9/26/17 – Breast Cancer Live Chat Transcript

2017 Breast Cancer Live Chat Image

Thank you to those of you who joined the Breast Cancer live chat hosted by Dr. Lea Gilliland and Dr. Preeti Subhedar with Winship Cancer Institute of Emory University’s Glenn Family Breast Center. The chat had a good turnout and the transcript is now available below.

Breast Cancer Live Chat Transcript

Overview: Dr. Lea Gilliland and Dr. Preeti Subhedar answer your questions about breast cancer risk factors, screenings, symptoms, and therapy.

[Sep 26, 11:59 AM] EmoryHealthcare: Welcome everyone! Thanks for joining us today for our web chat about Breast Cancer: Risk Factors, Screenings, Symptoms & Therapy with Dr. Lea Gilliland and Dr. Preeti Subhedar with Winship Cancer Institute of Emory University’s Glenn Family Breast Center.

[Sep 26, 12:00 PM] EmoryHealthcare: We’ll get started in just a minute. Dr. Lea Gilliland and Dr. Preeti Subhedar are here to answer all your questions!

[Sep 26, 12:01 PM] EmoryHealthcare: Please note that all questions are moderated before appearing in the stream, so you may not see yours appear right away, but we will do our best to answer all your questions today.

[Sep 26, 12:03 PM] EmoryHealthcare: We received some questions that were submitted in advance of the chat, so we’ll get started by answering a few of those first.

[Sep 26, 12:04 PM] EmoryHealthcare: Q. What are your screening recommendations for women over 55?

[Sep 26, 12:04 PM] EmoryHealthcare: A. American College of Radiology and Society of Breast Imaging recommend screening every year beginning at 40. This saves the most lives. A recent study by Cornell notes that 19% of all breast cancers occur in women age 40-49.

[Sep 26, 12:05 PM] EmoryHealthcare: Q. Does reproductive history affect breast cancer risks?

[Sep 26, 12:06 PM] EmoryHealthcare: A. According to the American Cancer Society, women who have not had children or who had their first child after age 30 have a slightly higher breast cancer risk overall. Having many pregnancies and becoming pregnant at an early age reduces breast cancer risk. Still, the effect of pregnancy seems to be different for different types of breast cancer. For a certain type of breast cancer known as triple-negative, pregnancy seems to increase risk.

[Sep 26, 12:07 PM] EmoryHealthcare: Q. How often should I go to my doctor for a check-up?

[Sep 26, 12:07 PM] EmoryHealthcare: A. Once a year if you do not have a recent history of breast cancer. Screening mammography is recommended once a year.

[Sep 26, 12:08 PM] EmoryHealthcare: Q. What risk factors exist for breast cancer… I’ve heard alcohol, aluminum in deodorant, alkalizing versus natural pH in drinking water…

[Sep 26, 12:10 PM] EmoryHealthcare: A. According to the American Cancer Society(ACS), drinking alcohol is clearly linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed. Compared with non-drinkers, women who have 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 3 drinks a day have about a 20% higher risk compared to women who don’t drink alcohol. Excessive alcohol consumption is known to increase the risk of other cancers, too.

[Sep 26, 12:11 PM] EmoryHealthcare: A. (continued) The ACS recommends that women who drink have no more than 1 drink a day.

Additional risk factors noted by the ACS include being overweight after menopause (fat creates estrogen), not being physically active, not having children or delaying having children, not breast feeding, use of birth control (during use), and use of combined estrogen and progesterone therapy after menopause.

[Sep 26, 12:15 PM] EmoryHealthcare: Let’s move on to your live questions now!

[Sep 26, 12:15 PM] EmoryHealthcare: Please sign in using one of the options at the bottom of the chat and submit your questions for [enter doctor name] in the comment box.

[Sep 26, 12:15 PM] Guest1876: What type of doctor should I see if I think I have breast cancer?

[Sep 26, 12:20 PM] EmoryHealthcare: If the concern is a new mass, you should have a diagnostic mammogram and ultrasound.  If you have a current diagnosis of breast cancer, you should visit your breast cancer surgeon for a consult.

[Sep 26, 12:20 PM] Simone: What is the hormone receptor status of my cancer? What does this mean?

[Sep 26, 12:23 PM] EmoryHealthcare: All breast cancers have a hormone that makes it grow. We look at 3 receptors for hormones to decide on what kind of treatment you need. We look at the estrogen, progesterone and Her2 receptors to direct therapy.

[Sep 26, 12:23 PM] Guest6133: How do I get a copy of my pathology report?

[Sep 26, 12:23 PM] EmoryHealthcare: Your surgeon should be able to help guide you.

[Sep 26, 12:24 PM] EmoryHealthcare: Or you could contact the hospital’s medical records department.

[Sep 26, 12:25 PM] JJL94: What about genetic testing? What would the pros and cons of testing be?

[Sep 26, 12:27 PM] EmoryHealthcare: There are certain situations in which genetic testing is important. Not all people need to have genetic testing. If you are a woman under the age of 45 with a diagnosis of cancer, are 50 years old with breast cancer and have a relative with a history of cancer, or multiple family members with cancer, you may want to consider testing. These are just some of the indications.

[Sep 26, 12:29 PM] EmoryHealthcare: Pros: allows you to understand your specific genetic risk

Cons: the result can sometimes be distressing. Talk to your family about what the results may mean to you

[Sep 26, 12:29 PM] Guest8532: Does smoking cause breast cancer?

[Sep 26, 12:31 PM] EmoryHealthcare: Smoking is a risk factor for all types of cancer, including breast. It is also a risk factor for non-cancer related diagnoses such as heart disease. Talk to your primary care physician if you are interested in smoking cessation.

[Sep 26, 12:33 PM] Guest4423: I had wire localization a few years ago. Are they using seeds now, to guide the surgeon?

[Sep 26, 12:36 PM] Guest6133: What kind of impact does stress have on breast cancer?

[Sep 26, 12:37 PM] EmoryHealthcare: There are no known direct links between stress and breast cancer, but we may just not know enough about the link yet. Stress can have an adverse effect on things like blood pressure, heart rate and can therefore be deleterious. Talk to your primary care physician for ways to reduce stress.

[Sep 26, 12:38 PM] Simone: Are mammograms painful?

[Sep 26, 12:38 PM] EmoryHealthcare: Mammograms can be uncomfortable but they should not be painful. It can be difficult to image all of the breast tissue that needs to be included. Please let your technologist know if you are experiencing pain or have experienced pain in the past.

[Sep 26, 12:41 PM] Guest1876: Is there a link between hormone replacement therapy (HRT) and breast cancer?

[Sep 26, 12:41 PM] EmoryHealthcare: There are 2 main types of hormone therapy. For women who still have a uterus (womb), doctors generally prescribe estrogen and progesterone (known as combined hormone therapy or HT). Progesterone is needed because estrogen alone can increase the risk of cancer of the uterus. For women who’ve had a hysterectomy (who no longer have a uterus), estrogen alone can be used. This is known as estrogen replacement therapy (ERT) or just estrogen therapy (ET).

[Sep 26, 12:42 PM] EmoryHealthcare: Combined hormone therapy (HT): Use of combined hormone therapy after menopause increases the risk of breast cancer. It may also increase the chances of dying from breast cancer. This increase in risk can be seen with as little as 2 years of use. Combined HT also increases the likelihood that the cancer may be found at a more advanced stage. The increased risk from combined HT appears to apply only to current and recent users. A woman’s breast cancer risk seems to return to that of the general population with

[Sep 26, 12:43 PM] EmoryHealthcare: population within 5 years of stopping treatment.

[Sep 26, 12:44 PM] EmoryHealthcare: Bioidentical hormone therapy: The word bioidentical is sometimes used to describe versions of estrogen and progesterone with the same chemical structure as those found naturally in people. The use of these hormones has been marketed as a safe way to treat the symptoms of menopause. But because there aren’t many studies comparing “bioidentical” or “natural” hormones to synthetic versions of hormones, there’s no proof that they’re safer or more effective. More studies are needed to know for sure.

[Sep 26, 12:45 PM] Guest8532: What are the side effects of Tamoxifen?

[Sep 26, 12:45 PM] EmoryHealthcare: The common side effects of tamoxifen include menopausal symptoms such as night sweats, insomnia, weight gain. Other side effects include muscle or joint pain. The most serious risk of blood clots and risk of uterine cancer is only 1/1000 patients. Although these risks sound serious, remember that when tamoxifen is prescribed to you, it reduces your risk of another breast cancer by 50%.

[Sep 26, 12:46 PM] Guest6015: Where can i learn about clinical trials for breast cancer?

[Sep 26, 12:47 PM] EmoryHealthcare: You can always ask your breast cancer physician (medical, surgical, or radiation oncologist). Also, Winship Cancer center has a website that can specifically allow you to see if a clinical trial is appropriate for you.

[Sep 26, 12:48 PM] Guest6133: My grandmother said wearing my cellphone in my sports bra could cause cancer? Have you seen any research to support this?

[Sep 26, 12:48 PM] EmoryHealthcare: There has not been any reliable research to support this.

[Sep 26, 12:49 PM] EmoryHealthcare: These questions have been great! We have time for just one more question today.

[Sep 26, 12:51 PM] Guest8532: Can benign cysts become cancerous?

[Sep 26, 12:53 PM] EmoryHealthcare: Benign cysts are areas of fluid within your breast. These cysts are at no more risk of becoming cancer than any other area in your breast.

[Sep 26, 12:54 PM] EmoryHealthcare: That’s all the time we have for today. Thanks so much for joining us! As we mentioned, we’ll follow up with a blog post to answer any questions we didn’t get a chance to address today.

[Sep 26, 12:55 PM] EmoryHealthcare: Thanks for your questions!

[Sep 26, 12:58 PM] Guest3978: Thank you.

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Emory Glenn Family Breast Center at Winship Cancer Institute is dedicated to breast cancer prevention, detection and comprehensive treatment of breast health issues and breast cancer including aggressive forms of triple negative breast cancer.

Our breast cancer doctors and researchers are thought leaders in the field of breast cancer and are uniquely positioned to have access to the latest information on cancer care. The breast cancer program at Winship Cancer Institute of Emory University offers multidisciplinary teams including oncology surgeons, radiologists, medical oncologists, pathologists, and advanced practice nurses with expertise in only breast cancer. There are a variety of treatment options for breast cancer; for some patients, a combination of treatment methods may be used.

 

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