Q: Hi Doctor Pritchard, I just wanted to tell you how thankful I am for you. I am doing well today because of you. Thanks again.
Dr. Pritchard: Thanks, I'm glad you're doing well.
Q: I was just wondering if since my grandmother had breast cancer, can I get it too? Or does it have to be my mom?
Dr. Pritchard: How old your grandmother was when she had her cancer?
Q: I’m not sure. I think she was in her 70's late 60's
Dr. Pritchard: Screening mammograms should be routinely done beginning between age 35-40, then yearly after age 40. Cancers detected on a mammogram have a higher cure rate. Since your grandmother was that age, you need to start your mammograms at 35.
Q: I am only 31 with three kids. I Guess I will start my mammograms in 4 years to be safe
Moderator: Dr. Pritchard says that mammograms are needed earlier than 35 if the relative's breast cancer was diagnosed at a young age--less than 50 years old.
Q: How likely are you to get cancer with very fibrocystic breasts?
Dr. Pritchard: Only some types of fibrocystic change, proliferative changes, increase the risk of breast cancer. Routine screening is all that is needed in women with fibrocystic change. Remember, you don't have to have a family history or other risk factors to need screening.
Q: Do you have to have your breast removed if you have breast cancer?
Dr. Pritchard: If breast cancer is caught in an early stage it can be treated without removal of the breast.
Q: Is breast cancer inherited?
Dr. Pritchard: Breast cancer, in some instances, is inherited. But most breast cancer is not.
Q: What percentage of women have breast cancer?
Dr. Pritchard: 1 out of 9 women have a risk of breast cancer in their lives.
Q: When do you know when to get checked for breast cancer?
Dr. Pritchard: Baseline mammograms should start at 35 and then yearly after age 40. It's never too early to start self-exams, and if you have any question on your exam, see your health care provider.
Q: How does a doctor know whether a suspicious lump is cancerous?
Dr. Pritchard: There are some findings on physical exams and mammograms that make a mass suspicious for cancer but the only way to be certain is biopsy
Q: Do I stand a better chance of getting breast cancer if my great aunt had it?
Moderator: Dr. Pritchard says that a single distant relative having breast cancer does not significantly increase your risk.
Q: I had breast cancer a number of years ago but didn't have reconstruction. Is it too late? What is involved?
Moderator: Dr. Pritchard says it's not too late. There are several options for reconstruction. You should see a plastic surgeon.
Q: What is the recovery time for reconstruction?
Moderator: Dr. Pritchard says it depends on what type of reconstruction you have. It could be anywhere from 4-8 weeks.
Q: I have fibroid tumors in my breasts, so there are lots of lumps in them. How can I tell if a lump is cancer?
Moderator: Dr. Pritchard says the main thing you watch for is a change in the exam. If you note a new lump, it should be checked. Because you can't tell by an exam if it's cancerous or not.
Q: I have frequent tenderness and sometimes I feel lumps under arm which are sore, should I be concerned?
Dr. Pritchard: Breast tenderness is not uncommon and is not usually associated with breast cancer. But if it's something new, you should see your health care provider.
Q: What if the arm where you had a modified radical is always sore from six months ago?
Dr. Pritchard: You should talk with your surgeon about this. There are ways to improve this.
Q: I am 39, should I have my first mammogram?
Dr. Pritchard: You should have your mammogram now, if you've never had a baseline mammogram.
Q: What kind of counseling is done with the husbands of breast cancer patients?
Dr. Pritchard: There is family counseling available through cancer centers and the YMCA and other community organizations.
Q: My daughter is 30, and has no children, she's worried about an increased risk of cancer since I had it. How worried should she be?
Dr. Pritchard: It depends on how old you were when you had breast cancer. If you were young, she may need to start screening earlier than 35. If not, she should have screening as outlined earlier.
Q: Dr. Pritchard, I saw you on TV. We didn't know you were famous too. We just knew you are a wonderful doctor and a very caring person. We love you.
Dr. Pritchard: Thank You!
Q: Should my sisters take extra precautions? They've both had children.
Moderator: Dr. Pritchard says your sisters should be screened closely and need to let their health care providers know that they have a sister with breast cancer.
Q: I've heard about a new lymph node test. Do you know about this?
Moderator: Dr. Pritchard says there is a newer way to study lymph nodes that has fewer side effects. It is appropriate for some women but not all women with breast cancer.
Q: Is there any new pharmaceutical research being done to prevent breast cancer?
Moderator: Dr. Pritchard says, yes, studies have been ongoing with Tamoxifen and with other drugs.
Q: I have heard that mammograms are very painful, is that still true.
Dr. Pritchard: They can be uncomfortable for some women, but are not exttremely painful.
Q: I have recently had reduction surgery, and through that the Dr. found that I have breast cancer. Could you please give me a realistic view on how the radiation and chemo will affect me. I have a 19 month old and I don't know if maybe I should plan for child care for him, or not.... I'm a little overwhelmed. Thank you
Moderator: Dr. Pritchard says there are a lot of factors that influence your outcome and your response to radiation and chemotherapy. But chemotherapy and radiation do decrease the risk of disease spread and recurrence.
Q: A friend had breast cancer which was in her nodes yet she only had a partial mastectomy. Is that common now?
Moderator: Dr. Pritchard says a partial mastectomy or breast conservation is very common and is appropriate treatment for many breast cancers.
Q: What about a lumpectomy for someone with cancer that has spread to the nodes?
Dr. Pritchard: The choice of lumpectomy VS mastectomy depends more on tumor size and other factors than on lymph node status. You can have lumpectomy (breast conservation) even if you have positive nodes.
Q: For someone recently diagnosed with breast cancer, what reading materials do you most recommend?
Dr. Pritchard: there's so much information available through the internet and the library, etc. I will send Cathy a list of books/materials and it will be posted on the web site.
Q: I went through early menopause. I am now 39 and have been on HRT (Activella) for about a year. Does this increase my breast cancer risk? How long should a woman stay on HRT?
Dr. Pritchard: Long term use of hormones may increase your risk of breast cancer, but the benefits of hormone replacement outweigh the risk of breast cancer. You should discuss your concerns with your health care provider. How long to stay on HRT is debatable. There's no clear evidence on how long you can safely stay on it and reap the benefits of it.
Q: Does a lower dose of HRT pose less of a risk than higher doses?
Dr. Pritchard: there's not a clear answer to that question... it's continually under study
Q: I had breast cancer, should I take hormones?
Dr. Pritchard: that's a very personal decision and one that you need to discuss with your health care provider. There are a lot of factors in that decision and you need individual advice.
Q: How often do you think I should be examined by an oncologist if it has been eight years since my diagnosis?
Dr. Pritchard: You should have checkups yearly unless you develop a change in your self-exam or symptoms in which case you should be seen right away.
Q: Should I be seen by an oncologist or can I rely on my yearly visit to my gynecologist?
Dr. Pritchard: You can never be checked too often, so I would recommend yearly exam by your oncologist as well as your gynecologist. You might stagger them so that you're seen every 6 months.
Q: When can I stop worrying about a recurrence of my cancer?
Dr. Pritchard: You are at risk for recurrence for the rest of your life, but your risk, since it has been eight years since diagnosis is low. You will need to be followed for the rest of your life.
Q: I had surgery 15 month ago. I had a mass or lump in breast which was benign, I am still feeling sore from the surgery. Is this normal? I have had mammogram and ultra sound before I had the surgery. Should I have another or is this just normal that I feel like I just had the surgery especially around that time of the month?
Dr. Pritchard: Scar tissue may feel tender to you for some time. Also, if your biopsy showed fibrocystic change, you may have breast tenderness related to that around the time of your periods.
Q: I have a mole that has gotten larger over several years but has not changed color. They have seen it with my yearly mammogram. Would it be a good idea just to have it removed even though I have had no problems so far?
Dr. Pritchard: You should show this to your health care provider since it has increased in size, but this would not increase your risk of breast cancer.
Dr. Pritchard: I'd like to thank everyone for your questions. If you have other questions, please call UT Medical Group - 448-6610 - or ask your health care provider. Most importantly - get screened for breast cancer and if you find something new on your exam, seek medical attention right away!
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