One in eight women will develop breast cancer in her lifetime. And for most women, the diagnosis will be a complete shock. Here, Dr. Patricia Sacks, medical director of the Vasek & the Anna Maria Polak Breast Diagnostic Center;
Dr. Melanie Friedlander, with the Association of South Bay Surgeons; and Drs.
Charles Spenler and
Lisa Jewell with South Bay Plastic Surgeons, break down diagnosis, treatment and reconstruction.
The goal is to find a lump before you feel it, Dr. Sacks says, and thanks to the screening mammogram, when it’s done on a yearly basis, breast cancer can be detected when it’s very small and often very treatable.
“Many women come in frightened to death of a mammogram,” she says. “It’s perfectly fine to be nervous; just remember the earlier we find something, the better.” If the mammogram shows something suspicious, the patient is called back for additional imaging and sometimes an ultrasound. A call-back doesn’t mean cancer: Dr. Sacks says some 10 percent of call-backs are due to a photographic problem.
If additional views and an ultrasound confirm a mass, a biopsy is recommended. Within two days, biopsy results show if the mass is cancerous. If it is, an oncologist delivers the results and shares information about size, tumor markers, treatment options, etc.
Torrance Memorial’s cancer support community is top-notch, Dr. Sacks says. There are support groups (including those for the newly diagnosed); the Cancer Resources Center; a Woman-to-Woman Image Enhancement Center; and more.
Some of the hospital’s most helpful to the newly diagnosed are Breast Health Navigators who assist patients through the overwhelming process of treatment decisions and appointments while also checking in regularly to offer emotional support.
Every patient is different when it comes to the right treatment for their situation—whether it’s chemotherapy, radiation therapy or a combination, and whether they have a mastectomy or lumpectomy. By the time the patient has an appointment with their surgeon they’ve had some time to process their diagnosis, so the meeting is more productive and the patient more engaged, says Dr. Friedlander.
“We walk through all the options—it’s a very personal choice for each patient. Some women want to avoid a mastectomy. Others are more aggressive; they don’t want to have to worry anymore.”
Dr. Friedlander, who was diagnosed with stage III breast cancer nine years ago at 35, is comfortable sharing her personal story with her patients. “When you’re diagnosed, it’s important to find someone who went through the same situation—or worse—and who’s doing well. If I have a patient who is worried about surviving, I tell them, ‘I’m fine and you will be too.’ It helps a lot of people.”
She also recommends support groups and other resources, such as Torrance Memorial registered nurse Evelyn Calip’s “Breast Friends Forever” program, designed to bring breast cancer patients and survivors together for social activities and information sharing. www.evsbff.org. Calip is also the founder of the hospital’s Breast Reconstruction Mentorship Program.
“It’s helpful when patients see another patient two steps ahead of them doing just fine,” Dr. Friedlander says.
Her biggest piece of advice: “Take time to recover—don’t push too fast too soon. And remember that five years from now, your diagnosis will be a flash in the pan. Don’t make any major life changes. Down the road, when you’re on the other side, you’ll be glad you didn’t.”
Patients who undergo mastectomy or lumpectomy are often referred to a plastic surgeon for cosmetic reconstruction. Laws mandate that insurance companies cover breast reconstruction if they provide coverage for treatment, and many patients don’t realize this, say the physicians at South Bay Plastic Surgeons.
At the time of mastectomy or lumpectomy, a plastic surgeon is usually present and starts the breast reconstruction that day so that the patient never has to face not having a breast.
Reconstruction typically takes more than one surgery for completion, which can happen two months to two years after the initial surgery, depending on whether the patient needs chemotherapy or radiation.
Dr. Newman and team recommend that every patient see a plastic surgeon soon after diagnosis, as reconstruction plays an integral role in treatment.
“General surgeons and plastic surgeons typically work together to come up with the ideal treatment plan for the patient, so it’s best for that conversation to start before treatment begins,” Dr. Newman says.
He says many patients view reconstruction as “the sugar coating. Whether it’s getting the tummy tuck you’ve always wanted, since tissue is often removed from this area for reconstruction, or getting the breasts you’ve always wanted, reconstruction can be a positive thing.”
Although a cancer diagnosis is terrifying, these physicians reassure patients that breast cancer is often highly treatable. While treatment can take up to two years, once it’s over, many patients never have to worry again.
As Julie Crow advises, and Dr. Newman agrees, try to keep an open mind and be patient with the process.
Although the final phase of the breast cancer journey—getting on with life—doesn’t happen overnight, he says that most patients are cancer-free with good cosmetic results in the end.
Dr. Newman also encourages a strong support network, including those who’ve been through it before.
“Many women have had breast reconstruction, and they can be an excellent resource for knowledge and support.”