Definitely, you should always discuss your personal preferences in terms of your goals for treatment with your health care team. This will help your team come up with the best treatment plan for you. We need to know whether you have limited time off work. We need to know whether it's more important for you that everything is accomplished at one operation, or whether you're open to having two operations in order to have the best long-term cosmetic outcome. All of these nuances in terms of travel distance, your fears about radiation, your fears about chemotherapy, your fears about surgery are important so that your health care team can put your mind at rest and can also dispel any potential myths that you may have that may be inaccurate.
This is a very common question that I get. And essentially the answer is no. Cancer does not spread or jump from one breast to the other breast. If a patient with breast cancer develops a subsequent breast cancer on the contralateral side or on the other side. This is usually a "de novo" or a new primary breast cancer, and it's very unlikely for a single breast cancer to spread from one side to the other.
No, the needle biopsy is commonly performed and this does not increase the chance of spreading of the breast cancer.
Well, there have been a lot of advances in both breast surgical options and reconstructive options. In terms of breast surgery, increasingly, women have the option of breast-conserving surgery, allowing them to maintain their normal breast. For those women who do need to undergo mastectomy, we now have more options in terms of how that mastectomy is performed. And for some women, we are able to preserve the nipple and areola complex at the time of their mastectomy so that their reconstructed breast mound has their normal skin and their normal nipple and areola complex. In terms of breast reconstruction, increasingly that reconstruction is performed in front of the muscle, minimizing the muscle spasm and some of the pain associated with that after reconstructive surgery.
Well, here at Mayo Clinic, we have a strong multidisciplinary team. Usually your first portal of entry is our breast clinic. This is a group of internal medicine boarded physicians specializing in breast care. And they can see you, evaluate your imaging and pathology and discuss all of the findings with you before they then refer you on to breast surgery, breast medical oncology and breast radiation. For patients with more advanced disease, where upfront medical therapy prior to surgery is likely to be recommended, you'll be seen as part of our multidisciplinary team, where you'll meet with both the surgeon, the medical oncologist, and the radiation oncologist on the same day. In terms of surgery, we have strong support from our pathologists with our frozen section pathology. This means, for women undergoing breast-conserving surgery, where we are removing just the breast cancer or the lump, also called a lumpectomy, our pathologists will actually evaluate the edges of that lumpectomy during surgery. And if there's any disease at an edge then we will re-excise that edge or that margin during that same operation. This means that the chances of needing a second operation to clear those margins is as low as about 3%, as in fact has been shown to be four-fold lower than any other institution.
The best way to partner with your medical team is to be completely honest about everything that you're taking or doing and your own personal preferences. Many people are often drinking alcohol or smoking and even the use of herbal supplements. And it's really important that your health care team is aware of all of these behaviors. Smoking can definitely impact some of the potential options in terms of reconstruction, if you choose a mastectomy. And even herbal supplements can sometimes interact with some of the medical therapies. So be transparent and discuss everything openly with your medical team, so that together you can come up with the best treatment plan.
I recommend working closely with a multidisciplinary team specialized in the care of breast cancer. Look at all of the treatment options and plan your journey with your multidisciplinary team and include your family and friends. And remember, as you embark on this journey and go through this journey, there are thousands of women out there that have successfully completed this journey, decades out from their breast cancer diagnosis, living full lives.