Breast Cancer Clinic
with Scott Maizel, MD
Breast cancer is the second most common form of cancer among women, after skin cancer. Currently, approximately two million women in the United States are living with a breast cancer diagnosis and another one million women do not yet know they have it.
According to Scott Maizel, MD, General Surgeon at GBMC, a timely diagnosis of breast cancer is the best treatment. “It is always better to find breast cancer before you can feel it,” he says. That’s why mammography is such an important tool. Standard guidelines recommend that women start having routine mammograms at age 40, or earlier if they have certain risk factors.
Through research, Dr. Maizel and other experts at GBMC have made some interesting discoveries about how some women view their risk for breast cancer.
Nearly all women who have a relative with breast cancer believe they will be diagnosed with it at some point in their lives, but that’s not always the case. Many women, depending on their age, can have different perceptions of their risk. “Younger women tend to overestimate their risk and worry unnecessarily about getting breast cancer, while older women often tend to underestimate their risk,” says Dr. Maizel.
All women may benefit from an initiative known as the Breast Cancer Risk Assessment Program at GBMC. The program offers genetic counseling for risk assessment and provides an in-depth look at a woman’s family history. Risk assessments are given with a comparison to the age-specific risk that all women, regardless of family history, have for developing breast cancer.
As part of the program, the physician conducts a breast exam and reviews the patient’s past mammograms or other imaging tests. All the information is entered into a computer program that calculates the woman’s risk for breast cancer. “Women receive their results before they leave their appointments,” says Dr. Maizel. Currently, gene testing is available to detect mutations in two breast cancer genes, BRCA1 and BRCA2.
“Depending on the risk assessment, regular breast exams may be recommended,” says Dr. Maizel. “If further testing is needed, a biopsy may be done, or the patient may be referred to a geneticist.”
Women who notice signs of breast cancer should see their doctor. Common symptoms include a lump or thickening in or near the breast or in the underarm area. Other symptoms include a change in the size or shape of the breast, nipple discharge or unusual tenderness. Some women are fearful and don’t see their doctors soon enough, which Dr. Maizel hopes to help change. “Patients who see their physicians at the earliest sign of a change in their breast self-exams have the best outcomes,” he says.
Today, most women treated for breast cancer don’t usually need a mastectomy, or total breast removal. Instead, many women undergo breast conservation surgery, in which just the cancer in the breast and some surrounding normal tissue is removed. This less radical treatment is able to be used thanks in part to early detection.
“As we find more early-stage cancers through ultrasounds and mammograms, lumpectomy is just as effective as breast removal,” says Dr. Maizel. “These tools, along with breast self-exam and a physician’s exam, enable us to save more women’s lives each year.”
