Mary Ellen Broadstone-Gaeke, MD, Medical Oncologist, Discusses Breast Cancer Video Transcript

My name is Mary Ellen Broadstone-Gaeke. I am a medical oncologist. I’ve been in practice for over 32 years here in Middletown seeing cancer patients.

You can do so much for people who need so much. These people have real disease; there’s not hypochondriasis. They need you and you can be really real with them and make a big difference in their lives.

Mammograms

The vast majority of women who have breast cancer are diagnosed in a stage where they can’t see it, they can’t feel it; it’s an abnormal screening test. So the big thrust in our medical oncology life with breast cancer has been to emphasize screening. We know that breast cancer is a disease of aging and as you get older you have a bigger and bigger chance of getting breast cancer. It has been well-documented that breast cancer screening saves lives.

Breast Cancer Screening

We know that screening for breast cancer has always been a three-part process. You do the breast self examinations on a regular basis, usually monthly. You are examined by a skilled observer once a year. And you get a mammogram.

Abnormal Mammogram

We like to see women who have no symptoms of breast cancer, who have had an abnormal screening test. By the time a woman has symptoms of breast cancer, usually it means their breast cancer has progressed to a point where it’s not small anymore. There may be a lump. There may be an ulcer. There may be some bleeding. There may be pain in the breast or elsewhere in the body. What we want to see is a woman who has no symptoms with her breast cancer.

Breast Cancer Indicators

Some of the other symptoms that we see that are indicative of breast cancer are a change in the nipple with inversion of the nipple that has not been inverted before or a rash in the skin of the breast – sometimes a red, warm rash which is often indicative of a very aggressive breast cancer.

Treatment of Breast Cancer

The treatment of breast cancer depends on the stage. With early breast cancer we can talk to the patient about breast-conserving therapy which means we can diagnose the breast cancer with a needle biopsy. We can do definitive surgery with a lumpectomy as opposed to having a mastectomy. And we can sample a sentinel node at the time of definitive surgery so when the patient has had the full diagnostic range of tests, she has very small incisions and she has a breast that is very similar to the breast she started out with.

In patients who have larger tumors or have a preference for having a mastectomy, then certainly that procedure can be done. Part of breast-conserving therapy is radiation therapy. After the lumpectomy has been performed and the sentinel node biopsy has been done, radiation therapy can be given to the intact breast to complete the breast-conserving therapy to the breast.

Risk Factors

The major factors that predispose a woman to breast cancer are age, estrogen exposure, and hereditary factors. The vast majority of women have no hereditary factors that can be found. Over 85 percent of patients do not have genetic factors that are identifiable. In those women who do have genetic factors that have been identified, they need to start their surveillance tests including mammography, breast self examination and examination by a skilled observer earlier than what is recommended by guidelines for people who are at average risk for breast cancer.

Male Breast Cancer

I do have patients in my practice who have breast cancer who are men. It is not a very common problem. To put it into perspective, every year there are over 225,000 new breast cancer patients who are women as opposed to only about 1,900 who are men.

Complete Care at Atrium Medical Center

Here at Atrium Medical Center we have excellent pathology, fine surgeons, up to date radiation therapy and excellent medical oncology with the availability to enroll patients into controlled clinical trials just as is done anywhere throughout the state and the nation.