As part of Breast Cancer Awareness month, we asked five breast specialists at Baystate Health what they wish every woman understood about breast cancer and treatment. As specialists representing different parts of the breast cancer treatment spectrum, their answers cover a wide range of topics.
As varied as their responses are, they all encourage women to appreciate the value of early screenings and to expand their knowledge of the potential and limits of different breast cancer treatment options.
What’s the one thing you wish women understood about for breast cancer?
"I wish people weren’t afraid of the discomfort of mammography"
Dr. Jennifer Hadro, Interim Medical Co-Director of Breast Imaging, Department of Radiology:
“I wish people weren’t afraid of the discomfort of mammography. Technology has come a long way in recent years and any potential discomfort is truly just a matter of seconds … 1-2-3. But those few seconds can save your life.
“In addition, when we call someone back for a second set of images, usually it turns out to be nothing. Some women have dense tissue that makes it hard to get a clear image. But we always want to take the extra step to get a clear image so we are certain there’s nothing unusual. And to take that further, most of the biopsies performed on suspicious-looking tissue come back benign, or, harmless. Again, we err on the side of being certain that all is well. Breast cancer is much easier to treat when caught early. Annual mammograms for women over 40, or earlier if you have a family history or other risk factors, is one of the most important things you can do to ensure your breast health. They are worth your time and the few seconds of discomfort.”
"That the work of treating breast cancer doesn’t end when their breast is removed"
Dr. Grace Makari-Judson, Associate Medical Director of Cancer Services at Baystate and specialist in medical oncology.
“I can’t tell you how many patients who have had a mastectomy don’t understand that the work of treating breast cancer doesn’t end when their breast is removed.
“A mastectomy is very effective at removing the cancer within the breast, but it doesn’t address the risk of cancer spreading outside the breast or coming back as a metastatic disease. So, while a mastectomy may be recommended it is not a substitute for chemotherapy.”
“That their choice of surgical treatments may be better when cancer is caught early”
Dr. Jesse Casaubon, Baystate Surgical Oncology & Breast Specialists
“As a surgeon, I think the most important thing women need to realize is that, should they require surgery for breast cancer, their choice of surgical options and surgical treatments may be better when the cancer is caught early. The longer the cancer has to spread and grow, the more difficult and complicated the surgery can become. If the cancer spreads beyond the lymph nodes, surgery may not even be an option.
“Mammograms are truly key to having the best surgical options available and having a better long-term prognosis.”
"I wish more people appreciated the role of radiation in treating breast cancer"
Dr. Seth Kaufman, Radiation Oncologist
“I wish more people appreciated the role of radiation in treating breast cancer. Patients tend to have a pretty clear idea of the role of surgery and chemotherapy before they start treatment but not so much radiation.
“I tend to explain it this way: if surgery is great for removing a tumor and chemotherapy is good for treating cells that have spread elsewhere in the body, radiation falls between them. Radiation can be aimed at the surgical site and clean up any lingering cancer cells. While it can’t knock out a huge number of cells in one fell swoop like surgery can, it is better at local control than chemotherapy. It can keep cancer from growing back where it started and provides some control in keeping it from coming back elsewhere. So, while surgery and chemo are great at what they each individually do, so is radiation. And when you combine their strengths together, you get better outcomes and better overall survival rates.”
“That there are psychological impacts of both the disease and treatments”
Dr. Ben Schalet, specialist in Plastic Surgery, Aesthetic Plastic Surgery, Reconstructive Plastic Surgery
“For obvious reasons, most patients are very focused on the physical aspects of breast cancer treatment and reconstructive surgery and don’t realize the psychological impacts of both simply having the disease and the treatments.
“While the surgery I provide is cosmetic, I spend a lot of time helping patients becoming comfortable with how their body looks and feels post-treatment and -surgery. Patients do recover but their bodies are never quite the same. Living with that takes some getting used to as well as acceptance. In addition, there’s the matter of learning to trust your body again and not live in fear of cancer coming back. That can take quite a while, especially for women who now have implants as their traditional screening—mammograms—are no longer an option as there’s no breast tissue to image.
“As is the case with other major changes in life, you can learn to adapt over time. And both Baystate’s Cancer and Breast Centers have social workers on staff to help women navigate their new reality. We can guide them to lots of resources and survivorship programs that can provide the support and comfort they need to embrace and make the most of the next chapter in their lives.”