inflammatory breast cancer, the first step is neoadjuvant chemotherapy before surgery. This type of cancer has a high likelihood of spreading to the lymph nodes and other parts of the body. Starting chemotherapy as soon as possible is essential to treating this aggressive breast cancer. A mastectomy is performed after chemotherapy, followed by radiation to the area of the mastectomy to lessen the chance of cancer growing back in that area. What are the advantages of “neoadjuvant chemotherapy”? Neoadjuvant chemotherapy is when chemotherapy is given before surgery, not afterwards. There are specific advantages to neoadjuvant chemotherapy in appropriately selected patients. How can a genomic “Oncotype DX” test be helpful? Patients who have a small, estrogen receptor positive, HER2 receptor negative tumor and no evidence of cancer in their lymph nodes may benefit from an Oncotype DX genomic assay. This cutting-edge test looks deeper into breast cancer cells to better identify people who may benefit from chemotherapy with ER+, HER2 – breast cancers.
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NAPBC Breast Centers: Accreditation means Quality
 
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We teach you about multidisciplinary breast cancer care. You will get better care when your breast cancer specialists work together as a team. This is the foundation of NAPBC accredited Breast Centers. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ___________________________________________ Questions for your Breast Cancer Specialists: 1. Do you participate with an NAPBC accredited Breast Center? 2. Will you present my case to a Multidisciplinary Breast Conference? 3. May I meet your Breast Cancer Patient Navigator? 4. Do you work with a team of breast cancer specialists? 5. If you do not participate, would I benefit from a Breast Center? What is a Breast Center? Accredited Breast Centers are places where breast cancer physicians and healthcare facilities work together as a team to achieve the best possible breast cancer outcomes. These centers can be small or large and are multiplying into smaller communities across the country. The main benefit is that participating physicians can present your unique cancer situation at a Multidisciplinary Breast Conference. This discussion about you with other breast cancer specialists explores your treatments options to make sure “no stone is left unturned.” Breast cancer care is very complicated and there are sometimes multiple options for treating the same patient. Research has shown that cancer outcomes are better when you have a team, working together for you. Another advantage for newly diagnosed patients is the personalized assistance you will get from a Breast Cancer Patient Navigator. Patient navigator programs are designed to help patients navigate the complicated journey from diagnosis through treatment. The National Accreditation Program for Breast Centers (NAPBC) is the driver for developing quality breast centers across the country. The NAPBC has developed numerous quality standards and services that are required for breast centers to be NAPBC accredited. Breast centers with this accreditation meet these standards and actively work as a team to assure quality breast cancer care in their respective communities. What is a Multidisciplinary Team and Conference? All accredited breast centers have a multidisciplinary team of breast cancer specialists that meet and review the treatment options for every newly diagnosed breast cancer patient. If your breast surgeon presents your unique situation to a team of physicians at a “Multidisciplinary Breast Conference” you may benefit from new ideas and cutting-edge treatment advances. Some patients have very complicated cancer situations that requires this team approach to determine a tailored, personalized solution. Breast cancer specialists that actively participate in breast centers also learn from each other how to better care for their own patients. We recommend seeking out a NAPBC accredited breast center if it is available in your community. What if my physician does not participate in a Breast Center? Many smaller and rural communities do not yet have breast centers and you can still receive excellent care if there is not a breast center near your home. But if there is a breast center in your community and your breast surgeon does not participate, it is important to ask them, “Why not?” Breast cancer physicians that work with an accredited breast center team may be able to offer you unique and important benefits. Breast Patient Navigators are your personal advocate Breast Patient Navigators are trained to help you through the complexities of your breast cancer diagnosis, treatment, and recovery. This journey requires making physician appointments, learning about your unique cancer, and undergoing tests and treatments that can tax your strength and endurance. Breast Patient Navigators know each step ahead and are your advocate to make sure you get the best care possible. Ask your breast surgeon if you can be introduced their breast center Breast Patient Navigator immediately upon being diagnosed with breast cancer.
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Breast Cancer Recurrence: It can be a threat to you
 
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We teach you about the types of breast cancer recurrence, why recurrence is a threat to you, and how recurrent breast cancer is treated. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ____________________________ Questions for your Breast Cancer Doctor: 1. What is my chance of distant metastasis in the next 5 years? 2. What is my chance of local or regional recurrence in 5 to 10 years? 3. What is the chance of a new breast cancer in the next 10 years? TYPES OF BREAST CANCER RECURRENCE: Distant Metastasis: The most important recurrence is distant metastasis. This is when cancer grows back in other organs of the body such the bone, brain, or liver. If this happens, it is a major threat to your life. If you are diagnosed with distant metastasis, it means you have Stage IV cancer. Think of distant metastasis as tiny cells that have spread to other organs before you were initially diagnosed and treated. If these cells survive in those organs despite chemotherapy and/or endocrine therapy, they can grow larger over time and threaten your life. If someone dies of breast cancer, it is usually due to this type of recurrence. Local or Regional Recurrence: Local or regional recurrence is when the cancer grows back in the breast, the skin, or the regional lymph nodes after surgery, endocrine therapy, chemotherapy, or radiation.  It is a serious threat, but less so than distant metastasis. Usually more surgery, chemotherapy, and possibly radiation therapy is needed when cancer recurs locally or regionally. These can be very challenging problems for your breast cancer team. You benefit most when you have a multidisciplinary team of specialists working together to determine the best approach to your breast cancer recurrence. Entirely New Breast Cancer: (not a true recurrence) Most patients use the term “recurrence” when referring to the chance of developing a completely new breast cancer in the future. A new cancer is not a true “recurrence.” It is really a new problem and not a reflection of your prior breast cancer coming back. Your initial breast cancer treatment choices can lessen the chance of developing a recurrent breast cancer. If you have a mastectomy rather than a lumpectomy/radiation your chance of local recurrence in the same breast is less. Taking hormonal therapy (anti-estrogen medications) has a “good side effect” of lessening your risk of developing new breast cancer in either breast after a lumpectomy. In general, a new breast cancer is less threatening than local or regional recurrence or distant metastasis. Why is recurrence so life-threatening? An early stage breast cancer is usually removed with surgery, and often requires radiation, chemotherapy, and hormonal therapy. If cancer grows back in the breast, the lymph nodes, or in other parts of the body, it means that some of the original breast cancer cells survived the initial treatment. Think of “recurrent cancer cells” as more resistant, aggressive cells. They require more aggressive surgery and usually chemotherapy when they recur. A recurrent breast cancer is often considered more threatening than the original breast cancer situation years before. This is why we strongly recommend a team approach to breast cancer recurrence to make sure no stone is left unturned in deciding your treatment options. Common Scenarios about Recurrence: “I have a favorable, early stage (I or II) breast cancer and will be treated with a lumpectomy, radiation, and hormonal therapy. What is my chance of recurrence?” The risk of distant metastasis is 5 to 15 percent over 5 - 10 years. Local or regional recurrence occurs in about 5 to 10 percent of patients over 5 years. A new breast cancer can develop at a rate of about one-half a percent a year. “What is my risk of recurrence when choosing between a mastectomy or a lumpectomy for a small, early stage breast cancer?” The risk of distant metastasis and death are exactly the same at 10 years. The risk of local or regional recurrence is slightly higher for patients with a lumpectomy (5-8% over 10 years) when compared with a mastectomy (3% over 10 years).  If this occurs, you will need a surgery to remove the recurrent cancer and possibly more treatment like chemotherapy, endocrine therapy, or radiation. When all's said and done, the same number of women are alive and cancer free if they have a lumpectomy (and radiation) or a mastectomy (without radiation) for early stage breast cancer. The risk of an entirely new breast cancer is slightly higher if one preserves their breast with a lumpectomy and radiation versus removal of the breast with a mastectomy. This is solely because there is more breast tissue remaining after a lumpectomy.
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DCIS Breast Cancer: Learn What You Need To Know
 
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We teach you about DCIS and how it is treated. This pre-cancerous problem is also a risk factor for developing invasive cancer and is linked to the BRCA genetic mutation. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________________ Questions for your Breast Surgeon and Medical Oncologist: 1. Is DCIS a cancer or a pre-cancerous growth? 2. What exactly is the threat to my health from DCIS? 3. Are both surgery and radiation always needed for DCIS? 4. May I have a copy of my pathology reports? 5. Do I qualify for genetic testing if I have DCIS? 6. Will DCIS turn into an invasive cancer if not treated? Ductal Carcinoma In-Situ (DCIS) refers to breast cells that are growing abnormally in an area of the breast, but have not yet evolved to the point where they are considered “invasive breast cancer” and can spread beyond the breast to other parts of the body. Even the medical field is unsure whether to call it “non-invasive” breast cancer or a “pre-cancerous” problem. By definition, DCIS is considered a Stage O breast cancer. Important facts if you have DCIS: *If left untreated, it can evolve into an invasive breast cancer *You have a slightly higher lifetime risk of forming a new cancer in either breast in the future *You may now qualify for BRCA genetic testing. How is DCIS different from invasive cancer? Invasive Breast Cancer can threaten your life because it mau have the capacity to spread (metastasize) to other organs of the body. DCIS does not yet have this ability to spread, but it might if it evolves into an invasive breast cancer in the future. So we treat DCIS very seriously in order to lessen the risk of it developing into an invasive, life-threatening problem. Learn more about “Invasive Breast Cancer“ with our video lesson (here). What is the chance I will die of my DCIS? The risk is very low. The most comprehensive study (here) on the subject in 2015 showed that the risk of dying from any type of breast cancer 20 years after having your DCIS treated with a lumpectomy and radiation is about 1%. One take home message from this study is that you have plenty of time to make decisions with your breast specialists about how to best treat your DCIS. Lumpectomy or Mastectomy for DCIS? Removal of the area of DCIS with surgery is usually the first treatment. A lumpectomy removes the area with a surrounding margin of normal tissue. It is a great surgery if the area of DCIS is small. Radiation is generally recommended after surgery to further lessen the risk of the DCIS or an invasive cancer growing back in that area of the lumpectomy. Some women who are older or have a lower-risk type of DCIS sometimes can avoid radiation after a lumpectomy. A mastectomy is generally recommended only if DCIS involves a large area of the breast and thus would not be a good candidate for a lumpectomy and radiation. A mastectomy for DCIS does not make you live longer, but it does reduce the chance of cancer growing back in that breast. Radiation is generally not needed after a mastectomy for DCIS. Take our video lesson on “Lumpectomy or Mastectomy“ (here) to learn more. You and your breast surgeon must work closely together to decide what surgery is best for your unique cancer situation. Should I take “anti-estrogen” medicines for DCIS? When someone is diagnosed with DCIS, the pathologists will run special studies on the tumor cells to determine if Estrogen receptors and Progesterone receptors are present. If your DCIS is “Estrogen receptor positive,” taking anti-estrogen medications for 5 years can lessen the chance of developing a new breast cancer (either DCIS or invasive cancer) over the next 5 to 10 years if you had a lumpectomy. Taking “tamoxifen” or an “aromatase inhibitor” medication for this purpose is called “chemoprevention.” If a woman has bilateral mastectomies there is no need for chemoprevention because the breast tissue has been removed. Women with DCIS are felt to have an increased risk for developing new cancers in both breasts in the future. Taking these medications can reduce the risk of new breast cancers in these higher risk women, but these drugs are not without potential side effects and risks. That is why a “risk vs benefit” discussion with a medical oncologist is important. You may qualify for genetic testing if you have DCIS. DCIS is now known to be associated with the BRCA gene mutation in as similar way as women with invasive breast cancer. The BRCA (Breast Cancer) gene is commonly referred to as “The Breast Cancer Gene.” If someone inherits a broken version (mutation) of this gene at conception, they carry a very high lifetime risk of breast cancer and ovarian cancer.
Просмотров: 3256 Breast Cancer School for Patients
Breast Cancer School for Patients: Free Online Course
 
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Learn everything about Breast Cancer to get the highest quality care in your community. Our free course teaches you everything you will need to know. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________________ Why create the online “Breast Cancer School for Patients?” If you’ve been diagnosed with breast cancer, you probably have lots of questions. The Breast Cancer School for Patients (www.breastcancercourse.org) helps you in a unique way. We have completed the difficult task of organizing the vast field of breast cancer into one, patient-friendly site. No one else actually teaches you precisely what you need to know to get the best breast cancer care in your community. We arm you with knowledge. Our innovative 3- to 4-minute video “lessons” about every important breast cancer topic will get you up-to-speed on your treatment options. We give you the tools you need to begin your breast cancer journey. Print out your “lesson notes” listing the best questions to ask your doctors for cutting edge breast cancer care. Armed with these questions, you can work as a team with your breast cancer specialists. We share with you the best doctor-selected links and references so you can research a topic without getting horribly lost on the web. Learn as much or as little about any subject important to you. You will make monumental decisions quickly. Your treatment options come quickly. You will make decisions with your doctors during your appointments. You must be prepared and be your own advocate. When we make you an EXPERT in breast cancer from the start, you will make better decisions at every step of your treatment journey. When you wonder what comes next in your treatment…you will find it on our website. Learn about cutting edge advancements. Treatment methods are always advancing and research is constantly uncovering new information. We teach you the key cutting edge aspects about breast cancer that you could miss out on, unless you ask for them. With our short courses we give you the guidance to seek quality breast cancer care. This is the first “school” for breast cancer patients. The Breast Cancer School for Patients teaches you to be an expert and your own best advocate. Our patient-driven quality movement is all about empowering you to be at the center of all discussions and treatment decisions. As a student of ours, you’ll get access to short, easy-to-follow videos, lesson notes, and doctor-selected links on every important breast cancer topic. Get informed before speaking with your doctors. You will improve your care with this approach. Register for our newsletter & “Cutting Edge” questions Sign-up for our breast health newsletter at www.breastcancercourse.org. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions to engage your breast surgeon, medical oncologist and radiation oncologist. We help you get quality breast cancer care in your community.
Просмотров: 44048 Breast Cancer School for Patients
Breast Imaging: Breast Cancer Screening & Biopsy
 
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We educate you about 3D mammograms, breast MRIs, ultrasounds, density and more. We teach you about breast screening and what to know if newly diagnosed with a breast cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ____________________________________ What does “Breast Imaging” refer to? Breast imaging generally refers to mammograms, breast ultrasounds, and breast MRIs. Mammograms are most often used to screen women annually for cancer. An ultrasound of the breast is usually performed to determine if a lump or mass is concerning for cancer. Breast MRIs are ordered most frequently for newly diagnosed women to better understand the extent of their cancer before surgery. MRIs are also used annually to screen women felt to be at “high risk” for developing breast cancer in their lifetime. Interpreting these studies is difficult to do really well. It is not uncommon for a breast cancer to be overlooked on your imaging, thus delaying a diagnosis of cancer for months or years. That is why you should seek a radiologist who specializes in breast imaging. Under their guidance, cancers may be detected earlier and fewer biopsies of non-cancerous areas may be recommended. If possible, seek your breast imaging at more specialized breast imaging centers. When should I start getting mammograms every year? We still recommend beginning annual, screening mammography at the age of 40. Recent national guidelines recommend starting later at 45 or 50 years old. This has generated an intense discussion and debate amongst patient advocacy groups and the world of medicine. Make sure to take our specific lesson “When should I start getting mammograms?” We address the advantages and disadvantages of breast screening so you can make an informed decision with your physicians about when to begin mammographic screening. What are the "Cutting-edge Advances" in breast imaging? Breast imaging technology is rapidly improving. You might hear about these advances occasionally from your friends or on the news. We are the first to organize all of these cutting-edge technologies into one, patient-friendly website. We cover breast imaging topics such as: *Should I have a 3D mammogram? *Would I benefit from a breast MRI? *Does my radiologist specialize in breast imaging? *Do I have dense breasts? What is my BI-RADS density score? *Am I at high risk for developing breast cancer? *What is “Automated Whole Breast Ultrasound” and breast density? Should I ask for copies of my breast imaging reports? All of your medical records belong to you. If you’ve been diagnosed with breast cancer, you need to read your reports to better understand your unique cancer. This allows you to engage your breast surgeon and make sure something is not missed or overlooked. You will likely forget the details about your cancer, treatment, and imaging as the years pass. We recommend you create a folder and gather all of your cancer information. You will get better quality care from future physicians when you can share with them the specifics of your breast cancer. Register for our newsletter and “cutting-edge” questions. Sign-up for our video-based breast health updates (here). Once registered, we’ll immediately email you our complete list of “cutting-edge” questions for your breast surgeon, medical oncologist, and radiation oncologist. We help you get quality breast cancer care in your community.
Просмотров: 484 Breast Cancer School for Patients
Genomic Testing in Breast Cancer: What You Must Know
 
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We teach you about genomic testing and how these sophisticated tests can guide you to personalized therapies for your breast cancer. THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/BreastCancerSchoolForPatients/ ________________________________ Questions for your Breast Surgeon and Medical Oncologist: *Do I qualify for an Oncotype DX genomic test? *If so, will you order genomic testing for me? *Would you order a genomic test before I see a medical oncologist? *Are there any other genomic tests that apply to me? *What is a genomic assay? These sophisticated tests are performed on a small sample of cancer tissue in appropriate patients with early stage breast cancer. Genomic tests are usually ordered after surgery when the pathology report is finalized. It measures unique aspects of the tumor to determine if a patient will benefit from chemotherapy in addition to hormonal therapy. Such “genomic assays” developed over the last decade are a dramatic advance in breast cancer care. The Oncotype DX assay by Genomic Health Inc. is the most utilized genomic assay of those available in the United States. Who should consider a genomic test? Patients who have small “Estrogen receptor positive” (ER+) and “HER2 receptor negative” (HER2-) tumors and no evidence of cancer in their lymph nodes may benefit from an Oncotype DX assay. The purpose of this test is to better identify people who do and do not benefit from chemotherapy. The decision to undergo chemotherapy is a complicated one. Your medical oncologist will examine multiple factors to help determine if you will benefit from chemotherapy. The NCCN Guidelines, listed in the website links below, outline in much greater detail recommendations for the use of genomic tests. An Oncotype DX test can be instrumental in this decision for many patients. You may qualify for a Genomic Assay if… You have early stage cancer (Stage I or II) Your tumor is Estrogen receptor positive (ER+) Your tumor is Her2 receptor negative (HER2-) No cancer was found in your lymph nodes You are willing to consider having chemotherapy You are healthy enough to undergo chemotherapy How is chemotherapy tailored to patients? Genomic breast cancer tests are a leap forward in our ability to “look inside” breast cancer cells. Sophisticated breast cancer care is based upon the principle of providing maximal benefit from the least toxic therapy. Newly diagnosed breast cancer patients deserve the best information available to decide whether they need chemotherapy. Take our video lesson on “Will I Need Chemotherapy?“ (here) to understand the general concepts. Genomics is a promising and rapidly developing field. OTHER GENOMIC TESTS: Oncotype DX Breast DCIS Test This assay of DCIS or “precancerous” breast cells may help identify some women who may not benefit from radiation therapy after a lumpectomy. Genomic Health Inc. is a leading personalized medicine company. More information is about this test is located (here). MammaPrint This genomic test is used for Stage I and II breast cancers to determine prognosis and survival. This test is now included in national guidelines for some with hormone sensitive breast cancers that are found to have a small amount of cancer in a few lymph nodes. It is also a genomic test for some without “node positive” breast cancer. Agendia is a leader in personalized and molecular cancer diagnostics. More information about MammaPrint is located (here). Endopredict EndoPredict is a 2nd generation genomic breast cancer recurrence test to assess for 10-year risk of cancer recurrence. This test also accounts for tumor size in helping determine if chemotherapy may be needed in early stage, favorable breast cancers. Myriad Genetics is global leader in genetic testing and personalized medicine. More information about Endopredict is located (here). Breast Cancer Index (BCI) This test is designed for women with favorable, early stage breast cancer who have been on hormonal therapy for 4 to 5 years. It can help determine if someone will benefit (or can avoid) five additional years of hormonal therapy, such as tamoxifen or an aromatase inhibitor. This test is not yet approved by the FDA. Medicare and some insurance companies may cover the cost. Biotheranostics is a molecular diagnostics company. More information about BCI is located (here). Take Home Message: Make sure to ask both your breast surgeon and medical oncologist if a genomic assay might play a role in your treatment decisions. For appropriate patients, these tests should be considered only one piece of the many “pieces of the puzzle” in deciding treatment decisions about chemotherapy and hormonal therapy.
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Breast Cancer Neoadjuvant Chemotherapy: For Patients
 
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We teach you about the benefits of neoadjuvant chemotherapy. Chemotherapy before surgery, rather than afterwards, may offer distinct advantages in your unique breast cancer situation. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ___________________________________ Questions for your Breast Surgeon and Medical Oncologist: 1. Do you know now, before surgery, if I will need chemotherapy? 2. If “yes,” should we consider “Neoadjuvant Chemo” before surgery? 3. What are the benefits of Neoadjuvant Chemotherapy? 4. Isn’t Neoadjuvant Chemo recommended more now? 5. Do my receptors suggest I will need chemotherapy? 6. Do I have cancer in my axillary nodes? 7. Will you ultrasound my axillary lymph nodes today? 8. What is Neoadjuvant Chemotherapy? Neoadjuvant chemotherapy is when chemotherapy is given before surgery, not afterwards. Most never require chemotherapy. But if chemotherapy is needed, there can be specific advantages to neoadjuvant chemotherapy. This approach is a “cutting edge” trend in sophisticated breast cancer care. If your breast biopsy “receptor pattern” suggests you need chemotherapy, it is important for you to inquire about the possible benefits of neoadjuvant chemotherapy with your breast surgeon. If cancer is detected in your lymph nodes before surgery, you may also benefit from neoadjuvant chemotherapy. Learn more about receptors and chemotherapy with our video lesson “My Tumor Receptors” (here). When is chemotherapy generally needed? If needed, chemotherapy is most commonly given after surgery (“adjuvant” chemo) for invasive breast cancer. It is a more intense cancer treatment than hormonal therapy. Only a minority of breast cancer patients will ever need chemotherapy. These complex decisions are ones you will make with your medical oncologist and breast surgeon. You will make better treatment choices when you are well informed about chemotherapy before you meet your breast surgeon and medical oncologist. Would I benefit from “Neoadjuvant Chemo?” What is often overlooked are the benefits of offering neoadjuvant chemotherapy for appropriate “Early-Stage” breast cancer. The decision to consider neoadjuvant chemotherapy always begins with your breast surgeon. You and your breast surgeon will choose the initial direction of your entire breast cancer treatment plan. You must address this treatment option before surgery to benefit from neoadjuvant chemotherapy. Some breast surgeons do not yet embrace neoadjuvant chemotherapy for early stage cancers. Do not be afraid to ask. This is a very important question. The Potential Benefits of Neoadjuvant Chemo: *Begin life-saving chemotherapy earlier *Reduce the need for a mastectomy *Improve cosmetic outcomes with a lumpectomy *Reduce the need for an “Axillary Dissection” *Allow more time for BRCA genetic testing *More time to think about “lumpectomy vs. mastectomy” *Shows your cancer team if the chemo is working *Can eliminate all cancer cells before surgery in some *Reduce the need for radiation after a mastectomy Who may benefit from Neoadjuvant Chemo: We list below a few of the criteria important in deciding if neoadjuvant chemotherapy is an option for someone who has yet to undergo breast cancer surgery. Your Breast biopsy “Tumor receptors” reveal *“HER2-positive” receptors *“Triple Negative” receptors *Estrogen receptor negative OR: *Cancer is found in the Axillary Nodes before surgery *A tumor larger than 5 centimeters *Diagnosis is inflammatory breast cancer What “Receptor Patterns” suggest Neoadjuvant Chemo? HER2-Positive Receptor (HER2+) tumors are incredibly responsive to chemotherapy when paired with new breakthrough drugs that target these cancers, such as Herceptin and Perjeta. The same holds true if a HER2-positive tumor is also ER positive. “Triple Negative” (ER-)(PR-)(HER2-) tumors are also fast growing tumors that are usually treated with a specific chemotherapy regimen. These tumors are not responsive to hormonal therapy, but can be very sensitive to chemotherapy. Visit our “Triple Negative Breast Cancer“ video lesson (here). Estrogen Receptor Negative (ER-) tumors do not respond to anti-estrogen oral medications that are essential for treating estrogen receptor positive (ER+) tumors. Quite simply, patients with ER negative tumors will benefit from chemotherapy. Why does “Inflammatory Breast Cancer” mean Neoadjuvant Chemo? If you have been diagnosed with inflammatory breast cancer, the first step is always neoadjuvant chemotherapy before surgery. This type of cancer has a high likelihood of spreading to the lymph nodes and other parts of the body. Starting chemotherapy as soon as possible is essential to curing this aggressive breast cancer.
Просмотров: 959 Breast Cancer School for Patients
Breast Biopsy: Why Ask for a Minimally Invasive Biopsy
 
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We teach you about image guided, minimally invasive breast biopsies. Make sure to ask your physician to call you with the results and get a copy of your pathology report. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ______________________________ Questions for your Breast Surgeon or Radiologist: 1. What is the best type of biopsy for me? 2. Can I avoid an open surgical breast biopsy? 3. Can we avoid surgery if my needle biopsy does not show cancer? 4. Will you personally call me with my biopsy results? 5. May I have a copy of my “Pathology Report?” What is a breast biopsy? When a concerning mass or lump is identified in the breast, a biopsy is needed to determine the cause of the mass. A biopsy is a procedure to sample the concerning mass. A pathologist then evaluates the biopsy sample under a microscope to determine if any cancer or precancerous cells are present. Most biopsies are performed with a “core needle device” under local anesthesia (so called “minimally invasive breast biopsy”). Some are performed in the operating room through an incision under general anesthesia (open surgical biopsy). Nearly 80% of all breast biopsies will not be cancerous. Why is a “Needle Biopsy” better? Most biopsies can be accurately performed by guiding a small sampling needle into the concerning area using local anesthesia. This is best performed with imaging (Ultrasound/Mammography/MRI) to make sure the correct area is biopsied. Minimally invasive needle breast biopsies are considered “The Standard of Care.” An image-guided breast biopsy is not feasible in about 5 to 10% of breast abnormalities. A surgical biopsy should be used only as a last resort. Always insist upon a minimally invasive needle biopsy. If it is not offered, make sure it is clearly explained to you why a surgical procedure is recommended by your breast surgeon. This minimally invasive approach to suspicious breast lesions has become commonplace over the last 10 – 15 years. There are numerous advantages associated with being diagnosed by a needle biopsy. This minimally invasive approach to breast biopsies is advocated by nearly all professional societies and patient advocacy groups. Ask your “biopsy doctor” to call you ASAP with results On the day of your biopsy, ask the radiologist or surgeon to call you directly with the result within the next 2 to 3 days. Write your contact information down for them and give them permission to leave the results as a voicemail. That way you can quickly learn the results (most are not cancerous) and get some guidance as to your next step. Too often, the results are delayed and you only hear from a staff member who will not be able to interpret the results. Interpreting your results is a critical quality aspect of every breast biopsy. Get a copy of your pathology report Make sure you get a copy of your biopsy “Pathology Report” from the ordering physician once it is available about a week later. Even when the results are “benign” it is helpful to have this information for future reference. “Ultrasound Guided” needle breast biopsy Ultrasound guided biopsies allow your breast surgeon or radiologist to guide a sampling needle into the suspicious breast lesion and obtain slivers of tissue from this area. It is highly accurate if performed with experience and good judgment. This procedure is performed with local anesthesia and is well tolerated. It is by far the most common type of minimally invasive breast biopsy performed today. “Stereotactic” breast biopsy This minimally invasive procedure is performed with a sophisticated biopsy device that uses small mammogram images to locate and guide a biopsy needle to the breast lesion. This procedure should be used to obtain breast tissue samples from a suspicious area detected only by mammography. It is also performed using local anesthesia. “MRI guided” breast biopsy This biopsy procedure is very similar to a stereotactic breast biopsy, but is usually performed for suspicious areas that are best seen on a breast MRI. It is also done under local anesthesia, but is more involved because of the MRI imaging needed to guide the biopsy needle to the area to be biopsied in the breast.
Просмотров: 411 Breast Cancer School for Patients
Dr. John P Williams: Breast Cancer Surgeon & Advocate
 
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Dr. John P. Williams is a national leader in patient education and advocacy. A breast cancer surgeon in Northern Virginia, he founded the Breast Cancer School for Patients. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _______________________________________ Why create the Breast Cancer School for Patients? Over the years, family and friends have called me for advice about their breast care. After a quick conversation, they were incredibly empowered to ask their own doctors exactly what was needed. You simply get better care when you know about the important topics and the questions to ask. That is why we created the Breast Cancer School for Patients. Currently, the medical profession does not actually “teach” patients how to obtain quality, cutting-edge care in their communities. This is a missing link in our collective efforts to provide better quality breast cancer care in the United States. We feel it should be our duty in healthcare to teach you what you need to know before you consult with your breast cancer physicians. This way you can be more engaged with your physicians about the complexities of cancer care. This information must be readily available online, well organized, and in short video format. Our sole mission at the Breast Cancer School for Patients is to fill this patient information gap online. You will make better treatment decisions when you are taught to be an “expert” in your own breast cancer care. What is a “team approach” to breast cancer? A large part of my general surgery training at Baylor College of Medicine in Houston, Texas was working with the experts in cancer treatment at the M. D. Anderson Cancer Center (MDACC). Also located in the Texas Medical Center, MDACC is the largest dedicated cancer hospital in the United States. My general surgery rotations there exposed me to the “team approach” to breast cancer. The cutting-edge care a multidisciplinary team can offer patients is why I founded the Novant Health UVA Health Systerm Breast Center in my community in Haymarket, Virginia. It is personally rewarding that those with breast cancer in my community will now benefit from this team approach for generations to come. Do you come from a family of physicians? Growing up, I knew that I would likely become a doctor. My grandfather, L. Polk Williams, Sr. MD, brought modern medicine to the small town of Edenton, North Carolina in the early 1920s. During the Great Depression, grateful patients would leave chickens and livestock at his back door in exchange for the house calls and lifesaving care he provided. My father, L. Polk Williams, Jr. MD, followed his father into medicine, also attending Wake Forest University and Bowman Gray School of Medicine. He returned to his home town of Edenton after training in general surgery at Baylor College of Medicine and brought Dr. Michael Debakey’s world-class surgical care with him. I was born in Edenton and grew up in Elizabeth City, just a short drive from there. Why is being a breast cancer surgeon rewarding? I find I am interconnected in so many ways to my patients. They call me with questions. I talk with them at the grocery store. I love being there as a physician and friend when they are in need. These personal relationships are the ultimate reward for being a dedicated physician. What drives me today is doing everything in my power to obtain the best care possible for my own patients. I use every ounce of thought and energy teaching them and guiding them to get the best possible breast cancer care. Where did you attend school and train to be a surgeon? I entered Duke University as a freshman knowing that becoming a doctor was my goal. I became fascinated by the complexities of the brain and soon found myself engaged in neurology research at Duke University School of Medicine while an undergraduate. I graduated with distinction in psychology, and then attended the University of North Carolina School of Medicine. Like my father, I trained in general surgery at Baylor College of Medicine with Dr. Debakey. He was the world’s greatest cardiovascular surgeon of the 20th century and a leader in promoting advances in medicine and in health. Professionally, I am most proud to have applied to breast cancer care the same pursuit of excellence that I learned from Dr. Debakey and his associates at Baylor in Houston, Texas. More about Dr. John P. Williams Dr. Williams is a breast cancer surgeon in Virginia. He founded and is medical director the Novant Health UVA Health System Breast Center which serves the communities of Manassas, Gainesville and Haymarket, Virginia. More information can be found at htttp://www.drjohnwilliams.com. .
Просмотров: 11247 Breast Cancer School for Patients
Breast Cancer Axillary Ultrasound: Find involved nodes
 
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We teach you how a simple ultrasound of your axillary lymph nodes can tell you more about your breast cancer and expand your treatment options. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __ Questions for your Breast Surgeon: 1. Will you ultrasound my axillary lymph nodes today? 2. If not, will you order an axillary ultrasound by a radiologist? 3. Would my treatment change if we found cancer in my axillary nodes? 4. What are the benefits of Neoadjuvant Chemo? 5. Why is Neoadjuvant Chemo recommended more now? 6. Why ultrasound my axillary lymph nodes before surgery? At diagnosis, one third of patients already have cancer in the lymph nodes under their arm (axilla). When the “Axillary Lymph Nodes” are involved with breast cancer your cancer is more threatening one. This information can dramatically change your treatment options. Studies have shown that “positive” axillary lymph nodes are commonly missed by your breast surgeon’s physical examination. A 5-minute ultrasound of your axilla can more accurately find cancer in these nodes. A pre-operative axillary ultrasound is a “cutting edge” advance in breast cancer care. Make sure to ask your breast surgeon about an axillary ultrasound when they are examining you. Many large cancer centers routinely utilize pre-operative axillary ultrasounds. How can this change my treatment plan? If an obviously abnormal node is found before surgery, then you have a more serious cancer. If appropriate, an ultrasound guided needle biopsy can be performed to confirm the node is involved with cancer. If you have cancer in your nodes, you will likely require chemotherapy either before (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy). Regardless of the findings of an axillary ultrasound, a surgical evaluation of your axillary lymph nodes will be needed when you undergo a definitive breast cancer surgery. The surgical procedures used today for lymph nodes are a “sentinel node biopsy” or an “axillary dissection.” What are the benefits of knowing you have involved nodes? Knowing you have “node positive” breast cancer before surgery can empower your breast cancer team to search for more sophisticated treatment options. A simple axillary ultrasound for early stage breast cancer identifies more “node positive” patients. If you are found early in your journey to have node positive breast cancer, more  pre-operative treatment options may be considered. We list some of the treatment benefits below. Multidisciplinary Cancer Team Lymph node “positive” breast cancer requires a more sophisticated treatment approach. An axillary ultrasound can help determine if you would benefit from a “multidisciplinary team” approach early on in your care, before surgery. Ask your breast specialists to present your unique cancer situation to their team so you will benefit from new ideas and cutting-edge treatment advances. Neoadjuvant Chemotherapy When you know you have involved lymph nodes at diagnosis, you likely will be offered chemotherapy at some point in your treatment. There can be distinct advantages to having chemotherapy before surgery, rather than afterwards. This is known as neoadjuvant chemotherapy. This complex decision is worth discussing with your breast surgeon. Breast surgeons choose the initial direction of your entire breast cancer treatment plan. An axillary ultrasound can better identify if you are a candidate for neoadjuvant chemotherapy. Take our lesson on “Neoadjuvant Chemotherapy” to learn more about the potential benefits of this treatment approach.
Просмотров: 1177 Breast Cancer School for Patients
Bilateral Mastectomy: Your Choice. One Side or Both?
 
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We teach you about bilateral or “double mastectomies.” You will learn about the advantages, disadvantages, and controversy of this approach to reducing your future risk for a new breast cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ___________________________ Questions for your Breast Surgeon: 1. Will I improve my chances of survival with a “Bilateral Mastectomy?” 2. What are the disadvantages of a “Bilateral Mastectomy?” 3. What are the advantages of a “Bilateral Mastectomy?” Isn’t it my choice to decide? 4. If I’m unsure, can I talk to a plastic surgeon? 5. What is a “Bilateral Mastectomy”? Also called a “double mastectomy,” this is when both breasts are surgically removed. The term “Contralateral Prophylactic Mastectomy” is also used by the medical community for removal of the opposite, non-cancerous breast. Most of the time the decision to have a bilateral mastectomy is a personal one and is not required to treat a breast cancer that is on one side. There are situations where a “bilateral mastectomy” may be offered for consideration by your breast surgeon. The medical aspects are more complicated than listed below, but we include some common scenarios. Cancer in both breasts BRCA (“breast cancer gene”) mutation or other high-risk genetic mutation Strong family history of breast cancer Younger than 35 with breast cancer High risk for developing a new cancer Radiation to your chest at a young age Am I at risk of developing a “New Breast Cancer” in my other breast? Simple statistics are important to understand this concept. Below is a common scenario where women consider undergoing bilateral mastectomies to treat their existing cancer and reduce the risk of developing a new cancer in the other breast. Let’s say you are 45 years old, have an early, Stage I or II breast cancer and either need or have chosen to have a mastectomy to treat your cancer effectively. What is your risk of developing a new breast cancer in the other breast in the future? If you were just diagnosed with breast cancer and have no other risk factors, you will have a slightly higher overall risk of developing a totally new breast cancer in your lifetime. This risk rises from the normal lifetime risk of 8% for both breasts to approximately 12%, assuming a lumpectomy is performed and you keep both breasts. If you are in this situation and are trying to decide if you want a bilateral rather than a mastectomy on one side, your risk of developing a new cancer in your lifetime in the other breast if you choose to keep it is about 6% (half of the 12% above). We cure about 90% of all breast cancers with current treatments. Therefore, your lifetime chance of dying from a new cancer in that other breast will be about 0.6%. “Bilateral Mastectomy” for cancer on one side? Most of the time the choice to have a bilateral mastectomy is a personal one for a variety of reasons. Even when well informed, many women decide to proceed with removing both breasts for “peace of mind” and the desire to “never go through this again.” It is important to realize that everyone has different goals, unique personal situations, and their own reasons as to how they manage their own breast cancer. “Patient autonomy” is essential to a great “doctor-patient” relationship. Controversy about “Contralateral Prophylactic Mastectomy” There has been a trend over the last decade of more women choosing a “double mastectomy” when they have cancer in one breast. About 25 to 50% of all mastectomy surgeries done today are “bilateral” procedures. The more informed you become, the better decision you will make for your own situation. There is an intense debate by breast specialists as to whether too many bilateral mastectomies are being performed. What are the “disadvantages” of a bilateral mastectomy? Surgical complication risks are slightly increased Loss of sensation in the skin of both breasts Increased need for revision surgeries in the future Does not improve your “overall survival” from breast cancer Does not lessen the chance you will need chemotherapy A chance you might regret the decision in the future What are the “advantages” of a bilateral mastectomy? Lessens the chance of a new cancer in the breast Screening mammograms are no longer needed Cosmetic outcomes have improved over the last decade Reconstructing both sides gives matching cosmetic outcomes Discuss with your Breast Surgeon Work to develop a close relationship with your breast surgeon. Print out and take these course notes with you when covering this topic. Ask to see a plastic surgeon about reconstruction options if you are unsure. Ultimately, your breast cancer treatment decisions are yours to make.
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Mastectomy Breast Reconstructions Options:
 
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We teach you about mastectomy reconstruction options. While treating your cancer comes first, a multidisciplinary team approach results in better cosmetic and cancer outcomes. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________ Questions for your Breast Surgeon and Plastic Surgeon: 1. Am I a good candidate for breast reconstruction? 2. What type of reconstruction do you recommend? 3. Am I a candidate for a nipple-sparing or skin-sparing mastectomy? 4. What are the complications and disadvantages of reconstruction? 5. What are the advantages and disadvantages of a bilateral mastectomy? What is Breast Reconstruction? Breast reconstruction is commonly performed after a mastectomy. The goal is to re-create the shape of the breast with one or multiple surgeries by a plastic-reconstructive surgeon. Today, the cosmetic results are leaps and bounds beyond where they were just a decade ago. With that said, breast reconstruction is far more complex and carries much higher complication risks than an elective breast augmentation. About half of women who have a mastectomy in the United States will undergo breast reconstruction. A mastectomy without reconstruction is also a surgical choice. One can wear a breast prosthesis and avoid the more extensive surgeries and risks of complications with a reconstruction. The decision to have breast reconstruction is complicated and personal. It is important to realize that everyone has different goals, different personal situations, and their own reasons as to how they manage their unique breast cancer situation. Treating your breast cancer comes first. There are many complex factors your breast cancer surgeon must consider about your reconstruction options. Most of the time your reconstructive options are not affected by your cancer treatment. But if you do have a complex breast cancer situation, ask your surgeon to present your dilemma to a multidisciplinary conference for further input from other surgeons, medical oncologists, and radiation oncologists. Balancing a great cancer outcome with a good cosmetic outcome sometimes requires intensive discussions amongst your breast surgeon’s team of breast cancer specialists. A surgical “Team Approach” is best. Your breast surgeon will likely guide you to a plastic-reconstructive surgeon he or she works with regularly. They will work as a “team” to plan the best surgical approach to your cancer and likely work together the day of your mastectomy to begin your reconstruction. Subsequently, the plastic surgeon works with you in planning further staged reconstruction procedures. What are your Breast Surgeon’s “Mastectomy Options”? A skin-sparing mastectomy preserves the skin of the breast but not the nipple or areola. Preserving the normal “skin envelope” in the shape of your breast leads to better cosmetic results. A nipple-sparing mastectomy preserves all the skin of the breast including the nipple and areola. If you have an early stage breast cancer located away from the nipple you may be a candidate for this approach. Nipple-sparing mastectomies generally lead to the best cosmetic results. Women with very large breasts may not be appropriate for a nipple-sparing technique. A traditional mastectomy saves only enough skin to cover the chest wall. Sometimes this is required to effectively treat the cancer. Reconstruction can still be performed in this setting, but the cosmetic results may not be as successful as nipple-sparing or skin-sparing approaches. What are your Plastic Surgeon’s “Breast Reconstruction Options”? Two-stage implant reconstruction involves implantation of a “tissue expander” implant at the time of your mastectomy to help mold and stretch the skin to the desired size and shape. This implant will be expanded one “fill” at a time at office visits until the desired result is achieved. At a second operation, the plastic surgeon will remove the expander and place a permanent implant filled with “saline” or “silicone.” This the most common approach to breast reconstruction today. One-stage implant reconstruction occurs with well-selected patients that can undergo placement of the “final implant” during the mastectomy surgery. This approach is not nearly as common as the two-stage approach outlined above. Tissue flap reconstruction is used in about 10% of all breast reconstructions in the United States. The benefit is that it uses a segment of your own tissue from your abdominal area or your back to fill the space needed to reconstruct the breast. It is a much more complicated and involved surgery but the results seldom require surgical revisions in the future. Types of tissue flaps include DIEP flaps, TRAM flaps, and latissimus flaps.
Просмотров: 399 Breast Cancer School for Patients
Breast Cancer Second Opinion: How and When to get one
 
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We teach you when to consider a second opinion and outline the advantages and disadvantages of a second look at your breast cancer treatment options.Visit our website: VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________________________ When should you consider a second opinion? Be reassured that most newly diagnosed patients do not need a second opinion. We outline here a few situations in which you may benefit from seeking a second opinion about your breast cancer. When you have a very unusual type or complicated breast cancer. When your surgeon or oncologist recommends a second opinion. When a clinical trial is available for your unique situation. What are the advantages of a second opinion? Reassurance and confirmation that your physician and breast cancer team is approaching your situation correctly. A possible offer of a different approach to treating your cancer. You can then weigh the advantages and disadvantages of both approaches and make a more informed decision. What are the disadvantages of a second opinion? This process can sometimes significantly delay beginning your cancer care. Depending upon the facility and availability of the second opinion appointment, the delay can be a few days to many weeks. If you do choose to return to your original physician to seek your cancer care, your surgery, chemotherapy, or radiation therapy will likely be delayed by your second opinion. However, if you work with your initial specialist to help you coordinate a second opinion as outlined below, he or she may likely work to continue scheduling therapies while you are seeking other ideas. How do I best seek a second opinion? Ask your surgeon or oncologist who they would recommend you see. They know who is the best in your area. This also indirectly asks them the question, “Are there any other services that are offered elsewhere that are not available here?” They can be very helpful in facilitating this referral and sharing your medical records for your second opinion. If your surgeon/oncologist appears offended when you ask this question, this is an indication that you may benefit from a second look at your breast cancer treatment options. Conduct your research. Look online for NAPBC accredited Breast Centers in your area. Contact the “Patient Navigator” at the breast center you are considering a second opinion. He or she will be very helpful in having you “worked in” to a physician’s busy schedule to have second look at your unique breast cancer situation. What is a breast biopsy, “pathology second opinion?” An incorrect reading of your breast biopsy can dramatically change your physician’s approach to your problem. Sometimes it is challenging to accurately determine whether breast cells are benign, atypical, precancerous, or an invasive breast cancer. Your pathology slides can be sent to an outside reference lab if there are questions about the certainty of a diagnosis with your local pathologist. In 2015, actress Rita Wilson publicly shared that a pathology second opinion of her breast biopsy showed invasive cancer, after initially being read as a more benign condition. A good commentary of her second opinion is located (here). Breast biopsy pathology second opinions are not routinely ordered. Here are a few situations that can generate sending pathology slides to a reference lab. Ask your breast surgeon if a second reading would be helpful in your unique situation. If the reading was performed at a very small hospital pathology laboratory. If the reading suggests one of the following diagnoses: atypical lobular hyperplasia (ALH), atypical ductal hyperplasia (ADH), lobular carcinoma in-situ (LCIS), or lobular intraepithelial neoplasia (LIN). What is a breast “imaging second opinion?” Formal requests for second readings of mammograms, breast ultrasounds, and breast MRIs are rare. But if you visit another institution for a second opinion to treat a newly diagnosed breast cancer, it’s commonplace to have a new, formal reading by that institution’s breast radiologists. The most reassuring second opinion is when your breast surgeon offers to review your imaging with your radiologists. This action shows engagement in your care and can add further insight into your breast cancer situation. Patient-Friendly References: breastcancer.org This detailed outline (here) “Getting a Second Opinion” is about all aspects of seeking a second opinion for breast cancer. This non-profit organization provides excellent patient resources about breast cancer.
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Breast MRI: Do You Have Breast Cancer or at High Risk
 
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Learn about Breast MRIs for newly diagnosed women. We help you identify if you at High Risk and would benefit from annual screening MRIs. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________________ Questions for your Breast Surgeon: 1. Will you order a Breast MRI to look for other tumors? 2. Could a Breast MRI change our treatment plans? 3. Do I qualify for a “Screening Breast MRI?” 4. What are the disadvantages of a Breast MRI? 5. What are the benefits of Breast MRIs in newly diagnosed women? By the time someone has had a biopsy showing cancer, they likely have already had a mammogram and possibly a breast ultrasound. Once diagnosed, a “Pre-operative Breast MRI” can sometimes show other cancers that have yet to be identified by mammography or a physician’s breast examination. A Breast MRI can also provide more information about the tumor’s size and involvement of other structures such as the muscle or skin. When used before surgery (pre-operatively), Breast MRIs identify additional cancers in the same breast in about 16% of women and can find previously unknown cancers in the opposite breast in 3 to 5%. The findings from a pre-operative Breast MRI can change the surgical plans to treat your breast cancer. Breast MRIs are commonplace today and ordered by breast surgeons. Ask your surgeon if you would benefit from a Breast MRI before your surgery. Why a “Screening Breast MRI” for women at “High Risk?” Women identified to be a very high risk of developing breast cancer should consider an annual screening Breast MRI in addition to their annual mammogram, according to recommendations (here) by the American Cancer Society. Together, these two screening tests give doctors a better chance of finding breast cancer in high risk women when the cancer is smaller, easier to treat, and easiest to cure. Consider a “Screening Breast MRI” if: You are a BRCA1 or BRCA2 mutation carrier You have a first-degree relative (parent, sibling, child) with a BRCA1 or BRCA2 mutation, even if you have yet to be tested yourself Your lifetime risk of breast cancer has been scored at 20 to 25% or greater, based on one of several accepted risk assessment tools that look at family history and other factors such as a biopsy showing Atypical Ductal Hyperplasia (ADH), Atypical Lobular Hyperplasia (ALH), and Lobular Carcinoma In-Situ (LCIS) You had radiation therapy to the chest for cancer (usually lymphoma) treatment between the ages of 10 and 30 What are the downsides of a Breast MRI? If a breast MRI identifies a suspicious area in the breast, it may require a needle guided breast biopsy. Most of these additional biopsies prove to be benign, and can result in further imaging, anxiety, discomfort, and cost. In other words, Breast MRIs can lead to breast biopsies that might be considered unnecessary. There is also evidence to suggest that women who undergo a pre-operative Breast MRI for cancer are more likely to choose to have a mastectomy than those who do not have a Breast MRI. Some leading physicians argue that Breast MRIs lead to unnecessary mastectomies without improvements in cancer outcomes. (see below reference) Ultimately, the choice of having a mastectomy is based on your unique breast cancer situation and your personal priorities. Should I have a pre-operative Breast MRI? Most importantly, speak with your breast surgeon. Ask specifically what the advantages and disadvantages are for your unique situation. Over the last decade, more and more pre-operative Breast MRIs are being performed. This trend will likely continue as breast surgeons seek more information before making surgical treatment decisions. Those that benefit most from a pre-operative breast MRI are women younger than 50 years old, those with dense breasts, and BRCA mutation carriers. Ask your surgeon if your biopsy report also shows several high risk findings such as Atypical Ductal Hyperplasia (ADH), Atypical Lobular Hyperplasia (ALH), and Lobular Carcinoma In-Situ (LCIS). If your cancerous breast biopsy also showed these High Risk findings, then you benefit more from a pre-operative Breast MRI. You would likely also qualify for annual screening Breast MRIs in the years to come after your treatment if you are deemed at high risk and have a lumpectomy. What is the take-home message? In general, most breast surgeons feel pre-operative Breast MRIs are a good idea unless someone is elderly or extremely claustrophobic and would not tolerate the confined space of the MRI machine. If your breast surgeon never mentions a pre-operative Breast MRI as an option, you should inquire to become better informed.
Просмотров: 910 Breast Cancer School for Patients
Breast Cancer Basics: We Teach You the Essentials
 
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This course outlines the basics of breast cancer and the steps ahead to treat it. Our video lessons teach you to be expert in the key concepts of breast cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________ Where do I learn about my cancer? If you have breast cancer you will likely look online to learn more. Your initial teacher will be your breast surgeon. His or her primary goal will be to teach you about your cancer, the best treatment options, and create a treatment timeline for you. You will learn more details and insight into your breast cancer from your medical oncologist and radiation oncologists when you ultimately consult with them. It is your job to learn as much about breast cancer quickly. There is good information online, but it is difficult to find exactly what you need to know, when you need to know it. Why we created the Breast Cancer School for Patients The Breast Cancer School for Patients helps you in a unique way. We have completed the difficult task of organizing the vast field of breast cancer into one, patient-friendly site. We teach you exactly “what you need to know” to get the best breast cancer care. Breast cancer care is very complicated, even for breast cancer specialists. You need to learn as much as you can. The “Key Concepts” you must learn about your cancer You must learn the important details about your cancer. Our short video lessons will teach you the basics to prepare for your breast cancer physician consultations. Take our video lessons on: *What type and stage is my cancer? *Will I survive breast cancer? *Do my tumor “receptors” suggest I need chemotherapy? *Do I have a “HER2-positive” or “Triple Negative” cancer? *What is cancer “recurrence?” Our short video lessons, printable notes, and selected references will point you in the right direction to learn more about the basics of breast cancer and will help you get quality, cutting edge care in your community. You have time to make good decisions The most important and difficult part of having breast cancer is that you must make good decisions for yourself. You will naturally feel pressed for time to learn everything and start your treatment as soon as possible. Time is usually on your side. You must work with your breast cancer team to learn everything about your cancer and your treatment options. We created the Breast Cancer School for Patients to quickly teach you to be your own expert in breast cancer. As such, you will make better decisions once you become your own “expert” in breast cancer. Engage your breast specialists with questions Print out our lesson notes with the key questions to make sure you are offered the best treatment choices. We educate you so you can engage and work as a team with your breast cancer specialists. You will make better decisions when you go into your doctor consultations already knowing the essentials and able to speak their language. This is the first “School for Breast Cancer Patients” The Breast Cancer School for Patients teaches you to be an expert and your own best advocate. Our “Patient-Driven Quality” movement is about empowering you to be at the center of all discussions and treatment decisions. Get informed before speaking with your doctor. Register for our newsletter & "Cutting Edge" questions Sign-up for our breast health updates and latest videos. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions to engage your breast surgeon, medical oncologist and radiation oncologist. We help you get quality breast cancer care in your community. Patient-Friendly References: cancer.net This printable booklet "ASCO Breast Cancer" (here) is a comprehensive guide to breast cancer for the newly diagnosed. The American Society of Clinical Oncologists is a leading organization of clinical cancer physicians and providers.
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Screening Mammograms: When Do I Start Getting Them?
 
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Learn when to begin screening mammography. Guidelines have recently changed and this has created confusion for women and physicians. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________________ Questions for your Primary Care Physician: 1. Am I at a High Risk for breast cancer in my lifetime? 2. Should I start mammograms at 40, 45 or 50? 3. What are the downsides to screening mammography? How “Screening Mammograms” save lives Annual screening mammograms often detect small breast cancers before you may notice them yourself. “Breast screening” can save lives by finding cancers when they are smaller and easier to cure. Mammograms account for much of the improved survival from breast cancer over the last 30 years. Until recently, most guidelines have recommended beginning annual screening mammograms at the age of 40. At what age should I begin screening? Screening guidelines are currently evolving towards screening less women in their 40s. These newer guidelines recommend beginning mammography at age 45 or 50. Some suggest every other year rather than every year. The new guidelines have not been widely adopted and are quite controversial and confusing. The Breast Cancer School for Patients recommends continuing annual screening mammograms for women age 40 and older. We provide an overview of both the wisdom and risks of these controversial recommendations. Consult with your physician to see what mammographic screening program will suit your unique situation. Guidelines now encourage screening later. Why? The American Cancer Society and the U.S. Preventive Services Task Force now recommend delaying annual screening mammography until 45 or 50 years old. The American College of Obstetricians and Gynecologists continue to recommend beginning at 40 years of age and annually thereafter. These new guidelines have created confusion for both physicians and women. As currently written, they have been impossible to implement by medical communities across the country. There is also disagreement amongst physician, patient advocacy and breast cancer organizations. What are the risks of annual mammograms? Screening for breast cancer is a balance between benefits (saves lives) and risks (cost, radiation, biopsies, stress). There are distinct risks to mammographic screening. The newer guidelines are based upon re-evaluations of these risks and benefits. Risks of screening: *Being “called back” for more imaging and nothing is found *Most breast biopsies prove to be benign *Radiation to the breasts from a mammogram *The “stress & anxiety” when something is detected, but is not a cancer *The monetary cost to you, insurance, and society *Some cancers would have been cured anyway, without screening Make informed screening decisions All “guidelines” should be used as a starting point for making health care decisions. Make decisions about breast screening with your physicians. One benefit is that the new guidelines have encouraged women to educate themselves and engage their physicians about their personal risk for breast cancer. One key component of screening is determining if you are at an increased lifetime risk for developing breast cancer. Such “High Risk” women should be more aggressive with breast screening. Seeing a breast surgeon is the best way to determine if you are at an increased risk for breast cancer. Your goal should be to develop a “tailor-made” breast screening approach that fits your unique situation. Patient-Friendly References: www.breastscreeningdecisions.org This website helps women ages 40 – 49 make decisions about when to start and how often to get screening mammograms. This “Mammogram Decision Aid” (here) was developed by Weill Cornell Medical College. www.komen.org This page (here) on “Breast Cancer Screening for Women at Average Risk” is excellent and covers all the guidelines in easy to understand terms. The Susan G. Komen organization is a leading advocacy group dedicated to assisting patients, funding research and ensuring quality breast cancer care. www.jamanetwork.com This JAMA Patient Page on “Breast Cancer Screening in the United States” (here) outlines both major guidelines and is good summary of the current recommendations. The Journal of the American Medical Association is a network of publications from the American Medical Association. www.cancer.gov Their “Breast Cancer Screening (PDQ)-Patient Version” (here) is an easy to read document on the details of breast screening. It does not deal specifically with the new screening guidelines. The National Cancer Institute is a governmental agency that is dedicated to distributing information to the public about cancer and cancer research trials.
Просмотров: 10346 Breast Cancer School for Patients
Breast Cancer Radiation: Radiation Oncology Consultation
 
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Learn why breast cancer radiation lowers your risk of recurrence and how to discuss new technologies with your radiation oncologist. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _________________________________________ What is a radiation oncologist? If you have been diagnosed with breast cancer, there is a good chance you will be offered breast radiation. You will ultimately consult with a radiation oncologist, usually soon after your surgery or possibly after surgery and chemotherapy are both completed. You’ll get better breast cancer care when your radiation oncologist works as a team with your breast surgeon. Many of the recent cutting-edge treatments in breast cancer care are advancements in breast radiation. Radiation oncologists are different from breast radiologists, who interpret mammograms, breast ultrasounds, and MRIs at an imaging center. Radiation oncologists are specially trained cancer doctors that use sophisticated radiation equipment to focus beams of intense radiation to kill cancer cells. Who needs radiation? If you are going to have a lumpectomy to remove your breast cancer, then you will likely need radiation to reduce the chance of cancer growing back in the surgical area. Radiation is occasionally needed after a mastectomy. This is called Post-Mastectomy Radiation Therapy (PMRT). It is usually reserved for more advanced cancers that are larger, have spread to the lymph nodes, or if cancer has recurred in the breast or skin after a prior breast cancer surgery. If you think you might need PMRT, it is essential to see your radiation oncologist before you have mastectomy surgery. He or she will better understand the size, shape, and extent of your breast tumor before it is removed by surgery or has shrunk away with neoadjuvant chemotherapy. What are some cutting-edge advances in breast radiation? New, cutting-edge radiation therapies are designed to achieve excellent outcomes with more focused treatments, fewer side effects, and less personal distress. Even if you qualify for one of these treatments, that does not mean it is the best option for your unique cancer. This is where you and your radiation oncologist work together to decide the best treatment pathway for you. Most of the cutting-edge options discussed at the Breast Cancer School for Patients are appropriate for a few, select breast cancer patients. We teach you how to bring these options into your discussions with your breast specialists. Here are some questions to ask your radiation oncologist about breast cancer radiation. How can I avoid radiation and its side effects? Would I benefit from a shorter course of radiation? Am I a candidate for Brachytherapy or Intraoperative radiation? Is “Prone Breast Radiation” a better option for me? Would a genomic assay help me avoid radiation? Should I see a radiation oncologist before surgery? Ask your breast surgeon or medical oncologist if you should be referred to see a radiation oncologist before surgery or chemotherapy. It is best to see your radiation oncologist before surgery when you have a more advanced cancer such as inflammatory breast cancer or if the cancer has grown into the skin of the breast or the muscles behind the breast. Your care will be more comprehensive in these situations if you visit your radiation oncologist early in your treatment journey. Most patients have early stage cancer and do not need to see their radiation oncologist before surgery. You must engage your radiation oncologist with questions The Breast Cancer School for Patients helps you engage your radiation oncologist in your care. We teach you with short video lessons exactly what will be discussed so you can quickly become an expert in breast cancer treatment. You will be asked to make important treatment decisions quickly. Print our course notes with the key questions to make sure you are offered the best treatment choices. We educate you so you can engage and work as a team with your breast cancer specialists. Get informed before speaking with your doctor. Register for our newsletter and “Cutting-Edge” questions Sign-up for our video-based breast health updates (here). Once registered, we’ll immediately email you our complete list of “Cutting-Edge” questions for your breast surgeon, medical oncologist, and radiation oncologist. We help you get quality breast cancer care in your community.
Просмотров: 236 Breast Cancer School for Patients
Breast Brachytherapy: A Shorter Course of Radiation
 
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We teach you about short-course breast brachytherapy radiation for women who undergo a lumpectomy for early stage breast cancer. This is an option for well-selected patients. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _________________________________ Questions for your Breast Surgeon and Radiation Oncologist: 1. Am I a candidate for brachytherapy after my lumpectomy? 2. If it is an option, would you recommend it for me? 3. Do you offer brachytherapy? 4. What are the outcomes compared to whole breast radiation? 5. What are the side effects and complications of brachytherapy? 6. What is Brachytherapy? Brachytherapy, a type of Accelerated Partial Breast Irradiation (APBI), is a technique of delivering a more focused radiation dose to the area of a lumpectomy over a shorter time period (one week) compared to whole breast radiation (four to six weeks). This one week course of radiation, applied just to the inside edges of the lumpectomy cavity, treats the areas of the breast that has the highest chance of having residual cancer cells. The goal is to reduce the chance of a “local recurrence.” Less than half of early stage breast cancer patients meet the criteria for brachytherapy. Well selected candidates may choose this option. Brachytherapy does require an outpatient procedure to place a “brachytherapy catheter device” into the breast. This device usually has a small catheter that exits the breast and is cared for by the patient for about 7 to 10 days. Who qualifies for brachytherapy radiation? Brachytherapy is an option for patients who undergo a lumpectomy for early stage cancer who have a number of favorable tumor characteristics. These include a small tumor, favorable receptors, no evidence of cancer in the lymph nodes, and generally women 50 years old and older. Ask your surgeon or radiation oncologist if you meet the specific guidelines they follow. Why does radiation reduce “local recurrence” of cancer? Radiation therapy is very effective at killing cancer cells while sparing the normal surrounding tissue. It is generally performed after surgery has removed your breast tumor. If you are going to have a lumpectomy surgery to remove your breast cancer, then you will most likely need radiation to reduce the chance cancer will grow back in the surgical area. Quite simply, radiation reduces the chance of cancer growing back in the area where the tumor was surgically removed or in nearby areas where the cancer is at risk for recurring in the future. When a “local recurrence” of your cancer does occur, it can be a threat to your life. Radiation reduces this risk of local recurrence, and as a result, may increase your chances at a cancer-free future. Is “Whole Breast Radiation” the gold standard? Whole breast radiation involves radiating the entire breast without placing a device inside the breast. It is well tolerated. Most breast radiation is performed with this technique over a 4 to 6-week treatment period. Modern brachytherapy techniques likely will prove to be very similar to whole breast radiation outcomes. Although it is now available in more communities, brachytherapy has its own set of advantages and complications. What are brachytherapy (APBI) treatment expectations? Brachytherapy radiation is performed as an outpatient within a dedicated radiation center. It is very well tolerated. A few facts about brachytherapy or accelerated partial breast irradiation (APBI) are listed below. Expectations during Brachytherapy Each treatment takes about 10 minutes Radiation does not hurt when administered Treatments are twice a day, Monday through Friday for one week The “catheter device” is removed immediately after treatment What are the side effects and toxicities of brachytherapy? The field of radiation has dramatically reduced its side effects over the last decade. CT Scan Radiation Planning has revolutionized the ability to better focus radiation on the area of cancer and avoid damaging adjacent normal tissue. Some side effects and toxicities *Irritated and tender breast and skin *Skin thickening and redness *Infection *Soreness of the breast and ribs *Cosmetic deformity *Rarely, unusual cancers can be caused by breast radiation *Situations some choose brachytherapy? If you cannot visit the radiation center daily for 4 to 6 weeks. Many women do not live close enough to a radiation center to drive daily for 4 to 6 weeks of treatments. Those that live in rural areas may be attracted by a one week series of treatments. Lifestyle, work, and vacation plans can sometimes conflict with dedicating an uninterrupted 4 to 6-week period of daily trips to the radiation center.
Просмотров: 837 Breast Cancer School for Patients
Breast Cancer Intra-Operative Radiation (IORT):
 
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We teach you about intraoperative radiation therapy (IORT) for early stage breast cancer. This one-time dose of accelerated partial breast radiation is an option in some with early stage breast cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________________________________________ Questions for your Breast Surgeon and Radiation Oncologist: 1. Am I a candidate for IORT? 2. Would you recommend I consider IORT? 3. What are the advantages of IORT compared to standard radiation? 4. What are the disadvantages of IORT? 5. What is intraoperative radiation therapy (IORT)? Intraoperative Radiation Therapy is an evolving technique of radiation therapy for women having a lumpectomy for favorable, early stage breast cancer. “Whole Breast Radiation” is still considered the standard of care. IORT is slowly becoming more available at hospitals across the country. It is appropriate for only a small proportion of patients with small breast cancers. Also known as a type of Accelerated Partial Breast Irradiation (APBI), IORT is a technique of delivering a one-time dose of radiation to the lumpectomy area during surgery versus whole breast radiation – a treatment that takes usually four to six weeks. IORT is still an investigational therapy and not yet incorporated into national breast cancer guidelines. When a lumpectomy is performed for breast cancer, radiation is usually recommended to reduce the chance of cancer re-growing in the lumpectomy area of the breast. IORT applies a single dose of radiation to the operative lumpectomy site while under anesthesia in the operating room. Only women who meet the strict criteria for IORT should consider this mode of radiation. What are the general criteria to have IORT? This therapy may be an option for women older than 45, a “favorable” tumor smaller than 2.5 cm, and no evidence of cancer in the lymph nodes. There are other, specific criteria that can exclude eligibility. The decision to consider IORT must be made with your breast surgeon and radiation oncologist before surgery. It takes a great deal of coordination with your surgeon, radiation oncologist, and hospital to be prepared to perform IORT during your lumpectomy surgery. Most hospital facilities currently do not offer this form of breast cancer radiation. What are the Advantages of IORT? The most attractive aspect of IORT is completing a surgical lumpectomy, sentinel node biopsy, and radiation therapy in one day. If successful, you can avoid the 4 to 6 weeks of daily trips to your radiation center to receive whole breast radiation. Another advantage is that IORT applies the radiation to only the site of the surgery, where cancer cells could be unknowingly left behind and grow again in the future. Whole breast radiation is applied to the entire breast and could affect other healthy tissue. As a result, IORT can focus radiation just on the area of the lumpectomy site. Review our lesson on “Brachytherapy” to learn more about shorter course radiation options. What are the disadvantages of IORT? IORT is a new technology, so the long-term success rate for keeping cancer from returning in the breast is still uncertain with this technique. As a result, whole breast radiation is still considered the standard of care to reduce “local recurrence” of cancer in the breast after a lumpectomy. The “Targit-A” and “ELIOT” clinical trials did show statistically higher recurrence rates at 5 years for IORT when compared to whole breast radiation in highly selected patients. The NCCN (see below link) has yet to add IORT to their treatment guidelines. Other studies are in progress to study IORT’s effectiveness. We currently are awaiting studies to see if IORT is effective at 10 years which is the benchmark for success in the field of radiation therapy. Patient-Friendly References: breast360.org An excellent detailed overview of IORT is located (here). This site is created for patients by the American Society of Breast Surgeons. cancer.org This page (here) has a general outline of breast radiation. It mentions IORT briefly as an option. The American Cancer Society is an organization that supports patients with cancer and funds research for cancer of all types. Videos about IORT: zeiss.com This Zeiss Medical Technologies YouTube Video animation (here) describes intraoperative radiation using their Intrabeam IORT system. Carl Zeiss Meditech is a leading medical device company. xoftinc.com Xoft Incorporated has several videos (here) on their website that describe the operative procedure using their “eBx” IORT system. Xoft Inc. is a medical device company that specializes in therapeutic radiation.
Просмотров: 315 Breast Cancer School for Patients
3D Mammograms: Who Needs 3D & Why Get One Every Year
 
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We teach you about the advantages of 3D digital mammograms for women with dense breasts and those at a higher lifetime risk of breast cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ___________________________________ Questions for your Primary Care Physician or Breast Surgeon: 1. Should I have a 3D Mammogram? 2. What are the benefits of 3D mammograms? 3. Do I have significantly Dense Breasts on my prior mammograms? 4. Am I at a High Risk for breast cancer in my lifetime? 5. Is the extra cost covered by my insurance? 6. What is “3D mammography?" “Three-dimensional” (3D) mammograms can image your breasts with better clarity than standard, “two-dimensional” digital mammograms. This new technology, also called “breast tomosynthesis,” will become the standard of care in breast screening in the next few years. 3D imaging is performed just like a normal mammogram, but with an X-ray machine that moves during the imaging. The radiation dose is about the same as a digital mammogram.3D mammograms capture images from more angles and uses computer technology to allow breast radiologists to not only find more cancers, but lessens the chance you will be “called back” for further imaging studies. Women that have 3D mammograms also have a slightly lower chance of undergoing a “benign breast biopsy.” It is a leap forward in breast care and is slowly rolling out to breast imaging centers across the country. Who benefits most from 3D Mammograms? *Women with very Dense Breasts *Younger Women (aged 40 to 49) *Women at “High Risk” for developing breast cancer Why is Breast Density a risk factor for cancer? We have learned over time that women with dense breast tissue have a higher risk of developing breast cancer in their lifetime. Breast density is a term now used to describe how much glandular and supportive tissue appears on a mammogram. Studies estimate that if you have very dense breasts, your lifetime risk is twice and possibly up to four times the risk of others. Dense breasts also make it more difficult for radiologists to see a small breast cancer because these growths can be overshadowed by the dense or “white” appearing tissue on a mammogram. 3D imaging helps address this “double-whammy” of increased risk and decreased ability to find breast cancers. The “Take-Home Message” for those with dense breasts is to begin annual screening mammograms at 40 and ask for 3D mammograms, if available. Why should younger women get 3D mammograms? “Younger women” generally have denser breasts. In most women, breast tissue slowly becomes less dense as one ages. By younger for this discussion, we are referring to women aged 40 to 50 who undergo screening mammograms. More than half of women in this age group have dense breasts. Because it is more difficult to find small cancers in dense breasts by regular mammography, we recommend 3D imaging for all women younger than 50. Why should women at “High Risk” get 3D mammograms? Women at high risk for breast cancer will benefit most from 3D mammography. Some of these “High Risk” factors include: BRCA mutation carriers, a prior breast biopsy that showed “atypical hyperplasia,” a strong family history of breast cancer, or radiation therapy to the chest region before the age of 30. Many of these same women will benefit from “Screening Breast MRI’s” in addition to annual screening mammograms. Does insurance cover 3D mammograms? Federal law mandates that all health insurance pay for “screening” studies such as routine digital mammography. 3D imaging is considered an additional study by many insurance companies and may not be covered. We expect more commercial insurance companies will cover the 3D part of screening mammograms in the future. Medicare and Medicaid do not currently cover the additional charge for 3D imaging. Some breast imaging centers do offer 3D imaging at no extra charge. It is worth asking about coverage and out-of-pocket costs when you schedule a mammogram. Should I pay cash for a 3D mammogram? Your breast imaging facility may ask you at the time of your mammogram if you are willing to pay for the “3D mammogram add-on charge.” This charge ranges between $25 and $50. Sometimes that question may seem unexpected when you are undressed in the exam room or undergoing imaging. Inquire about the availability of 3D imaging when you arrive and ask what charges you might encounter. You will then have time to make an informed decision.
Просмотров: 3795 Breast Cancer School for Patients
What is Breast Radiation? We Teach You Everything
 
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We teach you about radiation for breast cancer. Learn about the types of breast radiation and how radiation reduces the risk of cancer “local recurrence.” VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________________ Questions for your Radiation Oncologist and Breast Surgeon: 1. What are the risks and benefits of radiation? 2. What different radiation options do I have? 3. Can you explain what I should expect during and after radiation? 4. What are the long-term side effects? 5. How can I avoid radiation altogether? What is Breast Radiation? What is a “Local Recurrence?” Radiation therapy is very effective at killing cancer cells while sparing the normal surrounding tissue. This is only one component of a comprehensive treatment plan. Breast radiation is generally performed after your tumor has been surgically removed. If you are going to have a lumpectomy surgery to remove your breast cancer, then you will most likely need radiation to reduce the chance cancer will grow back in the surgical area. Quite simply, radiation reduces the risk of “local recurrence” in the area where the tumor was surgically removed or in nearby areas where the cancer is at risk for recurring in the future. When a “local recurrence” of your cancer does occur, it is a threat to your life. When indicated, radiation reduces this risk of local recurrence, and as a result, may increase your chance of surviving breast cancer. Is “Whole Breast Radiation” the standard of care? Breast radiation is most commonly offered to women who undergo a breast conserving lumpectomy for early stage breast cancer. “Whole Breast Radiation” is the most utilized and researched form of radiation after a lumpectomy and is generally considered the “standard of care.” For many women older than 50 with favorable early stage cancer, a cutting-edge, “shorter course” of whole breast radiation can be administered over 4 weeks rather than 6 weeks. We outline below some other techniques of delivering radiation for breast cancer. General Radiation Treatment Expectations: Breast radiation is usually performed as an outpatient procedure within a dedicated radiation center. Depending on the patient and the course of treatment, it is generally well tolerated. A few facts about radiation therapy are listed below. Expectations during whole breast radiation The actual treatment takes about 15 minutes (although you will be at the appointment a little bit longer than that to change clothes before and after your treatment) Radiation does not hurt when administered Treatments are daily, Monday through Friday for about 4 to 6 weeks You can work while undergoing radiation treatment Truths about Radiation: Breast radiation does not make you feel ill There is no hair loss with radiation to the breast You will not become “radioactive” from treatment Side Effects of Radiation Therapy: Your breast and skin can become irritated and tender Some constricting or shrinkage of the treated breast and surrounding tissue may occur Breast reconstruction and implants can be affected General fatigue is common Your breast and ribs can be sore for an extended period of time You cannot have radiation if you are pregnant There is a small risk of increasing coronary heart disease There are very rare cancers that can be caused by breast radiation Other types of breast radiation: Breast Brachytherapy This shorter course (1 week) of radiation is applied directly to the area of surgery using devices made for this purpose. The results are promising for women over 50 years old with favorable tumors that undergo a lumpectomy. Not everyone is a candidate for brachytherapy. Review our video lesson on “Breast Brachytherapy“ to learn more. Intra-Operative Radiation Therapy Intra-Operative Radiation Therapy (IORT) is an evolving form of radiation therapy available at some hospitals. It is currently appropriate for only a small proportion of patients with early stage breast cancer. The benefit is that the radiation is administered and completed during the lumpectomy surgery in the operating room. Post-Mastectomy Radiation Therapy Post-mastectomy radiation therapy is the term for applying radiation to the area of the mastectomy and lymph nodes, usually performed about 4 weeks after surgery. It is generally recommended for those who are at a high risk to have a local recurrence of their cancer. Palliative Radiation Therapy Palliative radiation is used to treat the symptoms of cancer growing in the breast or within other parts of the body. An example is someone who has severe back pain and leg weakness from breast cancer in their spine. Palliative radiation to the spine can help alleviate these symptoms.
Просмотров: 171 Breast Cancer School for Patients
Treatment Timeline for Breast Cancer: The Steps Ahead
 
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We teach you about the steps needed to diagnose and effectively treat your breast cancer. Know what comes next in your breast cancer journey. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________________________ You have plenty of time to make decisions Making good decisions is the most difficult part of having breast cancer. You will feel pressed for time to learn everything and start your treatment as soon as possible. Time is usually on your side. You must work with your team to learn everything about your cancer and treatment options. We created the Breast Cancer School for Patients to quickly teach you to be your own expert in breast cancer. You will make better decisions once you become your own “expert” and best advocate. A few facts about time to treatment: The average time from the date of cancer diagnosis to the day of lumpectomy surgery is about 32 days. The average time to mastectomy surgery is about 40 days. It can take anywhere from 3 to 12 months from cancer diagnosis to complete your final treatments, and up to ten years if you need hormonal therapy. It is a marathon. Conserve your emotional and physical efforts for the challenges ahead. Finding your breast cancer (1 – 3 weeks) Most small breast cancers are found on screening mammography and possibly by ultrasound or maybe a breast MRI. You may have detected your own breast lump and sought further help from your physician. The time to schedule a mammogram, have it performed, return for further breast imaging and then get the results can take days to weeks. Always ask to have your tests and appointments scheduled as soon as possible. Getting a diagnosis: biopsy & results (2 – 14 days) Getting scheduled to have an image-guided breast biopsy by a breast surgeon or radiologist can vary. Most NAPBC accredited Breast Centers work quickly to schedule biopsies for those who might have a breast cancer. Our “Minimally Invasive Breast Biopsy“ lesson (here) outlines why needle biopsies are the standard of care. Make sure to ask (demand) that the physician who does your biopsy personally calls you with the results within a day or two. Call for your biopsy pathology results if you think there is a delay. My pathology report: (3 – 14 days) Ask for a copy of your initial biopsy report that will be available in 2-3 days. Ask for a copy of your final pathology report with your receptor results. Our courses on “My Pathology Report” and “My Receptors” offer more details. Surgery or chemotherapy first? Surgery is usually the first treatment for early stage breast cancer. Most patients will not need chemotherapy. If you have Estrogen receptor negative (ER-) or a “HER2-Positive“ tumor, then you will likely need chemotherapy either before or after surgery. There are distinct benefits to “Neoadjuvant Chemotherapy” before surgery. Take our video lessons linked to these topics. Is radiation needed? (4 – 6 weeks) Most patients that have a lumpectomy will need radiation. Whole breast radiation is the most common type and takes 4 to 6 weeks. Only a few patients that have a mastectomy will also need radiation. Patient-Friendly References: NCCN Guidelines for Patients www.nccn.org You will find well-organized guides (here) on breast cancer treatment by stage. Follow the prompts to breast cancer and then “stage” in the dropdown menus. The National Comprehensive Cancer Network is a consortium of organizations and governmental agencies to promote quality
Просмотров: 726 Breast Cancer School for Patients
What Exactly is Breast Cancer? We Teach You Everything
 
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We teach you about breast cancer and your chance of developing it. We outline when to begin screening mammograms and how to reduce your risk for developing cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _______________________________ Questions for your physicians: 1. What is my chance of getting breast cancer? 2. What is invasive breast cancer? 3. What are my risk factors for breast cancer? 4. When should I start getting screening mammograms? What does “Breast Cancer” mean? Invasive breast cancer is defined by breast cells that grow abnormally fast and may develop the ability to spread beyond the breast to other parts of the body. It can take years for breast cells to slowly develop the genetic changes (mutations) to change from a normal cell to an invasive cancer cell. Invasive breast cancer can threaten your life. Learn more with our video lesson on “Invasive Breast Cancer“ (here). Non-invasive breast cancer are cells that also grow abnormally fast, but cannot yet spread beyond the breast to threaten someone’s life. Ductal Carcinoma In-Situ (DCIS) is an example of the most common type of non-invasive breast cancer. Take our video lesson (here) to learn more about “DCIS.” Important facts about Breast Cancer: Almost 10% of women will develop breast cancer in their lifetime Treatments can cure 90% of women with breast cancer Surgery, hormonal therapy, and chemotherapy are treatment options Genetic testing and genomic assays are commonly used today What’s the chance I will develop breast cancer? About one in ten women will develop breast cancer in their lifetime. One in one thousand men will develop male breast cancer. There are many “risk factors” that increase the chance someone will be diagnosed with breast cancer. Some of these “high risk” factors include inherited genetic factors, dense breasts, never having children, or a strong family history of breast cancer. How is breast cancer treated? The most common first treatment for early stage breast cancer is surgery, possibly followed by chemotherapy, radiation therapy, and then hormonal therapy. Breast cancer treatment is incredibly complex and there can be many different approaches to the same type of breast cancer. There are some situations that are better treated by “neoadjuvant chemotherapy” as a first treatment rather than surgery. The Breast Cancer School for Patients was created to educate you to make the best treatment decisions with your breast specialists. How do I reduce my risk of getting breast cancer? Two hours a week of regular exercise has been shown to significantly reduce the lifetime risk of developing breast cancer. Other risk reduction activities include avoiding obesity, breastfeeding your children, and limiting alcohol or tobacco use. When should I start getting screening mammograms? Beginning annual screening mammography at 40 years old is likely the safest approach. Over the past few years, multiple organizations are slowly revising their mammography screening guidelines to start at 45 or 50 years of age. But this is an ongoing debate that will take years for the medical community and patient advocacy organizations to come to a consensus as to the correct age to start screening and how frequently to get mammograms. Our video lesson (here) on “When Do I Start Mammograms?“ which covers this controversial topic in detail. Patient-Friendly References: komen.org This page (here) on “What is Breast Cancer” is excellent. The Susan G. Komen organization is a leading advocacy group dedicated to assisting patients, funding research, and ensuring quality breast cancer care. www.cancer.org An outline of “What is Breast Cancer” is located (here). The American Cancer Society is an organization that supports patients with cancer and funds research for cancer of all types. www.cancer.net This simple, two page summary “ASCO Answers: Breast Cancer” is located (here). The American Society of Clinical Oncologists is a leading organization of clinicians who care for people living with cancer. More Detailed References: NCCN Guidelines for Patients This is a detailed outline of treatment options for women with breast cancer written specifically for patients. Choose the brochure that best reflects your own unique situation. The NCCN is a consortium of organizations and governmental agencies to promote quality breast cancer care. NCCN Breast Cancer Clinical Practice Guidelines nccn.org If you want to get deep into the details, this free 200-page pdf document has guidelines to help clinicians to make treatment recommendations about nearly all aspects of breast cancer. You can easily register (here) as a non-professional to get access.
Просмотров: 300 Breast Cancer School for Patients
Breast Cancer Medical Oncology: Your Consultation
 
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We teach what you will cover with your breast cancer medical oncologist. Learn about chemotherapy, hormonal therapy, and cutting-edge treatment options. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________________ What is a medical oncologist? Your medical oncologist is a critical member of your breast cancer team. By the time you meet with an oncologist, you most likely have seen a breast surgeon and may have had your tumor removed by surgery. The goal with your medical oncologist is to work together to tailor a treatment plan with medications (hormonal medications, chemotherapy, and immunotherapy) that specifically targets your unique breast cancer and prevents it from ever coming back. Your medical oncologist will be with you for as long as 10 years, so it’s critical to find a medical oncologist you can trust. What can you learn from your medical oncologist? A medical oncologist can add to the knowledge you have already gained from your breast surgeon and online research. He or she should teach you about the “biology” of your unique tumor and the best treatment options for you and your cancer. Understanding this information is critical for you to be able to make the best treatment decisions. The Breast Cancer School for Patients helps with your medical oncology consultation in a unique way. We have completed the difficult task of organizing the vast field of breast cancer into one, patient-friendly site. We teach you to be a breast cancer “expert” and give you the key questions to ask your medical oncologist to make sure you get cutting-edge cancer care in your community. Do you work with a “Multidisciplinary Team?” Ask your medical oncologist if he or she regularly participates in a breast cancer multidisciplinary team. These breast cancer teams are usually associated with breast centers accredited by the National Accreditation Program for Breast Centers (NAPBC). The most sophisticated breast cancer treatment originates from a detailed discussion of your breast cancer situation with many specialists. These brainstorming sessions specifically about you can improve your treatment options and outcome. Can cutting-edge advances in oncology be lifesaving? The greatest lifesaving advances in breast cancer care are in the field of medical oncology. The overarching goal of cutting-edge research is to improve outcomes and lessen side effects of treating cancer. You must learn about these advances and specifically ask your medical oncologist if they are appropriate for your breast cancer situation. Our short video lessons at the Breast Cancer School for Patients www.breastcancercourse.org will teach you how to bring these options into your discussions with your medical oncologist. Take our lessons that cover topics like: Would a genomic assay help determine if I need or can avoid chemotherapy? What are the new drugs to treat “HER2 Positive” breast cancers? Do I qualify for BRCA genetic testing? Would I benefit from a clinical trial? Engage your medical oncologist with questions The Breast Cancer School for Patients helps you engage your medical oncologist. We teach you with short video lessons exactly what will be discussed so you can quickly become an expert in breast cancer treatment. You will be asked to make important treatment decisions quickly. Print out our course notes with the key questions to make sure you are offered the best treatment choices. We educate you so you can engage and work as a team with your breast cancer specialists. Get informed before speaking with your breast cancer medical oncologist. Register for our newsletter and “Cutting-Edge” questions Sign-up for our breast health newsletter at www.breastcancercourse.org. Once registered, we’ll immediately email you our complete list of “cutting-edge” questions to engage your breast surgeon, medical oncologist, and radiation oncologist. We help you get quality breast cancer care in your community.
Просмотров: 455 Breast Cancer School for Patients
Cutting Edge Advances in Breast Cancer Treatment:
 
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New Breast Cancer advances and technologies that may apply to your unique breast cancer situation. We teach you about everything new. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _________________________________ Why are cutting-edge advances important? Advanced, cutting-edge tests and treatments are often overlooked when treating complex problems such as breast cancer. This can impact your care and survival. When combined with traditional methods, cutting-edge treatments can improve outcomes, reduce treatment side effects, and speed up your recovery. When you don’t know what you are missing, you could lose the possible benefits of these new advances and treatment options. How do I get these advances in my community? When you understand the treatment options available in your community, you and your breast cancer specialists will develop a treatment plan that is best for you. You must quickly learn about cutting-edge options to make sure they are incorporated into your treatment decisions. Not all communities have access to all advanced treatments. Make sure to ask your physicians about cutting-edge topics to make sure all options are considered for your cancer care. When you are educated about treatment advances up front you will be able to make sure nothing was overlooked with your breast cancer team. Finding these cutting-edge advances online has been very difficult, until now. What is the solution? The Breast Cancer School for Patients (www.breastcancercourse.org) has organized the complex world of breast cancer into the key cancer topics and treatment choices you will face. Our free, online school has short video lessons about each cutting-edge technology, and provides you lesson notes and the questions to ask your doctors so you don’t miss out. Use our doctor selected links and references that will lead you to the best online resources. Our innovative approach easily teaches you to make better treatment decisions. What are some examples of cutting-edge technologies? Breast MRI Axillary Ultrasound of your lymph nodes BRCA genetic testing Oncoplastic surgical techniques Genomic breast cancer assays Neoadjuvant chemotherapy Intra-operative and brachytherapy radiation New technologies are rapidly emerging. We keep up with the advances in breast cancer, so you don’t have to. Engage your breast specialists with questions Print out our lesson notes with the key questions to make sure you are offered the best treatment choices. We educate you so you can engage and work as a team with your breast cancer specialists. You will make better decisions when you go into your doctor consultations already knowing the essentials and able to speak their language. This is the first “School for Breast Cancer Patients” The Breast Cancer School for Patients teaches you to be an expert and your own best advocate. Our “Patient-Driven Quality” movement is about empowering you to be at the center of all discussions and treatment decisions. Get informed before speaking with your doctors. Register for our latest videos & “Cutting Edge” questions Sign-up for our breast health updates and latest videos at www.breastcancercourse.org. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions to engage your breast surgeon, medical oncologist and radiation oncologist. We help you get quality breast cancer care in your community.
Просмотров: 111 Breast Cancer School for Patients
Patient Driven Quality Breast Cancer Care: Be Educated
 
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Patient-Driven Quality breast cancer care means making sure every option is offered. Become an important part of your “treatment team.” VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________________ Become a breast cancer “expert” Breast cancer care is complicated, but advancing by leaps and bounds every day. This is the high-quality care you hear about on TV and read about online. But unfortunately, there can be barriers between you and quality care in your own medical community. Our innovative Breast Cancer School for Patients was created to begin a “Patient-Driven Quality Movement” in breast cancer care. When you are educated, at diagnosis, by breast specialists, you will know about the key topics and recent advances in breast cancer care. Only then can you make sure you are getting the highest quality care. What is “quality” breast cancer care? Quality breast cancer care simply means achieving the best possible outcomes while minimizing the toxicities of surgery, chemotherapy, and radiation therapy. Your goal is to get only the specific treatments you need to get the best outcome while avoiding over-treatment. Cutting edge advances are an important part of getting the very best breast cancer care. For example, it is quite common for patients to not be offered genetic testing and genomic assays that could have helped their cancer care. Quality care requires dedicated breast physicians, access to cutting edge technologies and an informed patient working with their breast cancer team. Why patients must seek quality cancer care? The best breast cancer care requires a close, long-term relationship with your physicians. Asking great questions about your care engages your doctors in who you are and what your needs are. This is be the best way to work together to make the best breast cancer treatment decisions. Patient-Driven Quality Breast Cancer Care should begin with you learning exactly what you need to know and the questions to engage your breast cancer team. Despite our best efforts, the medical community sometimes doesn’t do enough to guide patients about how to get the very best breast cancer care. The Breast Cancer School for Patients was created to fill this patient information gap and specifically teach you to be your own expert in breast cancer. We encourage other organizations and institutions to do the same. What barriers exist to quality cancer care? Traditionally, breast cancer treatment is a physician-to-patient flow of information and physician directed decision making. One barrier that exists is that new advances in imaging, genetics, genomics, and treatments can take years to filter to and be implemented by breast cancer physicians. Another barrier is that your physicians are human. They can have a bad day where they are pressed for time, running late seeing patients, or distracted by emergencies in the hospital. This can lead your breast specialists to forget to ask you important questions or order a test that could have helped with your care. This is why patient-driven care can make sure everything is on the table when you make key treatment decisions for your breast cancer. You should know exactly what is going on and what questions to ask. The Breast Cancer School for Patients feels it should be our job as breast cancer specialists to teach you to be your own advocate. What is the solution? The Breast Cancer School for Patients (www.breastcancercourse.org) has organized the important topics and treatment choices you will face. We give you short video lessons about each cancer treatment topic, and provide you the essential course notes and questions to ask your doctors in their language. We also give you doctor selected links and references that lead you to the best websites. Our innovative approach easily teaches you to make the best treatment decisions. Learn as little or as much as you desire about any breast cancer subject on our educational website. Register for our newsletter & “Cutting Edge” questions Sign-up for our breast health newsletter at www.breastcancercourse.org. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions to engage your breast surgeon, medical oncologist and radiation oncologist. We help you get quality breast cancer care in your community.
Просмотров: 81 Breast Cancer School for Patients
Oncoplastic Breast Cancer Surgery: Would I Benefit?
 
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We teach you about oncoplastic surgical techniques. The goal is to achieve better cancer and cosmetic outcomes in those that require a lumpectomy for breast cancer. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________________ Questions for your Breast Cancer Surgeon: 1. Do you use “Oncoplastic techniques” for better cosmetic outcomes? 2. What can we do to avoid a deformity or asymmetry of my breasts after a lumpectomy and radiation? 3. Will you try to make my breasts look better after my cancer surgery than they do now? 4. Do you use “Oncoplastic” techniques? This question begins an important conversation with your surgeon. Good cosmetic outcomes with lumpectomy and breast conserving surgery are difficult to achieve in some patients. Oncoplastic surgery integrates breast cancer and plastic surgical techniques. The goal is to achieve better cancer and cosmetic outcomes in patients that require a lumpectomy. Talk to your breast surgeon about their expectation for your breast shape and symmetry after a lumpectomy and radiation therapy. If they have taken the time to learn oncoplastic surgical techniques, they will be keenly interested in the best cosmetic outcome possible. You must understand your expected cosmetic outcome as well as cancer outcome in order to make informed decisions regarding your breast cancer surgical options. What does “Oncoplastic” mean? This term was coined to describe combining breast cancer (“onco-”) surgery with plastic (“-plastic”) surgical techniques to achieve better cancer and cosmetic outcomes. The field was pioneered and promoted in the United States by breast surgeon Dr. Melvin Silverstein at Hoag Breast Center in California. He has promoted these techniques to other surgeons nationwide to achieve better cosmetic outcomes for breast cancer patients. These methods are not universally utilized or taught to all surgeons during their surgical training. More and more breast surgery fellowships and general surgery residencies are teaching oncoplastic surgery to newly trained surgeons. Do I need an “Oncoplastic” breast surgeon? No. Less than 20% of breast surgeons utilize oncoplastic techniques. This approach generally applies to less than 50% of patients who are candidates for a lumpectomy. You can still achieve a good cancer and cosmetic outcome in most instances with a good breast surgeon. What can we do to avoid breast asymmetry? Excellent breast cancer surgeons learn to anticipate and try to avoid permanent cosmetic lumpectomy defects. Unfortunately, what is often left out of the surgical discussion is the fact that removing a portion of the breast can result in a significant size difference and can sometimes distort the shape of the breast. It is important to ask your surgeon how much change in appearance of your breast will result from your planned lumpectomy and subsequent radiation therapy. The change in some can be significant and possibly disappointing once everything heals from lumpectomy surgery and breast radiation. Up to 20-30% of patients are dissatisfied with the appearance of their breast after treatment. Our suggestion is to ask your surgeon what can be done at the time of your lumpectomy to avoid asymmetry or a deformity when everything heals after your surgery and radiation are completed. Can we make my breasts look better than they do now? Most newly diagnosed women do not prioritize achieving a great cosmetic outcome in their initial discussions with their surgeon. There are opportunities that can offer options to achieve better cosmetic outcomes than they had before cancer surgery. For example, some women with very large breasts have always desired a breast reduction for a better appearance and to lessen discomfort. These patients may be able to undergo a formal breast reduction or a smaller breast lift on both breasts at the time of their breast cancer lumpectomy. Such oncoplastic procedures are generally covered by insurance as a part of your cancer care. Patient Friendly References: breast360.org Their page (here) on “Oncoplastic Surgery” is a nice overview. This site is created for patients by the American Society of Breast Surgeons. oncoplasticmd.com This YouTube video (here) is an excellent overview of the principles of oncoplastic surgery. The School of Oncoplasitc Surgery provides education and courses for breast surgeons to learn oncoplastic techniques. wsj.com This Wall Street Journal article (here) “New Surgery Eases the Toll of Breast Cancer” is an excellent overview of oncoplastic surgical techniques.
Просмотров: 184 Breast Cancer School for Patients
Quality Breast Cancer Care: Learn How to Find the Best
 
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Quality breast cancer care simply means achieving the best possible cancer outcomes while minimizing the toxicities of surgery, chemotherapy, and radiation therapy. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _______________________________________ Questions for your Breast Cancer Specialists: 1. Will you present my cancer case to a Breast Center team? 2. How do your quality statistics compare to benchmark standards? 3. Would you share with me your quality statistics? 4. What does quality breast cancer care mean? Quality breast cancer care simply means achieving the best possible cancer outcomes while minimizing the toxicities of surgery, chemotherapy, and radiation therapy. Your goal is to only undergo the treatments you need to get the best outcome. Some of these approaches can be measured. They are called “quality measures.” Quality care is difficult to achieve. Newer technologies must be blended with standard-of-care treatments to achieve the best results. Breast cancer care requires a team of specialists dedicated to searching for the best treatment approach for you. You can make yourself a part of that team by engaging your physicians at every appointment. Part of receiving the best care may involve a long-term, close “human relationship” with your physicians. Asking questions about your care will help to engage your physician about your needs and desires. This route may lead to you ultimately receiving the best care possible. At the Breast Cancer School for Patients, we feel it is our duty as breast cancer specialists to teach you how to ask for the best quality care. We are convinced that a well-informed patient who asks “targeted questions” will get better care. Why are quality statistics important? “Health Care Quality” is a movement to improve quality and value to all aspects of healthcare and cancer care. Collecting statistics about specific aspects of cancer treatment is an essential part of improving outcomes nationwide. There are now “benchmark” statistics for surgical procedures, chemotherapy, and radiation therapy. For example, these can include measuring successful outcomes or rates of specific complications. Quality statistics are just a small, but important part of quality breast cancer care. Inquire with your physicians about their own quality measures. Quality care and cutting edge advances? Cutting edge technologies are an important part of modern breast cancer care. Quality care is still mostly dependent upon standard treatments. Seek out the best breast cancer specialists in your area. They likely already embrace cutting edge advances in care. Examples of quality measures National Accreditation Program for Breast Centers (NAPBC) A few NAPBC quality measures include: the percentage of breast cancers diagnosed with needle biopsies (best approach) rather than surgical biopsies, success in placing patients in clinical trials, and adherence to breast cancer staging guidelines. Breast Surgeon quality measures include: rates of infection after surgery, offering breast reconstruction when a mastectomy is performed, and the frequency of re-operations after a lumpectomy surgery to assure clear margins. Medical Oncologist quality measures include: hospitalization rates for complications of chemotherapy, success of administering all the recommended doses of chemotherapy, assurance that patients take their hormonal medications. Radiation Oncologist quality measures include: rates of completion of recommended radiation treatment courses, skin and lymphedema rates, and rate of recurrence of cancer in the area treated by radiation. How do I get quality care? Seek breast cancer specialists who participate in an NAPBC accredited breast center. To achieve this designation, the team of breast specialists must review and report their own quality statistics and cancer outcomes. You should be reassured when your breast surgeon, medical oncologist, or radiation oncologist shares with you an interest and commitment to benchmark quality standards. The best scenario is when your individual physicians or NAPBC accredited breast center share with you their own quality outcome statistics. When someone takes the time to collect their own statistics, you can be assured they are deeply interested in quality breast cancer care. Register for our newsletter & “Cutting Edge” questions Sign-up for our “Breast Health Updates & Latest Videos“ (here). Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions to engage your breast surgeon, medical oncologist and radiation oncologist. We help you to get quality breast cancer care in your community.
Просмотров: 34 Breast Cancer School for Patients
Breast Cancer Surgery: Start with your Breast Surgeon
 
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Learn the key breast cancer topics you will cover with your breast surgeon. Learn about breast cancer surgery and cutting-edge care. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _____________________________ Your breast surgeon guides your cancer care. This consultation is the start of your breast cancer treatment journey. Your breast surgeon sets the initial direction your cancer care. It is essential to be well prepared for this meeting. The issues discussed should be more about your overall cancer care rather than about a surgical procedure. You must be engaged with the key topics outlined in our “Breast Surgery Course.” We created the Breast Cancer School for Patients to prepare you to ask for the very best breast cancer care in your community. Learn everything about your breast cancer. Your breast surgeon is the first person to teach you about your unique breast cancer. You should ask about the threat to your life (usually less than you think) and the treatment options ahead. When you are well informed, you will make better treatment decisions with your breast cancer specialists. Your breast surgeon is your initial source for this information. Watch our video lessons and read the attached information to learn what you need to know about your breast cancer. Use our “Questions” in each lesson to engage your breast cancer specialists in their language to get the information you need to know. Discuss your surgical options. Breast surgeons have a broad knowledge base about chemotherapy, hormonal therapy, and radiation therapy. They will formulate the initial direction of your cancer treatment plan. Breast cancer surgery is just one component of the comprehensive treatment plan they will design for you. Surgery is usually the first treatment step in early stage breast cancer. You will discuss the surgical options that are appropriate for your situation. The decision to have a “lumpectomy” or a “mastectomy” requires input from your breast surgeon and a discussion about your personal desires. Make sure you have all the information you need to make a decision. You have time to think about your options and can return to discuss them again with your breast surgeon when needed. Sometimes chemotherapy is the best first step in treating a breast cancer. In this situation, you will have months to contemplate your surgical options while undergoing chemotherapy before surgery. In general, time is usually on your side in making surgical decisions. Does your surgeon work with a “Multidisciplinary Team?” Ask your breast surgeon if he or she works with an accredited breast center team. If your breast surgeon presents your cancer situation to a team of physicians at a “Multidisciplinary Breast Conference” you may benefit from new ideas and cutting-edge treatment advances. Some patients have very complicated cancer situations that require this “team approach” to determine a tailored, personalized solution. These brainstorming sessions focusing on you can expand your treatment options and improve your outcome. Many smaller and rural communities do not yet have breast centers, but you can still receive excellent care if there is not one near your home. If there is a breast center in your community and your breast surgeon does not participate, it is important to ask them, “Why do you not participate?” Breast cancer physicians that work as a team may offer you distinct benefits. What “cutting edge” treatment options should I ask about? Recent advancements in breast cancer care are sometimes overlooked. The overarching goal of cutting edge research is to improve outcomes and lessen side effects of treating cancer. You must learn about these advances and specifically ask your breast surgeon if they are appropriate for your breast cancer situation. Our short video lessons in this “Breast Surgery Course” will teach you how to bring these options into your discussions. Take our lessons on: Breast MRI Axillary ultrasound Neoadjuvant chemotherapy Oncoplastic surgery Genetic and Genomic testing Brachytherapy radiation There are many options that can improve outcomes. Ask your doctor if you qualify for any of these advances. By doing so, you and your breast surgeon will develop a treatment plan that’s best for you. Register for our newsletter and “Cutting-Edge” questions Sign-up for our video-based breast health updates. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions for your breast surgeon, medical oncologist, and radiation oncologist. We help you get quality breast cancer care in your community.
Просмотров: 358 Breast Cancer School for Patients
Breast Cancer Clinical Trials: Should I Participate?
 
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FWe teach you how to locate clinical trials for breast cancer. Participating in clinical trial research can help you and others get better breast cancer care in the future. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________ Questions for your Breast Cancer Physicians: 1. Do you participate in clinical trials for breast cancer? 2. Would a clinical trial offer me new treatment options? 3. What are the risks of participating in a clinical trial? 4. Where is the closest institution that participates in clinical trials? 5. What is a clinical trial? Any new cancer drug, device, or treatment needs to be studied to make sure it is safe and effective. Every breast cancer drug, such as tamoxifen or chemotherapy, must complete the clinical trial process before being approved by the Food and Drug Administration (FDA) for cancer treatment. New devices for surgery and radiation also go through this complex process. Less than 5% of all patients with cancer are enrolled in clinical trials. Patients with cancer willing to participate in clinical trials are essential for the advancement of cancer care. All treatment options available for patients today are based on the generous participation of others in breast cancer clinical trials. Who may benefit from participating? Newer treatment advances may be available only through clinical trials. Many of these new therapies will not prove to be better than current treatments, but some will. Participating in a clinical trial may give you the opportunity to benefit from these new therapies. Patients who have more advanced stage cancer (inflammatory breast cancer or stage III and IV cancers) usually have more clinical trial options. These cancers are the most worrisome and threatening. Many new treatments are first studied with those who have advanced cancer. It is worth inquiring with your breast specialists about clinical trials if you have advanced stage cancer. Another active area of research involves “triple negative” and “HER2-positive” breast cancer. Many clinical trials are trying to find better therapies for these more aggressive cancers. Clinical trials are also available for early stage breast cancer. The majority women diagnosed with breast cancer have Stage I or II disease. These early stage trials involve surgical techniques, chemotherapy, hormonal therapy, immunotherapy, and radiation therapy. Sharing your time to advance breast cancer care can be a rewarding experience during a difficult time. What are the possible risks of participating? Clinical trials require a personal commitment of time and effort during a stressful time. Before participating, make sure you have the personal and emotional resources for your own breast cancer treatment journey. “Adverse Events” with new treatments can result in harm. Although there is risk with any cancer treatment, the risks with new treatments are not as well known. Some seek clinical trials for their unique cancer situation. Others are asked to participate in clinical trials by their physicians. Make sure you are willing and able to participate if you are asked. You can always say “No” to participating. Make sure you do not feel pressured into entering a clinical trial by your breast cancer team. Patient-Friendly References: lbbc.org This excellent brochure (here) “Guide to Understanding Breast Cancer Treatment Research Studies” is a good overview. Living Beyond Breast Cancer is a non-profit organization dedicated to providing quality information about breast cancer to patients. cancer.net This online resource (here) “Clinical Trials” is a comprehensive database to research clinical trials in breast cancer. The American Society of Clinical Oncology is a leading organization of physicians that care for those with cancer. breastcancertrials.org This resource can introduce you to breast cancer clinical trials across the country. It has an online, personalized matching tool that can help find a clinical trial for your unique cancer situation. More Detailed References: fda.gov There are excellent resources (here) “FDA Drug Approval Process Infographic” from the Food and Drug Administration. cancer.net This detailed site (here) outlines information in video and text format about clinical trials and how to find clinical trials in cancer. The American Society of Clinical Oncologists is a leading organization of clinicians who care for people living with cancer.
Просмотров: 59 Breast Cancer School for Patients
Questions to Ask Your "Breast Cancer Specialists"
 
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Get our complete list of “Doctor Questions” to engage your breast cancer physicians. Register and we'll also share with you our latest breast health updates and videos. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ _______________________________________ Register (below) for our “Cutting Edge” questions & Latest Videos Sign-up for our video-based breast health updates. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions for your breast surgeon, medical oncologist and radiation oncologist. Why register? What’s in it for me? If you find the information in our website www.breastcancercourse.org helpful, then you will enjoy getting our latest video updates on new topics we cover about breast health and breast cancer in the future. The Breast Cancer School for Patients is continually adding content to our educational website. We share these new topics with our “registered” users immediately upon release. What’s in our “Complete Doctor Question Lists?” Each lesson on our website already has 4 – 5 questions to ask your breast specialists about a particular topic. Our “Complete List” is a more comprehensive list of questions, many not covered on the Breast Cancer School for Patients website. This way you can research other topics in more detail. Be well informed before visiting with your breast specialists. Four Separate Lists of Questions: 1. Questions for your Breast Surgeon 2. Questions for your Medical Oncologist 3. Questions for your Radiation Oncologist 4. Cutting Edge advances in Breast Health & Breast Cancer Each list is organized for the different breast cancer specialists that you will likely encounter. We also add a separate list of “Cutting Edge” questions that pull together many of the new advances in breast cancer care you will want to know about. Share our School If you find our information helpful, please spread the news to others. Our goal is to educate women how to become “experts” in their own breast care. Every time you share our website or YouTube videos, it helps share our innovative educational platform with others. Help us help others! Our privacy policy No personal information provided to the Breast Cancer School for Patients will be shared with any other person, business or governmental agency.
Просмотров: 69 Breast Cancer School for Patients
Contact Us: The Breast Cancer School for Patients
 
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Share your thoughts with "The Breast Cancer School for Patients" about our educational website. We welcome your suggestions. Unfortunately, we cannot answer personal health questions. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ __________________________________ Email Address: contact@breastcancercourse.org Mailing Address: Breast Cancer School for Patients P.O. Box 1032 Gainesville, Virginia 20156 USA We want your feedback! Please share with us your honest thoughts about the Breast Cancer School for Patients. Only with your input can we continually improve this educational outreach. We work hard to make this the most innovative breast cancer educational platform on the internet. Your testimonials about how our website has helped you or a friend or family member are welcome. Suggestions are welcome! When you take the time to make suggestions to improve the Breast Cancer School for Patients, we take them seriously. We will continuously add new topics about breast cancer and breast health going forward. Your suggestions will improve our existing website and make our new content more powerful. We cannot comment on personal health questions All questions about your health should be directed to your personal physicians. The Breast Cancer School for Patients is not a clinical entity that treats patients. We are an educational website. Please review our “Medicolegal Disclaimer” lesson which outlines the limitations of our outreach in great detail. Register for our newsletter & “Cutting Edge” questions Sign-up for our breast health newsletter. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions to engage your breast surgeon, medical oncologist and radiation oncologist. We help you get quality breast cancer care in your community. Share us on Facebook and YouTube “Friend” us on Facebook and share our posts with others. If you find our information helpful, please spread the news to others. Our goal is to educate women how to become “experts” in their own breast care. Every time you share our Facebook posts or new YouTube videos, it assists us in sharing our innovative educational platform with others. Our privacy policy No personal information provided to the Breast Cancer School for Patients will be shared with any other person, business or governmental agency.
Просмотров: 17 Breast Cancer School for Patients
Learning Breast Cancer Online: How to Search the Web
 
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Navigate breast cancer online. We teach you how to quickly find the topics that are important to you and get the best breast cancer care. VISIT THE BREAST CANCER SCHOOL FOR PATIENTS: http://www.breastcancercourse.org LIST OF QUESTIONS FOR YOUR DOCTORS: http://www.breastcancercourse.org/breast-health-updates-latest-videos/ FOLLOW US: Facebook: https://www.facebook.com/Breast-Cancer-School-for-Patients-958519147618444/ ________________________________ First, learn about “Breast Cancer Basics” You must learn the essentials about breast cancer and cancer care. Our short video courses will teach you the pertinent information you will need in order to obtain the best care in your community. At our website, www.breastcancercourse.org, you can learn as much or as little as you desire. Begin with reviewing our “Breast Cancer Basics” course. These video lessons guide you to the key information you must quickly learn in order to make good treatment decisions. Take our specific lessons on: “What is Breast Cancer?” “Will I Survive Breast Cancer?” “My Tumor Receptors” “HER2-Positive” and “Triple Negative” cancer “Breast Cancer Recurrence?” At the Breast Cancer School for Patients, we feel it is our duty as breast cancer specialists to teach you how to ask for the best quality care. We are convinced that a well-informed patient who asks “targeted questions” will get better care. Get informed before speaking with your doctors. Prepare for your Surgery, Oncology & Radiation Consultations Learn everything about your unique breast cancer: For each medical consultation, review our “Course Overview” video to learn what you will address with your surgeon, medical oncologist and radiation oncologist. You can then prepare by reviewing our “lessons” on the key topics ahead. Watch our quick video “lessons” in the order they are presented. Use our “Questions” in each lesson to engage your breast cancer specialists to get the information you will need to know about the topics important to you. Go deeper into detail with our “Patient-Friendly” links and even further with our “More Detailed” links. Your time is important to us. When you follow our innovative educational model, you will stay focused and avoid getting lost on the internet. Your Breast Surgery Course: Your breast surgeon is the first person to teach you about your unique breast cancer. You will learn about the threat to your life and the treatment options ahead. Review our “Breast Surgery Course” before and after your breast surgeon consultation. This way, you will be better prepared to engage, then re-engage your surgeon on follow up visits about important issues. Your Medical Oncology Course: A medical oncologist will add to the knowledge you have already gained from your breast surgeon and online research. Take our quick “Medical Oncology Course.” Watch each “lesson” in the order they are presented. Learn about hormonal therapy, chemotherapy, genomic tests and much more. When you understand the basics, you will remember the details about what is discussed and make better treatment decisions for yourself. Your Radiation Oncology Course: You may ultimately consult with a radiation oncologist, usually soon after surgery or possibly after surgery and chemotherapy are completed. Our “Radiation Oncology Course” will outline the details of breast cancer radiation therapy. Many of the recent cutting-edge treatments in breast cancer care are advancements in breast radiation. We educate you about these new approaches. Sign-up for our breast health newsletter at www.breastcancercourse.org. Once registered, we’ll immediately email you our complete list of “Cutting Edge” questions to engage your breast surgeon, medical oncologist and radiation oncologist. Search for “Video Lessons” on any topic Use our website “Search” engine in the top banner of the website. This approach will allow you to quickly find any subject covered by the Breast Cancer School for Patients. We are the only breast education website that prioritizes using video to teach you about breast cancer. We encourage other societies and institutions to embrace this approach to healthcare education. How to find good breast cancer information online? We have organized the key topics in breast cancer that you must learn. These topics are presented in the order you will likely encounter them. Because of this, we recommend using the Breast Cancer School for Patients as your “Table of Contents” to search the internet for more information. Search well established websites. The best information is provided by medical societies and non-profit organizations. We provide links to the best evidence-based sites on every breast cancer topic. We suggest searching all the topics that are pertinent to you, rather than spending hours on the details of one aspect of your care. This way you will have a better understanding of your entire breast cancer situation.
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