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The Breast Cancer Book

The Breast Cancer Book: What You Need to Know to Make Informed Decisions

Ruth H. Grobstein
Copyright Date: 2005
Published by: Yale University Press
Pages: 240
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  • Book Info
    The Breast Cancer Book
    Book Description:

    A diagnosis of breast cancer is among the most frightening moments in a person's life-so frightening that even to formulate questions for the doctor may seem impossible. This helpful book is written as a guide for women and men facing breast cancer and for their caring families and friends. It is also written for women who have not been diagnosed with breast cancer but are concerned that they may be.Drawing on her many years of experience with breast cancer patients, Dr. Ruth H. Grobstein provides exactly the information they want and need in order to make the best health decisions. Her jargon-free book deals with general issues of interest to all women-mammography, hormone replacement therapy, risk factors for breast cancer, and more-as well as the numerous issues that patients diagnosed with breast cancer confront. Her book will be an indispensable companion, providing reliable information for patients on the journey through a sometimes confusing and impersonal medical system.

    eISBN: 978-0-300-13079-9
    Subjects: Health Sciences, Public Health

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Foreword
    (pp. ix-xiv)
    Margaret Foti

    Breast cancer—few words carry as much fear. In the United States alone, one out of every seven women will be diagnosed with breast cancer if all live their full life span. This sobering statistic, however, is only part of the story.

    Today, more women than ever before are surviving their initial diagnosis—with the help of early screening and detection. And research is offering new hope for effective treatments that attack the tumor without destroying surrounding tissue. In fact, the scientific community believes that we are at a crossroads for conquering this disease.

    In addition to scientific and medical...

  4. Preface
    (pp. xv-xviii)
  5. Acknowledgments
    (pp. xix-xxii)
  6. Chapter 1 Facts You Should Know and Questions You Might Ask
    (pp. 1-10)

    Are you terrified by the notion that you might have breast cancer? For most women, fear of breast cancer is greater than fear of heart disease, colon cancer, and other cancers. Why this is so is unclear. But women in other Western countries are as frightened of breast cancer as American women. Is it the loss of a breast? Perhaps. In Western countries, breasts are important to a woman’s body image. Certainly, fear of breast cancer is greater in developed countries than in developing nations. Western clothing styles can cover up a colostomy. They can even conceal the fact that...

  7. Chapter 2 Detection: Mammograms and Breast Exams
    (pp. 11-38)

    This long chapter has two separate decision trees, Decision Trees 1 and 2. Because of its size, Decision Tree 1 is divided into Decision Tree 1a and Decision Tree 1b. Decision Tree 1a is the path to follow if you have a new breast lump or abnormality. Decision Tree 1b is the path to follow if you haven’t. Almost everyone should follow Decision Tree 1b. Essentially, it is a component of breast cancer screening that should be a regular part of your life. Since Decision Tree 1a requires immediate action, we’ll start with that.

    You may have been examining your...

  8. Chapter 3 The Path to Your Diagnosis: Breast Biopsies
    (pp. 39-52)

    Your primary care physician has confirmed the lump you feel. It may or may not have shown up on your screening mammogram. Or there’s no palpable lump, but a routine mammogram looked suspicious and you’ve been referred for a diagnostic mammogram.

    The mammographer who carries out your diagnostic mammogram is a member of your diagnostic team. The other two members are your pathologist and your surgeon.

    Mammographers can grade the level of suspiciousness by using a code in their report—for example, the ACR code (see Box 6, in Chapter 2). But a diagnosis cannot be made until a biopsy...

  9. Chapter 4 The Pathologist’s Report
    (pp. 53-66)

    By this time you have received a diagnosis based on the biopsy findings. You know whether or not you have cancer. Your diagnosis was made by the pathologist—the only member of your diagnostic team whom you probably won’t meet. In Chapter 3 you learned a good deal about what a pathologist does, and about his or her role in a surgical biopsy. Let’s look now at what sort of report you can expect.

    A cytopathologist issues a cytology report if you had a fine-needle aspiration biopsy (FNA); a surgical pathologist issues a pathology report if you had any other...

  10. Chapter 5 Your Treatment Team and Second Opinions
    (pp. 67-72)

    The radiologist/mammographer has read your mammograms, the surgeon and/or a mammographer has carried out your biopsy, and the pathologist has looked at your biopsy specimen under the microscope and given you the final diagnosis. These three specialists constitute yourdiagnosticteam. Although you may have met the first two and will probably never meet the third, each specialist is critically important to your care (Box 7). A mistake by any one of them could have profound consequences for you. That is why it is essential to select well-trained, experienced physicians as well as an excellent hospital where, for example, high-quality...

  11. Chapter 6 Surgery and Staging of Your Breast Cancer
    (pp. 73-96)

    If you were diagnosed with breast cancer between 1900 and the late 1970s, you were referred to a surgeon and you had the only available procedure, which in those days was a radical mastectomy. You did not need a decision tree. You did not need a treatment team. If you grew up during that time, or if you read the statistics on breast cancer during those years, you know that women who were newly diagnosed to have breast cancer were diagnosed in the late stages of the disease and often had little chance of recovery. They had either locally advanced...

  12. Chapter 7 Radiation Therapy
    (pp. 97-116)

    Many patients are confused about the necessity for radiation after breast surgery. In your discussions with your treatment team before surgery, you may be so preoccupied with the surgery that all your questions are for your surgeon, and your surgeon may have tunnel vision about his or her own role. It may not occur to you to ask in detail about the treatment that follows. You may think that chemotherapy and radiation are equivalentalternativeoptions. It’s not uncommon to wonder, “If I have a lumpectomy and I have chemotherapy, do I then need radiation?” Or, “If I have a...

  13. Chapter 8 Systemic Therapy
    (pp. 117-134)

    Systemic therapy treats the whole body. It is delivered by the medical oncologist member of your treatment team. It is given to combat metastases—the spread of cancer cells from the primary tumor in your breast to other sites. It can also be used to inhibit the growth of an existing cancer, even to shrink it. Chemotherapy, hormonal therapy, and biological therapy are the three forms of systemic treatment, all of which can be given as pills or by injection. The therapy gets into your bloodstream, going everywhere and acting everywhere. It gets into your entire system—hence the term...

  14. Chapter 9 More Facts You Should Know
    (pp. 135-148)

    I am often asked, “What did I do to bring on this diagnosis of breast cancer? I live a good life—good home, good family, no smoking, no carousing, no unusual stress, so why me?”

    The underlying questions really being asked are “What risk factors precipitated my diagnosis?” and “Can something be done about any one of those risk factors to reverse my diagnosis and maybe cure this cancer?”

    Those are perfectly legitimate questions. So let’s take a few moments to talk about risk factors and see if altering any one of them can prevent or cure breast cancer.


  15. Chapter 10 Transition Time
    (pp. 149-158)

    As the years pass, what happens to those of us who have been treated for breast cancer? Long after we become “survivors,” do we go about our daily activities as usual or are we forever scarred? What happened to our significant others during this battle? Were they too scarred by this experience? What about other loved ones—parents, siblings, friends? And children—what about them? If they were living in the same house, how could they escape? Didn’t they hear the vomiting? Didn’t they see the bald head? Didn’t they experience the anxiety of waiting for the biopsy results? Could...

  16. List of Resources
    (pp. 159-182)
  17. Index
    (pp. 183-188)
  18. Back Matter
    (pp. 189-189)
  19. Tear-out decision trees
    (pp. None)