Ask the Expert: Understanding Breast Surgical Oncology

November 16, 2023

Harvey Bumpers, MD, FACS, Jessica Henderson, DO and Mary Smania, DNP, FNP-BC, AGN-BC, FAANP are faculty within the Department of Surgery in the MSU College of Human Medicine and provide care as breast surgical oncologists and advanced genetics nurse practitioner at MSU Health Care. They discuss breast surgical oncology, myths related to breast cancer, and how to get screened for breast cancer.

What is breast surgical oncology?

Breast surgical oncology is a medical specialty dedicated to the surgical aspects of breast cancer diagnosis, treatment, and management, with a strong emphasis on preserving both physical and emotional well-being for patients. Breast surgery as an umbrella also focuses on benign breast disease. We see a wide spectrum of breast disease and work with our multidisciplinary partners, including medical oncologists and radiation oncologists, to find a cure. Our goal is to remove all of the breast cancer surgically and safely.

Breast surgical oncology aims to provide comprehensive care to individuals diagnosed with breast cancer. It focuses on not only treating the disease but also preserving a woman's quality of life and emotional well-being throughout her cancer journey. Patients receive individualized care plans and support from a team of health care professionals to help them navigate the challenges of breast cancer and its treatment. 

What are some risk factors related to breast cancer?

There are some risk factors that women can change and some that they can’t. They can’t change their age, inherited gene mutations (like BRCA1 an BRCA 2), or family history. Increased estrogen levels, smoking, alcohol intake, and obesity are risk factors that women can change. Increased estrogen levels can come from longer natural cycles, women who don’t have children or don’t breastfeed, obesity, and hormone replacement therapy around the time of menopause.

It's important to note that having one or more of these risk factors does not guarantee that an individual will develop breast cancer. Many women with no known risk factors still develop the disease, while others with multiple risk factors do not.  

Can anything be done to prevent breast cancer?

There are steps women can take to reduce their risk of breast cancer. Lifestyle modifications like exercising regularly, reducing alcohol intake, and reducing their overall estrogen exposure over their lifetime can protect you from developing breast cancer to some degree. For women at elevated risk, breast surgeons along with the nurse practitioners recommend more frequent and comprehensive surveillance and screening protocols. This often includes regular mammograms, breast MRI scans, and clinical breast exams. These screenings can detect breast cancer at its earliest, most treatable stages. 

What is the best way to screen for breast cancer?

For most women, a mammogram is the best initial screening test for identifying cancer at an early stage. For women at average risk, mammograms should start at age 40. For women with a family history or at higher risk, mammograms should start earlier than 40, usually 10 years earlier than their relative was diagnosed. There are additional screening imaging for higher risk women or if a mammogram is not consistent with what we are seeing on a physical exam. If an abnormality is seen on mammography the radiologist may add ultrasound, at the time of screening, to better define the abnormality. 

I have a lump on my breast. Does that mean I have breast cancer?

People come in with a variety of lumps and cysts and other abnormalities. Not all lumps or cysts are cancerous. Anything that looks suspicious or malignant gets a biopsy. If you do notice a change to your breast, including the formation of a lump, please seek medical attention.

What are some myths relating to breast cancer?

Some breast cancers are genetic. But one of the myths we hear a lot is that a lot of women think that all breast cancer is genetic and that if they don’t have a family history that they’re not likely to develop breast cancer. Only a small portion of breast cancers are genetic. Having a family history does increase your risk, but it’s not required to develop breast cancer. About 1 in 8 women will develop breast cancer in their lifetime before the age of 85 even without a family history. 

Another myth we hear a lot is that if a woman does not have any symptoms in her breast such as a palpable lump or pain, they feel that they can’t have cancer because they associate those things with having cancer. Most of the time, women with breast cancer do not have any symptoms, especially those with early-stage cancers.

Anything else we should know?

Some women tend to put off coming in for a visit or to be screened. Or if they feel something abnormal in the breast, they tend to delay coming in because they’re afraid of what it might mean. Most of the time, the treatment for early-stage cancer is well tolerated by most women, and it has changed so much in the last five to ten years. We also treat male patients. Men do get breast cancer. About one percent of the cancers occur in men. Don’t delay care because you’re afraid of what the treatment might entail.

 

If you would like to schedule a mammogram or learn more about the MSU Health Care at McLaren Greater Lansing Breast Imaging Center, please call (517) 975-6425 or visit https://www.mclaren.org/doing-whats-best/health/lansing-early-detection-starts-with-a-mammogram-429.

Genetic testing for breast cancer is available at MSU Health Care Surgery. Learn more at https://healthcare.msu.edu/services/specialty-care/surgery/msu-breast-center.aspx.