Ask the Doctor

I have been physically active and involved in sports all of my life. Do incidents such as accidentally getting hit in the breast with a basketball or tennis ball or the natural bumps or knocks to the breast during sports and other physical activity affect a woman’s risk of breast cancer?

There is no association between trauma and breast cancer.  Bruises do not change into cancer.  That being said, however, sometimes a trauma may bring your attention to a lump that is already in the breast.  If a lump persists after a trauma it should be checked.  One strange occurrence in my practice happened years ago when a patient came in complaining that she had a lump because a horse had bitten her on the breast.  In her case the horse may have saved her life because it bit her on her breast cancer which was then treated.

Dr. Arbutina

 

There is no evidence that injury to the breasts increases the risk of breast cancer.  Injury can change the appearance of the breast on a mammogram, which can lead to additional testing.

Dr. Biggs

If a woman has cancer in a body organ, other than her breast, does that put her more at risk for developing breast cancer?

If a woman has cancer in another organ she is not at higher risk of breast cancer unless she has one of the uncommon genetic defects.  For example, if a woman does not know she as a BRCA deletion and develops ovarian cancer, she is also at risk for breast cancer.  But thankfully this is not a common occurrence.

Dr. Arbutina

Do all women get lymphedema following breast cancer surgery?

Usually, only women who have lymph node spread of their breast cancer are at risk for lymphedema following breast cancer surgery.  Only 30% of these women with positive lymph nodes will get lymphedema and most these cases are minor.  These minor cases of lymphedema are easily treated with physical therapy and massage.  Rarely do patients get significant edema, which causes them to alter their daily routines.  In the distant past, when radical mastectomy was the standard therapy for breast cancer, massive lymphedema was more common.  Thankfully, today, surgery is much more conservative and massive lymphedema is rare.

Does nipple piercing increase the risk of breast cancer?

Nipple rings do not increase the risk of breast cancer.  However, they can disrupt the milk ducts and cause persistent and sometime very complicated infections.

If a woman develops breast cancer while in her child bearing years, will the cancer affect her fertility?

Breast cancer in itself does not affect fertility.  If a patient requires chemotherapy, however, this may stop ovulation in some but not all cases.  If there is any chance that the cancer has metastasized then pregnancy is not advised.  The hormones which a woman’s body develops to support a pregnancy may also promote growth of the cancer and help the cancer spread.

 

Dr. Arbutina

Does taking Hormone Replacement Therapy increase breast cancer risk?

Hormone replacement therapy has been shown to be associated with a small increase in the risk for breast cancer. Estrogen is the only thing we know of at this time that stimulates breast cancer and it also makes the breast cells more active which increases the breast cancer risk. However, if estrogen is needed for other medical reasons, these benefits may outweigh the risk for breast cancer. Therefore, speak with your doctor about the benefits and risks of hormone replacement and see what would be best in your case.

Does breast feeding increase the risk of breast cancer?

Breast feeding has never been shown to have any relation to breast cancer. Only factors that increase estrogen can increase the risk for breast cancer.

If a woman is diagnosed with breast cancer, how important is it for her to get a second opinion about her diagnosis?

Today, most pathology labs run special tests on the cancer cells to make certain the diagnosis is correct.  Staging a tumor surgically is also fairly straight forward.  When it comes to chemotherapy, this is where some differences of opinion may occur and a second opinion may be a good idea.  Today, oncologists often go to a cookbook put out by the NCCN.  This cookbook approach may not take all of your cancer characteristics into account.  You want to find an experienced oncologist who will look at your big picture to make sure you are not under or over treated.

Are there any health conditions that seem unrelated to breast cancer that can increase a person’s risk of developing breast cancer?

There are certain immune suppressing therapies for patients with organ transplants or auto immune diseases such as psoriasis which can cause a person to be much more susceptible to cancers, breast cancer included.

 

Dr. Arbutina

 

If a woman has breast cancer, is it important for her to have a lot of details about her disease? Or is it best to just leave the details to the doctor?

It is best to know as much about your breast cancer and proposed treatments as possible.  For early cancers some treatments have very little benefit.  Before undertaking such a treatment you should know your options.  It has also been shown that a good understanding of your choices and taking an active role in your care leads to better results.  Believe it or not your immune system which helps you fight cancer is in tune with your sense of control and well being.

Dr. Arbutina