I Have Breast Cancer - What Now?
Dr. Kara Kort discusses breast care and breast cancer diagnosis.
Featuring:
Kara Kort, MD, FACS
Kara Kort, MD, FACS is the Medical Director, Breast Care and Surgery, St. Joseph's Health. Transcription:
Bill Klaproth: (Host) Hearing that you have breast cancer can be a frightening experience. One way to reduce your fear and anxiety is to learn about the condition and your treatment options. So let's find out more with Dr. Kara Kort, medical director, breast care, and surgery at St. Joseph's Health. Dr. Kort, thank you for your time. It is great to talk with you. So I know this can be very frightening you or a loved one receives a breast cancer diagnosis. I imagine the first thought that goes through your mind, is am I going to die from this? This doesn't necessarily mean a death sentence though, is that correct?
Dr. Kara Kort: (Guest) No, not at all. In fact, I see hundreds of breast cancer patients every year. And that's when they first walk in that's the first thing that they're thinking that that is absolutely not true. Most women, most, not all, but most women do very well given all the recent advances, the current five-year survival, if you take all comers is over 90% and even the 10-year survival of breast cancer is now over 80%. So, that's the first thing I tell people is that most people will do very, very well and that's, that's the truth.
Host: Well, that is good news and that is very comforting. And you mentioned recent advances. So researchers around the world are working to find better ways to prevent and detect and treat breast cancer and to improve the quality of life of patients and survivors. So can you tell us how has breast cancer treatment changed?
Dr. Kort: I think it changes faster than almost any other, disease. You talked about detection. Mammography has improved over the years to the point that now we pick up things that are so small, that sometimes we question whether or not we should even be finding such tiny cancerous, but that's, that's a whole nother story. Treatment, the way we operate on people has changed, changed dramatically. Much less aggressive surgery that we've learned does just as well. So for example, back when I was first in practice, every time we operate on someone with breast cancer, we took all the lymph nodes out of their armpit. Many women probably have had that. We don't routinely do that anymore so that's a huge advance. Some of the plastic surgery advances we have now are much better than they used to be. A simple example, when we do a mastectomy, we used to say it wasn't safe to keep the nipple not to be graphic, but now we believe that most of the time that is, and that, really results in a much more beautiful outcome. So that's nice as well, there are numerous examples.
Host: Yeah, really good news. And how about genetic testing? I know that has evolved as well over the years.
Dr. Kort: That became very popular. People remember back when Angelina Jolie had her double mastectomy. I don't know if people remember that because she carried a breast cancer gene. Since that time, number one, she made great awareness of that, disease that people can carry a gene. And since then, we've discovered multiple other genes that put people at potential risk of developing a cancer. And so nowadays when people get that genetic testing, if they qualify, or if there's someone were concerned, might carry that gene. Now we can test them for a whole slew of genes at once probably about 28 genes were with Angelina Jolie it was just a one or two. So that's another huge advance.
Host: Right. So I know testing is I don't want to say it's the wild West, but you hear different things all the time. Let me ask you this, should women under the age of 50, get a mammogram?
Dr. Kort: So you're right, that's a very touchy subject. So even right now, there are three national organizations that have put out their national recommendation for screening and all three of them are different. And so, the controversy comes from the fact that there was some people believe that if you start less than 40, the chance that you're going to diagnose, or put a woman through a biopsy and find something that turns out to be nothing is greater. And to some degree, that's true because people less than 50 are less likely to have breast cancer. So that's where the controversy comes in. It is a lot of false, positive findings and a lot of mental anxiety put people through, but I personally, and my institution, we do recommend mammography starting at the age of 40.
Host: Okay, very good. And then it might even be earlier for somebody that is in a higher risk. For example, somebody that has breast cancer in their family, is that correct?
Dr. Kort: That is correct. So sometimes if I see a woman whose mother was diagnosed at age 45, then we would typically start her five to 10 years earlier than that. So we would start her in the 35 to 40 range. So, yeah, so much of your recommendation comes from a person's individual risk factors.
Host: So it really behooves someone to really understand their risk. Is that right? So, Dr. Kort, is there anything women can do to help prevent breast cancer?
Dr. Kort: We always talk about the risks for breast cancer that you can change and the risk factors that you can't. So things like, when you got your first menses, whether or not you ever had children, how late in life that you had children, things like that, you can't change and you can't change your family history. So those are things that are just your own personal risk factors that you're born with. But then there are other things we realized that people can improve on. So we know for a fact that consuming moderate amounts of alcohol increases a woman's risk of breast cancer. The other thing we've realized is obesity increases one's risk of breast cancer. I think that's a tough thing to talk about, but it's a fact. And so sometimes, you know, I think it's, beneficial for, Primary care doctors to sort of talk about that as well. Well, obviously things like exercise, keeps people's weight down and so all those, things help.
Host: So true. And then Dr. Kort, last question, and thank you for your time. What advice do you have for a woman who might recently have been diagnosed with breast cancer?
Dr. Kort: Take a deep breath because I can tell you that when most people come in there, so anxious because always tell my patients breast cancer is one word, but there is a huge variation in the degree of significance of that. So some breast cancers are very serious and they might need chemotherapy and significant treatments, but the majority are not. And so I always urge people to get a good opinion, get a second opinion. If you, feel the need, there's always time to do that. I always encourage my patients not to rush into a decision and really seek the advice of an expert. Someone who sees and takes care of a lot of breast cancer patients, because like I said earlier in the talk, the literature and the recommendations are changing constantly. And so you really have to see someone who's up to date on what's the current recommendations.
Host: Really good advice Dr. Kort, and thank you for your time. This is really an important topic and this has really been informative and insightful. Thank you so much, Dr. Kort. We appreciate it.
Dr. Kort: Absolutely. My pleasure.
Host: That's Dr. Kara Kort. And for more information, please visit S J H S Y R.org/breast health. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is St. Joseph's Health med cast from St. Joseph's Health, I'm Bill Klaproth. Thanks for listening.
Bill Klaproth: (Host) Hearing that you have breast cancer can be a frightening experience. One way to reduce your fear and anxiety is to learn about the condition and your treatment options. So let's find out more with Dr. Kara Kort, medical director, breast care, and surgery at St. Joseph's Health. Dr. Kort, thank you for your time. It is great to talk with you. So I know this can be very frightening you or a loved one receives a breast cancer diagnosis. I imagine the first thought that goes through your mind, is am I going to die from this? This doesn't necessarily mean a death sentence though, is that correct?
Dr. Kara Kort: (Guest) No, not at all. In fact, I see hundreds of breast cancer patients every year. And that's when they first walk in that's the first thing that they're thinking that that is absolutely not true. Most women, most, not all, but most women do very well given all the recent advances, the current five-year survival, if you take all comers is over 90% and even the 10-year survival of breast cancer is now over 80%. So, that's the first thing I tell people is that most people will do very, very well and that's, that's the truth.
Host: Well, that is good news and that is very comforting. And you mentioned recent advances. So researchers around the world are working to find better ways to prevent and detect and treat breast cancer and to improve the quality of life of patients and survivors. So can you tell us how has breast cancer treatment changed?
Dr. Kort: I think it changes faster than almost any other, disease. You talked about detection. Mammography has improved over the years to the point that now we pick up things that are so small, that sometimes we question whether or not we should even be finding such tiny cancerous, but that's, that's a whole nother story. Treatment, the way we operate on people has changed, changed dramatically. Much less aggressive surgery that we've learned does just as well. So for example, back when I was first in practice, every time we operate on someone with breast cancer, we took all the lymph nodes out of their armpit. Many women probably have had that. We don't routinely do that anymore so that's a huge advance. Some of the plastic surgery advances we have now are much better than they used to be. A simple example, when we do a mastectomy, we used to say it wasn't safe to keep the nipple not to be graphic, but now we believe that most of the time that is, and that, really results in a much more beautiful outcome. So that's nice as well, there are numerous examples.
Host: Yeah, really good news. And how about genetic testing? I know that has evolved as well over the years.
Dr. Kort: That became very popular. People remember back when Angelina Jolie had her double mastectomy. I don't know if people remember that because she carried a breast cancer gene. Since that time, number one, she made great awareness of that, disease that people can carry a gene. And since then, we've discovered multiple other genes that put people at potential risk of developing a cancer. And so nowadays when people get that genetic testing, if they qualify, or if there's someone were concerned, might carry that gene. Now we can test them for a whole slew of genes at once probably about 28 genes were with Angelina Jolie it was just a one or two. So that's another huge advance.
Host: Right. So I know testing is I don't want to say it's the wild West, but you hear different things all the time. Let me ask you this, should women under the age of 50, get a mammogram?
Dr. Kort: So you're right, that's a very touchy subject. So even right now, there are three national organizations that have put out their national recommendation for screening and all three of them are different. And so, the controversy comes from the fact that there was some people believe that if you start less than 40, the chance that you're going to diagnose, or put a woman through a biopsy and find something that turns out to be nothing is greater. And to some degree, that's true because people less than 50 are less likely to have breast cancer. So that's where the controversy comes in. It is a lot of false, positive findings and a lot of mental anxiety put people through, but I personally, and my institution, we do recommend mammography starting at the age of 40.
Host: Okay, very good. And then it might even be earlier for somebody that is in a higher risk. For example, somebody that has breast cancer in their family, is that correct?
Dr. Kort: That is correct. So sometimes if I see a woman whose mother was diagnosed at age 45, then we would typically start her five to 10 years earlier than that. So we would start her in the 35 to 40 range. So, yeah, so much of your recommendation comes from a person's individual risk factors.
Host: So it really behooves someone to really understand their risk. Is that right? So, Dr. Kort, is there anything women can do to help prevent breast cancer?
Dr. Kort: We always talk about the risks for breast cancer that you can change and the risk factors that you can't. So things like, when you got your first menses, whether or not you ever had children, how late in life that you had children, things like that, you can't change and you can't change your family history. So those are things that are just your own personal risk factors that you're born with. But then there are other things we realized that people can improve on. So we know for a fact that consuming moderate amounts of alcohol increases a woman's risk of breast cancer. The other thing we've realized is obesity increases one's risk of breast cancer. I think that's a tough thing to talk about, but it's a fact. And so sometimes, you know, I think it's, beneficial for, Primary care doctors to sort of talk about that as well. Well, obviously things like exercise, keeps people's weight down and so all those, things help.
Host: So true. And then Dr. Kort, last question, and thank you for your time. What advice do you have for a woman who might recently have been diagnosed with breast cancer?
Dr. Kort: Take a deep breath because I can tell you that when most people come in there, so anxious because always tell my patients breast cancer is one word, but there is a huge variation in the degree of significance of that. So some breast cancers are very serious and they might need chemotherapy and significant treatments, but the majority are not. And so I always urge people to get a good opinion, get a second opinion. If you, feel the need, there's always time to do that. I always encourage my patients not to rush into a decision and really seek the advice of an expert. Someone who sees and takes care of a lot of breast cancer patients, because like I said earlier in the talk, the literature and the recommendations are changing constantly. And so you really have to see someone who's up to date on what's the current recommendations.
Host: Really good advice Dr. Kort, and thank you for your time. This is really an important topic and this has really been informative and insightful. Thank you so much, Dr. Kort. We appreciate it.
Dr. Kort: Absolutely. My pleasure.
Host: That's Dr. Kara Kort. And for more information, please visit S J H S Y R.org/breast health. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is St. Joseph's Health med cast from St. Joseph's Health, I'm Bill Klaproth. Thanks for listening.