Q
: 1
12/01/2009 |
I read on another ask the expert site that "the majority of stage III breast cancer patients progress to stage IV." I recently had aggressive treatment to remove three tumors. Is it true that most patients with stage III breast cancer progress to stage IV?
The risk of recurrence can be high for patients with stage III disease, the important thing to remember is that chemotherapy, hormonal therapy and surgery, and chest wall radiation therapy significantly reduce the risk of local and distant recurrence. I also would like to mention that participation in clinical trials helps us to find/develop new and more effective treatments for breast cancer. As a result, I encourage all women to consider clinical trials as an option.
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Q
: 2
10/18/2009 |
I am quickly approaching 40 and have multiple relatives with breast and ovarian cancer. I do monthly breast exams and have noticed more nodules, but I have also been drinking more coffee lately. Do you think I am a candidate for genetic testing and if so, what does it entail?
I would recommend genetic counseling first. You should be able to find a high risk BC program locally. Screening mammograms should be done annually, and a screening breast MRI can be considered. Follow-up appointments with your gynecologist should be ongoing at least annually.
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Q
: 3
09/07/2009 |
About three months ago I started having pains in my left breast. I recently had a mammogram and a sonogram. I was told that I have a cyst. The pain still hasn't gone away, should I get a second opinion?
A breast cyst can be painful and sometimes an aspiration has to be done to control the pain. You would need to see a breast surgeon or a breast radiologist to have it aspirated.
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Q
: 4
08/08/2009 |
I recently had a sudden appearance of a nickel-sized flat, hot, red area on my breast. Over 24 hours it expanded to silver-dollar size. It was completely painless and there was no lump. There was no sign of a puncture, bite, or injury. I saw my family doctor who prescribed 10 days of antibiotics and topical steroid cream. Over that time, the redness faded almost completely. There is only the slightest bit of peeling skin at the site. I have read about others who had IBC skin symptoms come and go a few times prior to diagnosis. I am worried about the possibility of IBC even though the antibiotics/steroid seems to have cleared the redness. I am wondering if I should push for a biopsy or a specialist consultation, or am I overly anxious since the redness has cleared? I am 56 and on HRT for over 25 years now.
Antibiotics/steroids would not have cleared the IBC; however, if the redness comes back, a skin biopsy should be done. You may also want to revisit the issue of continued HRT, which has been associated with increased risk of developing breast cancer.
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Q
: 5
08/07/2009 |
My mother was diagnosed with breast cancer at age 38 and had her breast removed. She later had bladder cancer and then died of liver cancer by the age of 48. I am now 28. At what age should I start being checked for this? I have already had a hysterectomy at the age of 26 for similar problems.
I think it would also be important to know if you have any other family history of breast cancer and/or ovarian cancer and/or other cancers; however bladder cancer is not typically associated with the genetic predisposition to breast cancer (BRCA genes) and, in fact, may be associated with smoking; given a relatively early onset of breast cancer in your mom, you may want to contact a local university-based breast center/breast program and find out if they have a genetic counselor and a high risk breast cancer screening program.
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Q
: 6
07/09/2009 |
My 90 year old mother-in-law had a mammogram and was told she had breast cancer, but no biopsy was done. Her doctor wants to take her to surgery immediately. She is in moderately good health and still takes care of her own home etc. I was in favor of a biopsy and then if needed a lumpectomy. As she is 90 years old, a radical masectomy could be to harsh of a treatment for her. Have you known or seen data on women of this advanced age getting the full treatment? What would you tell your 90 year old patient to do in this situation?
I have patients who are 90+ and receiving therapy for BC. If she is in good shape medically, she maybe able to tolerate lumpectomy surgery. However, the main cause for concern is whether or not she is medically stable to undergo surgery. If the cancer is estrogen and/or progesterone positive, she can be considered for therapy with one of the aromatase inhibitors (pills) such as Arimidex or Femara or Aromasin. These agents are generally well tolerated by the elderly; I have patients 90+ taking these medications and doing well.
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Q
: 7
07/05/2009 |
My good friend has been diagnosed with Inflammatory BC and had positive results in many of her lymph nodes after surgery. What can you suggest as the best treatment from this point forward?
Inflammatory BC is one of the most aggressive types of early stage BC (stage IIIB). Usually chemotherapy, radiation therapy, surgery and hormonal therapy are indicated. Some patients may also need Herceptin if the tumor is HER2 positive.
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Q
: 8
06/17/2009 |
I am 42 years old and have undergone a bilateral mastectomy with lymph node removal, followed by chemotherapy for stage IIA breast cancer. Will tamoxifen significantly improve my cure rate or reduce my risk of recurrence?
I think you should consider taking tamoxifen assuming that your cancer was ER and/or PR positive. Tamoxifen has been shown to significantly improve disease free and overall survival rates in premenopausal women with early stage breast cancer.
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Q
: 9
06/02/2009 |
My 24-year-old daughter was seen yesterday for a lump in her breast. They did an ultrasound, and said it looked like a fibroadenoma and was 3cm in size. To be sure, she wants to have a biopsy, and she is waiting for that dept. to call her to set that up. If it is confirmed that this is a fibroadenoma by the biopsy, should this be removed? Is there any harm in leaving it there? Can these turn into cancer? Do these ever go away on their own?
Fibroadenoma is a benign type of lesion which can be diagnosed based on ultrasound features, but a biopsy is reasonable (core usually by ultrasound) to confirm. Excision can be considered, especially if the lump is large and painful. They rarely go away on their own.
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Q
: 10
05/29/2009 |
I'm 25 and currently breastfeeding. About 3 months ago, I noticed a hard round lump in my right breast. It is in the upper inner quadrant just above the aerola. It has been painless up until recently. I had an ultrasound done at the hospital about a month ago and was told it was just normal dense breast tissue which would slowly dissapear once I stopped nursing. However, these past few days it has grown significantly in size extending up towards my collarbone and is tender. The other breast feels fine - no lumps and no tenderness.
Does this still sound OK? Would the ultrasound have detected something other than dense tissue or is it unreliable?
Although you are very young, I think you should see a medical doctor to make sure that this is not anything more serious, breast cancer is rare in women of your age but I have seen it, so a biopsy may need to be done if the lump is getting larger.
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Q
: 11
05/10/2009 |
I have one nipple that seems to always be erect. It is tender to the touch and appears redder than the other side. What could the problem be? Is my internist OK to see, or should I find a OB/GYN doctor? I just had a mammogram done a couple of months ago and all was fine. I was on Solumedrol for 3 IV treatment and then on a declining Predisone pills for 10 days
I think you need to have a clinical breast exam; a GYN or primary care doctor is fine initially.
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Q
: 12
04/30/2009 |
In the fall, I had what appeared to be a large inflamed bug bite the size of a quarter under my left breast. I treated it with topical benadryl and after a few weeks it went away. I still have a faint scar, and the breast has ached pretty much continually off and on since then, but no other redness or swelling. I am 50 and in peri-menopause. Should I be concerned?
I think you should be seen by your primary care doctor and have a clinical breast exam.
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Q
: 13
03/29/2009 |
My wife has been taking evening primrose oil for some years. The specific reason was that it ended a chemical sensitivity problem that afflicted her when she reached her 50's. She has now been diagnosed with breast cancer and she fears that EPO could be cancer-inducing. Everything I could find suggests that the opposite may be the case, if anything. Would you be concerned about her using it? Dose is 4-500 mg caps per day containing about 200 mg of active ingredient. There is even a suggestion that it may help the effectiveness of chemotherapy.
I am not aware of any data that it could be detrimental although I do not recommend using it.
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Q
: 14
03/29/2009 |
I am 10 years post radical mastectomy of less than 1cm. Said to have clear lymph nodes. What is the percentage rate of reccurence?
The tumor size is one of many factors that play a role in the assessment of your risk of recurrence, but being disease free 10 years after diagnosis is a positive.
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Q
: 15
02/18/2009 |
Can you have a papilloma with no discharge or any other symptoms? I had a mammogram & an ultrasound. Doctors say because I have no discharge, they think it is a papilloma. All the literature mentions a discharge. The next step planned is for me to see a surgeon for a biopsy and possible removal. My last mammogram a year ago was fine and I am in good health.
Papilloma is usually associated with nipple discharge, but not always. The biopsy is the way to go to rule out other abnormalities.
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