Tags
Blog

'cancer' posts

Becoming a Breast Surgeon

Surgeons are often Type A personalities, the ones who sit in the front of the class, who volunteer for everything, who stay scrubbed in the OR all day with appendicitis and do a post-op check before checking themselves into the emergency department (yes, that was me.) As such, surgeons are often dismissive of the subspecialty of breast surgery. The surgeries are not as complex as cardiac bypass surgery or Whipple procedures for pancreatic cancer. In fact, it’s often a rotation for interns. I was a Type A personality. I had no plans to do breast surgery.

Then, a funny thing happened. I had my first son during residency. Planned with military precision, of course, to coincide with the beginning of my designated research years, as I had hoped to squeeze another baby in there somewhere. After his birth, I would breastfeed, because that is what Type A mothers do these days. It’s the best! Of course, I would do the best! However, like many mothers out there, we had an incredibly rocky start. Poor latch with inadequate weight gain. Triple feeding with pumped milk. Cracked nipples leading to mastitis. As a Type A person, I threw myself into research in an effort to solve the problems. Not just the many, many baby books out there, but Medline searches on breastfeeding management. I learned more than I ever had in my surgery textbooks about the breast, the physiology of lactation that is both incredibly simple and enormously complex, and most importantly, miraculous. I was reminded constantly in my reading of the importance of preserving this ability to breastfeed my son, for his and my health, and how challenging that could be.

I would sit in my office, working on surgical infections research, as I pumped and read about normal breasts and infected breasts and cancerous breasts. Antibiotic rotations in ICUs and glucose control became less exciting than being able to offer targeted medical advice to a frustrated friend in Boston, whose refractory mastitis was being met with shrugs from some of her local doctors until we correctly identified MRSA as the source. Maybe it wasn’t saving lives, but it saved her breastfeeding relationship with her child. Who knows, maybe in the end it would be saving lives! I read more ....

What should I know about radiation if I have breast cancer?

If you’ve been diagnosed with breast cancer, you may wonder if radiation is an option for you.

Radiation is an important pillar of treatment for breast cancer and has never been safer when designed by an experienced team with state of the art technology. Radiation will be part of a standard treatment plan after breast conserving surgery (also called lumpectomy or partial mastectomy). With the addition of radiation to the breast as an insurance policy, patients will do just as well as those undergoing mastectomy. Even after a mastectomy there are indications when radiation to the chest wall and nodes are recommended for best outcome. After a lumpectomy, radiation to the whole breast is the current gold standard.

How does radiation actually work?

Radiation works by aiming it at a target. Free radicals are produced which kill cancer cells, while normal cells have the capability to repair the damage. Cancer cells don’t.

Having the most advanced technology available to precisely plan and deliver radiation to the target will protect healthy tissue for optimal outcomes and the best possible cosmetic result.

How can I make sure I receive the best radiation?

The radiation oncologists treating you should be part of an interdisciplinary team. I, for example, work closely with the patient, the breast surgeons and the medical oncologists. I then design a personalized radiation plan, tailored to the unique characteristics of the tumor and each patient’s personal preferences. The more personalized the treatment the better.

To allow patients to feel their best during and after treatment, I often work with physical therapists, naturopaths, and other support staff (social worker, dietitian etc).

What type of radiation treatment do I need?

Radiation options after a breast conserving surgery can be very confusing. Here is a list that may help you understand the different options:

Results 99-100 of 100