Ann Romney recently reported that she was being treated for ductal carcinoma in situ (DCIS). The headlines read that she was being treated for breast cancer, but Mrs. Romney was very clear in her statement that DCIS is technically a precancer because it is not invasive.
DCIS is often referred to as an early stage of breast cancer, but there is an important distinction. DCIS differs from invasive cancer in that it stays in the breast ducts. It is the capacity to spread, or metastasize, that makes invasive breast cancer dangerous. The concern with DCIS – a noninvasive cancer — is that it can transform to become invasive breast cancer.
Scientists believe that DCIS would not always progress to breast cancer. Once detected, though, it is removed surgically to eliminate the possibility that it would become cancer because no one can predict which women would have it transform and which would not.
DCIS is a serious condition that requires treatment, but many women face greater anxiety than they should because it is referred to as an early stage of breast cancer. The implication is that it is the first of an inevitable series of stages. Instead, it is a precancerous lesion that could undergo a transformation to become invasive. The distinction is important, but it is often lost.
Depending on how extensive the DCIS is and what its characteristics are, it may be removed with a lumpectomy or a mastectomy and may require radiation. The risk of recurrence is very low.
There are sometimes stories in the news about women with DCIS choosing to have both breasts removed to prevent the possibility of getting breast cancer. Having a bilateral prophylactic mastectomy for DCIS is more than is needed, though it might be considered when a woman has additional risk factors like a faulty BRCA gene or a very strong family history of breast cancer.
Mrs. Romney’s health care providers deserve credit for being clear about what her diagnosis meant. Too many women who are diagnosed with DCIS do not realize that it has important differences from invasive breast cancer. With proper treatment and attention to lifestyle factors that reduce breast cancer risk, future problems are unlikely.
Thursday, January 8, 2009
Thursday, November 20, 2008
Eat to Beat Cancer -- Even on Thanksgiving
The American Institute for Cancer Research (AICR) is a great resource for healthy recipes that follow guidelines they've developed for reducing cancer risk. They offer several recipes for nutritious Thanksgiving dishes in addition to the following one for pumpkin pie. Their web site has helpful information about reducing cancer risk and recurrence through lifestyle.
Mom's Pumpkin Pie - From The New American Plate Cookbook
Canola oil spray
2 cups canned pumpkin
Dough for whole-wheat pie crust*
1 1/2 teaspoons unbleached all-purpose flour
1/2 teaspoon ground nutmeg, divided
3/4 teaspoon ground cinnamon, divided
1 can (12 oz.) evaporated fat-free milk
1/2 cup packed dark brown sugar
2 or 3 large eggs, lightly beaten
1/4 teaspoon salt
1/4 teaspoon ground allspice
1/2 teaspoon vanilla extract
Canola oil spray
2 cups canned pumpkin
Dough for whole-wheat pie crust*
1 1/2 teaspoons unbleached all-purpose flour
1/2 teaspoon ground nutmeg, divided
3/4 teaspoon ground cinnamon, divided
1 can (12 oz.) evaporated fat-free milk
1/2 cup packed dark brown sugar
2 or 3 large eggs, lightly beaten
1/4 teaspoon salt
1/4 teaspoon ground allspice
1/2 teaspoon vanilla extract
Lightly coat the inside of a large, nonstick skillet or saucepan with canola oil spray. Add the pumpkin and cook over medium-high heat, stirring often with a wooden spoon, about 5-10 minutes. Transfer the pumpkin to a blender or food processor and let it cool slightly.
Set a baking rack in the middle of the oven. Preheat the oven to 400 degrees.
Meanwhile, roll out the dough. On a sheet of waxed paper, press the dough into a flattened disk. Cover the dough with another sheet of waxed paper and, using a rolling pin, roll the dough out into a 12-inch circle. Remove the top sheet of waxed paper and lift the bottom sheet to invert the dough over a 9-inch pie plate. Remove the waxed paper and gently press the dough down against the sides and bottom of the plate, pressing out any air bubbles. Crimp the edges by pinching between your thumb and forefinger.
In a small bowl, combine the flour with 1/4 teaspoon of the nutmeg and 1/4 teaspoon of the cinnamon. Sprinkle the flour and spice mixture evenly over the bottom of the pie crust and set it aside. Chill prepared crust while preparing filling.
Gradually turn the blender or food processor to the highest speed and purée the pumpkin. Stop the motor and scrape down sides of the blender or processor with a rubber spatula. At medium speed, gradually add first the milk, then the sugar, then the eggs, blending only until each addition is incorporated into the mixture. Add the salt, the remaining 1/4 teaspoon nutmeg, the remaining 1/2 teaspoon cinnamon, the allspice, and vanilla extract and blend just until combined. Do not overmix. Pour the filling into the pie crust, scraping down the sides of the blender or processor with a rubber spatula.
Bake the pie for 15 minutes. Reduce the oven heat to 325 degrees and bake about 45 minutes more, until the filling looks set and a thin knife inserted into the center of the pie comes out almost clean. If the rim of the pie crust browns before the filling is set, cover it loosely with strips of foil.
Cool the pie on a wire rack before serving.
*Whole-Wheat Pie Crust
1/4 cup whole wheat flour
3/4 cup unbleached all-purpose flour
1 Tbsp. powdered sugar
1/8 tsp. of salt
1 Tbsp. butter, chilled
3 Tbsp. canola oil
1-2 Tbsp. ice water or cold apple juice
In a food processor, combine the whole wheat flour, all-purpose flour, sugar, and salt. Pulse for a few seconds to combine. (The dough can also be made by hand. In a medium bowl, mix the dry ingredients with a spoon, then use a fork or pastry blender to mix in the remaining ingredients.) Add the butter and canola oil. Pulse again until the ingredients are well combined and the mixture resembles crumbs. With the food processor running, add the ice water, beginning with 1 tablespoon and adding more, one teaspoon at a time, until the dough starts to come together. Gather the dough into a ball and let it rest for a few minutes.Makes 10 servings.
Per serving: 194 calories, 7 g. total fat (1 g. saturated fat), 29 g. carbohydrates, 6 g. protein, 2 g. dietary fiber, 158 mg. sodium.
1/4 cup whole wheat flour
3/4 cup unbleached all-purpose flour
1 Tbsp. powdered sugar
1/8 tsp. of salt
1 Tbsp. butter, chilled
3 Tbsp. canola oil
1-2 Tbsp. ice water or cold apple juice
In a food processor, combine the whole wheat flour, all-purpose flour, sugar, and salt. Pulse for a few seconds to combine. (The dough can also be made by hand. In a medium bowl, mix the dry ingredients with a spoon, then use a fork or pastry blender to mix in the remaining ingredients.) Add the butter and canola oil. Pulse again until the ingredients are well combined and the mixture resembles crumbs. With the food processor running, add the ice water, beginning with 1 tablespoon and adding more, one teaspoon at a time, until the dough starts to come together. Gather the dough into a ball and let it rest for a few minutes.Makes 10 servings.
Per serving: 194 calories, 7 g. total fat (1 g. saturated fat), 29 g. carbohydrates, 6 g. protein, 2 g. dietary fiber, 158 mg. sodium.
A happy -- and healthy -- Thanksgiving to all.
Sunday, November 16, 2008
Understanding Breast Cancer Risk
All women are at risk for breast cancer -- and most of us think our risk is higher than it actually is.
The commonly cited statistic – that women have a 1 in 8 lifetime risk of breast cancer – is a bit misleading because 1 in 8 women in the United States do not actually get breast cancer. The 1 in 8 number is an estimate of lifetime risk. A woman with average risk has a 1 in 8 chance of getting breast cancer sometime during her life if she lives to be 90. Some women are less likely to get breast cancer, and some have a greater risk. Some will not live to be 90.
A more meaningful way to look at risk is the chance of getting breast cancer during each decade of life. A woman in her twenties has a 1 in 1,837 (0.05%) risk of getting breast cancer, and her risk increases as she ages to a maximum in her seventies of 1 in 26 (3.88%). If you add up the percentages for each decade, you get 13% lifetime risk (1 in 8). During no ten-year period during her lifetime, though, does a woman face a risk of getting breast cancer as high as 1 in 8.
Of course, some women are at greater risk of developing breast cancer. And they, too, overestimate their risk for getting this disease.
Women with a faulty breast cancer gene are said to have “up to” an 85% lifetime risk of getting breast cancer, but according to the National Cancer Institute, the risk ranges from 36% to 87%. As with women who have an average risk, their chance of getting breast cancer increases as they age. (The exception to this is women with close relatives who got breast cancer when they were young.)
Others with a higher than average risk for breast cancer are women diagnosed with precancerous conditions like lobular carcinoma in situ or atypical hyperplasia. Women who have had breast cancer or ductal carcinoma in situ, a noninvasive cancer, are also at increased risk.
It should be noted that many women who are high risk will never get breast cancer. No one knows why they don’t or why some women get breast cancer even though they have no risk factors. The interplay of genetic make-up, age, reproductive history, environmental exposures, and lifestyle determines whether or not we develop breast cancer.
But those of us who are high risk can’t help feeling we’re destined to get breast cancer. Some choose overly aggressive treatment because they can’t live with the possibility that they might get this disease. They get bilateral mastectomies, reducing their risk by 90%. In some cases, this surgery is more drastic treatment than is necessary, and it does not guarantee they will never get breast cancer.
Women do it to ease their fears. Being high risk for breast cancer is more frightening than it should be because of misperceptions about the level of risk for the average woman.
The commonly cited statistic – that women have a 1 in 8 lifetime risk of breast cancer – is a bit misleading because 1 in 8 women in the United States do not actually get breast cancer. The 1 in 8 number is an estimate of lifetime risk. A woman with average risk has a 1 in 8 chance of getting breast cancer sometime during her life if she lives to be 90. Some women are less likely to get breast cancer, and some have a greater risk. Some will not live to be 90.
A more meaningful way to look at risk is the chance of getting breast cancer during each decade of life. A woman in her twenties has a 1 in 1,837 (0.05%) risk of getting breast cancer, and her risk increases as she ages to a maximum in her seventies of 1 in 26 (3.88%). If you add up the percentages for each decade, you get 13% lifetime risk (1 in 8). During no ten-year period during her lifetime, though, does a woman face a risk of getting breast cancer as high as 1 in 8.
Of course, some women are at greater risk of developing breast cancer. And they, too, overestimate their risk for getting this disease.
Women with a faulty breast cancer gene are said to have “up to” an 85% lifetime risk of getting breast cancer, but according to the National Cancer Institute, the risk ranges from 36% to 87%. As with women who have an average risk, their chance of getting breast cancer increases as they age. (The exception to this is women with close relatives who got breast cancer when they were young.)
Others with a higher than average risk for breast cancer are women diagnosed with precancerous conditions like lobular carcinoma in situ or atypical hyperplasia. Women who have had breast cancer or ductal carcinoma in situ, a noninvasive cancer, are also at increased risk.
It should be noted that many women who are high risk will never get breast cancer. No one knows why they don’t or why some women get breast cancer even though they have no risk factors. The interplay of genetic make-up, age, reproductive history, environmental exposures, and lifestyle determines whether or not we develop breast cancer.
But those of us who are high risk can’t help feeling we’re destined to get breast cancer. Some choose overly aggressive treatment because they can’t live with the possibility that they might get this disease. They get bilateral mastectomies, reducing their risk by 90%. In some cases, this surgery is more drastic treatment than is necessary, and it does not guarantee they will never get breast cancer.
Women do it to ease their fears. Being high risk for breast cancer is more frightening than it should be because of misperceptions about the level of risk for the average woman.
Saturday, November 8, 2008
Putting Breast Cancer Awareness To Work
October was the month to raise our awareness about breast cancer – as if we weren’t aware enough. We bought all sorts of pink products so that money would go for breast cancer research, and maybe we were reminded to schedule a mammogram. But there's more we can do to fight breast cancer. We can make changes in our lifestyle to lower our risk for this disease.
It may seem inconceivable that healthy living could protect anyone from breast cancer, but scientists have done hundreds of studies that demonstrate a link between certain behaviors and breast cancer risk. They don’t know which of us can hope to stop this dreaded disease, but we don’t need to wait for all the answers to use what they’ve learned about reducing breast cancer risk and recurrence:
It may seem inconceivable that healthy living could protect anyone from breast cancer, but scientists have done hundreds of studies that demonstrate a link between certain behaviors and breast cancer risk. They don’t know which of us can hope to stop this dreaded disease, but we don’t need to wait for all the answers to use what they’ve learned about reducing breast cancer risk and recurrence:
- Eat wisely. Base your diet on vegetables, fruits and whole grains. Limit fats, sugar and anything made with white flour.
- Get moving! Moderate physical activity is enough to reduce breast cancer risk and recurrence. It can be as simple as brisk fifteen-minute walks twice a day, but any amount of exercise helps.
- Keep your weight under control. Eat moderate portions of healthy foods and exercise regularly to keep weight down.
- Limit alcohol consumption to one drink per day -- less is better.
- Breastfeed for six months or more, if possible.
- Avoid hormone replacement therapy. The hormones in these pills are known to fuel the growth of some types of breast tumors.
- Guard your environment. Avoid exposure to chemicals like pesticides and some ingredients in cosmetics and toiletries that might play a role in increasing breast cancer risk.
- Control stress. It dampens your immune system, and there's nothing like stress to make you eat and drink more than you should.
- Don't smoke. And avoid second-hand smoke.
- Get regular mammograms and breast exams. Treatment is more likely to be successful when breast cancer is caught early.
Of course, some women do everything possible to reduce breast cancer risk and still get breast cancer. But there are some of us who might be able to stop this disease.
Friday, October 31, 2008
Overestimating Breast Cancer Risk
Whenever I hear that a woman has a 1 in 8 risk of being diagnosed with breast cancer, I cringe. First, because this is a scary statistic. And second, because it is misleading.
It does not mean that 1 in 8 women in the United States will actually get breast cancer. It is an estimation that a woman has a 1 in 8 (12.3%) chance of getting breast cancer during her entire lifetime -- if she lives to the age of 85. Of course, some women die from other causes before they reach 85. The leading cause of death in women is heart disease and the leading cause of cancer death in women is lung cancer, not breast cancer.
The 12.3% figure comes from adding up the average risk women face during each decade of their lives. Some women face a higher or lower risk than average, but according to the American Cancer Society, a woman’s chance of being diagnosed with breast cancer is:
Age
20-29...........0.05%..........1 in 1,837
30-39...........0.43%.............1 in 234
40-49...........1.43%...............1 in 70
50-59...........2.51%...............1 in 40
60-69...........3.51%...............1 in 28
70-79............3.88%..............1 in 26
----------------------------------------------
Lifetime......12.28%.................1 in 8
The lifetime risk is roughly the sum of the risk in each decade. (The math whizzes among us may have noticed that the percentages for each decade do not add up to 12.28%, but to 11.81%. These numbers were taken directly from the American Cancer Society’s Breast Cancer Facts and Figures 2007-2008, and do not include risk to age 85.) What is clear – though a bit mysterious mathematically – is that at no time during her life does a woman face a risk of getting breast cancer as high as 1 in 8. No one should be mislead to think that if she’s sitting in a room with 8 women, one of them is destined to get breast cancer.
I am not among the mathematically inclined, but I do have to question whether it’s valid to add up the risk during different periods to get a picture of overall risk. Suppose we were trying to predict the weather instead of the likelihood of getting breast cancer. If the forecast next week was for a 10% chance of rain each day, you’d expect pleasant weather. But if you added up the risk for each day and estimated that there was a 70% chance of rain next week, you’d be sure to take your umbrella.
Carrying around an umbrella is one thing, but when women are made unduly anxious about breast cancer, they may opt for overly aggressive treatment – prophylactic mastectomy -- when they are diagnosed with precancerous conditions, ductal carcinoma in situ (DCIS), or the breast cancer gene. Hearing you’re high risk for breast cancer becomes even more frightening when you have an inaccurate perception of what average risk is.
It does not mean that 1 in 8 women in the United States will actually get breast cancer. It is an estimation that a woman has a 1 in 8 (12.3%) chance of getting breast cancer during her entire lifetime -- if she lives to the age of 85. Of course, some women die from other causes before they reach 85. The leading cause of death in women is heart disease and the leading cause of cancer death in women is lung cancer, not breast cancer.
The 12.3% figure comes from adding up the average risk women face during each decade of their lives. Some women face a higher or lower risk than average, but according to the American Cancer Society, a woman’s chance of being diagnosed with breast cancer is:
Age
20-29...........0.05%..........1 in 1,837
30-39...........0.43%.............1 in 234
40-49...........1.43%...............1 in 70
50-59...........2.51%...............1 in 40
60-69...........3.51%...............1 in 28
70-79............3.88%..............1 in 26
----------------------------------------------
Lifetime......12.28%.................1 in 8
The lifetime risk is roughly the sum of the risk in each decade. (The math whizzes among us may have noticed that the percentages for each decade do not add up to 12.28%, but to 11.81%. These numbers were taken directly from the American Cancer Society’s Breast Cancer Facts and Figures 2007-2008, and do not include risk to age 85.) What is clear – though a bit mysterious mathematically – is that at no time during her life does a woman face a risk of getting breast cancer as high as 1 in 8. No one should be mislead to think that if she’s sitting in a room with 8 women, one of them is destined to get breast cancer.
I am not among the mathematically inclined, but I do have to question whether it’s valid to add up the risk during different periods to get a picture of overall risk. Suppose we were trying to predict the weather instead of the likelihood of getting breast cancer. If the forecast next week was for a 10% chance of rain each day, you’d expect pleasant weather. But if you added up the risk for each day and estimated that there was a 70% chance of rain next week, you’d be sure to take your umbrella.
Carrying around an umbrella is one thing, but when women are made unduly anxious about breast cancer, they may opt for overly aggressive treatment – prophylactic mastectomy -- when they are diagnosed with precancerous conditions, ductal carcinoma in situ (DCIS), or the breast cancer gene. Hearing you’re high risk for breast cancer becomes even more frightening when you have an inaccurate perception of what average risk is.
Wednesday, October 22, 2008
Confusion About Lobular Carcinoma In Situ?
Almost every day, someone comes to this blog because they have done a Google search on the terms “LCIS” and “prophylactic mastectomy.” My breast surgeon was surprised that women needed to look this up.
Ideas have changed in the 20 years since she gave me the diagnosis of lobular carcinoma in situ (LCIS) and advised me to have regular check-ups. She added that I would hear about another way to treat LCIS, but left no doubt that her recommendation was careful follow-up. She was firm enough that when I learned the alternative was double mastectomy, I gave it less consideration than I might otherwise have.
At the time, the medical community was evenly divided on whether to recommend careful follow-up for women with LCIS or a bilateral prophylactic mastectomy. (A single mastectomy is not an option because LCIS indicates a risk for breast cancer in both breasts.) These days it would be unusual for doctors to suggest a double mastectomy, but something else may be recommended. Tamoxifen is sometimes used for prevention in women who are high risk for breast cancer.
So why, then, are people Googling “LCIS” and “prophylactic mastectomy?”
I suspect women are told there are options without being told as clearly as I was that one of the choices is by far the most reasonable. When we hear there are various ways to treat a disease, we might assume the most drastic must be the best. In this case it is not.
LCIS is not cancer, and it is not even considered a true precancer because if invasive cancer develops, it does not necessarily arise from the LCIS cells. LCIS is a warning sign that a woman is at risk for breast cancer. It sounds scarier than it is because it is called a carcinoma, or cancer. It got that label when it was first identified years ago under a microscope because the LCIS cells looked like cancer cells. The fact that there were important differences in their biological activity was learned later on.
The danger with invasive cancer is that it can spread outside the breast to other organs. LCIS does not have that capacity and remains in the breast. The phrase “in situ” is Latin for in place – and that is where LCIS stays.
There are some exceptions to favoring careful surveillance for women diagnosed with LCIS. Those who have a strong family history of breast cancer, those who have a defective form of the breast cancer gene, and those who have a type of LCIS called pleomorphic LCIS might take this warning more seriously and act more aggressively.
When the choice is not clear, however, it is wise to go for a second opinion. The best place would be one of the National Cancer Institute approved cancer centers. If there is not one nearby, look for a breast specialist by checking with a large hospital in your area. Friends, family, or your internist or gynecologist may be able to recommend a breast surgeon.
It might also be advisable to get a second opinion for the pathology report on tissue removed during biopsy. My doctor does this because there are sometimes difficulties identifying LCIS on pathology slides.
Ideas have changed in the 20 years since she gave me the diagnosis of lobular carcinoma in situ (LCIS) and advised me to have regular check-ups. She added that I would hear about another way to treat LCIS, but left no doubt that her recommendation was careful follow-up. She was firm enough that when I learned the alternative was double mastectomy, I gave it less consideration than I might otherwise have.
At the time, the medical community was evenly divided on whether to recommend careful follow-up for women with LCIS or a bilateral prophylactic mastectomy. (A single mastectomy is not an option because LCIS indicates a risk for breast cancer in both breasts.) These days it would be unusual for doctors to suggest a double mastectomy, but something else may be recommended. Tamoxifen is sometimes used for prevention in women who are high risk for breast cancer.
So why, then, are people Googling “LCIS” and “prophylactic mastectomy?”
I suspect women are told there are options without being told as clearly as I was that one of the choices is by far the most reasonable. When we hear there are various ways to treat a disease, we might assume the most drastic must be the best. In this case it is not.
LCIS is not cancer, and it is not even considered a true precancer because if invasive cancer develops, it does not necessarily arise from the LCIS cells. LCIS is a warning sign that a woman is at risk for breast cancer. It sounds scarier than it is because it is called a carcinoma, or cancer. It got that label when it was first identified years ago under a microscope because the LCIS cells looked like cancer cells. The fact that there were important differences in their biological activity was learned later on.
The danger with invasive cancer is that it can spread outside the breast to other organs. LCIS does not have that capacity and remains in the breast. The phrase “in situ” is Latin for in place – and that is where LCIS stays.
There are some exceptions to favoring careful surveillance for women diagnosed with LCIS. Those who have a strong family history of breast cancer, those who have a defective form of the breast cancer gene, and those who have a type of LCIS called pleomorphic LCIS might take this warning more seriously and act more aggressively.
When the choice is not clear, however, it is wise to go for a second opinion. The best place would be one of the National Cancer Institute approved cancer centers. If there is not one nearby, look for a breast specialist by checking with a large hospital in your area. Friends, family, or your internist or gynecologist may be able to recommend a breast surgeon.
It might also be advisable to get a second opinion for the pathology report on tissue removed during biopsy. My doctor does this because there are sometimes difficulties identifying LCIS on pathology slides.
Saturday, October 11, 2008
Overtreating Breast Cancer
The following press release from the University of Michigan on Medical News Today describes the growing trend of women choosing to have both breasts removed when a single mastectomy is all that is needed:
Women sometimes choose to have both breasts removed when a single mastectomy is recommended as treatment for breast cancer or ductal carcinoma in situ (DCIS). Some do it because they don't want to face the possibility of the cancer returning, even though the risk of recurrence is low for invasive cancer and unlikely for DCIS. There is no survival advantage for women who choose to have a second healthy breast removed.
Others may opt for prophylactic mastectomy of their healthy breast because their cosmetic surgeon suggests that the appearance of the breasts will be better if both are removed and reconstructed at the same time. It would seem that loosing the sensation of touch in a healthy breast would be too high a price to pay for a matching set.
Medical treatment is not the only avenue for reducing the likelihood that breast cancer will recur. Lifestyle choices can reduce breast cancer risk and recurrence.
When Treatment Goes Too Far
Recent research has shown that more women are choosing to have their healthy breast removed after being diagnosed with breast cancer. The number of double mastectomies from
1998 to 2003 more than doubled, according to one study.
But this additional surgery has little impact on long-term survival or whether the cancer will recur, says Lisa Newman, M.D., M.P.H., director of the Breast Care Clinic at the U-M Comprehensive Cancer Center.
"Women are choosing to have more radical surgery than is necessary because of fear that their cancer will come back. Bilateral (double) mastectomy will decrease the possible need for future breast surgery, but it has little or no impact on the overall survival of a woman who has already been diagnosed with a single breast cancer," Newman says.
For women who test positive for the BRCA1 or BRCA2 gene mutations such as actress Christina
Applegate opting for a double mastectomy may make sense. The risk of developing
breast cancer in the other breast is 30 percent. But women without the BRCA mutation do not face a higher risk of breast cancer in the unaffected breast.
"Women have the opportunity to choose the treatment that feels right for them. But over-treating breast cancer by removing a healthy breast is unnecessary," Newman says.
Women sometimes choose to have both breasts removed when a single mastectomy is recommended as treatment for breast cancer or ductal carcinoma in situ (DCIS). Some do it because they don't want to face the possibility of the cancer returning, even though the risk of recurrence is low for invasive cancer and unlikely for DCIS. There is no survival advantage for women who choose to have a second healthy breast removed.
Others may opt for prophylactic mastectomy of their healthy breast because their cosmetic surgeon suggests that the appearance of the breasts will be better if both are removed and reconstructed at the same time. It would seem that loosing the sensation of touch in a healthy breast would be too high a price to pay for a matching set.
Medical treatment is not the only avenue for reducing the likelihood that breast cancer will recur. Lifestyle choices can reduce breast cancer risk and recurrence.
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