Can You Trust Your Mammogram?
Reticence on Reconstruction continued...
Why it matters: Both procedures will alter your appearance, but in
different ways. This may seem like a minor worry when you're newly diagnosed
and terrified, but it's likely to become important when you're well.
What you should do: "Ask your surgeon how your breast will look,
how your clothing will fit," says Amy Alderman, M.D., M.P.H., an assistant
professor of surgery at the University of Michigan. Even if you're sure you
want breast-conserving surgery, you may want to consult with a plastic surgeon.
Lumpectomy sometimes changes the breast more than women expect; a specialist
can help you assess what might happen in your case. This is not vanity: Women
who end up with extremely uneven breasts are more likely to be depressed and to
worry that their cancer will return, a brand-new University of Michigan study
found. Or you may want to seek out a breast surgeon who's experienced in
oncoplastic techniques, which can improve the look of the breast.
Thankfully, the days of "Doctor knows best" are behind us. But that
means breast cancer patients have to work with their physicians to make tough
choices. To do that, women must share their fears and desires. "The doctor
only knows what's on your X-ray and pathology report," says Karen Sepucha,
Ph.D., a senior scientist with the Health Decision Research Unit at
Massachusetts General Hospital: "What you care about needs to get on the
And you have to be the one who makes sure it does.
More Ways to Get the Answers You Need
Going for a Third Opinion
Kim Friedrich, 37
Kim Friedrich was in shock. In February 2007, her left breast had a tumor
one-and-a-half times the size of a golf ball; because it was so big and
aggressive, the surgeon told her she needed to have that breast removed, as
well as the other as a precaution. A second doctor agreed. "I kept seeing
myself on my deathbed," Friedrich says. She'd look at her two daughters and
seize up with grief — would they grow up without her? While she would have done
anything to live, she wasn't convinced she had to lose her breasts. Neither
doctor had taken much time with her, she realized. Friedrich began to do
research and talked to everyone she could. When an acquaintance raved about her
breast specialist, at a cancer center a three-hour drive away, Friedrich
pressed for an appointment. The mastectomy recommendations did not surprise the
doctor. "That's old thinking," he told her. His advice: a course of
chemotherapy (which shrank the tumor down to the size of a pea), followed by a
lumpectomy and radiation. It was very tough, but Friedrich has no doubt she
chose the right treatment — and doctor: "I got two quick assessments, and
felt like they were thinking, 'Let's just do what's fastest and move on to the