Advances in breast cancer treatment have paved the way for treating many types of cancer—today, treatments are individualized to each patient's unique tumor and cancer type.
At Cancer Treatment Centers of America® (CTCA), we want to empower women with knowledge, so that they can make a more informed treatment decision. A breast cancer diagnosis is life-changing, and since every breast cancer is different, it requires a personalized approach.
Dr. Citrin, a medical oncologist who focuses on helping women with breast cancer explains how the treatment of breast cancer has changed over the years, and what women need to know about in order to help prevent and fight breast .
At CTCA, your breast cancer team helps you develop a treatment tailored to your needs, using diagnostic tools and treatment technology to target even advanced cancers.
What Every Woman Needs to Know About Breast Cancer
Featured Speaker:
Dr. Citrin earned a medical degree and PhD at the University of Glasgow in Scotland. He also completed an internal medicine residency and fellowship in academic medicine at the university. He then completed a human oncology and medicine fellowship at the University of Wisconsin-Madison. Dr. Citrin is a member of several professional associations, including the American Society of Clinical Oncology, American Association for Cancer Research and the Chicago Medical Society. His research has been published extensively over the years in journals such as Cancer and the Journal of Clinical Oncology.
Transcription:
What Every Woman Needs to Know About Breast Cancer
Melanie Cole (Host): After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. My guest is Dr. Dennis Citrin, he is a medical oncologist with Cancer Treatment Centers of America. He is also the author of the book Knowledge is Power: What Every Woman Should Know About Breast Cancer. Welcome to the show Dr. Citrin. Let's talk about what every woman should know about breast cancer, especially in this awareness month. First, give us some of the risk factors, genetic or controllable and then some of the symptoms we might experience that will send us to you.
Dr. Dennis Citrin (Guest): Thank you. The most important risk factor for developing breast cancer is being a woman. Breast cancer, unlike lung cancer where there is a clearly single defined cause factor like smoking, we don't have that in breast cancer. One woman in eight will develop breast cancer during her lifetime. So, this is a disease that affects women of all sizes and shapes, of all sorts of different background. There are several risk factors however, that are clearly identified, those would include family history of breast cancer or cancer of the ovary. Alcohol use is also associated with an increased risk of breast cancer and the use of hormone replacement therapy, particularly combined estrogen and progesterone in post-menopausal women. These are risk factors that have been defined. But, for many women there's no clearly obvious risk factor other than the fact that she's a woman.
Melanie: So symptoms. Now, we know we are supposed to get our mammograms and we get them every year. Is there something a woman can do to catch it earlier, then maybe her yearly mammogram?
Dr. Citrin: Well, we do advise women to check their breasts regularly. I tell women, you should be familiar with how your breasts feel. You know, the breast changes during a woman's monthly cycle because of estrogen stimulation. The best advice is simply this, check your breasts regularly, if you feel anything in the breast that is different or feels strange to you, different from the rest of the breast tissue or the other breast, then go see a knowledgeable doctor. See a knowledgeable doctor because it's very important to recognize that sometimes breast cancer usually produces a lump in the breast that sometimes can produce very subtle changes only. So, it's as well to see someone, a doctor who is really familiar with breast disease.
Melanie: Now, when we've done that, we've had our mammogram, we go then for that dreaded diagnostic mammogram after maybe they've seen something suspicious. You know, then the doctor says "ok, you know, this is what we're thinking." Maybe there is a needle biopsy or a core biopsy, stereotactic, whatever involved. So, once the diagnosis is made, then Dr. Citrin, then what? What is going on in treatment for breast cancer today?
Dr. Citrin: The first piece of advice to give any woman who is newly diagnosed with breast cancer is this, do not panic. The vast majority of woman diagnosed with early stage breast cancer today can confidently expect to be cured of their disease. That's very important to recognize that fact. I say, don't panic because sometimes doctors will almost rush patients into making decisions regarding treatment and that is not in a woman's best interest. There has been a huge change in how we approach breast cancer. I've seen a paradigm shift. The old concept was, diagnosis of breast cancer, do surgery immediately and then after surgery, either lumpectomy or mastectomy will decide what else has to be done. That has all changed. You mentioned a core biopsy before. A core biopsy gives us enough breast tumor tissue that we can accurately assess the disease. Not only the stage of the disease, in other words, how much cancer is present and where is it, but also the type of breast cancer. Because, there have been tremendous advances in our understanding of the different types of breast cancer. And very often, surgery is not the first treatment which is required. So my advice is this, do not panic. By all means see a surgeon, but before any treatment is given the patient should also see a medical oncologist, particularly, if possible, a medical oncologist who specializes in breast cancer. Because treatment today is very very different from what it was even five years ago.
Melanie: So speak about what the treatment is that is different from five years ago. So, you know, you mentioned lumpectomy and not rushing into surgery, not panicking, seeing a doctor that you trust, a medical oncologist that has plenty of experience with breast cancer...then what? If you've done the core biopsy, you've gotten the information that you need, what then are some of the treatments available? So they are not so scary for the women listening Dr. Citrin.
Dr. Citrin: There is really two different forms of treatment. There is what we call local treatment, which means treatment for the tumor in the breast and also to check the lymph nodes in the armpit, in the axilla. There's also a need for what we call systemic treatment, which is treatment for the rest of the body. Now, that may be as simple as taking a hormone blocking pill or may involve chemotherapy. And in each of these areas; surgery, radiation and drug treatment, there have been tremendous advances over the last five to ten years. If I had to characterize it, I'd say the following, "The approach now is, we want to do everything to cure the patient, but we don't want to over-treat the patient." And secondly," the buzzword is kind of personalized medicine." We now recognize that each and every patient and every tumor is different. And so the treatment has to be tailor made to the individual patient and her disease. There is no longer one size fits all.
Melanie: You know, people are afraid of things like mastectomies. Obviously, women have been seeing women with scarves on their heads for years. Are there changes in the types of surgery and in the chemotherapies that are received?
Dr. Citrin: Yes. There's been advances in all three different basic forms of treatment; surgery, radiation and drug treatment. It's hard in nine minutes to try and describe them all to you, but let me just say this...most women diagnosed with early stage breast cancer today do not require mastectomy. There are some special cases where mastectomy is still required. For example, if there's multiple tumors in the breast, or if there's a very large tumor, or if the patient has the breast cancer gene, the BRCA gene. But, outside those kind of special kind circumstances, mastectomy is generally not required. A lot of women seem to think "Well, if the whole breast is removed my chances of cure are much better." That is not true. The cure rate for limited surgery, a lumpectomy, the cure rate in most women is exactly the same as for mastectomy. And obviously, cosmetically and functionally and psychologically it is much more acceptable. So, that's surgery.
Melanie: Now, Dr. Citrin, in just twenty seconds...wrap it up for us. Give us your best advice and hope for the advances in breast cancer.
Dr. Citrin: Best advice is, if a woman feels anything abnormal in her breast, she should not panic. She should seek medical treatment immediately. Before starting treatment, at the very least, she should see a surgeon and a medical oncologist. And finally, when the specialists who are treating her develop a treatment plan, she should stick with that plan and make sure that she follows the treatment recommendations.
Melanie: Thank you so much Dr. Dennis Citrin. You're listening to Managing Cancer. For more information you can go to cancercenter.com, that's cancercenter.com. This is Melanie Cole, thanks for listening.
What Every Woman Needs to Know About Breast Cancer
Melanie Cole (Host): After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. My guest is Dr. Dennis Citrin, he is a medical oncologist with Cancer Treatment Centers of America. He is also the author of the book Knowledge is Power: What Every Woman Should Know About Breast Cancer. Welcome to the show Dr. Citrin. Let's talk about what every woman should know about breast cancer, especially in this awareness month. First, give us some of the risk factors, genetic or controllable and then some of the symptoms we might experience that will send us to you.
Dr. Dennis Citrin (Guest): Thank you. The most important risk factor for developing breast cancer is being a woman. Breast cancer, unlike lung cancer where there is a clearly single defined cause factor like smoking, we don't have that in breast cancer. One woman in eight will develop breast cancer during her lifetime. So, this is a disease that affects women of all sizes and shapes, of all sorts of different background. There are several risk factors however, that are clearly identified, those would include family history of breast cancer or cancer of the ovary. Alcohol use is also associated with an increased risk of breast cancer and the use of hormone replacement therapy, particularly combined estrogen and progesterone in post-menopausal women. These are risk factors that have been defined. But, for many women there's no clearly obvious risk factor other than the fact that she's a woman.
Melanie: So symptoms. Now, we know we are supposed to get our mammograms and we get them every year. Is there something a woman can do to catch it earlier, then maybe her yearly mammogram?
Dr. Citrin: Well, we do advise women to check their breasts regularly. I tell women, you should be familiar with how your breasts feel. You know, the breast changes during a woman's monthly cycle because of estrogen stimulation. The best advice is simply this, check your breasts regularly, if you feel anything in the breast that is different or feels strange to you, different from the rest of the breast tissue or the other breast, then go see a knowledgeable doctor. See a knowledgeable doctor because it's very important to recognize that sometimes breast cancer usually produces a lump in the breast that sometimes can produce very subtle changes only. So, it's as well to see someone, a doctor who is really familiar with breast disease.
Melanie: Now, when we've done that, we've had our mammogram, we go then for that dreaded diagnostic mammogram after maybe they've seen something suspicious. You know, then the doctor says "ok, you know, this is what we're thinking." Maybe there is a needle biopsy or a core biopsy, stereotactic, whatever involved. So, once the diagnosis is made, then Dr. Citrin, then what? What is going on in treatment for breast cancer today?
Dr. Citrin: The first piece of advice to give any woman who is newly diagnosed with breast cancer is this, do not panic. The vast majority of woman diagnosed with early stage breast cancer today can confidently expect to be cured of their disease. That's very important to recognize that fact. I say, don't panic because sometimes doctors will almost rush patients into making decisions regarding treatment and that is not in a woman's best interest. There has been a huge change in how we approach breast cancer. I've seen a paradigm shift. The old concept was, diagnosis of breast cancer, do surgery immediately and then after surgery, either lumpectomy or mastectomy will decide what else has to be done. That has all changed. You mentioned a core biopsy before. A core biopsy gives us enough breast tumor tissue that we can accurately assess the disease. Not only the stage of the disease, in other words, how much cancer is present and where is it, but also the type of breast cancer. Because, there have been tremendous advances in our understanding of the different types of breast cancer. And very often, surgery is not the first treatment which is required. So my advice is this, do not panic. By all means see a surgeon, but before any treatment is given the patient should also see a medical oncologist, particularly, if possible, a medical oncologist who specializes in breast cancer. Because treatment today is very very different from what it was even five years ago.
Melanie: So speak about what the treatment is that is different from five years ago. So, you know, you mentioned lumpectomy and not rushing into surgery, not panicking, seeing a doctor that you trust, a medical oncologist that has plenty of experience with breast cancer...then what? If you've done the core biopsy, you've gotten the information that you need, what then are some of the treatments available? So they are not so scary for the women listening Dr. Citrin.
Dr. Citrin: There is really two different forms of treatment. There is what we call local treatment, which means treatment for the tumor in the breast and also to check the lymph nodes in the armpit, in the axilla. There's also a need for what we call systemic treatment, which is treatment for the rest of the body. Now, that may be as simple as taking a hormone blocking pill or may involve chemotherapy. And in each of these areas; surgery, radiation and drug treatment, there have been tremendous advances over the last five to ten years. If I had to characterize it, I'd say the following, "The approach now is, we want to do everything to cure the patient, but we don't want to over-treat the patient." And secondly," the buzzword is kind of personalized medicine." We now recognize that each and every patient and every tumor is different. And so the treatment has to be tailor made to the individual patient and her disease. There is no longer one size fits all.
Melanie: You know, people are afraid of things like mastectomies. Obviously, women have been seeing women with scarves on their heads for years. Are there changes in the types of surgery and in the chemotherapies that are received?
Dr. Citrin: Yes. There's been advances in all three different basic forms of treatment; surgery, radiation and drug treatment. It's hard in nine minutes to try and describe them all to you, but let me just say this...most women diagnosed with early stage breast cancer today do not require mastectomy. There are some special cases where mastectomy is still required. For example, if there's multiple tumors in the breast, or if there's a very large tumor, or if the patient has the breast cancer gene, the BRCA gene. But, outside those kind of special kind circumstances, mastectomy is generally not required. A lot of women seem to think "Well, if the whole breast is removed my chances of cure are much better." That is not true. The cure rate for limited surgery, a lumpectomy, the cure rate in most women is exactly the same as for mastectomy. And obviously, cosmetically and functionally and psychologically it is much more acceptable. So, that's surgery.
Melanie: Now, Dr. Citrin, in just twenty seconds...wrap it up for us. Give us your best advice and hope for the advances in breast cancer.
Dr. Citrin: Best advice is, if a woman feels anything abnormal in her breast, she should not panic. She should seek medical treatment immediately. Before starting treatment, at the very least, she should see a surgeon and a medical oncologist. And finally, when the specialists who are treating her develop a treatment plan, she should stick with that plan and make sure that she follows the treatment recommendations.
Melanie: Thank you so much Dr. Dennis Citrin. You're listening to Managing Cancer. For more information you can go to cancercenter.com, that's cancercenter.com. This is Melanie Cole, thanks for listening.