While breast cancer survival rates have been steadily improving, a breast cancer diagnosis is still a frightening experience for any woman.
Beth Roy, LICSW, a licensed social worker and coordinator of The Hoffman Breast Center at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, is encouraging. She says, “Early detection is the key to surviving breast cancer. Both mammograms and ultrasound tests can catch cancer cells just as they are starting to develop and that is when they can be most effectively treated.”
Roy points out that early breast cancer detection is based on a three-pronged approach. First, every woman should start having regular annual mammograms by the time she is forty years old, earlier if she has a family history of breast cancer. Second, she should also have a clinical breast exam performed by her physician or nurse practitioner each year. Third, women over 18 should perform monthly breast self-exams. You can learn how to perform a thorough breast exam by talking with your gynecologist or family physician. In addition to feeling your breasts for lumps, it is also important to look at your breasts in a mirror while raising your arms above your head. You should look for any changes in the nipples or any dimpling, redness, puckering, or indentations in the skin.
Mammograms are particularly effective in detecting microcalcifications, which are cells that are starting to change but haven’t reached the “lump” stage yet. If these kinds of cells are detected, a biopsy is usually performed. Biopsy results are typically 80 percent benign, but the other 20 percent pick up early cancer cells. A mammogram is the only way to detect these early calcifications since they cannot be felt on physical exam. Mammograms can also detect suspicious dense masses. When that occurs, ultrasound tests are usually performed to look at the mass differently. Ultrasound is an imaging technique that uses high-frequency sound waves to characterize further any masses or nodules inside the body. Sometimes an abnormality will be detected on an ultrasound test that is not seen on a mammogram. A mass detected through a mammogram or ultrasound could be benign, such as a fluid-filled cyst, or it could be malignant.
If a biopsy comes back with cells that are cancerous, then the next step is usually surgery. The amount of breast tissue that is removed will depend on the pathology report. For calcifications or very small localized cancer cells, the treatment might be a “lumpectomy” where only the affected area is removed. For larger, more aggressive cancers, a mastectomy, removal of the entire breast, might be the best option. Follow-up treatment depends on the size and type of cancer and might include chemotherapy or radiation therapy. Radiation therapy is almost always the follow-up treatment for a lumpectomy. Data shows that if you do not treat the breast with radiation, there is a higher risk of reoccurrence, even if all the affected areas were removed.
As difficult as a mastectomy is for a woman, Roy points out that reconstructive options have improved dramatically in recent years. Sometimes a woman’s own tissue is used in the breast reconstruction process.
At The Hoffman Breast Center at Mount Auburn Hospital, a breast cancer patient’s care is coordinated from the time an abnormality is discovered through treatment and follow-up care. The center provides mammograms, ultrasounds, biopsies and other tests to detect breast cancer. The center also provides other imaging services, such as bone density tests, which reveal the strength of a woman’s bones and her likelihood of developing osteoporosis. Beth Roy consults with women who have suspicious test results and continues with her coordination and support services if the diagnosis is cancer. She provides extensive information to patients about what to expect from surgery and follow-up treatment and also coordinates support groups. She is a valuable resource for women going through the very difficult experience of being diagnosed with breast cancer.
The Hoffman Breast Center is named after well-known Cambridge author, Alice Hoffman. Alice was successfully treated for breast cancer at Mount Auburn Hospital about seven years ago and she has generously helped to raise money to create and improve the center.
Roy says that The Hoffman Breast Center’s services have been very beneficial to patients. She says, “It can be confusing for patients to go from one doctor to the next, and we help to coordinate those visits so the woman always has one resource for all her questions and concerns about her cancer care.” She points out that it is an asset that all the oncology services at Mount Auburn Hospital are on one floor. All the doctors involved in each patient’s care meet weekly to talk about how best to care for their patients.
“There is a lot of communication going on between patients and medical professionals. Each patient has individual needs when dealing with breast cancer and we try to be there to meet those needs,” says Roy. She continues, “Survival rates for cancer are excellent if it is caught early. Many women are effectively treated for breast cancer and go on to lead full, productive lives.”
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