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Breast Cancer Screening & Surgery

Our guest experts in June 2011 were the nurses from the Henrietta Banting Breast Centre at Women’s College Hospital. The Women's College Hospital breast program encompasses breast cancer prevention, early detection, diagnosis, treatment and care, and research in breast disease and public and professional education. Learn more about the Breast Centre here.

Here are the responses to your questions on Breast Cancer Screening & Surgery.

1) I am 43 and have never had a mammogram. When should I begin breast cancer screening, and how often should it be done? There is no history of breast cancer in my family.

Dr. Sandy Messner replies:

It is recommended that regular mammograms begin no later than age 50. Between ages 40 and 50 this is a personal choice to made after discussing the pros and cons with your physician.



2) I am confused about breast self-examinations. Some sources have stopped advising women to do monthly self-exams, while others still recommend them. Are self-exams useful?

There is a lot of conflicting information about doing breast self-exams and many women feel confused about whether or not to do them. Here are some helpful tips from the Breast Centre physicians, Dr. Sandy Messner and Dr. Laura Catz-Biro:

  • Breast self exam (BSE) is a way to become familiar with what is normal for your breasts, so if there are any changes you can let your physician know.
  • The best time to start doing BSE is after you have had a clinical breast exam by your physician, so you know what “normal” is for you.
  • BSE does not have to be done every month. It is OK to do it three or four times a year.
  • If doing BSE causes you anxiety, then DON’T do it, but make sure your breasts are checked yearly by your family doctor.
  • Most importantly, BSE does not replace having your breasts examined by your physician, or having your yearly mammogram.



3) In cases where a lumpectomy is performed instead of a full mastectomy, is it possible to do reconstructive surgery to restore lost breast volume?

Breast Centre nurses reply:

Having a consultation with a plastic surgeon that specializes in breast surgery, such as the plastic surgeons at Women’s College Hospital, is the safest way to determine if further surgery or procedures can be done to restore the volume in the breast after lumpectomy. There are also many non-surgical options to help with breast symmetry that can be found in a specialty bra store.



4) What are the options for reconstruction after mastectomy? Can reconstruction be done at the same time as the cancer surgery?

Helen Mark, nurse clinician replies:

I would recommend going to the website: www.breastreconstruction.ca to get a full overview of all the different options for breast reconstruction. It is important to remember, however, that not all options are available to everyone. Breast radiation, smoking, previous abdominal surgery and ongoing medical conditions are just some of the things that can determine which options are for you.

Timing of the reconstruction is a decision that is made with you and the breast and plastic surgeons. They will let you know if immediate reconstruction (reconstruction done at the same time as the mastectomy) is an option for you, or if it is recommended that you wait until all the cancer treatments have been completed before you start breast reconstruction (delayed reconstruction).



5) How soon after breast cancer surgery does a woman have to make a decision about breast reconstruction? It seems like such a stressful time to be making decisions. Is there a ‘time limit’ for reconstruction, or can it be done years after the mastectomy?

There is no time limit as to when breast reconstruction can be done. Many women wait years before making the decision, while others decide to have it done as soon as possible after cancer treatment is completed. The length of time you wait after your mastectomy does not affect the final outcome of the reconstruction. The most important part of timing for reconstruction depends on YOU and when you feel ready to start that journey.


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