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Expert Analysis Highlights:
This interview of Martina Navratilova with Robin Roberts (herself a breast cancer survivor) describes the initial emotional reaction that women go through when informed: “you have breast cancer”. In her case, there was a “good news/bad news” circumstance, for her diagnosis was “ductal carcinoma in situ” (DCIS). This is actually a precursor of invasive breast cancer and associated with a very low risk of relapse or dying of breast cancer. Nevertheless, the diagnosis can strike fear and uncertainty because breast cancer can be a “silent killer” and it can occur – and recur – without warning or symptoms.
I can imagine how Martina felt when informed that she had breast cancer. She is one of the most athletically fit women in the world and is the Health and Fitness Ambassador to the American Association of Retired Persons (AARP). She exercises regularly, has a healthy diet, drinks very little alcohol – and yet that doesn’t protect her against cancer.
Listen to the emotional reaction as she described her initial encounter with the diagnosis of breast cancer in this interview: “This was my personal 9/11”…. “I couldn’t think, couldn’t move”…..“The emotions took so much strength out of me.” She is no doubt an emotionally strong person in other domains of her life, but facing the diagnosis of cancer is very unsettling. These are typical reactions of women and men when confronted with the diagnosis of cancer.
The treatment options for DCIS vary enormously. They range from a lumpectomy (or segmental mastectomy) alone, to lumpectomy plus radiation, to mastectomy. What is right for you depends upon the size of the tumor and other features of the tumor such as the “nuclear grade”. Martina revealed that she had a Grade 3 DCIS tumor, which is associated with a higher rate of relapse within the breast after lumpectomy alone. So she and her doctors elected to add radiation therapy to the breast in order to reduce the risk of relapse.
In another article titled “Why Are Biomarkers Important for DCIS Breast Cancer Patients?“, I have discussed a new advance in using biomarkers in patients with DCIS that can help partition patients with this condition into very low risk for breast relapses (and therefore more safely allow for conservative treatments) compared to other presentations of DCIS associated with a higher risk of breast relapses for which breast radiation therapy or even mastectomy might be appropriate.
In retrospect, should she have done anything differently? Well, yes. She skipped a few years and did not have an annual mammogram, as we have recommended for someone of her age of fifty-two years old. “I let it slide. Everyone gets busy, but don’t make excuses,” she said. A central theme of her message (which I totally support) is: “Everyone (in my age group) should have a mammogram every year.” Good advice!!!
For those of you just confronting the diagnosis of cancer, here is what I would also recommend ( in addition to the valuable advice above):
I’m convinced after 35 years of counseling and treating cancer patients that an informed, educated patient will always get better care and enjoy a better quality of life. Make sure you are focusing on information that is pertinent to your own diagnosis and stage of disease. Don’t get misled by information that is too general or by reading about aspects of diagnosis and treatment that don’t apply to you. It can lead to unnecessary anxiety or, conversely, to unjustified complacency.
Cancer is a complex and diverse collection of diseases, so getting the right information from trusted and reliable sources that is directly pertinent to your situation is key. Look at comprehensive websites for cancer patients, such as www.patientresource.net, www.cancer.net, and www.cancer.org as starting places for information. Be sure to talk with your doctor and the staff in order to be sure that the information you are gathering correctly applies to your situation.