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 Road to Recovery Often Can Be Daunting
The road for a woman diagnosed with breast cancer can be daunting.
It starts with a mammogram, a scheduled check-in with medical professionals who examine a woman’s breast for abnormalities.
For most, mammograms come and go without a hitch; for others, it can be the start of a frightening journey.
“Nobody knows they have breast cancer until a pathologist tells them,” says Dr. Miguel Montes, chief of pathology and chairman of the Sky Lakes Medical Center’s oncology program.
Montes, who has worked in pathology for 13 years, and has seen numerous cancer tumors. The job of Montes, and other pathologists like him, is to determine if an abnormality — lumps in the breast, bleeding or otherwise — is cancerous.
Diagnosing the cancer
Montes performs a biopsy on women whose mammograms show abnormalities. In a biopsy, tissue from the breast is removed. It’s sliced and placed under a microscope with chemical additives so it can be examined by medical staff. “We can tell if it’s breast cancer, usually within 15 or 20 minutes (of the test),” Montes said. If the lump in a woman’s breast is large, the biopsy will be surgical, and the patient will most likely be anesthetized. That means, in many cases, that the discovery of a malignant tumor is made while the patient is unconscious. It’s up to the patient to decide before the surgery if doctors should continue with removal of the tumor immediately after the malignancy is discovered, or if they want to wait to discuss options.
"It’s something where (the patient) has to decide if that is the way they want to go,” Montes said.
Removing the tumor
A crucial moment in breast cancer treatment is determining whether the cancer has spread to the lymph nodes.
The discovery of cancer in the lymph nodes suggests a cancer is more severe than if it were confined to the breast, Montes said.
Pathologists like Montes use the information they’ve gathered to decide just how severe the cancer is.
For other doctors, like Raul Mirande, discussing the severity of cancer in a patient can often be the most difficult part.
Mirande said it’s important for the patient’s family to take a supporting role.
Many women mistakenly interpret a breast cancer diagnosis as a death sentence, Mirande said. But he reminds them that only 20 to 25 percent of breast cancer cases each year lead to death. By contrast, more than 80 percent of lung cancer patients will die.
“It’s treatable, and curable in a majority of cases if it’s caught early enough,” Mirande said.
Recovery
The path to recovery is far from over, even after doctors successfully remove a tumor.
Mirande said he consults with women about whether they would like any breast reconstruction surgery — particularly if the cancer has spread to the lymph nodes. A woman can opt to undergo a procedure that reconstructs most of the breast area.
Mirande said that is important for many women. But others, particularly older patients and those who are done having children, opt to forego reconstruction.
When surgery is complete, women enter into what Mirande calls a “grey zone.” Patients can expect to undergo radiation therapy or chemotherapy. In serious cancer cases, both may be necessary.
Mirande said the side effects of these intensive treatments are similar to having the flu every day for six months. Patients feel weak, their bodies feel sore and even the simplest movements can be too much.
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