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Navigating Surgical Options for Breast Cancer

October 3, 2011 10:59 AM with Dr. Katharine Yao

October is Breast Cancer Awareness Month. Join Dr. Katharine Yao as she answers your questions about how to identify the best surgical options for breast cancer. She will talk about who is the best candidate for a lumpectomy, mastectomy, bilateral mastectomy and other surgeries. Your participation and questions are welcomed.

Angela (Moderator) - 10:57 AM:
Welcome! Today’s chat: Navigating Surgical Options for Breast Cancer will begin shortly. Please start submitting your questions and Dr. Katharine Yao will begin answering them as soon as we get started. 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.

Angela (Moderator) - 11:06 AM:
Thank you for your patience. This chat will begin in a few minutes.

  Yolanda (Chicago) - 11:16 AM:
Why do my breast hurt after the Lumpectomy...I had last yr in sept 2010. The chemo sent me into menopause, Both of my breasts hurt from time to time meaning enough for me to notice. I've had my six month and one yr breast mammogram and everything was great.
Dr. Katharine Yao (NorthShore)
If you had radiation then that would explain the breast symptoms-many patients have little aches and pain after breast radiation for yrs afterwards-it is normal and not a sign of recurrence

  Fatma (Vernon Hills, IL) - 11:18 AM:
When people actually win the battle against breast cancer, does this mean they now 'qualify' for the 5 year life expectancy? Is that what is called 'winning' the battle? and for those who lose the battle, heaven forbid, how does breast cancer eventually kill? What is the most common scenario?
Dr. Katharine Yao (NorthShore)
Most breast cancers recur at five years, but some cancers, especially ER positive cancers can recur outside of five years. Breast cancer can metastasize to lung, bones, liver. So "winning" the battle changes according to each patient but remember breast cancer is a survivor's disease and there are over 2.5million survivors out there today-

  Anne (Evanston) - 11:24 AM:
How can breast reconstruction help after breast cancer surgery?
Dr. Katharine Yao (NorthShore)
Breast reconstruction is for patients who undergo a mastectomy and it can restore a normal looking breast for these patients. Studies have shown that women who undergo reconstruction are happy with their decisions and have good quality of life after reconstruction and better body self image.

  John (Chicago) - 11:26 AM:
Can men get breast cancer? Are the surgery options for men different?
Dr. Katharine Yao (NorthShore)
Approximately 5% of men get breast cancer. Men with breast cancer undergo mastectomy because they have smaller breasts and lumpectomy is usually not an option for them. Men can undergo sentinel node biopsy as well like women.

  Sue (Evanston) - 11:28 AM:
I was recently diagnosed with breast cancer. What are my surgery options? What is the difference between radiation therapy and chemotherapy?
Dr. Katharine Yao (NorthShore)
if your cancer is less then 4cm then you would probably be a candidate for lumpectomy or mastectomy. Remember there is no survival difference between lumpectomy or mastectomy, we have studies that are 20yrs old and show no difference. Radiation therapy treats the "local area", that is the breast and you would be treated in a radiation facility. Chemotherapy is administered thru an IV or sometimes injections and treats the "whole body".

  Rebecca (Chicago) - 11:31 AM:
I recently found a lump on my breast. While it was benign, does this mean I have an increased risk of breast cancer?
Dr. Katharine Yao (NorthShore)
Breast biopsy does put you at a little increased risk for breast cancer because it is just telling us that your breast is prone to a positive finding on a MGM. It will probably only raise your overall risk by 1% at most so not a huge risk factor. If your biopsy showed atypia that could raise your risk more.

  Tina (Evanston) - 11:34 AM:
What are the different types of breast surgery possible? What is the best way to select a breast surgeon?
Dr. Katharine Yao (NorthShore)
The two types of breast surgery are lumpectomy and mastectomy. I would select a breast surgeon who has focused their practice on breast care, preferably fellowship trained, and who works in a breast center. A general surgeon who sees some breast patients is not ideal since they are not dedicated to breast care and may not be up to date on current literature with regards to breast cancer.

  Mary (Chicago) - 11:38 AM:
Why is it that the appearance of the breast looks different in people of color after surgery? Can anything be done to prevent this?
Dr. Katharine Yao (NorthShore)
I am not sure if that difference in appearance is secondary to surgery or to radiation. Maybe it is a combination of both. I do not know of anything you can do to prevent this.

  Melissa (Chicago) - 11:39 AM:
What is delayed breast reconstruction? How do you know if you are a good candidate for this?
Dr. Katharine Yao (NorthShore)
Delayed breast reconstruction is when reconstruction is performed after the patient has completed all of their breast cancer treatment. For example,if you had a mastectomy and then had chemo and then radiation the "delayed" reconstruction would occur after the radiation.

  Patty (Skokie) - 11:41 AM:
I am considering getting implants. Are there disadvantages to getting them after cancer? Risks to getting them?
Dr. Katharine Yao (NorthShore)
Implants will not lead to an increased risk of cancer recurrence and they are not dangerous after having a cancer operation. Risks of implants are rupture which can occur about 1% per year risk after 10 yrs although a lot of these ruptures are not clinically significant, meaning the patient does not even know about them and nothing needs to be done about them.

  Jeana (Chicago) - 11:44 AM:
What can women do to reduce their breast cancer risk? Does alcohol consumption increase my risk?
Dr. Katharine Yao (NorthShore)
Risk reduction measures would include exercise, quit smoking and watching your alcohol intake. We usually recommend no more than three drinks a week to our breast cancer survivors according to the data. I would also try to avoid hormone replacement therapy, especially the estrogen and progesterone combination agents. There are really no specific dietary recommendations other then watching for weight gain later in life.

  Pam (Evanston) - 11:48 AM:
I just turned 55. Do I still need be screened for breast cancer? Should I still be performing self-exams? Until when should women be screened?
Dr. Katharine Yao (NorthShore)
Most medical societies recommend screening start at 40yo and continue to at least 70 yo or whenever it is not appropriate. We do not have many mammography studies beyond 70yo so the data in inconclusive but I would still screen beyond age 70 if the patient is healthy and is willing to act on an abnormality if found.

  Ana (Highland Park) - 11:50 AM:
I just underwent surgery. What can I expect for recovery? Are there support groups I should be made aware of?
Dr. Katharine Yao (NorthShore)
It depends on the type of surgery you had, if you had a lumpectomy and sentinel node biopsy alone then 1-2 weeks recovery, if you had a mastectomy with reconstruction then it could be 4-8 weeks depending on the type of reconstruction. There are many support groups out there- NorthShore has a great survivorship program which offers free seminars, they are called the LIFE program.

Angela (Moderator) - 11:51 AM:
Thank you everyone for your great participation. The chat will be ending in approximately 10 minutes. Please submit your final questions.

  Donna (Chicago) - 11:55 AM:
Why are lymph nodes removed in breast cancer? Is this always necessary?
Dr. Katharine Yao (NorthShore)
Lymph nodes are removed so that we can get an accurate stage on your cancer and they help us make treatment decisions for your cancer. The nodal status is still the most important prognostic factor in breast cancer. For most invasive cancers removal of the nodes is necessary.

  Donna (Chicago) - 11:58 AM:
I have a history of breast cancer. How does genetic testing for breast cancer work? Are there other steps I should be considering for screening?
Dr. Katharine Yao (NorthShore)
Genetic testing is usually recommended for patients who have a significant family history of breast cancer. You would see the genetic counselor and geneticist in the Center for Medical Genetics and they would evaluate your family history and determine the need for testing. If you do need testing then they would draw your blood and send it to a lab that does the analysis. If you have significant family history you may also want to consider a breast MRI and having breast exams every 6mos. This is the typical high risk protocol.

  Sally (Evanston) - 12:02 PM:
What is the treatment for metastatic breast cancer?
Dr. Katharine Yao (NorthShore)
There are many different treatments for metastatic breast cancer ranging from chemotherapy to hormonal therapy. We usually do not operate for metastatic disease.

Angela (Moderator) - 12:03 PM:
Thank you again for participating in our chat today. Please visit Kellogg Cancer Center pages for more information about breast cancer. A transcript of this chat will be available shortly.

Angela (Moderator) - 12:06 PM:
Help make a difference for Breast Cancer Awareness Month. For each new "like" on Facebook, $1 will be donated to the NorthShore Breast Cancer Research Fund. Learn how you can Like. Share. Give. during October.

This chat has ended.

Thank you very much for your participation.