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Breast Cancer: The Journey through Diagnosis and Recovery

Dr. Catherine Pesce October 17, 2012 12:00 PM This chat has ended. Thank you for participating.
Moderator (Evanston, IL) - 11:55 AM:
Welcome! Today’s chat: Breast Cancer: The Journey through Diagnosis and Recovery will begin shortly. Please start submitting your questions and Catherine Pesce, MD will begin answering them as soon as we get started.

Moderator (Evanston, IL) - 11:58 AM:
We will do our best to answer all of your questions, but because this is such a popular chat, the physician may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated. Thank you everyone for your great participation.

Claire (Deerfield, IL) - 12:03 PM:
I just found a lump on my right breast yesterday. I will be going in for a mammogram tomorrow morning. I am a nervous wreck. How long can I expect to have an answer? Is there anything I can do to calm my nerves?

Dr. Catherine Pesce (NorthShore):
I know this can be a very nervous time for you. The good news is you found it and are doing something about it quickly. Usually the radiologist will send the results to your doctor right away, so if you call their office hopefully they can get it to you. In the meantime, try relaxation techniques, whatever you do that makes you happy, calm, etc... Focus on the fact that you have done everything correctly so far and you will continue to do so once you have the results.

Barbara (Evanston, IL) - 12:05 PM:
I have gained a lot of weight throughout my nine months of treatment. I want to get back into shape, but have zero energy to workout, much less go for a walk. What can I do to get motivated again? Is it common to feel so lethargic?

Dr. Catherine Pesce (NorthShore):
Hi Barbara, I hear this quite a bit unfortunately, so know that you are not alone in this. I think it is easy to get totally overwhelmed with trying to get back into shape so you have to take it one step at a time, one day at a time. Set very small goals for yourself each day, and each week, and I think you will slowly but surely surprise yourself. Maybe change what you considered "a walk" to 1/2, maybe even 1/4 of the total distance. And be proud of yourself once you walk that distance. Small goals, with patience, and I know you can get there.

Stephanie (Lake Forest, IL) - 12:09 PM:
I just got diagnosed with breast cancer and will begin treatment next month. I have always been very active in long distance running and soccer and am afraid I won’t be able to continue these activities once treatment begins. Is this true? Are there certain exercises/activities that might be better for me to become involved in?

Dr. Catherine Pesce (NorthShore):
Hi Stephanie. What's great is you are obviously healthy and in shape at the get-go. Usually women like you tolerate treatment perhaps better than someone who is out of shape before treatment. While a lot depends on the treatment you are getting, it is common for fatigue to set in and it's possible you won't be able to do the things you used to do. Usually a common problem is at the end of treatment, getting the motivation to get moving again... but for you, I don't think this will be as much a problem. Also, maybe try some less strenuous activities/exercises that you haven't tried before - yoga, hiking, anything that also helps with relaxation can also help you very much.

Sharon (Chicago, IL) - 12:15 PM:
What are the standard screening options available for testing for breast cancer? I know that mammograms are pretty standard, but are MRIs too?

Dr. Catherine Pesce (NorthShore):
Hi Sharon. Yes, mammogram at the age of 40 is the standard screening test. Every woman should start getting one at the age of 40, and every year after that. MRIs are not standard for all women, in fact insurance companies will not cover them for everyone for that reason. MRIs have been shown to be helpful for women at high risk for the development of breast cancer - these include women who have the gene for breast cancer (called BRCA) or those who are deemed at high risk based on other factors.

Daniel (Skokie, IL) - 12:18 PM:
My wife tested positive for the BRCA 1 & 2 genes. Does this mean that she will get breast cancer? To the best of her knowledge she doesn’t think she has a family history of the disease—at least not in her mother or grandmothers.

Dr. Catherine Pesce (NorthShore):
Hi Daniel. Women who test positive have about an 80% lifetime chance of getting a breast cancer, and for these reasons we have multiple ways to manage patients like your wife. Sometimes the test does surprise you (as in your wife, where her family history doesn't show it clearly), however the important thing is that you know she has it and she should now speak to her physician to talk about options.

Nancy (Northbrook, IL) - 12:21 PM:
Is there an age that is most common for being diagnosed with breast cancer? I feel like I’ve known a lot more young women being diagnosed as of late, and I always thought it was something that happened more in older women (50 and up).

Dr. Catherine Pesce (NorthShore):
Hi Nancy. You're right that the average age is a woman over the age of 50. However, because we start screening every woman at the age of 40 we find cancers often at a early, small stage.

Elaine (Evanston, IL) - 12:26 PM:
My sister was just diagnosed with breast cancer and is currently undergoing treatment. How likely am I to also be diagnosed? She is 5 years older than me and I am wondering if there are some precautionary things I can do now to either reduce my risk or identify a problem sooner.

Dr. Catherine Pesce (NorthShore):
Hi Elaine. Having a first degree relative does increase your risk. This risk also increases if there is more than one family member in your family with a history of breast cancer. However, when deciding what you can do or if you should get any imaging studies it depends on her age at diagnosis. The standard screening is to get a mammogram at the age of 40. If she was a lot younger than this, you may want to speak with your physician to see if you should also get screened.

Carol (Highland Park, IL) - 12:29 PM:
I underwent a mastectomy a couple years ago and thought the adjustment to a new body wouldn’t be so difficult. I am now considering getting some plastic surgery work done. What are some of the risks? Am I better off just managing to live with a new body image?

Dr. Catherine Pesce (NorthShore):
Hi Carol. I always recommend at least setting up an appointment with a plastic surgeon to even just discuss options available. There are many options out there and it's important to go through all them in depth with your plastic surgeon to determine what would make you happiest. We have some great plastic surgeons here at NorthShore that I work with every day who would be delighted to speak with you about options.

Tom (Winnetka, IL) - 12:32 PM:
My wife was diagnosed with breast cancer ten years ago and underwent treatment. They just found another tumor that they suspect will be malignant at her last appointment. Is it common for this type of cancer to be reoccurring? What can we do to avoid her getting diagnosed a third time?

Dr. Catherine Pesce (NorthShore):
Hi Tom. Sorry to hear what your wife is going through. Unfortunately, breast cancer recurrence does happen and every patient is different. Some patients recur a year later, some ten years later, some never recur. As surgeons, we wish we could predict this better but again, everyone is different. Depending on her first treatment course, there are more options today than there were 10 years ago, so speaking with your physician about her treatment will be important.

Maggie (Evanston, IL) - 12:35 PM:
I am having a hard time with my survivorship. I know that my beating cancer is an accomplishment, but I don’t want for it to define who I am. Everyone who knows I went through it seems to treat me differently than before my diagnosis. Any tips on how to return to normalcy? Is it possible?

Dr. Catherine Pesce (NorthShore):
Hi Maggie. As a physician, I do hear this quite a bit unfortunately from patients. While I don't have a magic solution to the problem, I can imagine you are trying to get back to your normal life and wish to be treated no differently than your peers. Perhaps next time you feel someone is treating you differently, politely mention that while you are proud of yourself for all you've been through, it's behind you, you are happy about that, and you don't want to dwell on it anymore. There is also a great Survivorship group at NorthShore who could suggest other helpful tips.

Amy (Skokie, IL) - 12:40 PM:
I found that I was much stronger during my chemotherapy and radiation than I am now. I thought once I beat it, I’d be happy. Is it common to feel depressed and grieve?

Dr. Catherine Pesce (NorthShore):
Hi Amy. Of course. You have every reason to feel that way. Have you reached out to any support groups or tried to get help in any way? You are not alone in this and there are so many women who feel very similarly to you. Sometimes getting the chance to meet them and just discuss your similar experiences can make you feel much better. I would think the Survivorship group at NorthShore would also be a great refernce for you.

Jennifer (Highland Park, IL) - 12:42 PM:
My mom is in the midst of treatment and is in surprisingly good spirits. I’ve heard from some of my friends who have witnessed a love one go through cancer say that the most support is often needed after treatment is complete. Why is this? How can I prepare for this now?

Dr. Catherine Pesce (NorthShore):
Hi Jennifer. You are undoubtedly a great daughter and very sweet for trying to anticipate the challenges the future may hold for your mom. While everyone is different, yes sometimes once all the treatment is over, the little things, day in and day out, can be difficult not only from a fatigue standpoint, but also from a psychological standpoint. Sometimes everything someone like your mom has gone through doesn't hit them until it's over, and sometimes "survivors" don't like the label that comes with completing treatment... perhaps the fear of being treated differently. I would suggest looking into the Survivorship group at NorthShore as a great reference for you for the after-effects of treatment.

Moderator (Evanston, IL) - 12:50 PM:
Thank you everyone for your great participation. The chat will be ending in approximately 10 minutes. Please submit your final questions.

Linda (Glenview, IL) - 12:51 PM:
I start chemotherapy next week, which will be followed by radiation. What can I expect from my treatment? When will I start feeling the side effects?

Dr. Catherine Pesce (NorthShore):
Hi Linda. Everyone is different and it depends a lot on the specific treatment you are receiving. Radiation is usually pretty well tolerated. The effects of chemotherapy can vary but for breast cancer, usually it isn't as rough on your system like it can be for other cancers. I wish you the best with your future treatments.

Tom (Winnetka, IL) - 12:54 PM:
How have treatment options for breast cancer changed in recent years? What options are most common?

Dr. Catherine Pesce (NorthShore):
A lot depends on the treatment she first received and the tumor characteristics of the recurrence. Sometimes more surgery is involved, sometimes patients who received radiation may even be candidates for re-radiation, there are more chemotherapy drugs available now than before, as well as hormonal treatments depending on the type of cancer.

Sarah (Gurnee, IL) - 12:57 PM:
Breast cancer runs in my family. Are there any preventative measures that might help reduce my risk? I am 34 years old, should I plan to get a mammogram soon or will self breast exams be enough?

Dr. Catherine Pesce (NorthShore):
Hi Sarah. Depending on the number of relatives in your family with a history of breast cancer, you may want to look into getting genetic testing for you or anyone who has been affected to see if your family carries the BRCA gene. Also, if for instance your mother or another family member was diagosed with breast cancer at a young age, sometimes that means you should get a mammogram or other imaging study at a younger age.

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