What is the one thing all breast cancer patients have in common?
It might seem the answer to the question would be pretty generic, but the opposite is true. What all breast cancer patients have in common is that each person is unique.
Breast cancer is a "me" experience, which is why Dr. Soley Bayraktar, the Cancer Center's in-residence oncologist specializing in breast cancer, says communication is vital. It's important each patient has all the information available in order to make the right decisions for them personally.
"There are several important things to consider before deciding on the treatment plan," says Dr. Soley, who prefers to use her first name. "The most important one, I think, is if the patient needs chemotherapy up front before surgery (neoadjuvant chemotherapy) or after the surgery. The surgeon plays a great role in this situation, because he/she is the one who can refer the patient to medical oncologists early in the diagnosis to make the appropriate treatment plan."
What are some pre- or post-surgery chemo considerations?
"If the mass is large, more than 5 centimeters, or if there is any skin involvement or extensive local spread to lymph nodes, then the patient should be treated with upfront chemotherapy, otherwise she can have surgery and then chemotherapy if needed," she explained.
Other treatment options may include preserving the breast or removal, a procedure known as mastectomy.
"If the surgeon thinks that the breast mass cannot be removed by lumpectomy (partial breast resection), then the patient should have a mastectomy," Dr. Soley advises. "Other situations that we consider mastectomy are patients who present with very large tumors, skin involvement, more than one breast mass or lupus patients."
A final option could also include breast reconstruction.
"Young patients may also be interested in breast reconstruction after radiation therapy. So, the treatment plan should be coordinated between the medical oncologist, surgeon, radiation oncologist and plastic surgeon to achieve the best outcome for the patient," the doctor suggests.
Are there things patients should be asking that they aren't? Dr. Soley says, yes.
"I commonly give hormone-blocker therapy to my breast cancer patients whose tumors are driven by their female hormones. One of the most common side effects of the pill is the decreased libido. I have only a few patients asking questions about this side effect, or if they are experiencing it, what they can do. I think it is a very important thing patients and their mates should discuss with physicians before the start of the therapy," she advises.
Patients also ignore asking questions about their general overall health.
"Patients do not ask about weight loss after the breast cancer therapy," Dr. Soley says. "I think they need to pay more attention to their overall health — eating healthy, doing exercise, not smoking and so forth."