Ask the Doctor

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

 

I heard that standing too close
to a microwave when it is operating
can cause breast cancer.
Is this true?

Answer: There is no science behind the microwave myth.  High doses of radiation, from nuclear explosions have been associated with breast cancer but to this date, nothing on microwaves.

 

 

 

How is MRI used in the detection of breast cancer?

Answer: MRI has been used for many years to detect breast cancer. While a very sensitive tool for finding cancer, it is not accepted as a screening tool for the general population primarily because it detects a high number of benign abnormalities that mimic cancer. This can lead to a large number of additional diagnostic studies, including biopsies, for abnormalities that pose no harm to the patient. For women who are at significantly greater than normal risk for breast cancer due to family history, a gene mutation, or other risk factor, MRI is deemed an acceptable screening tool (in addition to but not in place of mammography). Even these women must weigh the benefits of MRI’s sensitivity against the high number of false positive MRI findings.

MRI can also be useful as a problem solving tool, when mammography and ultrasound don’t adequately assess a possible breast abnormality.

Some clinicians advocate the use of MRI to determine the extent of disease in patients diagnosed with breast cancer by other means. In other words, a mammogram may show one breast cancer in a patient, but the MRI may show additional sites of cancer that could change how the surgeon or oncologist treats the disease. This practice is not uniformly accepted because it hasn’t convincingly been shown to reduce breast cancer death.