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Breast Cancer: Risk, Diagnosis and Treatment

October 31, 2014 10:59 AM with Barbara Guido

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Knowing your risk for breast cancer is necessary for all women. NorthShore’s Center for Breast Health emphasizes the importance of early detection and part of early detection is knowing your family history and personal risk. Barbara Guido, Nurse Practitioner at NorthShore Center for Breast Health, and Jada Hansberry, PA in General Surgery at NorthShore, will take questions on breast cancer, from risk, including high risk, and diagnosis to treatment and recovery. Submit your questions early.

Brenna (Moderator) - 10:04 AM:
Our chat--Breast Cancer: Risk & Treatment--with Barbara Guido, Nurse Practitioner at NorthShore Center for Breast Health, and Jada Hansberry, PA in General Surgery at NorthShore, will begin in one hour. You can submit your questions now or at any time during the chat.

Brenna (Moderator) - 10:59 AM:
Welcome to our Breast Cancer Awareness Month chat. We'll get started right at 11.

  Vicki (Evanston) - 11:00 AM:
How do you know if you are at high risk for brest cancer? Is a family history the only thing that makes you high risk?
Barbara Guido (NorthShore)
There are many things that can increase a woman's chance of breast cancer. Family history of breast cancer is a risk factor, especially if it was diagnosed pre-menopausally. Other things such as hormone relacement therapy, alcohol intake, and genetic factors can play a role. We have a High Risk Breast Program that can assess your risk and provide you with information on appropriate screening.

  Lindsey (chicago) - 11:04 AM:
How does being at high risk change your screening recs? When should you start if you have a family history? Both my mother and my aunt both in their 60s.
Barbara Guido (NorthShore)
Screening recommendations are often based on age and risk status. If you are low risk, mammograms are recommended beginning at the age of 40. We have risk models that can stratify your risk. If you are determined to be at high risk, you may need to start screening earlier, perhaps at the age of 30. In addition, you may need additional types of imaging such as a breast MRI. Without doing a personal assessment of your risk factors, it is hard to know your risk category. Screening recommendations are individualized.

  Anna (chicago) - 11:09 AM:
Do breast implants increase your risk? Do they affect your ability to be screened, like a mammogram?
Barbara Guido (NorthShore)
Breast implants do not increase the risk of cancer. You can still have a regular mammogram with implants. They may need to be displaced during the mammogram, in order to obtain proper images. Our radiologists in mammography are all breast specialists and are very experienced in reading mammograms in patients with implants.

  Brit - 11:12 AM:
Is a mastectomy recommended for all cases of breast cancer? Is that the only optoin?
Barbara Guido (NorthShore)
Mastectomy is an option for some types of breast cancer, but not the only option. In many cases, breast conservation is an option. This is when the tumor is removed with a small amount of surrounding tissue. This is called a lumpectomy. There are many options for treating breast cancer which can be discussed with a breast surgeon upon diagnosis.

  Susie - 11:19 AM:
Should all women be tested for BRCA mutations? That is all over the news. How do you know if this is something you shoudl be tested for if not everyone shoudl do it.
Barbara Guido (NorthShore)
This is certainly a hot topic in the media. Genetics is a rapidly exploding field. We use national guidelines and recommendatons to help determine who is an appropriate candidate for testing. NorthShore uses the National Comprehensive Cancer Network (NCCN) guidelines to assess if a patient is at risk for a genetic mutation, and could benefit from testing. We do not currently recommend that all women be tested for BRCA mutations. If you feel you may be at risk, you may benefit from an evaluation in our High Risk Breast Program.

  Makayla - 11:25 AM:
I've had skin cancer. Does having other kinds of cancers increase a woman's changes of developing breast cancer?
Barbara Guido (NorthShore)
Having a skin cancer does not necessarily mean you are at increased risk for breast cancer. There are some gene mutations that are linked with both breast cancer and skin cancer, such as melanoma. However hereditary cancers account for a small percent of all cancers.

  Ebele - 11:33 AM:
I'm about 2 months out from double mastectomy. My doctor says pain will fade but I think I might have post-mastectomy pain syndrome. There are treatments for this, I would think. is it just pain meds? Is there rehab perhaps that could help with this?
Barbara Guido (NorthShore)
I'm sorry you are still having pain after your surgery. Unfortunately, it is not uncommon to have continued pain two months after surgery. It may take up to a year for your body to adjust after a major surgery. I would recommend that you can speak with your breast surgeon for other possible treatment recommendations. Often physical therapy can help.

  Emma - 11:38 AM:
My mother developed breast cancer at 45. Thank goodness she is still with us but I'm almost 25 and I'm wondering what i can do to reduce my risk? Are there diet recommendations? Medications or lifestyle stuff I should be doing?
Barbara Guido (NorthShore)
This is a great question. Lifestyle factors such as maintaining a normal body weight, getting 30 minutes of moderately intensive physical activity daily, limiting alcohol and adhering to a plant-based diet has been shown to help prevent some breast cancers. I would recommend you call our High Risk Breast Program for an assessment, as you may need to begin screening at an earlier age. You can ask your physician to place a referral, or call us directly at 847-570-1700.

  Arjun - 11:44 AM:
What is stage 0 breast cancer? What do the other stages mean too?
Barbara Guido (NorthShore)
Stage 0 breast cancer is DCIS or ductal carcinoma in situ, a non-invasive breast cancer. It means there are cancer cells lining the milk ducts, but has not spread beyond the ducts. Invasive breast cancer is classified as stages I-IV. Invasive breast cancer has the ability to spread within the breast or throughout the body. The stage depends on the extent of the disease.

  Patrice (Oak Park) - 11:51 AM:
Hi Barbara and Jada. My question is are you only at a higher risk for breast cancer if breast cancer is on your maternal side? Is your risk higher if it is paternal family history?
Barbara Guido (NorthShore)
Your family history on your father's side (paternal side) is just as important as your mother's family history. Hereditary breast cancer can be passed down from either side, or both. For example, if your father tested positive for a BRCA gene mutation, which increases breast cancer risk, he can also pass it on to his children.

Brenna (Moderator) - 11:52 AM:
There are 10 minutes left in our chat. Please submit final questions.

  Nikki - 11:56 AM:
Do all women develop lymphedema after breast cancer treatment? is there something you can do to prevent this from happening.
Barbara Guido (NorthShore)
Although lymphedema is a risk in any patient that has lymph nodes removed during surgery or a lymph node biopsy, it does not mean that you will develop lymphedema. Not all breast surgery includes removal of lymph nodes. If patients have multiple lymph nodes removed, their risk for lymphedema increases and they would benefit from an evaluation in our Lymphedema Clinic. Preventive treatments such as a compression sleeve might be indicated.

Brenna (Moderator) - 11:59 AM:
This will be the final question of our chat today. Thank you all for participating. And thank you Barbara and Jada for your time today. For more information on risk, go to our High Risk Breast Program page.

This chat has ended.

Thank you very much for your participation.