Cynthia Drogula, MD, answers frequently asked questions about treating breast cancer.
Dr. Drogula is a breast surgeon, medical director of the Aiello Breast Center and assistant professor of surgery at the University of Maryland School of Medicine.
What is the Aiello Breast Center?
The Aiello Breast Center is a comprehensive breast center focusing on the healthcare of women and occasionally men with breast cancer, where we treat all aspects of breast health. We take care of cancer, early detection, high-risk patients, as well as basic patient education and community outreach.
What are the latest developments?
There are an awful lot of exciting, new treatments available to women with breast cancer. This is not your grandmother's disease anymore. And one of the most exciting that we're offering here is partial breast radiation therapy. Traditionally, women who have a lumpectomy have followed up their surgery with whole breast radiation to the breast. This takes approximately seven weeks to get through the course of therapy, although they tolerate very well.
Partial breast radiation is a modality where you can put the radiation right where the tumor was. We're using balloon therapy, which is placed into the tumor site, and it delivers the radiation for five days, and then they're finish. It spares the rest of the breast tissue from the treatment of radiation. It is new, it's still being evaluated, but the early results are very promising.
What are the risk factors for breast cancer?
Breast cancer is one of the most common diseases a woman might face in her lifetime. Currently, in the United States, one out of every 7 women will develop breast cancer at some point. It also is a disease that many women have a lot of questions and a lot of fears about. Typically, we look for women at risk who have a family history of breast cancer, particularly in a mother, sister, or daughter. We look at early age of first period, we look at women who've never been pregnant or never breast fed, as well as women who are a little heavier set. At this point, alcohol intake does seem to play a factor in the development of breast cancer.
What are the benefits of partial breast radiation?
Partial breast radiation can benefit women in several ways. First off, rather than going through a seven-week course of radiation, the women get their treatments over a five-day period. Additionally, rather than radiating the entire breast, the radiation is put directly where the tumor was, sparing the rest of the tissue from the radiation. Finally, women nationally, as we've been studying, seem to be pleased with the cosmetic outcome, and they've been beginning to report they would recommend it to a friend.
What if I need breast surgery?
At this point in time, 75 percent of women who have breast cancer can have their disease successfully treated with a lumpectomy, but there are still women who require mastectomy for adequate surgical treatment of their disease. This is no longer as disfiguring a procedure as it once was, and immediate reconstruction can be offered. Our reconstructive techniques have improved dramatically over the last ten years. A reconstruction can be done either with an implant, or with a woman's own tissue, which can be quite natural, though nothing can be quite as good as mother nature.
We're even, for some women, offering areola-sparing, and nipple/areola-sparing techniques, for a much more natural look, so that many women would have the fact that they've had this surgery invisible, even in a bathing suit.
How is breast cancer detected?
The detection of breast cancer has three main components. Self breast examination, clinical breast examination, and mammography. We recommend self breast exams for all women, even women who feel that everything they feel is a lump and they don’t know what they're doing. Our motivation is to get women to become comfortable with their own breast, so they can detect a change, but not necessarily diagnose their own lumps.
Clinical breast exams are done by a health care practitioner. Women in their 20s should have breast exams every three years. Once a woman is in her 30s or 40s, clinical breast exams should be done annually. Annual mammography is recommended at the age of 40, although many women with medical histories and family, this date might be moved earlier.
What can I do to reduce my risk of breast cancer?
One of the questions women have is how can I keep myself from getting breast cancer. Currently, in 2008, there are some lifestyle changes that you can make. We do know that women who exercise regularly (30 minutes of walking, 3 times a week or more), have up to a 50 percent reduction in their risk for breast cancer. This is astounding.
Additionally, women should keep a healthy body weight and avoid excess body fat, if possible. And keep the use of alcohol to a moderate level, because we know as little as two drinks a day can increase your risk of breast cancer. There's never been any evidence to link breast cancer risk to fat intake, but, by eating salad, you don't necessarily reduce your risk. However, a balanced diet that leans towards a more traditional approach is a good idea.