Elective Surgery Cuts Risk of Cancer

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38 BREAST CANCER SPOTLIGHT

/health

TUESDAY, OCTOBER 23, 2007

Elective surgery cuts risk of cancer By Abigail Ekue-Smith Special to amNewYork

Dr. Kathy-Ann Joseph New York-Presbyterian/ Columbia University Medical Center

Most women undergoing the procedure are BRCA mutated gene carriers in their 20s or 30s. Some have already battled breast cancer or had a family member die from the disease. Having an elective mastectomy lessens the risk of developing breast cancer by 90 percent. However, breast tissue can be found throughout the thoracic cavity, above the collarbone, in the armpits and in the abdomen. That still leaves a chance for

breast cancer to develop. When elective mastectomies were first performed, many surgeons thought it was wrong to remove healthy tissue and expose patients to risks of surgery, such as reactions to anesthesia or infection. But for a high-risk woman, the secondary health risks of surgery outweigh drug therapy that can induce menopause, the cost of frequent doctor visits, MRIs and mammograms, and the mental strain of possible cancer diagnosis. Although some insurance companies do not cover elective procedures, a case can be made for high-risk pre-cancer patients and the surgery may be covered. Mastectomies are irreversible. Breast surgeons work closely with plastic surgeons to perform breast reconstructions. The reconstructed breasts will look like natural breasts under clothing, but depending on the procedure used, the

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Women facing a high risk of breast cancer may want to explore elective surgery. breast may not look the same as before to the naked eye. Also, the reconstructed breast will not function as a normal breast, eliminating the ability to breast feed, and breast and nipple sensitivity can change. Some patients may decide not to have breast reconstruction at all. There is no set require-

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You can’t get breast cancer if there’s no breast. That’s the logic behind elective or prophylactic mastectomy. Prior to the introduction of the procedure, mastectomies were performed on women already diagnosed with breast cancer. Within recent years, the number of breast cancer “previvors” has increased. Women are taking steps to beat cancer to the punch. Carrying the mutated BRCA1 and BRCA2 genes, a family history of breast cancer or a previous bout with breast cancer can increase a woman’s chances of getting breast cancer to 85 percent. “Women faced with those odds may feel they’re not going to take those chances,” said Kathy-Ann Joseph, assistant professor of surgery at New York-Presbyterian/Columbia University Medical Center.

‘WOMEN FACED WITH THOSE ODDS MAY FEEL THEY’RE NOT GOING TO TAKE THOSE CHANCES.’

■ The latest research ■ Up-to-date health news ment for pre-op mental health care, but a patient

Men’s goods go pink Many women know that October is the time to think pink, as in breast cancer awareness pink. And they know many of their favorite beauty and fashion products will be offered in special pink versions as fundraising tools. But the campaign to raise the profile of — and raise money for — breast cancer has entered other consumer realms to court different sectors of the shopping public. Men’s cologne and ski helmets are among the items to go “pink” this month, without actually changing color. Lifetime TV’s public-service campaign features spots by football stars Jake Delhomme and Ronde Barber on how breast cancer has touched their lives. The network and NFL are also teaming up to highlight breast cancer awareness at participating teams’ home games.

(iStockphoto)

should expect to undergo some counseling before a surgeon will agree to perform the procedure. Joseph said any patient who is planning to get a double elective mastectomy at New York Presbyterian/ Columbia University Medical Center must meet with a psychiatrist and receive counseling.

Tests may miss cancer. (iStockphoto)

An elusive, fatal threat QB Jake Delhomme has made cancer PSAs. (AP) “It’s happening all over, it’s happening across the board,” said Evelyn Lauder, founder of the Breast Cancer Research Foundation and a senior corporate vice president of the Estée Lauder Cos. Wilson Sporting Goods has been a strong partner in fundraising for the cause yearround, she said. “People don’t get sick in isolation,” Lauder said. “They get sick as a family. ... It’s not just a disease for women. Men also are usually partners to women in families as husbands, sons and brothers.” (AP)

Health-conscious women know to examine their breasts for lumps every month and, when they reach age 40, to have yearly mammograms. But there is a type of breast cancer that probably won’t be caught by either of these screens. Inflammatory breast cancer is a rare but aggressive type that may cause the affected breast to become warm, reddish or bruised and swollen. Skin may become like the ridged, dimpled peel of an orange, and the nipple may invert. In appearance, it resembles a breast infection, so misdiagnoses can occur. Breastinfection patients who complete a week’s course of antibiotics with no improvement should see their doctor or a specialist immediately. (Chicago Tribune)


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