BREAST CANCER AWARENESS MONTH Meet Dr. Hisa Yamaguchi: Breast Cancer Surgeon For those women affected by breast cancer in the Snellville area, Dr. Hisa Yamaguchi is a familiar and welcoming face. She’s known for her wonderful bedside manner and after 22 years of working with breast cancer patients, the surgeon has touched the lives of thousands. Born in Kearny, NJ, she graduated from Lafayette College in Easton, PA in 1982, New York University in 1984, Hahnemann University School of Medicine in Philadelphia in 1988 and did her general surgery residency at the Medical Center of Delaware from 1988-1993. She has been in private practice in Gwinnett County since 1995 and is currently working for Eastside Surgical Associates practicing general surgery with an emphasis on breast disease/ cancer treatment. The Snellville Spirit recently asked Yamaguchi about herself and her efforts to help women in the battle against breast cancer. Snellville Spirit: Why did you want to get into the field you are in? Dr. Hisa Yamaguchi: Actually, I wanted to be a marine biologist. Then I went to grad school and wanted to work in the lab. Then I got into med school. I actually taught undergrad pre-med students at (New York University) and found it fascinating. Once I was in med school, I immediately fell in love with surgery. Despite knowing that there were very few women in surgery and I faced many obstacles, it felt so natural and I knew it was my calling. My mother was a physician in Japan and my grandfather was a surgeon. But she actually tried to talk me out of it, because she knew how demanding and challenging this career would be for me. SS: Why breast cancer? HY: Breast cancer receives a lot of attention and funding. It is the leading cancer in American women. One in eight American women, if they reach the age of 90, will develop breast cancer. Most people, if not everyone, know someone with breast cancer. Over 200,000 new diagnoses are made yearly in America. Because of the extensive research, many new treatments are significantly helping women with this disease. It is because of the large number of people with breast cancer, that it is easier to do research and clinical studies. With cancers such as ovarian, the number of patients are much smaller so it is harder to accrue patients for studies. SS: What would you tell a women diagnosed with breast cancer? HY: It’s not a simple answer. Breast cancer is so diverse. It really depends on the cancer. If the patient has early stage breast cancer, (Stage I or IIA) she has an excellent prognosis. SS: How has treating breast cancer changed over the years? HY: This is the most important concept that I discuss with each breast cancer patient. Breast cancer treatment dramatically changed by the beginning of the 21st Century. Before then, all breast cancers were treated the same (all women had mastectomy, same chemo, maybe radiation and no immediate reconstruction). We learned that all breast cancers are as unique as the patient. We now
use the molecular biology (genetic profile or finger print) to characterize each cancer. This allows us to determine if treatment such as chemo would be effective and provide a survival benefit. If not, we could spare the patient the deleterious effects of our drugs. Also many women who previously would have had a mastectomy in the past can now have the choice to preserve her breast. Surgeons have also learned that the extremely morbid surgeries of the past (radical mastectomy and full axillary dissection) provided no survival benefit. Our surgeries are now oncologically safe yet also attempt to preserve symmetry and better cosmetic results for the patient. I stress to patients, that the internet and your friends and family, should not help you with your medical decision choices. This should be discussed with a dedicated breast specialist. Breast cancer treatment is a very complex and dynamic field of medicine. Changes can occur very quickly. Physicians who treat breast cancer keep up to date with any changes in research and clinical trials. I attend a weekly multidisciplinary conference to discuss each newly diagnosed breast cancer. This allows the physicians of all specialties (medical oncology, radiation oncology, surgery, radiology, pathology) to discuss each case and then agree on the proposed treatment plan. Also I attend yearly conferences to learn from the national specialists in this field. SS: What are some preventative measures women can take to avoid breast cancer? HY: There are a few factors that you can do to decrease your risk for breast cancer. Ten percent of all breast cancers are hereditary - a genetic mutation is inherited. The majority of breast cancers are not hereditary (called sporadic). Obesity increases your risk. Long term hormone use, alcohol intake, nulliparity (no children) and having children after age 30 also imparts a higher risk. SS: Breast cancer is often considered an older woman’s disease. Is this true? HY: That is true. The rate of breast cancer increases after menopause. We are seeing women diagnosed at younger ages.Those are the women who are screened for genetic mutations. I believe in part this is due to screening at a younger age. When I was in training, you would not order a mammogram in a women under 50 (premenopausal).Women are much more aware and health conscious today. This is a result of trying to practice preventative care. The screening mammogram starts at 40, although certain societies are trying to raise the age to 45. Again, breast cancer discussion focuses on the specific characteristics of the patients cancer. The only difference in young women with breast cancer, is that she would undergo genetic testing. SS: What do you see as the future of breast cancer treatment? HY: Less surgery is the trend. There are studies now investigating, whether performing lymph node biopsy (sentinel node) will be replaced by ultrasound imaging. Radiation therapy has certainly expanded its role in breast cancer treatment and is showing possible improved survival in women receiving radiation. (Three dimensional) mammography (tomosynthesis) is now utilized and helps radiologist scan through dense breast tissue, and will decrease rates of call back imaging. For more information about breast cancer treatment and prevention visit www.eastsidemedical.com/service/breast-health.