Swedish News 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 ....

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 ...

Detecting thyroid cancer using ultrasound

Joseph C. Sniezek
The incidence of thyroid cancer is steadily increasing in the U.S. while the reasons for this increase are still unclear.  No environmental exposure or lifestyle trend has been linked to this recent rise but interestingly, some researchers believe that the increasing use of ultrasound in evaluating the neck and thyroid has raised the number of cancers being detected at earlier stages. Regardless of the cause of this recent uptick in thyroid cancer, there is no doubt that ultrasound has fundamentally changed the way in which thyroid lesions and cancers are evaluated and followed.
 
Ultrasound technology has undergone a dramatic improvement in recent years providing clear and precise images without exposing the patient to any radiation.  Thyroid nodules that are suspicious for malignancy can now be identified before they are large enough to be felt in the neck by the patient or health care provider.

 
When a  ...

Summer, sun, and skin cancer - what you should know

Andrew R. Ting, MD, FACS

Andrew R. Ting, MD, FACS
General Surgeon

It is easy to get carried away enjoying the string of lovely sunny summer days we have had in Seattle. Our sun is strong, and our unprotected skin vulnerable to UV damage that can lead to sun damage and perhaps skin cancers. Skin cancers fall into the broad categories of squamous cell cancer, basal cell cancer and melanoma. Each of these cancers are usually surgically excised or destroyed by either a dermatologist or general surgeon.

How to tell if a skin lesion is concerning

Warning signs include moles larger than a pencil eraser head, change in size, change in color, itching, bleeding or scab forming over the mole. Areas of particular concern include face, neck, back and extremities. However, skin cancers can also develop in areas where the sun does not shine.

What to do if I have a skin cancer?

If you have a mole or skin lesion that is concerning, bring it up with your family physician who may biopsy it or refer you ..

Summer 2014 Cancer Community Walks & Runs

Brian Aylward, BS, CHES

Brian Aylward, BS, CHES
Health Navigator

Each year, the Swedish Cancer Institute (SCI) partners with local and national organizations in an effort to help spread awareness of cancer, associated treatments, and resources available in our communities.
 
Summer 2014 is no different. We’ve signed on to take part in more events than ever before—and we want you to join us! As an active patient, survivor, family member, friend or advocate, your voice and participation matter.
 
American Cancer Society Relay for Life
These overnight community fundraising walks help raise money to fund cancer research, education, and support services like Hope Lodge®, Road to Recovery®, Look Good, Feel Better®, and Reach to Recovery®, all American Cancer Society-run programs. The Swedish Cancer Institute patients gain access to these programs throughout the Swedish network. There are several Relay for Life events going on in the Puget Sound. The Swedish Cancer Institute is taking part in:

Facts and myths about antioxidants and cancer

Jeffery C. Ward
Some of the most popular misconceptions surrounding cancer, cancer prevention and cancer treatment are about the role of antioxidants. Like many of the popular myths about cancer, there are facts, half-facts and outright falsehoods.
 
Fact: Damage to genes, particularly those involved in the regulation of cell division and cell death, is the key event in the development of cancer. 
Fact: Oxidants are substances, most often generated by our own body, that cause damage to chemicals, including the DNA that makes up our genes, by oxidizing them. The oxidation reaction most familiar to us is when metal rusts. 
Fact: Our bodies’ oxidants can contribute to cancer.
 
Half-fact: Antioxidants are chemicals we ingest that then run around neutralizing oxidants, rendering them powerless to promote cancer. The so-called antioxidant vitamins, of which vitamin C, E, and beta-carotene are the most well known are more properly called redox agents. In a particular environment, they prevent or reverse oxidation, called reduction. But they may change the acidity or even just the concentrations of the components of the reaction, and they may facilitate just the opposite. For example ....

To Mammogram or Not to Mammogram? A note on recent studies

Mary Kelly, MD

A Canadian medical research study has recently been published questioning the value of doing screening mammograms on women in their forties. The article has spurred controversy because the results contradict multiple other similar research studies which showed that women in that age group who get regular mammograms actually are spared death from breast cancer more often that women who are not invited to screening.

Some problems with the methods of Canadian study, published in the journal BMJ, were pointed out by a scientist at the University of Washington, Judith Malmgren, who has worked with Swedish Medical Center doctors to see how women in their forties have fared in our system. Click here to read Dr. Malmgren’s letter to the editor of BMJ.

There are two ironic features to the Canadian study. First, the authors say it is okay for women to not get screening starting in their forties “when adjuvant therapy for breast cancer is readily available.” This means that it is okay to diagnose breast cancer later because you can mop up bigger and more advanced cancers with treatment like chemotherapy, radiation and bigger surgery. But at Swedish, we do not think that many women prefer more severe therapy rather than earlier detection.

Secondly ...

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