Surgical Interventions for Breast Cancer
Q: Under what conditions is surgery for breast cancer recommended (as opposed to radiation or chemotherapy alone)?
A: Surgery is always recommended for breast cancer if the patient is healthy enough to undergo an operation with anesthesia. Depending on the stage of disease and risk of recurrence, we may also recommend chemotherapy and/or radiation in addition to surgery. The only time the patient is treated with radiation or chemotherapy without surgery is when the cancer is too advanced, or if the patient has too many other health problems that preclude surgery.
Q: Are there situations in which you can remove only the tumor without full or partial removal of the breast itself?
A: Tumors of the breast can’t be removed like cherry pits. A certain amount of healthy tissue must be removed with the cancer, either during a lumpectomy or complete mastectomy. This is what we call getting “negative margins.” This practice avoids leaving cancer cells in the breast once the tumor is excised.
Q: How do you address patient concerns about breast removal?
A: If a patient needs mastectomy, WMCHealth Physicians also offers immediate reconstruction of the breast, if possible. Breast removal is traumatic and I don’t try to minimize the patient’s sense of loss. But I do try to shift the focus from the breast itself to survival from breast cancer when mastectomy plays a role.
Q: When should patients start mammography screenings, and how often should they have them?
A: A patient at average risk should have an annual mammogram yearly starting at age 40. Mammograms should continue every year until the age when finding cancer early would not increase life expectancy. That means many healthy 80-year-old women, living independently, should continue with mammography.
Zoe Weinstein, MD
WMC Health Physicians
1561 Ulster Ave, 2nd floor
Lake Katrine, NY 12449
MidHudson Regional Hospital
1 Webster Ave, Ste 502
Poughkeepsie, NY 12601
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