By: Stephen Grobmyer, MD
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When it comes to breast cancer treatment, less can be more.
As breast cancer care becomes more personalized, we are learning that not all patients need the same treatments. If you have breast cancer, you may be able to avoid the short- and long-term side effects of treatment and still have highly positive outcomes. Start by asking these five questions.
1. What type of tumor is it?
We used to believe all breast cancers were the same. New research shows that breast cancers can actually be divided into several different subtypes. Different subtypes are treated differently, so it is important to know what subtype of breast cancer you have and how it should be treated.
“If you have breast cancer, you may be able to avoid the short- and long-term side effects of treatment and still have highly positive outcomes.”
Stephen Grobmyer, MD
Director of Breast Services
2. For what types of operations am I a candidate?
The types of operations and reconstruction available to you may depend on a number of factors, including the tumor size, your body type and your breast size. Discuss all of the above openly and honestly with your doctors. Doing so will help them coordinate their approach to meet your needs and expectations.
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3. How will you determine if I need chemotherapy?
Twenty years ago, most patients with breast cancer were treated with chemotherapy. Now we know that not all patients need it. In some cases, tumor gene studies can help us determine which patients have a very low risk of breast cancer recurrence — even without chemotherapy. This means many patients can safely avoid chemotherapy treatments and the side effects that come with them.
4. Would anti-estrogen pills reduce my risk for recurrence?
The answer will depend on your type of cancer. Some patients have breast cancer that relies on estrogen to grow and spread, so they may benefit from pills that block estrogen in the body. Discuss this with your doctor to determine if these pills should be part of your treatment regimen.
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5. I’m having surgery. Do I need radiation?
For many patients, radiation after surgery reduces the chance that breast cancer will come back in the breast area. The decision to treat with radiation after surgery depends on many factors, including the type of breast cancer, the type of surgery and the area the surgery covers, as well as the stage of cancer.
Patients who do need radiation have more options now. In some cases, smaller doses of radiation delivered over a shorter time period result in the same outcomes as the more-intensive radiation treatments used in the past. Sometimes it’s even possible to complete radiation safely and effectively during surgery, with no need for further radiation.
Personalized breast cancer treatment clearly can improve lives. But to benefit from these advances, you need to be proactive. Learn as much as you can about your diagnosis — and don’t be afraid to ask these questions.