Breast cancer treatment advances have resulted in nearly 100 percent survival rates for stage 1 breast cancer, according to the American Cancer Society. Even so, newly diagnosed women face understandable concerns and uncertainty. What weighs on each patient’s mind is the question, “Am I going to be ok?” Thankfully, the answer is often a resounding, “Yes!” Although breast cancer is expected to be the most commonly diagnosed cancer in women in 2018, it’s one of the most treatable and survivable when discovered early.

Steady declines in breast cancer mortality since 1990 are attributed to a combination of early detection and treatment improvements. Still, fears of chemotherapy and potentially losing their breasts with mastectomy are the top immediate concerns voiced by my patients. To help them discuss those concerns among peers, we collaborate with Pink Positive, a nonprofit that provides support groups for patients and caregivers.

Improvements in Cancer Care Lead to More Options for Patients
All forms of breast cancer treatment – chemotherapy, surgical techniques, and radiation – continue to improve as experience and research reveal new breakthroughs and innovations. That progress gives patients more options and often less invasive treatment options to take into consideration during and especially after treatment. For chemotherapy patients, Texas Oncology–McAllen collaborates with local nonprofit Infinite Love to provide free lunch to patients receiving this treatment – a much-appreciated act of kindness that our patients enjoy.

It’s important to remember that a breast cancer diagnosis does not automatically result in a mastectomy. Most women diagnosed with breast cancer will need some form of surgery as part of their treatment, but it will vary with each case. Some women need removal of a small piece of breast tissue (lumpectomy), while others will need one or both breasts removed, and possibly lymph nodes. The type and stage of the cancer will impact the need for a mastectomy. Your breast surgeon and you will determine what type of surgery is best for you.

Physical and Emotional Considerations
Ridding our patients of cancer is priority one. Obviously. But it’s not the only priority. With breast cancer, physical scars intersect with emotional and psychological wounds. Surgery to remove cancer is more straightforward. Clinical considerations lead the way, but we also consider breast preservation and physical appearance. Advanced techniques like hidden scar or nipple sparing surgery are possible options for some patients. Ultimately, whether a patient undergoes a mastectomy, lumpectomy, or lymph node surgery, and whether in combination with chemotherapy and/or radiation, our priority is making the patient cancer free.

Reconstructive Surgery Options
Decisions about reconstructive surgery blend medical with deeply personal concerns. For some women, the desire to look and feel as “normal” as possible post-cancer is vitally important. Their range of options includes saline and silicone implants or some form of flap surgery. Those procedures use back, buttock, or abdomen tissue to reconstruct breasts, with nipple reconstruction and/or tattooing available to complete the process in some cases.

Some women opt for proactive surgery on the opposite, non-cancerous breast for symmetry. Breast reconstruction surgery has become increasingly refined and can be successfully accomplished in almost all women treated with mastectomy. The goal of breast reconstruction surgery is to create a breast that matches the opposite breast. This can be accomplished by using a breast implant alone, by actually reconstructing the breast with the patient’s own tissue, or by utilizing a combination of these two techniques.

Timing of Reconstructive Surgery
Breast reconstructive surgery can be performed immediately after mastectomy, or it can be delayed for some time. We recommend that patients include a plastic surgeon in their team of physicians as early in their treatment as possible so that their chosen method of breast reconstruction can be incorporated into the overall treatment plan.

Declining Further Surgeries
Other women decline reconstructive surgery altogether to avoid more medical procedures following cancer treatment. Some women choose to “go flat” in order to prioritize exercise, an active lifestyle, or to spend more time with their families.

Every Patient is Unique
For every breast cancer patient confronting these decisions, it is important to get complete information from your medical teams about all options. While you should trust your oncology team, you should also be comfortable with your treatment plan every step of the way.

Life After Cancer
Celebrating cancer survival is one of the reasons I helped start the Texas Oncology–McAllen Cancer Awareness Ride, Walk, and Run fundraising event 11 years ago. The event has raised hundreds of thousands of dollars to support personal and family living expenses for local cancer survivors in need. This year’s event on Saturday morning, Oct. 6, includes a 20-, 40-, or 60-mile bicycle ride, a 2.5- or 4.5-mile walk, and a 5K run. To register or obtain more information, visit https://endurancesplits.webconnex.com/11th-Annual-Breast-Cancer-Awareness-Walk/Run/Ride-. If attending, remember to thank local law enforcement and firefighters from Guns and Hoses for volunteering their services at this event.

While survivorship is the ultimate goal, some patients require hospice care. That is why we partner with local hospice care provider, Comfort House, which provides support for individuals needing hospice.

Our Pledge to Patients
The swirl of clinical, emotional, and lifestyle circumstances comprises a unique and personal decision for women diagnosed with breast cancer. Our pledge is to fully inform our patients about the risks and benefits, and to support them in whatever choice they make.

Alvaro Restrepo, M.D., is a medical oncologist at Texas Oncology–McAllen, 1901 South 2nd Street in McAllen, Texas. For more information, visit TexasOncology.com or call 956-687-5150.