Don’t let doctors rush you. A deliberate approach to prevention and treatment is best.
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Anxiety about breast cancer can prompt many women to make rushed decisions about prevention and screening.  For example, they might make drastic changes to their diet or opt for aggressive tests without adequately researching the pros and cons.

Even more disturbing are the quick decisions made by many of the estimated 240,000 American women diagnosed with breast cancer this year. Many had to choose between getting a mastectomy or lumpectomy, or had to select among various chemotherapy and radiation treatments. Women often make those decisions during their first visit to a cancer doctor, but that’s usually too soon, contends Steven J. Katz, M.D., a professor of health management and policy at the University of Michigan. “Too often, it’s a rush job,” Katz says, adding that breast cancer is rarely “an imminent danger” that requires immediate treatment.  Here are questions about breast cancer prevention, screening, and treatment for which it’s especially important to use a slow, deliberative approach to reach the right answer for you.

Are manual exams worthwhile?
A July 2008 review found that breast self-exams have no overall benefit and make needless biopsies more likely. But that’s probably because women don’t perform the tests properly. Our consultants still say that women should be familiar with the terrain of their breasts and report any lumps or changes to their physician. Talk with your doctor about the proper timing and technique for the exams. Similarly, while there’s little evidence backing up manual exams by doctors or nurses, a careful clinical exam by a skilled practitioner might catch some tumors missed by mammography  Consider having it done before your mammogram so that the radiologist will be aware of suspicious areas.

If I’m diagnosed with breast cancer, what should I do first?? Consider getting a second opinion, preferably from a cancer center that coordinates care using a team that includes surgeons, oncologists, radiologists, pathologists, and nurses. Consulting such specialists changed the original surgery recommendations for more than half of the breast-cancer patients in a recent study from the University of Michigan. In several cases the team found that the original doctor failed to follow Treatment guidelines and proposed overly aggressive surgery. For example, five patients advised to undergo a mastectomy could instead get a breast-conserving lumpectomy. And 19 could have just one lymph node removed, at least initially, rather
than several. Second opinions also disclosed problems missed by the first physician. In 43 women, radiologists spotted signs of tumors that required additional biopsies or imaging tests. In addition, the team found that two women who were originally told to
undergo a lumpectomy could not tolerate the follow-up radiation, so a mastectomy was recommended instead. You’re likely to find such a team at a large medical center, especially one affiliated with a medical school.

Should I consider reconstructive surgery?
Yes, though surgeons who perform lumpectomy and mastectomy often don’t discuss that option with their patients. Indeed, only about 17 percent of mastectomies, and even fewer lumpectomies, are followed by breast reconstruction. If you choose it, try
to schedule both surgeries on the same day. For mastectomies, surgeons can use silicone implants or tissue from other parts of your body. The so-called “TRAM flap” involves shifting skin, fat, and abdominal muscle into the chest area without removing
them from the body. The “DIEP flap” transplants skin and fat, often from your stomach, and leaves the muscle intact. But it is slightly riskier than the TRAM flap, and fewer centers offer it. Benefits from such reconstruction maybe more than cosmetic. A recent survey of more than 600 women post-lumpectomy found that those with pronounced breast asymmetry
were far likelier to have depressive symptoms than those with less asymmetry.

Source: Consumers Report on Health Newsletter October 2008  or visit: www.consumerreportsonhealth.org