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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 ....

Neck lump or mass

Namou Kim, MD, FACS

Namou Kim, MD, FACS
Medical Director, Swedish Head & Neck and Reconstructive Surgery

A palpable neck lump in any patient should raise some concern.  In the case of a pediatric patient, the concern may be less, since reactive and infectious nodes in the neck can be fairly common in children.  When a child has a bad episode of pharyngitis, tonsillitis (sore throat), or even a bad cold, the lymph nodes of the neck may react and become enlarged.  In that type of scenario, your doctor should prescribe appropriate antibiotics to resolve the enlarged lymph nodes and follow up to make sure that the nodes have regressed.

Very few pediatric neck masses will end up being concerning.  Besides infectious neck lymph nodes as stated above, some of the other more common causes of pediatric neck mass are congenital cysts.  However, none of the pediatric neck masses should be ignored.  A neck lump that persists for more than a few days should be looked at by a pediatrician.

In the adult population, a neck mass or lump can be much more concerning.  Essentially when an adult patient presents to us with a neck mass, we have to fine the root cause and basically rule out a tumor.  Of course, infectious lymph nodes do happen in the adult patients as well, but it is less common.  Congenital cysts are also much less common in the adult patient. 

The more common causes of a neck mass in the adult patient are ....

Oncology social workers help patients with cancer

Tricia Matteson, MSW, LSWAIC

Tricia Matteson, MSW, LSWAIC
Oncology Social Worker

“What happens if my insurance won’t pay for all of this treatment?”
“How do I tell my young daughter about my cancer?”
“My spouse is really struggling, but I don’t know how to help him.” 
“How will I get to radiation every day if I can’t drive?”
“My friends and family call a lot, but I don’t feel like talking to them”
“I’m scared.”   “I’m angry”   “I’m sad”    “I’m confused”
“What’s a power of attorney…and do I need one?”
“Where can I find out about a support group? ”
“I wish I knew where to turn.”

If you are faced with a diagnosis of cancer, you may be asking similar questions and wondering where to turn for answers.  A good place to start is with an oncology social worker.  Oncology social workers assist with the non-medical issues that often arise when someone is diagnosed with cancer.  We have master’s degrees in social work, and are specially trained to provide counseling and assistance with services that can reduce stress for you and your family through all phases of your cancer diagnosis and treatment.  Social work services are available at the Swedish Cancer Institute at our First Hill, Edmonds, and Issaquah campuses, and are provided at no cost to our patients. 

We can help you:

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