Selected Podcast
Basics of Breast Cancer Screening, Diagnosis and Treatment
Dr. French discusses breast cancer, screening, and treatment options.
Featured Speaker:
Dr. French has been a Fellow of the American College of Surgeons since 2010. In addition to her general surgery practice in the Bay Area prior to coming to Central Valley, she worked as a Healogics certified wound and hyperbaric medicine specialist in a Healogics wound clinic. Although her practice includes a broad spectrum of general surgery including, but not limited to Breast surgery, gallbladder disease, endocrine disease, and hernias, she has a special focus in minimally invasive and robotic surgery for gastroesophageal reflux disease, colon cancer and benign colorectal disease.
Dr. French strives to create a supportive, empathetic, patient centered doctor-patient experience for healing to minimize the impact of surgery on her patient’s lives. She does this by using advanced surgical techniques to shorten the physical impact of surgery on her patients and by providing personal attention tailored to each patient to minimize the stress of the surgical experience.
Andrea French, MD
Dr. Andrea French was born and raised in the San Francisco Bay Area. She obtained a Bachelor’s Degree in Equine Science from Colorado State University, and a Master’s Degree in Molecular Biology from San Jose State University. After receiving her Master’s degree, she moved to Valhalla, New York where she graduated with her MD from New York Medical College in 2003. She began her General Surgery Residency at the University of California, San Francisco/Fresno in 2003 and completed it at Abington Memorial Hospital in Philadelphia in 2008. Although interested in all aspects of general surgery, she pursued additional training in Minimally Invasive Surgery at Alta Bates Summit Medical Center, Oakland and Berkeley.Dr. French has been a Fellow of the American College of Surgeons since 2010. In addition to her general surgery practice in the Bay Area prior to coming to Central Valley, she worked as a Healogics certified wound and hyperbaric medicine specialist in a Healogics wound clinic. Although her practice includes a broad spectrum of general surgery including, but not limited to Breast surgery, gallbladder disease, endocrine disease, and hernias, she has a special focus in minimally invasive and robotic surgery for gastroesophageal reflux disease, colon cancer and benign colorectal disease.
Dr. French strives to create a supportive, empathetic, patient centered doctor-patient experience for healing to minimize the impact of surgery on her patient’s lives. She does this by using advanced surgical techniques to shorten the physical impact of surgery on her patients and by providing personal attention tailored to each patient to minimize the stress of the surgical experience.
Transcription:
Basics of Breast Cancer Screening, Diagnosis and Treatment
Amanda Wilde (Host): Breast cancer affects so many women and their families. In fact, breast cancer is the most frequently diagnosed cancer in the United States. So today, we'll get clarity on screening, diagnosis and treatment with Dr. Andrea French, a board-certified general surgeon who works with Dignity Health.
This is Hello Healthy, a Dignity Health Podcast. I'm Amanda Wilde. And Dr. Andrea French, welcome. It's so good to have you here.
Dr Andrea French: Thank you.
Amanda Wilde (Host): Where should we start when we consider breast health?
Dr Andrea French: Actually, we really should start with knowing our family history. So if you come from a family that has significant breast cancer, ovarian or uterine cancer, it is really important to know what your risk is. The second place that you would go is understanding and knowing your physical exam and knowing your breasts, and being able to identify changes in them that occur that are concerning.
Amanda Wilde (Host): Now, sometimes people's breasts are so dense, lumpy and bumpy and really hard to tell. Do you still recommend breast self-exams for people like that?
Dr Andrea French: I do recommend breast self-exams because masses alone are not the only changes in the breast that can occur with cancer. Other changes that occur that are very concerning are nipple retractions. So if your nipple begins to go into the breast, and it wasn't like that before, that's very concerning. You can have skin dimpling, so like the dimples in your cheeks. If all of a sudden you look at your breast and you have a dimple in your breast that wasn't there before, that's another sign of breast cancer. Now, breasts can have multiple forms of discharge, but the one that we find that's concerning is bloody nipple discharge or chocolatey nipple discharge because 5% of those patients are presenting with breast cancer as well.
The other thing that you can see is the skin changes of the breast. So if the breast looks like a peel of an orange, not orange, but the nubbly dimpled part, and usually it's associated with red, that's another sign of breast cancer. So although masses are important and should be monitored, they're not the only signs of breast cancer that we're looking for during a breast self-exam.
Amanda Wilde (Host): So, you really should know your breasts from the time you are developing until you get your first mammogram and beyond.
Dr Andrea French: Absolutely. Because breast cancers are presenting at younger ages and mammograms are only initiated at the age of 40 because that's when their sensitivity and accuracy becomes viable. So, you have from the age of 10 to the age of 40, where your only defense against changes in your breasts are physical exams. Now, you can do imaging like ultrasound or MRI, if you find something on physical exam that can help us at a younger age, but there are no screening mechanisms for that.
Amanda Wilde (Host): So if you are under the age of 40 and you have any of the symptoms you described, you should see your doctor, and there are other sort of screening processes you can go through.
Dr Andrea French: Absolutely. If there are any changes into your breast, you should go see your primary care physician and explain the issues. If they find a mass or if there's skin dimpling, we could get an ultrasound to look to see and quantify that mass, because there's a lot of different growths in the breasts that are benign or not cancerous, and the ultrasound can help us distinguish what those are. If we can't see something on ultrasound, we can go with an MRI because its sensitivity is the greatest of all the imaging that we have. It's not always very specific, so it'll find stuff that may or may not be relevant, but it can help us find things that we can't see in other modalities.
Amanda Wilde (Host): So, this will be true for someone who either has some of the symptoms you described or maybe has a family history of breast cancer and they're under 40.
Dr Andrea French: Right. So if you have a patient or you are a family member of somebody who has had breast cancer under the age of 40, then we really begin to worry about those genetic cancers that can be more aggressive. And so, you really should do those self-exams to know. We also usually will begin MRI screening if the risk of cancer is high enough. If you are BRCA positive or the family has a history of the breast cancer genes BRCA1 or 2, we will start screening earlier with an MRI to help try and identify those cancers early or we'll suggest prophylactic mastectomies and oophorectomies in those patients to try and prevent the risk of developing those aggressive cancers.
Amanda Wilde (Host): So, oophorectomy, being the removal of the ovarian tubes because the BRCA mutations are indicative in both those kinds of cancers, breast and ovarian cancer, right? So, it's really interesting because when we think screening, I think many of us just jump to mammogram, but you're talking about everything before age 40. But if we do manage to get to age 40 with no issues, we should still start screening then with mammograms?
Dr Andrea French: Yes, the recommendation is to start screening at the age of 40 and with screening mammograms.
Amanda Wilde (Host): So, mammograms are the gold standard after age 40?
Dr Andrea French: Correct.
Amanda Wilde (Host): And what else should we think about in terms of screening? We've talked about what kind, how often should we get screening done?
Dr Andrea French: So, still the recommendation is yearly mammogram screening, unless they find something that is of concern. So when you get a breast image, a mammogram, ultrasound, or an MRI, you're given a score. And that score is called a BI-RADS, B-I-R-A-D-S, and it ranges from zero to six. So, zero means they need more information. One means everything looks totally normal. Two means they see something and they're a hundred percent sure it's not cancer. Three means they see something and they're about 95% sure it's not cancer. Four means they see something and is about 80%. Five means they see something and it's a 50/50 shot. And then, six is a biopsy-confirmed breast cancer.
So whenever we get those screenings, then the screening after that is dictated by that. So if it's a BI-RADS 1 or 2, then annual mammographic screening is appropriate. If it's a BI-RADS 3, they feel comfortable enough, they being the radiologist, feel comfortable enough that the only thing that would initiate concern of it being a cancer would be change. So, what they'll do is get them screening every six months to make sure that whatever they're seeing on the imaging isn't changing. And as long as it isn't changing and it's stable for two years, then we typically leave it alone. If it's a BI-RADS 4 image, then the recommendation is to get a core needle biopsy immediately or as quickly as you can in the community to get that tissue pathology to confirm that it is not a breast cancer. Five also we would biopsy as well. So, the screening regimen is really dictated by the image that you get every year.
Amanda Wilde (Host): Now, if something is found in the screening, a BI-RADS 4 let's say, something questionable, and the next step is a biopsy. What does that look like? You said a core needle biopsy.
Dr Andrea French: So, the biopsy is going to be dictated by how they can see what is abnormal. So if they can see the lesion or calcifications on mammogram, but they can't see it on ultrasound, then you get what's called a stereotactic biopsy, which is where they actually do the core needle biopsy under mammogram. And one of the questions everybody asks me is, "Are we put to sleep?" And the answer's no. So, it's done under local, but you are awake for the procedure. If they can see the lesion on ultrasound, then we go with the ultrasound-guided biopsy. If we can't see it on mammogram or ultrasound, and we can only see it on MRI, then we send you for an MRI-guided biopsy. Those are more difficult to obtain because there're fewer centers that do them.
Amanda Wilde (Host): Then what happens after you've gotten that sample for the biopsy? It goes to the lab for diagnosis?
Dr Andrea French: It goes to the pathologist. So, the pathologist will get that specimen, and they will evaluate it under the microscope and with stains to determine what exactly that lesion is. And the one thing about the breast is it's made up of a lot of different types of cells. So, you have the lobules that make milk, you have the ducts that carry milk, and then you have the other cells that are within the breast that help create the structure. So, you can get breast cancer from any of the cells that are in the breast, and they're all considered breast cancer. So, the pathology is extremely important because we want to know if it is a cancer, what is it coming from? What is its receptor status? If it's benign, is it something that we need to take out anyway just because it carries a higher risk of malignant cells being close to it? Or if it's completely benign and we feel safe leaving it alone? All of that information is given to us with a pathology report.
Amanda Wilde (Host): I was going to ask you if you're diagnosed with breast cancer, what are the range of treatments? So, the range begins with maybe we end up doing nothing.
Dr Andrea French: Not with breast cancer. So, cancer is the malignancy, that's what we need to treat. If it's not cancer or it's benign, we may do nothing. So if it's something like a fibroadenoma, so there are masses that we can feel in the breasts that can be really large and often, in young women, including teenagers that are called fibroadenomas and these are benign, non-cancerous, non-life-threatening lesions in the breast and don't have to come out unless the patient is having symptoms or issues related to it. But if it's a breast cancer, it has to be treated.
Amanda Wilde (Host): And you were saying there's all different kinds of cells and different kinds of breast cancers. So, what are treatments available for these different kinds of cancers?
Dr Andrea French: The great thing about breast cancer is that we are greatly benefited by the amount of research that's been done and by all the women who have struggled with breast cancer before. So whenever I have patients come in with this diagnosis, I always like to start with one thing they have to remember, and that is cancer is a big word that describes a broad spectrum of disease. There are cancers that are very difficult for us to treat, and there's cancers that we're very good at treating, and breast cancer is one of those. And part of that is because we have five different modalities to treat it.
So when a patient comes in with breast cancer, it's really important for us to know the receptor status because it tells us how close it is to the original breast cell. And so, receptor status is estrogen receptor or progesterone receptor. And then, there's a third receptor that we look at that's called HER2 that's only found in cancer cells. So that receptor status, whether you're estrogen receptor positive, progesterone receptor positive, HER2 negative, which is the most common type or if you're a triple negative, like ER, PR, HER2 negative. All of those profiles dictates how aggressive we need to be in treating the cancer.
So, the five different modalities that we have to treat are surgery, radiation, chemotherapy, endocrine therapy, and immuno-targeted therapy. If a patient comes in and has cancer, what we have to determine is the likelihood that this is just still in the breast or whether or not it's gone out into the body, because that dictates what order the treatment occurs at. So if it's early and we're not very concerned or there's no evidence that it's gone out of the breast, then we are aggressive about local treatment first to take out the cancer before it goes outside into the rest of the body. When we do treat locally, we treat it with surgery and radiation.
Now, you don't have a choice of a diagnosis, but you do have a choice in the treatment. If you want to do breast-conserving therapy where we just go in and take out the breast cancer with the margins, we can conserve the breast. In that situation, we have to do radiation. Breast-conserving therapy is a lumpectomy with external beam radiation. There are other types of radiation as well. In our community, we don't have them available yet. Or you can have the mastectomy. It's a simple mastectomy where we just take the breast capsule off the muscle. And in those circumstances, if it's early, you often don't need radiation or any further treatment beyond the endocrine treatment.
If we feel that the tumor has gone outside of the breast, there's evidence that the breast cancer is in the lymph nodes under the arm or has gone in other locations, then local treatment is not the place you start. You start with the systemic treatments. And the systemic treatments are the chemotherapy, the endocrine therapy, and the immuno-targeted therapy first, because we don't want to delay treatment of the cells that are outside of the breast while waiting for the breast to heal. So, we do those therapies first. We try and treat those cancer cells in the body, and then we go back and deal with the breast when we feel that the cancer in the rest of the body has been treated.
Amanda Wilde (Host): So, you have to match the treatment to the cancer. What do you see in terms of outcomes for your patients who go through these different modalities? What's the success rate, shall we say?
Dr Andrea French: You know, for most of the people that I see, thankfully, we catch these cancers early and so, cure rates are very high. So, they're in the 80% to 90%, even in stage I and stage II disease. So, our success rate at treating patients is excellent. Even in patients that I've seen who've come in with stage IV disease, where there's cancer found in other parts of the body, I've had patients 10 years out present to my office living their normal life, and treating the disease more as a long-term diagnosis than a timestamp on your foot.
Now, there are forms of cancer. Triple-negative breast cancer is the more aggressive version of the breast cancer and the cure rates and success rates are not as high with that one. But with the vast majority of the breast cancers that we see, women are surviving for long periods of time.
Amanda Wilde (Host): Well, you do get excellent outcomes, which is really encouraging, and I know that there have been technological advances over the last 10 or 20 years that make things more optimal for people going through breast cancer. So thank you, Dr. French, for being here to sort out all this info and explain it so clearly.
Dr Andrea French: There's one thing that I think with this diagnosis that is the most important for patients, and that is to know they have a team that is working with them to help them through. So to have a surgeon that you trust, have an oncologist that you trust, have your radiation oncologist that are all willing to work together for the best outcome for the patient because this is a tough diagnosis for patients to have, and really knowing that their team is there to support them is really important in getting them through the process.
Amanda Wilde (Host): You're not alone.
Dr Andrea French: Yes, you're not alone.
Amanda Wilde (Host): Dr. French, really appreciate your work to give patients the best possible experience. Thank you again.
Dr Andrea French: Thank you.
Amanda Wilde (Host): For more information, visit Dignity health.org/merced/ Women's Health. That's M E R C E D slash Women's Health.
If you found this podcast helpful, please share it on your social channels and be sure to check out the podcast library for other topics of interest to you. Thanks for listening to Hello Healthy, a Dignity Health Podcast. I'm Amanda Wilde. Be well.
Basics of Breast Cancer Screening, Diagnosis and Treatment
Amanda Wilde (Host): Breast cancer affects so many women and their families. In fact, breast cancer is the most frequently diagnosed cancer in the United States. So today, we'll get clarity on screening, diagnosis and treatment with Dr. Andrea French, a board-certified general surgeon who works with Dignity Health.
This is Hello Healthy, a Dignity Health Podcast. I'm Amanda Wilde. And Dr. Andrea French, welcome. It's so good to have you here.
Dr Andrea French: Thank you.
Amanda Wilde (Host): Where should we start when we consider breast health?
Dr Andrea French: Actually, we really should start with knowing our family history. So if you come from a family that has significant breast cancer, ovarian or uterine cancer, it is really important to know what your risk is. The second place that you would go is understanding and knowing your physical exam and knowing your breasts, and being able to identify changes in them that occur that are concerning.
Amanda Wilde (Host): Now, sometimes people's breasts are so dense, lumpy and bumpy and really hard to tell. Do you still recommend breast self-exams for people like that?
Dr Andrea French: I do recommend breast self-exams because masses alone are not the only changes in the breast that can occur with cancer. Other changes that occur that are very concerning are nipple retractions. So if your nipple begins to go into the breast, and it wasn't like that before, that's very concerning. You can have skin dimpling, so like the dimples in your cheeks. If all of a sudden you look at your breast and you have a dimple in your breast that wasn't there before, that's another sign of breast cancer. Now, breasts can have multiple forms of discharge, but the one that we find that's concerning is bloody nipple discharge or chocolatey nipple discharge because 5% of those patients are presenting with breast cancer as well.
The other thing that you can see is the skin changes of the breast. So if the breast looks like a peel of an orange, not orange, but the nubbly dimpled part, and usually it's associated with red, that's another sign of breast cancer. So although masses are important and should be monitored, they're not the only signs of breast cancer that we're looking for during a breast self-exam.
Amanda Wilde (Host): So, you really should know your breasts from the time you are developing until you get your first mammogram and beyond.
Dr Andrea French: Absolutely. Because breast cancers are presenting at younger ages and mammograms are only initiated at the age of 40 because that's when their sensitivity and accuracy becomes viable. So, you have from the age of 10 to the age of 40, where your only defense against changes in your breasts are physical exams. Now, you can do imaging like ultrasound or MRI, if you find something on physical exam that can help us at a younger age, but there are no screening mechanisms for that.
Amanda Wilde (Host): So if you are under the age of 40 and you have any of the symptoms you described, you should see your doctor, and there are other sort of screening processes you can go through.
Dr Andrea French: Absolutely. If there are any changes into your breast, you should go see your primary care physician and explain the issues. If they find a mass or if there's skin dimpling, we could get an ultrasound to look to see and quantify that mass, because there's a lot of different growths in the breasts that are benign or not cancerous, and the ultrasound can help us distinguish what those are. If we can't see something on ultrasound, we can go with an MRI because its sensitivity is the greatest of all the imaging that we have. It's not always very specific, so it'll find stuff that may or may not be relevant, but it can help us find things that we can't see in other modalities.
Amanda Wilde (Host): So, this will be true for someone who either has some of the symptoms you described or maybe has a family history of breast cancer and they're under 40.
Dr Andrea French: Right. So if you have a patient or you are a family member of somebody who has had breast cancer under the age of 40, then we really begin to worry about those genetic cancers that can be more aggressive. And so, you really should do those self-exams to know. We also usually will begin MRI screening if the risk of cancer is high enough. If you are BRCA positive or the family has a history of the breast cancer genes BRCA1 or 2, we will start screening earlier with an MRI to help try and identify those cancers early or we'll suggest prophylactic mastectomies and oophorectomies in those patients to try and prevent the risk of developing those aggressive cancers.
Amanda Wilde (Host): So, oophorectomy, being the removal of the ovarian tubes because the BRCA mutations are indicative in both those kinds of cancers, breast and ovarian cancer, right? So, it's really interesting because when we think screening, I think many of us just jump to mammogram, but you're talking about everything before age 40. But if we do manage to get to age 40 with no issues, we should still start screening then with mammograms?
Dr Andrea French: Yes, the recommendation is to start screening at the age of 40 and with screening mammograms.
Amanda Wilde (Host): So, mammograms are the gold standard after age 40?
Dr Andrea French: Correct.
Amanda Wilde (Host): And what else should we think about in terms of screening? We've talked about what kind, how often should we get screening done?
Dr Andrea French: So, still the recommendation is yearly mammogram screening, unless they find something that is of concern. So when you get a breast image, a mammogram, ultrasound, or an MRI, you're given a score. And that score is called a BI-RADS, B-I-R-A-D-S, and it ranges from zero to six. So, zero means they need more information. One means everything looks totally normal. Two means they see something and they're a hundred percent sure it's not cancer. Three means they see something and they're about 95% sure it's not cancer. Four means they see something and is about 80%. Five means they see something and it's a 50/50 shot. And then, six is a biopsy-confirmed breast cancer.
So whenever we get those screenings, then the screening after that is dictated by that. So if it's a BI-RADS 1 or 2, then annual mammographic screening is appropriate. If it's a BI-RADS 3, they feel comfortable enough, they being the radiologist, feel comfortable enough that the only thing that would initiate concern of it being a cancer would be change. So, what they'll do is get them screening every six months to make sure that whatever they're seeing on the imaging isn't changing. And as long as it isn't changing and it's stable for two years, then we typically leave it alone. If it's a BI-RADS 4 image, then the recommendation is to get a core needle biopsy immediately or as quickly as you can in the community to get that tissue pathology to confirm that it is not a breast cancer. Five also we would biopsy as well. So, the screening regimen is really dictated by the image that you get every year.
Amanda Wilde (Host): Now, if something is found in the screening, a BI-RADS 4 let's say, something questionable, and the next step is a biopsy. What does that look like? You said a core needle biopsy.
Dr Andrea French: So, the biopsy is going to be dictated by how they can see what is abnormal. So if they can see the lesion or calcifications on mammogram, but they can't see it on ultrasound, then you get what's called a stereotactic biopsy, which is where they actually do the core needle biopsy under mammogram. And one of the questions everybody asks me is, "Are we put to sleep?" And the answer's no. So, it's done under local, but you are awake for the procedure. If they can see the lesion on ultrasound, then we go with the ultrasound-guided biopsy. If we can't see it on mammogram or ultrasound, and we can only see it on MRI, then we send you for an MRI-guided biopsy. Those are more difficult to obtain because there're fewer centers that do them.
Amanda Wilde (Host): Then what happens after you've gotten that sample for the biopsy? It goes to the lab for diagnosis?
Dr Andrea French: It goes to the pathologist. So, the pathologist will get that specimen, and they will evaluate it under the microscope and with stains to determine what exactly that lesion is. And the one thing about the breast is it's made up of a lot of different types of cells. So, you have the lobules that make milk, you have the ducts that carry milk, and then you have the other cells that are within the breast that help create the structure. So, you can get breast cancer from any of the cells that are in the breast, and they're all considered breast cancer. So, the pathology is extremely important because we want to know if it is a cancer, what is it coming from? What is its receptor status? If it's benign, is it something that we need to take out anyway just because it carries a higher risk of malignant cells being close to it? Or if it's completely benign and we feel safe leaving it alone? All of that information is given to us with a pathology report.
Amanda Wilde (Host): I was going to ask you if you're diagnosed with breast cancer, what are the range of treatments? So, the range begins with maybe we end up doing nothing.
Dr Andrea French: Not with breast cancer. So, cancer is the malignancy, that's what we need to treat. If it's not cancer or it's benign, we may do nothing. So if it's something like a fibroadenoma, so there are masses that we can feel in the breasts that can be really large and often, in young women, including teenagers that are called fibroadenomas and these are benign, non-cancerous, non-life-threatening lesions in the breast and don't have to come out unless the patient is having symptoms or issues related to it. But if it's a breast cancer, it has to be treated.
Amanda Wilde (Host): And you were saying there's all different kinds of cells and different kinds of breast cancers. So, what are treatments available for these different kinds of cancers?
Dr Andrea French: The great thing about breast cancer is that we are greatly benefited by the amount of research that's been done and by all the women who have struggled with breast cancer before. So whenever I have patients come in with this diagnosis, I always like to start with one thing they have to remember, and that is cancer is a big word that describes a broad spectrum of disease. There are cancers that are very difficult for us to treat, and there's cancers that we're very good at treating, and breast cancer is one of those. And part of that is because we have five different modalities to treat it.
So when a patient comes in with breast cancer, it's really important for us to know the receptor status because it tells us how close it is to the original breast cell. And so, receptor status is estrogen receptor or progesterone receptor. And then, there's a third receptor that we look at that's called HER2 that's only found in cancer cells. So that receptor status, whether you're estrogen receptor positive, progesterone receptor positive, HER2 negative, which is the most common type or if you're a triple negative, like ER, PR, HER2 negative. All of those profiles dictates how aggressive we need to be in treating the cancer.
So, the five different modalities that we have to treat are surgery, radiation, chemotherapy, endocrine therapy, and immuno-targeted therapy. If a patient comes in and has cancer, what we have to determine is the likelihood that this is just still in the breast or whether or not it's gone out into the body, because that dictates what order the treatment occurs at. So if it's early and we're not very concerned or there's no evidence that it's gone out of the breast, then we are aggressive about local treatment first to take out the cancer before it goes outside into the rest of the body. When we do treat locally, we treat it with surgery and radiation.
Now, you don't have a choice of a diagnosis, but you do have a choice in the treatment. If you want to do breast-conserving therapy where we just go in and take out the breast cancer with the margins, we can conserve the breast. In that situation, we have to do radiation. Breast-conserving therapy is a lumpectomy with external beam radiation. There are other types of radiation as well. In our community, we don't have them available yet. Or you can have the mastectomy. It's a simple mastectomy where we just take the breast capsule off the muscle. And in those circumstances, if it's early, you often don't need radiation or any further treatment beyond the endocrine treatment.
If we feel that the tumor has gone outside of the breast, there's evidence that the breast cancer is in the lymph nodes under the arm or has gone in other locations, then local treatment is not the place you start. You start with the systemic treatments. And the systemic treatments are the chemotherapy, the endocrine therapy, and the immuno-targeted therapy first, because we don't want to delay treatment of the cells that are outside of the breast while waiting for the breast to heal. So, we do those therapies first. We try and treat those cancer cells in the body, and then we go back and deal with the breast when we feel that the cancer in the rest of the body has been treated.
Amanda Wilde (Host): So, you have to match the treatment to the cancer. What do you see in terms of outcomes for your patients who go through these different modalities? What's the success rate, shall we say?
Dr Andrea French: You know, for most of the people that I see, thankfully, we catch these cancers early and so, cure rates are very high. So, they're in the 80% to 90%, even in stage I and stage II disease. So, our success rate at treating patients is excellent. Even in patients that I've seen who've come in with stage IV disease, where there's cancer found in other parts of the body, I've had patients 10 years out present to my office living their normal life, and treating the disease more as a long-term diagnosis than a timestamp on your foot.
Now, there are forms of cancer. Triple-negative breast cancer is the more aggressive version of the breast cancer and the cure rates and success rates are not as high with that one. But with the vast majority of the breast cancers that we see, women are surviving for long periods of time.
Amanda Wilde (Host): Well, you do get excellent outcomes, which is really encouraging, and I know that there have been technological advances over the last 10 or 20 years that make things more optimal for people going through breast cancer. So thank you, Dr. French, for being here to sort out all this info and explain it so clearly.
Dr Andrea French: There's one thing that I think with this diagnosis that is the most important for patients, and that is to know they have a team that is working with them to help them through. So to have a surgeon that you trust, have an oncologist that you trust, have your radiation oncologist that are all willing to work together for the best outcome for the patient because this is a tough diagnosis for patients to have, and really knowing that their team is there to support them is really important in getting them through the process.
Amanda Wilde (Host): You're not alone.
Dr Andrea French: Yes, you're not alone.
Amanda Wilde (Host): Dr. French, really appreciate your work to give patients the best possible experience. Thank you again.
Dr Andrea French: Thank you.
Amanda Wilde (Host): For more information, visit Dignity health.org/merced/ Women's Health. That's M E R C E D slash Women's Health.
If you found this podcast helpful, please share it on your social channels and be sure to check out the podcast library for other topics of interest to you. Thanks for listening to Hello Healthy, a Dignity Health Podcast. I'm Amanda Wilde. Be well.