Breast Cancer – Page 3 – Medical Lessons

More News On Lymph Nodes and Breast Cancer Surgery

February 10, 2011February 13, 2011 Elaine Schattner, MD

Last week the New England Journal of Medicine (NEJM) printed a major research article on lymph node dissection in breast cancer surgery. When I first saw the Times’ recent headline, I thought it would cover this paper: Effect of Occult Metastases on Survival in Node-Negative Breast Cancer.*

It turns out there were separate articles on axillary node dissection after sentinel node biopsy in breast cancer – one in JAMA and one in the NEJM – published a week apart. For some reason, the NEJM paper got little attention…

Posted in Breast Cancer, cancer treatment, Oncology (cancer), Pathology, Under the RadarTagged Breast Cancer, lymph nodes, metastases, occult mets, prognosis, sentinel node dissection, surgery, treatment options, Women's HealthLeave a Comment

Breast Cancer Study Shows No Benefit In Extensive Lymph Node Removal

February 9, 2011February 11, 2011 Elaine Schattner, MD

Today’s Times leads with a story on surgical removal of lymph nodes in women with breast cancer. The dramatic digital headline, Lymph Node Study Shakes Pillar of Breast Cancer Care, made me tremble at first glance. The article by Denise Grady covers a new report* in the Journal of the American Medical Association (JAMA).

The key finding is that for women with apparently limited disease before surgery who undergo subsequent radiation and chemotherapy, taking out all the cancerous nodes from the axilla (armpit) has no advantage.

I read the original publication and took some notes:

Posted in Breast Cancer, cancer treatment, Medical News, Oncology (cancer)Tagged axillary lymph nodes, Breast Cancer, lymphedema, prognosis, sentinel node dissection, surgical treatment, survivalLeave a Comment

Pink’s OK With Me

February 7, 2011March 28, 2019 Elaine Schattner, MD

On Sunday, Feb. 20, the Northeastern Pennsylvania Affiliate of Susan G. Komen for the Cure will host its seventh annual Pink Elegance on Parade fashion show at the Radisson at Lackawanna Station hotel, reports the Scranton Times Tribune. The fundraiser will feature breast cancer survivors and others modeling fashions from Coldwater Creek, Lee’s Denim Diner, Luna Bleu and Suburban Casuals.

Some BC survivors, thrivors, thrivers, in-the-throws-ers and whatever we might call ourselves (I still can’t make up my mind on this) express disdain. Others, lately, convey cynicism, if not frank contempt, for the pink cancer culture in its entirety. Pink is tacky, pretty and possibly too rosy a color to link with the fate of so many sick and dying women.

I half-agree. But then again, I’ve never favored pastels:

Posted in Breast Cancer, cancer awareness, Essential Lessons, Oncology (cancer), Women's HealthTagged Breast Cancer, breast cancer awareness, cancer culture, fundraising, pink, Susan G. Komen Foundation8 Comments

After Breast Cancer, Get a Gym Membership!

December 31, 2010March 28, 2019 Elaine Schattner, MD

The findings show that it’s safe for women who’ve had breast cancer surgery to work out in a way that includes a careful, progressive upper body strengthening. Weight lifting is not only safe; it can reduce lymphedema in women at risk. But “old wives’ tales” still persist in some doctors’ minds and established medical resources. These need be dispelled.

Posted in Breast Cancer, cancer survival, Essential Lessons, Fitness, Medical News, Oncology (cancer), Women's HealthTagged arm exercises, Breast Cancer, exercise, fitness, gym membership, lymphedema, strengthening, weightlifting, Women's Health1 Comment

Stem Cells, Breast Reconstruction and a Magazine Cover

October 26, 2010May 25, 2012 Elaine Schattner, MD

The cover of the November print edition of Wired features large, unnatural-appearing cleavage. Inside and toward the back of the issue, a curious article ties together stem cells and the future of breast reconstruction. It got my attention. The detailed and admittedly interesting piece, by Sharon Begley, describes what’s science or science fiction: first humans, […]

Posted in Breast Cancer, cancer treatment, Future of Medicine, Magazine, Plastic and Reconstructive Surgery, ScienceTagged beauty, biotechnology, Breast Cancer, Cytori, reconstructive surgery, stem cells, Wired Magazine1 Comment

New Findings on Postmenopausal Hormone Replacement Therapy and Breast Cancer

October 21, 2010January 9, 2011 Elaine Schattner, MD

This week the Journal of the American Medical Association (JAMA) published results of a large study with significant implications for women who consider taking hormone replacement therapy (HRT). The new findings are based on careful examination over 16,000 individuals, part of the larger Women’s Health Initiative, who were randomly assigned to take either a placebo, […]

Posted in Breast Cancer, clinical trials, Oncology (cancer), Women's HealthTagged Breast Cancer, breast cancer incidence, evidence, hormone replacement therapy, HRT, informed decision, Women's Health Initiative1 Comment

October 13 Would Be National Metastatic Breast Cancer Awareness Day

October 13, 2010February 14, 2011 Elaine Schattner, MD

Last October, the U.S. Senate (on 10/13/09) and House (retroactively, on 10/28/09) voted to support the designation of October 13, 2009, as a National Metastatic Breast Cancer Awareness Day. The point was to draw public attention to the distinct needs of metastatic BC patients: women who live every day with this condition but, for the most part, are not heralded in pink.

Posted in Annals of Pink, Breast Cancer, cancer awareness, cancer survival, Oncology (cancer)Tagged Breast Cancer, breast cancer as a chronic disease, cancer awareness, chronic illness, National Metastatic Breast Cancer Awareness Day, October 13, pinkLeave a Comment

Why I Went for My Screening Mammogram

October 5, 2010March 28, 2019 Elaine Schattner, MD

I was afraid to get a mammogram because I didn’t want to learn I had cancer….I feared having a “false positive,” and undergoing multiple tests to evaluate abnormal images that would turn out to be nothing…I didn’t have time for all that…

Posted in Breast Cancer, cancer screening, Essential Lessons, Life as a Doctor, Life as a Patient, Oncology (cancer), Women's HealthTagged benefits of mammography, Breast Cancer, cancer survival, empowered patient, fear of mammography, informed decisions, mammography, value of mammography, Women's HealthLeave a Comment

What’s Missing in the Recent Mammography Value Study

September 25, 2010September 27, 2010 Elaine Schattner M.D.

I’d say the opposite is true: It’s precisely because there are effective treatments for early-stage disease that it’s worth finding breast cancer early. Otherwise, what would be the point?

Metastatic breast cancer is quite costly to treat and, even with some available targeted therapies, remains

Posted in Breast Cancer, cancer awareness, cancer screening, cancer survival, Diagnosis, Medical News, Oncology (cancer)Tagged Breast Cancer, digital mammography, mammography, mortality in breast cancer, Norway study, Public Health, Women's HealthLeave a Comment

Stepping Back, and Thinking Forward to October

September 23, 2010June 1, 2013 Elaine Schattner M.D.

A question central to today’s discussion – which does at least acknowledge the decline in breast cancer mortality – is the extent to which mammography is responsible for this trend, as opposed to other factors such as increased awareness about cancer, better cancer treatments and other variables.

Posted in Breast Cancer, cancer awareness, cancer screening, clinical trials, health care costs, Medical News, Oncology (cancer)Tagged Breast Cancer, cancer screening, health, mammography, Women's HealthLeave a Comment

A Walk, or Race, for the Cure

September 12, 2010February 14, 2011 Elaine Schattner M.D.

“You can get discomboobulated in this place,” a NYC police officer told me today.

This morning, some 25,000 or so men, women and children converged on Central Park for the Susan G. Komen Foundation’s 20th annual Race for the Cure. It was my first time witnessing the event:

Posted in Annals of Pink, Breast Cancer, cancer awareness, cancer survival, Life as a Patient, Life in NYCTagged Breast Cancer, cancer awareness, cancer survival, NYC, pink, Race for the Cure, Susan G. Komen Foundation2 Comments

New NY State Law on Information for Women Undergoing Mastectomy

August 18, 2010March 5, 2011 Elaine Schattner M.D.

The reality is that many women, particularly poor women without newspapers or internet access in their homes, don’t know about any of this. They don’t know their insurance covers pretty much all of these options, by law. Now they will, or should as of Jan 1, 2011. Good. The other curiosity is that …

Posted in Breast Cancer, cancer treatment, Communication, Medical News, Patient Autonomy, Plastic and Reconstructive SurgeryTagged Breast Cancer, empowered patient, informed decisions, mastectomy, New York State law, reconstructive surgery, right to know, Women's Health2 Comments

The “Survivor” Term After Breast Cancer: Is There a Better Expression?

August 3, 2010September 6, 2021 Elaine Schattner M.D.

The question is, what’s the right, PC and emotionally-sound, sensitive but not sappy term to describe the situation of a person who’s living after breast cancer?

Some might say, who cares if you’ve had it?

Posted in Breast Cancer, cancer awareness, cancer survival, Essential Lessons, language, Oncology (cancer), Psychiatry, Women's HealthTagged aging, Breast Cancer, breast cancer awareness, breast cancer survival, cancer survival, life as a patient, Women's Health35 Comments

Suggestions to Reduce Errors in Breast Cancer Pathology

July 21, 2010October 31, 2021 Elaine Schattner M.D.

A prominent article in yesterday’s New York Times considers some troubling problems regarding inaccuracy in breast cancer diagnosis and pathology. The main point is that some women get needless, disfiguring and toxic treatments after being told they have breast cancer when, it turns out, their condition was benign. My main take is that, whenever possible, […]

Posted in Breast Cancer, Diagnosis, Oncology (cancer), Pathology, Women's HealthTagged Breast Cancer, cancer medicine, diagnosis, false positives, Pathology, second opinion, Women's Health1 Comment

Mind over Matter? Don’t Kid Yourself (on Stress and BC)

June 11, 2010October 31, 2021 Elaine Schattner M.D.

I learned of a new study implicating stress in reduced breast cancer survival by Twitter. A line in my feed alerted me that CNN’s health blog, “Paging Dr. Gupta,” broke embargo on the soon-to-be-published paper in the journal Clinical Cancer Research. The story – that women who undergo a stress relief program live longer after […]

Posted in Breast Cancer, cancer survival, clinical trials, Essential Lessons, Medical News, Oncology (cancer), Pseudoscience, Psychiatry, Women's HealthTagged Breast Cancer, cancer medicine, cancer survival, cancer treatment, health, medical news, Pseudoscience, psychology, stress, Women's Health3 Comments

Why Blog on OncotypeDx and BC Pathology?

May 21, 2010May 26, 2011 Elaine Schattner M.D.

I can’t even begin to think of how much money this might save, besides sparing so many women from the messy business of infusions, temporary or semi-permanent IV catheters, prophylactic or sometimes urgent antibiotics, Neulasta injections, anti-nausea drugs, cardiac tests and then some occasional deaths in treatment from infection, bleeding or, later on, from late effects on the heart or not-so-rare secondary malignancies like leukemia. And hairpieces; we could see a dramatic decline in women with scarves and wigs.

Posted in Breast Cancer, cancer treatment, Communication, Diagnosis, Empowered Patient, health care costs, Informed Consent, Pathology, Patient AutonomyTagged adjuvant chemotherapy, Breast Cancer, early-stage breast cancer, empowered patient, health care costs, medical tests, oncology, Oncotype Dx, Pathology2 Comments

More News, and Considerations, on OncotypeDx

May 16, 2010December 4, 2010 Elaine Schattner M.D.

This week I’ve been reading about new developments in breast cancer (BC) pathology. At one level, progress is remarkable. In the 20 years since I began my oncology fellowship, BC science has advanced to the point that doctors can distinguish among cancer subtypes and, in principle, stratify cases according to patterns of genes expressed within […]

Posted in Breast Cancer, cancer treatment, clinical trials, Diagnosis, Informed Consent, Oncology (cancer), Pathology, Patient AutonomyTagged Breast Cancer, ER+, estrogen receptors, evidence-based medicine, gene profiling, node-negative, Oncotype Dx, Pathology, risk of recurrence, Women's HealthLeave a Comment

Another Erroneous Report on Breast Cancer Screening by Mammography

March 26, 2010October 31, 2021 Elaine Schattner M.D.

What the authors tried to do was analyze trends in breast cancer mortality in relation to mammography’s availability in distinct regions of Denmark over several decades. Using Poisson regression, a form of statistical analysis, they looked for a correlation and found none. They concluded that they couldn’t detect a benefit of screening mammograms among Danish women who might benefit (see below).

Here’s what I think are the two most serious flaws in this observational study:

Posted in Breast Cancer, cancer screening, Under the RadarTagged BMJ, Breast Cancer, cancer screening, Denmark, mammographyLeave a Comment

A Small Study Offers Insight On Breast Cancer Patients’ Capacity and Eagerness to Participate in Medical Decisions

March 15, 2010December 3, 2010 Elaine Schattner M.D.

Last week the journal Cancer published a small but noteworthy report on women’s experiences with a relatively new breast cancer decision tool called Oncotype DX. This lab-based technology, which has not received FDA approval, takes a piece of a woman’s tumor and, by measuring expression of 21 genes within, estimates the likelihood, or risk, that her tumor will recur.

As things stand, women who receive a breast cancer diagnosis face difficult decisions…

Posted in Breast Cancer, cancer survival, Communication, Diagnosis, Empowered Patient, Informed Consent, Oncology (cancer), Pathology, Patient Autonomy, Patient-Doctor Relationship, Statistics, Under the RadarTagged Breast Cancer, cancer medicine, cancer treatment, communicating in medicine, decisions, empowered patient, genomics, health, medical information, medical tests, Oncotype Dx5 Comments

New Boss on The Office is a Breast Cancer Survivor

February 22, 2010September 13, 2021 Elaine Schattner M.D.

There’s a new survivor on TV and she means business.

In the latest episode of The Office, Kathy Bates walked into the Scranton branch of Dundler Mifflen and onto my living room TV screen as Jo Bennett, CEO of Sabre, a fictitious Tallahassee-based company. An assistant and two large canines accompany her as she meets the crew. She’s firm, graying and very much-in-charge.

When the camera gets her alone, in focus, here’s what she has to say:

“I’m Jolene Bennett, Jo for short.

“I’m a breast cancer survivor, close personal friends with Nancy Pelosi, and Truman Capote and I slept with three of the same guys. When I was a little girl I was terrified to fly, and now I have my own pilot’s license.

“I am CEO of Sabre International and I sell the best damn printers and all-in-one machines Korea can make.

“Pleased to meet ya.

Posted in Breast Cancer, cancer survival, Reviews, TVTagged Breast Cancer, breast cancer survivor, business, health, Kathy Bates, survivor, The Office, TV, Women's Health, workplace1 Comment

Medical Lessons