Harry S. Truman Memorial Veterans’ Hospital
Breast Cancer Education
According to womenshealth.va.gov, breast cancer is the second leading cause of cancer death in women, following lung cancer. Besides skin cancer, breast cancer is the most commonly diagnosed cancer among American women. About 1 in 8 U.S. women will develop invasive breast cancer over the course of their lifetime. This makes breast cancer a serious concern for women Veterans. The good news is that localized breast cancer has a 99% survival rate if detected early, and VA leads the nation’s health care systems in providing mammograms to those who need them.
But what do you do when you find out you have breast cancer? What are the steps? What does VA offer? We sat down with Dr. Donna Richardson, a VA surgeon, to discuss issues related to breast cancer, what to do when you find out you have breast cancer, and what VA offers to our Veterans.
There are a few ways that Veterans can detect if they have breast cancer. Sometimes it is feeling a lump during a self-exam. Others are notified after an abnormal mammogram. Rarely does a patient have outward symptoms of breast cancer.
If patients feel a lump, it is recommended that they go through a menstrual cycle and see if that lump changes throughout the 28 day cycle. There are times that these lumps are cysts that get inflamed during hormonal changes within the cycle itself, and will go away during this timeframe. If the lump does not change during this 28 day menstrual cycle, patients will need to see a provider to examine the lump.
After receiving a positive screening for breast cancer, Veterans will be contacted about the results of the mammogram. The provider will then set up a consultation to meet and discuss the results. During this consultation, the Veteran and physician will decide what measures will need to be taken to pursue the matter further. This might include additional testing.
Magnetic resonance imaging (MRI) may also be performed after an abnormal mammogram is detected as it provides a closer look at the breast tissue and lymph nodes. Breast biopsies are the usual next step after an MRI. A biopsy is when a piece of tissue is taken out and examined under a microscope. It is the only way to know for sure if the tissues removed contain cancer. While it may seem like a drastic step, it is important to note that most biopsy results are negative for cancer.
Dr. Richardson goes on to say that treatments are dependent upon which type of breast cancer is indicated. What the patient wants is the most important part of the treatment plan. Often, physicians can give options. If the patient wants breast conservation, physicians would work towards that goal. However, sometimes breast conservation for a patient is medically not an option. If the tumor is too large and the breast is not large enough to get all of the cancer removed without cosmetic complications, the better option would be to have the entire breast removed with a mastectomy.
Breast conservation, with radiation treatment to the remainder of the breast, is usually the scenario Dr. Richardson sees the most. She says that chemotherapy may also need to be prescribed to eradicate the cancer. A medical oncologist consult would be requested to confirm which oncology treatment, if any, is needed. Currently, Truman VA has a medical oncologist along with surgery services for breast cancer treatment.
VA also offers surgical treatment in the form of breast tissue conservation procedures, which could include the removal of the cancerous area while keeping the remainder of the breast versus having a mastectomy, which would remove the entire breast. It may also be advised that, with either one of these options, treatment may include the removal of lymph nodes. If a Veteran chooses breast reconstruction, a non-VA care consult would be requested and the surgery would be completed at the University of Missouri Hospital or a facility closer to where the Veteran resides.
“We are available for your breast cancer needs.” Dr. Richardson states. “We are available for any questions that you may have in regards to your breasts. We can see you in clinic before, during and after your treatment for breast cancer. We are also available if there are any issues that need to be addressed - not just regarding your breasts, but regarding the swelling of the arm or arms. Our goal is to have you back to the way you were prior to your breast cancer diagnosis.” She wants anyone who is going through this process to “hang in there, we can get through this, this will involve a change in your life for at least the next year, but the majority of people do well with this cancer treatment.”
For more information on breast cancer, please visit: http://www.womenshealth.va.gov/WOMENSHEALTH/outreachmaterials/generalhealthandwellness/breast_cancer_awareness.asp