Talking to Your Doctor About ... Video Transcript

Participants

Maura N. Dickler MD, Generosa Grana MD, Stephen E. Jones MD, Gabrielle Morris MD

Summary

Finding out you have early-stage breast cancer can be overwhelming. But you can get a handle on the disease by learning some very crucial things about your own cancer. Getting the proper tests to determine the stage and characteristics of your cancer can help dictate what treatments are appropriate. Assembling the right team of doctors who are not only skilled, but also easy to talk to is another key element for managing the disease in the best possible way.

Webcast Transcript

ANNOUNCER: This year, approximately 200,000 women will face the shocking moment when they sit in their doctor's office and learn they have breast cancer. Luckily for many, the cancer is caught at an early stage.

GENEROSA GRANA, MD: Early-stage cancer is a disease that by definition is localized to the breast, plus/minus the axillary lymph nodes. And the stage of that cancer will depend on the size of the tumor and the presence or absence of lymph node involvement. So that an early stage breast cancer can be a stage 0 cancer, noninvasive disease, or it could be a stage 1 cancer that's less than 2 cm, or it could be a stage 2 cancer that has lymph node involvement.

ANNOUNCER: Once diagnosed, it is important to speak with your doctor to learn as much as you can about your disease.

GENEROSA GRANA, MD: The goal should be to have an understanding of the stage of disease, the type of cancer present. For example, you want to know if the cancer is invasive or in situ, noninvasive. You want to know if the cancer is a high-grade lesion, meaning rapidly growing or a low-grade lesion.

And also the other studies that need to be done and the other physicians that need to be involved in her care.

ANNOUNCER: Discovering all you can about your cancer, even if it's at an early stage, often requires more testing since there is a small chance the cancer has spread.

GENEROSA GRANA, MD: At the very minimum, most women will have a thorough physical exam by a clinician asking her a variety of symptoms related to breast cancer. A chest X-ray and routine liver function studies are often obtained. In addition to that, once a cancer is stage 2, oftentimes a bone scan is obtained.

ANNOUNCER: Once information is gathered, treatment can begin. In early-stage breast cancer this always involves surgery. But there are different surgical options to consider.

STEVEN JONES, MD: One is where there is an attempt to save the breast, so breast conservation. It usually involves a lumpectomy removing the cancer and getting clear margin of normal tissue around it. The other option, other than saving the breast, would be to do a mastectomy which generally also takes the lymph nodes. And that's either done with or without reconstruction.

GENEROSA GRANA, MD: Also very important is the woman's choice, the woman's wishes with regards to surgery. Some women are perfectly good candidates for breast conservation from a medical standpoint, but they really would rather have a mastectomy. They feel more comfortable having the breast removed.

ANNOUNCER: Depending on the type and stage of breast cancer, there may be other treatments needed. These treatments are aimed at killing any left over cancer cells in the body.

STEVEN JONES, MD: That could be radiation therapy, which is probably six or seven weeks of using radiation, which is very targeted treatment to kill residual cancer cells. There is a possibility of adjuvant chemotherapy, which is drug treatment to try to improve her overall prognosis. And there is a possibility of adjuvant hormone therapy.

ANNOUNCER: In hormonal treatment in early stage disease, again there are options to consider.

STEVEN JONES, MD: The gold standard up to this time has been a drug called tamoxifen. Tamoxifen is an antiestrogen that works stop the cancer cells from multiplying or dividing. And that's proven to be extraordinarily effective treatment. There is now another option and that's one of the drugs called an anti-aromatase agent. The one drug that is approved for this is a drug called anastrazole or Arimidex.

ANNOUNCER: Speaking with your doctor is crucial to understanding the disease and its treatment.