Blog

Bilateral Mastectomies: a patient’s personal decision

Claire L. Buchanan, MD, FACS

Claire L. Buchanan, MD, FACS
Breast Cancer Surgeon

Last week the Seattle Times reported that women diagnosed with early stage breast cancer in one breast are choosing to have bilateral mastectomies to reduce their chances of getting cancer again, but recent research shows that that there is no survival benefit, even in younger women. Researchers at Stanford and the Cancer Prevention Institute of California evaluated the outcomes of over 190,000 women from the California Cancer registry who were diagnosed with breast cancer in one breast between 1998 and 2011. The rate of bilateral mastectomies rose from 2% to 12.3% over the study period, yet there was no survival benefit to bilateral mastectomies versus lumpectomy and radiation.

To those of us who work in the field, this data comes as no surprise; the trend of bilateral mastectomies is a known phenomenon. More than 10 years ago, I remember the chatter among surgeons at national meetings asking if others noticed that more and more, younger women were coming in asking for bilateral mastectomies. Back in 2007, Dr. Todd Tuttle authored a study in the Journal of Clinical Oncology that found that the rate of contralateral prophylactic mastectomy was on the rise, from just under 2% in 1998 to 5% in 2003. This week’s study only validates that this upward trend shows no sign of leveling off.

Why do patients choose bilateral mastectomies?

Many women ....

Multiple Sclerosis and the Winter Blues

Michelle T. Toshima
Many people with Multiple Sclerosis look forward to the cooler temperatures and reduced humidity that comes with fall and winter. Symptoms can be worse in the warm summer months so relief comes to many with the lower temperatures. With fall and winter right around the corner, it’s important to be aware of and prepare for the Winter Blues. 
 
The Winter Blues is fairly common in northern latitudes where the days become shorter and there is reduced sunlight.  The Winter Blues is often characterized by feeling irritable or gloomy, having less energy, sleeping more but not feeling more rested, and eating more, often with cravings for carbohydrates.  So what can one do to prevent the Winter Blues?

Red Doors at Swedish Cancer Institute

Kylie Davidson, MPH CHES

Kylie Davidson, MPH CHES
Supervisor, Health Education, Swedish Cancer Institute

During the next couple of weeks, you will find various doors and walls at the Swedish Cancer Institute decorated in a beautiful red wrapping paper. This is a symbol of Swedish’ support for Gilda’s Club and their Red Door campaign.
 

The Red Door campaign was established to ...

Newborn screening testing in Washington

Elizabeth Meade, MD

Elizabeth Meade, MD
Pediatric Hospitalist

For most parents, the newborn period is a time of profound joy, incredible challenges, and LOTS of questions.  As pediatricians, some of the questions we are frequently asked are related to a simple blood test done on all infants in Washington State.  Commonly referred to as the “newborn screen” or “NBS”, “PKU”, or “newborn metabolic testing”, this test checks for several congenital disorders that are rare but can be life-threatening. 

Often parents want to know:

  • What does the test involve? The newborn screen is done by pricking the heel of the infant at around 24 hours of age, then collecting a few drops of blood onto a piece of test paper.  This is dried and then sent to the state lab, where the testing is performed.  Because some of the conditions may take several days to show up, the test is repeated at 7-14 days old (usually by your primary care doctor; it can also be done in the hospital if the baby is still there for any reason).

  • Does it hurt? The needle prick is performed by trained nurses and is done quickly.  It may feel similar to pricking your finger to test blood sugar.  And you can significantly decrease the discomfort of the quick poke by breastfeeding your baby during or immediately after the test!

  • Why do we need this? The diseases we check for are typically rare, but if undiagnosed and untreated can cause a variety of complications, including blindness, poor growth, brain damage, and even death.  The reason that testing every baby is essential is that babies with these conditions can look and act perfectly healthy even while the disease is damaging their bodies, until they get so sick they need to be hospitalized or have permanent damage.  Starting treatment as early as possible can prevent many of the complications.

  • What are you testing for? The ...

Preparing your teen for college and taking care of their health

Kimberlee I. Smith, MD

Kimberlee I. Smith, MD
Pediatric Hospitalist

College is a huge and exciting step in an adolescent’s development. Being prepared can help your teen stay healthy and know where to go when they’re not. Whether your child is staying close to home, or going across the country for school, here are a few tips to add to your college checklist:

Schedule a visit with your primary care physician. (See a list of local Swedish physicians who can see your teen here.)

  • Physicians can make sure your teen is up to date on immunizations that many colleges require. Teens commonly need influenza, Tdap, HPV, and meningococcal vaccines.

  • Ensure that your child has prescriptions (with refills) for all medications they routinely use. Even “as needed” medicines may become needed in college. These medicines should be kept in a locked box in your teen’s room, as many medications can be stolen or used illicitly.

  • Your teen should ...

Per Oral Endoscopic Myotomy (POEM) for achalasia

Brian E. Louie, MD

Brian E. Louie, MD
Director of Thoracic Research and Education

P.O.E.M. has come to Seattle at Swedish Medical Center.  No, not the kind that rhymes but one that is elegant in its own way.  Per Oral Endoscopic Myotomy or POEM is relatively new procedure used in the treatment of achalasia, which is a disorder of the esophagus due to degeneration of the nerve network within the walls of the esophagus.  The diseases leaves patients with little propulsive power to push food toward and into the stomach as well as causing the “valve” at the top of the stomach to remain closed.  This makes it difficult for patients to eat or drink.   Patients may need to drink a lot of fluid to get food to pass into the stomach whereas others may feel pain or discomfort after eating and still others may have undigested food come up many hours after eating or when lying down.
 
The treatment for achalasia is ...

Swedish Cancer Institute and community events in August

Nicole Filbert

Nicole Filbert
Health Education Intern, Swedish Cancer Institute

Can you believe the month of August has already arrived? Some may see the end of August as an end to summer, but it doesn’t mean the end of community events. Two particular events taking place toward the end of August are the American Cancer Society Relay for Life—Capitol Hill event and the Northwest Hope and Healing Alki Beach Run 5K. We are happy to announce the Swedish Cancer Institute will be supporting both!

On Saturday, August 23rd ...

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