PODCAST: Breast cancer myths dispelled
During a recent podcast, Comprehensive Breast Care surgeons Eric Brown, MD; Linsey Gold, DO; and Ashley Richardson, DO; discussed a few of the countless myths they hear from patients regarding breast cancer. Here are a few.
#1 If you have breasts you can get breast cancer. True. Cancer has no age limitations.
#2 Young women don’t get breast cancer. False.
#3 Finding a lump is the only way to detect breast cancer. False.
#4 If your mammogram is normal, you do not have breast cancer. False.
#5 I have no family history of breast cancer so I will not get breast cancer. False.
#6 Breast cancer has to be removed immediately. False.
#7 If you remove your breast, the cancer will not return. False.
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Comprehensive Breast Care recently launched “The Breast of Everything,” a podcast series designed to serve as a trusted resource for breast health information, support and encouragement.
If you have a subject you would like the surgeons to discuss, please email your ideas to https://compbreastcare.com. The doctors want to hear from you! The views, thoughts and opinions shared in “The Breast of Everything” podcasts are intended for general educational and informational purposes only and should not be substituted for medical advice, treatment or care from your physician or health care provider. Always consult your health care provider first.
Unknown Speaker 0:00
Welcome to the breast of everything podcast, your trusted resource for breast health information, support and encouragement. Your hosts today are Dr. Eric Brown, Dr. Lindsay gold. And Dr. Ashley Richardson of comprehensive breast care. Welcome.
Unknown Speaker 0:17
One of the most common questions I get as a breast surgeon is how do you deal with cancer all day, every day? How do you prepare yourself for that? And how is it that you prepare your patients when they walk in deer in a headlight? I’m Dr. Rick Brown. And I’m joined by my partner’s Dr. Lindsay golden, Dr. Ashley Richardson. And we’re going to take a little bit of time today to talk about how one prepares for a new breast cancer diagnosis consult both the patient and we as the surgical oncologists.
Unknown Speaker 1:02
Welcome everybody, I’m so glad you could join us today. Just like Rick said, there’s really no good way to deliver a diagnosis of any cancer breast cancer in our case, as a provider, we basically have two options, you can tell a patient face to face, or you can call on the phone, and whomever is telling the patient primary care doctor ob gyn, we have the same options. I personally don’t like face to face, because the minute you say the biopsy showed cancer, patient stops listening to you conversation is worthless. So for the breast surgeon, if you don’t know about your diagnosis, before you come in to see us, you know, we’re not going to be able to give you any additional information besides what that diagnosis is. So I think for this reason, our practice the three of us, we pretty much insist that the patient is made aware of the diagnosis before the console. Lindsay, I think you bring up a good point that the minute the patient hears cancer, they don’t listen to anything else. And so we often can inform them over the phone to make sure they bring family members with them, in our view, and are more prepared to listen to what we have to say and really get the details of their diagnosis, once it’s had some time to sink in.
Unknown Speaker 2:25
Yeah, I totally agree. Even when we are the ones either performing a biopsy or ordering the biopsy, if it comes back as a cancer, we will almost invariably give that result over the phone. Obviously, there’s no great way to give somebody that news. But at least there’s time for somebody to absorb that information. And as much as much as we make fun of it, it really is not all harmful for somebody to go to the Internet, and just start to get a little bit of a baseline in terms of the knowledge and background of that diagnosis.
Unknown Speaker 3:05
Absolutely. I always ask ladies,
Unknown Speaker 3:09
how much did you Google or who googled, if there’s a couple people in the room, I’m generally quite shocked if they say nobody or we didn’t look anything up. It I think it’s great actually to Google gives you an idea of the words we’re going to be using, you’ve heard them before, if you happen upon a really good website, it might allow you to print off a list of questions you should know about your tumor. So I don’t really see anything negative, per se, about googling or looking to the internet, the only negative is when you believe the internet instead of us. So that’s a bad idea. But other than that knowing some information before you come in is is always good. I think we also can really appreciate the anxiety that a patient may have after a biopsy. Patients will often say we want to know as soon as you know. And so by calling them we give them the information much sooner as opposed to waiting until they have to come into the office because that may delay getting the information to them. So we can totally appreciate the anxiety. And I do feel calling is more appropriate,
Unknown Speaker 4:18
especially in a breast surgical oncology practice like ours. Our physician extenders, make those calls and they have a background themselves. So the patients generally get kind of a pre consult consult. We don’t just throw the information at them. There’s a little bit of a kind of a screening, if you will, as to what the patient can expect when they come in for the consult. And patients invariably find that very, very effective and very helpful. The the come to the office will talk about the results and bring somebody with you. People know what they have means so there’s there’s no less anxiety this way, by verbally given results. I think that patience, definitely can handle it. And allow for a little bit of time to kind of write down lists of questions. Having questions really helps us a lot.
Unknown Speaker 5:20
Yeah, I mean, let’s face it, the reason
Unknown Speaker 5:24
the reason we call over the phone, is there’s no way to get around the shock and horror of a generally unexpected diagnosis. People need time to let their emotions out, right? Whether you’re going to cry, or scream, or kick the dog, smoke a joint, get drunk, whatever, whatever you’re going to do. You need to let the news just sit there for a bit, you need a little time to sort of rally your troops, if you will. And then you can come sort of prepared to listen, we do try and time the phone call, like, we’re not going to give you the news. You know, while you’re driving, right? We we try and find a time when in the evening, or, Hey, is this a good time? Do you want to call us back or pull over? I’ve even said, Hey, is there somewhere you can pull over? I mean, obviously, we tried to be safe about it. It’s a horrifying call to make to a patient, you know, that when you hang up the phone with them, that you’ve completely devastated them, you’ve turned their world upside down, you know, they’re scared, and there’s nothing you can say over the phone to reassure them because they’re not going to hear it. But hopefully, they’re coming in the next morning, or the day after that, we try to keep it to a minimum of 72 hours of sort of time between notification and seeing the patient as a maximum. And to add to that we often do the biopsies ourselves in the office. And I think all three of us are pretty honest that if what we see on ultrasound, and at time of biopsy, is very suspicious will usually give the patient an indication that we’re concerned, and it’s most likely a malignancy. And so then when we do call them with a biopsy results, they’re already a somewhat prepared, and we’ve already set up a follow up appointment to discuss those results in person. So we do get them into the office very quickly after making that phone call to give that diagnosis.
Unknown Speaker 7:26
Yeah, I often tell patients when I’m doing the biopsy that I’ve been doing it for a while, and I’m a pretty good guesser. And if I were to guess, I think this is going to turn out to be a cancer and then I can even at that point give a little bit of a reassurance that, you know, cure is what the goal will be. And basically kind of a pep talk. Because, you know, most patients, when they get diagnosed, they see themselves sitting at the foot of Mount Everest, where they can’t even see the top because of the clouds. And in their mind, there’s no way they’re going to get over that there’s no way they’re going to be on the other side. And everybody gets to the other side. And you need to as much as be a good surgeon have good hands and keep up with the latest. You also have to have at least some some background in the psychology of cancer and the, you know, trauma that it does cause patients and their families, of course,
Unknown Speaker 8:31
right. That’s that’s pretty much that the art of medicine, in addition to the science, I mean, we make the assumption that when a woman’s told she has a new diagnosis of breast cancer that she basically made an assumption that she’s probably going to die, and that she should get her affairs in order. Even if you logically know it’s something small found on a screening mammogram should be curable. That’s not generally where most people’s minds go. So we sort of are approaching it from a standpoint of the woman’s making an assumption of the worst. So that allows us to sort of talk you off the ledge, right? bring bring it down from the ceiling and explain, you know what, this diagnosis is not synonymous with a death sentence. You’ve got options, we’re just in the beginning here, and we’ve got a long way to go before you need to decide, you know, where you want to be buried, like we’re not going there at all. So, and I i think that’s worse with the younger ladies, especially with young children. Unfortunately, we see a lot of ladies that are diagnosed at a young age and their 30s and 40s and they have small children. And the minute you give the diagnosis they are concerned well what about my kids? What am I going to do with them, their job, their spouse, all getting older. have their affairs in order. And like you said, Our job is to try to bring them down, bring them down a notch, let them know that it’s going to be okay, we’re here to take care of them and to focus on one step at a time of getting going through their treatment plan. Exactly. The good news is that, I mean, in the vast majority of cases, we really do have good news to share, particularly compared to what’s generally going through their mind, right, most of what we see is early stage breast cancer. And really, by early, we pretty much mean, anything that has not spread to somewhere else in the body, right? If you have disease, and it’s just in your breast, maybe even in your lymph nodes, that’s an opportunity for cure, which means we’re going to develop a treatment plan, we’re going to do what we need to do, we’re going to make it go away. And the idea and hope is that it will stay away for good, does it always we can, I’m sorry, we can deal with that down the road.
Unknown Speaker 11:03
Yeah, no doubt, I commonly will say, this is not a cancer that we put into remission. This is a cancer that we cure. And I give that exact example. You develop a plan, you execute the plan, and then you move on. And that’s not only what’s going to happen, that’s the expectation, and we all have to be pulling in the same direction. So don’t automatically think the worst because the vast, vast majority of the time. It’s not the worst.
Unknown Speaker 11:34
And I think we all use that language or something similar. And I will often have ladies at the end of a console, say, wow, I feel so much better after this console, I was really scared, you really put me at ease. You know, I have a I have a plan and I know what to focus on. And when ladies do get kind of detoured, and that negativity, oftentimes I’ll say, I know you’re going to be okay. But you need to know that too. And that really kind of helps them bring back around to focusing on going forward. Totally agree.
Unknown Speaker 12:02
I keep talking until they say that, that’s why sometimes I’ll talk for five hours until they say I feel better, because that is my challenge. I am not leaving this room until you feel better. So
Unknown Speaker 12:12
yes, 100%, I feel I failed. If the patient does not say that, or does not at least crack a smile or laugh or, you know, show visible signs of being much more comfortable. I mean, that truly is our job right to educate, to calm down, we do not give a false sense of security, we, we never say hey, this is going to be no big deal. You know, we acknowledge the difficulty psychologically and physically, that the diagnosis is going to give people and in some instances, and we accept that and sort of decide that we’re going to partner with you and help you through it. And exactly like you guys said, People feel actually better when they leave the office. And sometimes patients are very strong and stoic at the beginning. And they respond to you very well. And they’re very receptive to the discussion. And then it’s the after surgery visit where they finally break down because they had been, you know, going at it the whole time with a positive attitude. And then it finally all hits them at once. So it’s not just at the beginning, but kind of throughout their whole treatment that were there to really be their cheerleaders. We are definitely their cheerleaders. I was a cheerleader. So I’m really good at it. I’m just kidding. I
Unknown Speaker 13:29
wasn’t but I became one and I grew up I know, I am one. I mean, it’s interesting, too, because, you know, for the most part when when we get the information, and we’re looking through it before we even walk in the door. I mean, generally people get very similar types of cancers, there’s kind of a general standard type of breast cancer that people get with little variation. So we I know for myself, that I’m sure my partners would feel the same way you kind of already know what you’re going to recommend before you even meet them. Because you can look at the mammogram, you can look at the images, you can look at some of the features of the tumor. I know when I walk in, however, that maybe not 50% but somewhere around 50% of the women there thought is double mastectomy tomorrow. So I know the challenge is to move them away from that knowing the information that I have in front of me,
Unknown Speaker 14:39
right I oftentimes will ask a patient when I first meet her, you know, while I’m examining her and we’re talking before we actually get into the meat of everything. You know, I want to know how she found out did what she told him person who told her what is her relationship with that person and what has she done Done or thought about since that time, and that way I can get some sort of insight into the next, you know, 45 minutes to an hour conversation that’s going to happen about the details of the tumor. I mean, I think I can speak for all of us, we really try to get to know our patients pretty well. I like to know things about your life, about how many children you have about, you know, what your kids are doing? Do you have grandchildren, all of those things, because that really, I think, helps a patient feel more comfortable, it helps us get to know you. I mean, we do see, you know, hundreds of new breast cancer patients per year. But truly, every person is quite memorable, because of this sort of relationship through the diagnosis. I absolutely agree. I know I trained with you. So maybe I learned it from you. But part of really getting to know them is that you’re treating the whole person and not just their diagnosis. And so you really have to know their social situation and their background. You know, where they work and who they live with, to really understand how they’re going to process the diagnosis as well as how they’re going to do through treatment. So I’ll always ask, Who do you have here with you? Or who do you live with? Where do you work, because that makes a big difference. There’s a lot of multidisciplinary treatment when it comes to breast cancer, and understanding where they live, or where they may work will help us set them up with future treatment plans. But like you said, Everybody is memorable. And it’s great to make a connection with the patient, because those are the things that really stick. And those are building blocks with the patients that they really can trust you with their care.
Unknown Speaker 16:40
So so one of the one of the issues that we have, and patients that call the office with a new diagnosis is not having all the information. Because you know, you’re you’re empathetic to patients, and you want to get them right in. But sometimes the next day is too soon. Because there’s you don’t have all the information, there’s a lot of information from a pathology report, that’s more than just a diagnosis of cancer.
Unknown Speaker 17:12
And some patients, when you give the diagnosis over the phone, they’ll just shut down. I mean, I’ve had patients that drop the phone and start crying, say I need to call you back. Other patients want you to spend an hour on the phone elaborating on the diagnosis and the pathology. And I just try and reassure them that when I see them in the office, I will spend over an hour with them going through all of the details, formulating a treatment plan and answering all of their questions. So I try not to give them too much over the phone. Otherwise, it just leads to more questions that they’re not really going to listen to her here. Because again, the shock of getting the cancer diagnosis causes them to not really hear what you’re saying.
Unknown Speaker 17:49
Yeah, I think that it really is kind of the beginning of the challenge is not wanting to brush off a patient when they just hear. But at the same time, there’s a lot of specific information that guides what the treatments going to be, and if it’s not all available, to go through. If and but and when with patients without the information when they just heard a diagnosis, it becomes not only challenging to do, but like you were saying it, people kind of stopped listening after a while because they’re still kind of hung up on just having that diagnosis. I mean, there’s a lot that goes into preparing for these consultez, as we’ve talked about. So
Unknown Speaker 18:40
we want patients to understand that we can appreciate how difficult receiving the News is. And we want you to understand that there is a lot of thought and energy and effort that goes in to how we deliver that news to you, and the environment, and the words we use and how we try and make it about the experience. So I often tell people, well, we’re going to cure your cancer, and all you’re going to be left with 123 decades from now is the feeling you had about your cancer experience. So it’s really important for all of us that that starts out on a really, you know, positive note I say positive like with air quotes. Because how can a cancer diagnosis be positive, but truly, that is our goal. To make it the the most positive experience it can be so that you remember it, you know, not with warm fuzzies but not with horror ification Yeah, we constantly do refer to the cancer journey. And I think that the three of us as as many of our colleagues, we were part of the journey and You know, we always tell patients, you’re gonna look back one day and you’re gonna be proud that you went through this and you did it. And you’re moving on, right? So if you are a patient and you’re listening to this, and this is not your experience, it wasn’t or currently isn’t. Just know that this is something you deserve, and that whether it’s us or another set of surgeons, second opinions are extremely common. And that is going to be a really awesome topic coming up is second opinion consultations. Well, thank you for joining us today on the breast of everything podcast. I’m Dr. Ashley Richardson and Dr. Lindsay gold,
Unknown Speaker 20:49
Dr. Eric Brown.
Unknown Speaker 20:51
We’ll see you next time.
Unknown Speaker 20:52
You’ve been listening to the breast of everything podcast with your hosts and board certified breast surgeons, Dr. Eric Brown, Dr. Lindsay gold and Dr. Ashley Richardson of comprehensive breast care. If you have a subject you would like the surgeons to discuss, please submit your suggestions online at comp breast care.com. That’s co mp BREAST ca r e.com. The views thoughts and opinions shared in this podcast are intended for general education and informational purposes only and should not be substituted for medical advice, treatment or care from your physician or health care provider. Always consult your health care provider first.
Transcribed by https://otter.ai