October is Breast Cancer Awareness Month, an annual campaign to educate the public to this complex disease; its causes, treatment, and cure.
Did you know?
* About 1 in 8 U.S. women will develop invasive breast cancer over the course of their lives.
* As of 2020, there were 2.26 million global cases of breast cancer, making it the most commonly diagnosed cancer in the world. 685,000 of those diagnosed have died.
* In 2022, an estimated 290,560 new cases of invasive breast cancer are expected to be diagnosed in the U.S., along with 51,400 new cases of non-invasive breast cancer. An estimated 43,780 people will lose their lives to metastatic breast cancer.
In this podcast, Mason City Clinic’s general surgeon Brittany Splittgerber, MD talks about how best to detect breast cancer and the different treatment and surgical options for it.
Welcome to Mason City Docs on Call, a podcast series with North Iowa specialists who educate us about how to stay healthy. I’m your host, Carol Gifford. So, today’s topic is breast cancer. According to the CDC, 255,000 women get breast cancer each year and, unfortunately, 42,000 die from it.
How can you lower your risk for getting breast cancer, and how soon should women start getting screening mammograms? What are the treatment and surgical options for women with breast cancer?
So with us today to answer all these questions and more is Board Certified General Surgeon, Brittany Splittgerber from the Mason City Clinic. So welcome to the program Dr. Splittgerber.
So who- it’s a two part question. So who is at most risk for getting breast cancer and is there a way to lower your risk?
Yes. So most risk for getting breast cancer is women. So one in eight women will get breast cancer at some point in their life, and then age. So an age over 50 does put you at a higher risk as well. There are a couple other factors that may affect your risk for breast cancer. So we are becoming more aware of genetic factors that play a role with your increased risk for breast cancer.
So it’s always important to bring those up with your primary care doctor if you have a strong family history of cancers or breast cancers, where we could then maybe get you in a high risk breast cancer clinic to do increased screening or to even get an appointment with a genetic counselor for possible genetic testing. So those are some of those factors.
Are there ways to lower your risks? Well, I think they found that having a healthy lifestyle and an active lifestyle and a healthy weight can all help lower those risk factors as well. And if you can avoid hormonal supplements like estrogens and progesterones, sometimes that can help reduce some risk factors.
And does, I had read somewhere or heard somewhere that alcohol contributes to breast cancer? I mean, can you tell us a little bit about that?
Yeah. There is studies out there showing that increased alcohol and increased drinking does play a role at increasing your risk factor to getting breast cancer. So that does.
So let’s talk about screening or symptoms. Are there symptoms of breast cancer or is it that you really have to kind of do self-examinations and get your screening mammograms to find out if you have breast cancer?
So I think it’s important to keep up with screening mammograms because finding breast cancer early is, makes it much more treatable. So most women should start screening mammograms at around age 40 and talk to their primary care provider to start to see if they can do annual exams, at least up to about 55 and then consider exams every other year. I think the other thing is just to have self-awareness of your body too. You can always detect a lump or a bump there, and if you do, to come in and get seen to then get additional imaging. So, but starting with screening mammograms and keeping up with that I think is the most important.
And if there is a family history of breast cancer, should you start getting those screening mammograms earlier than 40? Or is that a conversation one-on-one with your doctor?
I would have that conversation with your doctor, but yes, if you have a early family member with an early diagnosis, then your screening does start earlier and I would go through your primary care provider to see when you should start screening if you have an early family history of breast cancer.
So if breast cancer is detected through the screening mammogram, can you walk us through sort of what the next steps are for women?
Yeah, so usually women come in with screening mammogram and the radiologists finds something that they find concerning. And this happens to a lot of women and they’ll bring them back for additional imaging where they’ll do a diagnostic mammogram and then maybe an ultrasound to take a better look at an area of concern. If the area of concern kind of persists and they still see it and are concerned about it, then they’ll usually set you up for a biopsy to biopsy that area. And then if that biopsy comes back as a cancer or a pre-cancer or something concerning, then often women come in to my clinic to meet with me as surgeon to talk about treatment.
And what are some of the treatment options or surgical options?
Yeah. So the treatment for breast cancer is multi-modality. So breast cancer is treated with surgery, with radiation therapy, with medical oncology and chemotherapies or hormonal therapies and/or hormonal therapies. And so most women get a combination of all these treatments to help treat their breast cancer and then help prevent reoccurrence risks.
Usually a lot of women start with surgery, which is why most women actually come and see a surgeon first to start talking about what their treatment options all are and what treatment exists for them. In terms of basic surgical options, I think there’s two basic options to remove cancer out of the breasts that most women come and talk about.
And one is a lumpectomy where we remove that lump of tissue. We usually combine lumpectomies with radiation. Or the second surgical option to get the cancer out of the breast is a mastectomy where women can get either one mastectomy or they can get both mastectomies, a bilateral mastectomy, and those can often be combined with reconstruction options that we have here as well. And at the time of surgery, we also often check for spread into the lymph nodes, so…
And so, and we talked about this a little earlier, but once you remove the cancer and then perhaps the patient goes through radiation or chemotherapy, what is then, is there a certain amount of time that women wait until they know they’re absolutely cancer free?
Or is there recurrence?
So there are national cancer guidelines and here we follow those and women are kept at our Cancer Center and have regular appointments for five years outward. And then if you qualify for or if your tumor would respond to a hormonal therapy, women are often on an anti-estrogen therapy throughout that time period and checking in with their medical oncologist regularly and ensuring if they’ve kept breast tissue that they’re keeping up with their screening.
So tell us a little bit more about the, is it the MercyOne North Iowa Breast Center?
And what’s the kind of care that you offer women for their breast health?
So we have all of the specialists here to provide breast cancer care. So we have surgeons that do these surgeries. We have plastic surgeons here and available to do reconstruction options. We have somebody who provides genetic counseling and offers genetic testing. And we do even have someone here that is providing a clinic for high risk breast cancer patients who have maybe a high risk family, or they’ve made some irregular cells and need additional screening.
We have our radiation oncologist and our medical oncologist here. And then we also have a specialized nurse coordinator that helps work with all the patients when they come in to make sure that they can get through this system and are guided throughout all of their treatment. And then she does a nice setup of getting patients even enrolled in additional therapies to know what resources are in the communities and getting everything organized so they feel supported through this process.
That’s a wonderful service to have-
… for someone going through this journey and process, to have almost a sounds like a quarterback.
Yeah. And it’s nice because that nurse coordinator gets to kind of be with the patients through all the phases where I’m in the surgery side, but she can continue with them through radiation or to their medical oncology and provide support if needed.
Yeah, absolutely. So is there one key message that you would like to communicate to women out there of all ages about breast cancer and prevention and screening and treatment?
I think the biggest thing is to go in and get screening done, is actually to present and do the mammograms. Nobody really enjoys doing that, but just going in and getting it done because I think early-caught breast cancer is much more treatable. And I think also just having a self-awareness of your body and if you do identify a new lump or bump, don’t be afraid. Come and present to your primary care doctor and get it assessed. Yeah.
So early detection is really key.
Yes. And I love be aware of your body and get those screening mammograms.
Yes. Yes, absolutely.
So thank you for being on the program, Dr. Splittgerber.
Thank you for listening to Mason City Docs on Call. For more episodes, go to mcclinic.com/radio-podcasts.
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