A breast cancer diagnosis is often fraught with fear and anxiety. And those fears can persist through treatment, becoming worries about cancer recurrence. But increases in screening and earlier diagnosis, as well as improvements in treatment, have led to better outcomes and less risk of recurrence for many breast cancer patients.
The most important thing to know is that every patient and every case is unique and different and it’s vital for patients to have thorough, honest conversations with their physicians to understand their personal risks and best treatment options, explained Endeavor Health breast surgeon Christine Gresik, MD.
“We review everything — from the exact size and grade of the tumor to the specific molecular cell structure of the tumor — as we consider the risk of regrowth and the best initial treatment plan,” said Dr. Gresik.
Treatment strategies
From celebrities to social media influencers to neighbors or co-workers, many women are already inundated with ideas about their best treatment strategy before they even speak with their oncology specialist. “When it comes to surgery, more is not always better,” said Dr. Gresik.
Initial treatment, depending on tumor size and stage is typically a lumpectomy or mastectomy to remove the cancer, and often a lumpectomy is followed by radiation. The risk of cancer recurrence following a successful lumpectomy and radiation is less than 3 to 5%, compared to a 2% risk following a total mastectomy explained Dr. Gresik.
Genomic testing is used to determine the molecular tumor type, which helps further predict the risk of cancer recurrence.
Some women may feel that choosing a total mastectomy is the best way to protect themselves from recurrence, but studies show that this strategy does equate to better survival rates for all cancers.
Choosing to remove the entire breast rather than undergoing a lumpectomy also increases the risk of other surgical complications, explained Dr. Gresik.
Surveillance tools
“We have so many good tools now like advanced imaging to help with surveillance, so often if there is a recurrence it’s found immediately when it can be successfully treated,” said Dr. Gresik.
Still some women find regular screening tests, including mammography, ultrasounds and breast MRIs, too stressful after an initial cancer diagnosis and they choose a total mastectomy to avoid the anxiety associated with screening.
“These are very personal decisions and, as long as patients have the right information and understand their real risks, they are empowered to make the best decisions for themselves,” she added.
Healthy lifestyle
A cancer diagnosis can inspire patients to adopt healthier lifestyles. “The number one modifiable risk factor to lower your risk of cancer recurrence is to maintain a healthy BMI,” said Dr. Gresik. “There is a lot of data related to obesity and breast and other cancers.”
She recommends that her patients get at least 30 minutes of exercise three or more days a week.
There is no one recommended diet for breast cancer patients, but in general a heart-healthy diet is also breast-healthy, said Dr. Gresik.
“Anything in moderation is okay, you can still have cake on your birthday,” she added.
