Breast Surgery FAQ

Breast Surgery FAQ

Is breast surgery for tumor removal available at Baylor Frisco?

Answer:   Breast surgeons on the medical staff employ many techniques to treat breast cancer surgically. When possible, they strive to preserve as much of the breast tissue as possible through lumpectomy (removal of the tumor with a rim of normal tissue). In certain instances, mastectomy (removal of the breast) is required.

When is a mastectomy recommended?

Answer: A mastectomy is usually recommended if the tumor size is large compared to breast size, if there is more than one area of cancer in the breast, or if the patient cannot undergo radiation therapy. It can also be recommended if a patient has a genetic mutation predisposing to breast cancer.  Ultimately this will be at the discretion of the patient and the physician.

What is breast reconstruction surgery?

Answer:  Breast reconstruction is the process of rebuilding the breast after mastectomy surgery.  It is done by a plastic surgeon and is usually a staged process involving tissue expander placement at the time of mastectomy followed by either implant placement or tissue-based reconstruction at a second surgery. It attempts to restore the breast to near normal shape, appearance, and size following a mastectomy. Reconstruction can also be performed for lumpectomies in the event the area removed is a large defect.  This is called oncoplastic breast surgery/reconstruction where a lift/reduction technique is performed by a plastic surgeon to fill in the defect and leave a naturally lifted breast.

Does insurance cover reconstruction surgery?

Answer: Insurance does cover reconstruction surgery after either lumpectomy or mastectomy.  This is not to be confused with breast augmentation surgery which is cosmetic implant placement, unrelated to breast cancer.

How soon after breast cancer do you start radiation?

Answer: Radiation therapy can start as soon as three to eight weeks after surgery. However, if the patient needs chemotherapy after surgery this is given first.  Radiation will begin 3 to 4 weeks after the chemotherapy ends.  This is of course variable per patient and at the discretion of the patient’s physicians.

Do all patients need chemotherapy?

Answer:  No, not all patients require chemotherapy.  This is based on tumor size, lymph node involvement, and type.  There are several factors that go into this decision and is ultimately at the discretion of the patient’s treating medical oncologist.

What is endocrine therapy?

Answer:  Endocrine therapy is an antiestrogen treatment and will be recommended for patients who have an estrogen receptor-positive tumor.  It is not chemotherapy, but rather an antiestrogen pill that helps deprive the body of residual estrogen to prevent tumor recurrence. The 2 main sources of estrogen in a woman’s body are the ovaries and adipose tissue, i.e fat cells.  So even when a woman is in menopause, they still have low levels of estrogen-based on the amount of adipose tissue/fat cells they have. For this reason, it is recommended patients maintain ideal body weight after breast cancer treatment.

What are the risk factors for breast cancer?

Answer:  There are a variety of risk factors:

  1. Risks that you cannot change
    1. Increasing age
    2. Being female
    3. Family history
    4. Ethnicity
    5. Genetics
    6. Dense breast tissue
  2. Lifestyle-related risks – may increase the risk
    1. Being overweight or obese
    2. Not getting enough physical activity
    3. Early menarche, late menopause, not having children or older age at first birth, not breastfeeding
    4. Some hormone replacement therapy after menopause
    5. Drinking alcohol

What are the guidelines for breast screening?

Answer: The guidelines depend on each patient’s risk level which is determined by the patient and their physician.

In general:

For those at high risk

  • Monthly breast self-exams
  • Routine clinical breast exams
  • Yearly screening mammograms (possibly at an earlier age)
  • Possibly yearly screening MRI

For those with routine risk:

  • Monthly breast self-exams
  • Routine clinical breast exams
  • Screening mammograms every year starting at the age of 40