An estimated 252,710 women will be diagnosed with breast cancer in 2017.1 Early detection of breast cancer is critical for successful treatment of this disease - women who are diagnosed with early stage/localized breast cancer have a 5-year survival rate of 98.9% 1 We hope that this Breast Cancer Awareness Month will inspire more people to discuss their personal risk for breast cancer with their healthcare providers, as well as the signs, symptoms, and necessary screening for the disease.
Up to 10% of breast cancer is hereditary, and genetic testing can play an important role in determining the best management plan for patients to maximize early detection and prevention. We encourage everyone to be diligent about collecting family history of cancer and looking for possible signs of hereditary cancer to help determine if patients should consider genetic testing.
For a firsthand account of the experience of a clinician treating patients with breast cancer, we interviewed Dr. El-Eid, a breast surgeon in Las Vegas, NV.
1. How did you become interested in becoming a breast surgeon?
I grew up in Beirut during war times. After high school, I came to the U.S. to attend college and then medical school in Nebraska. During that time, I fell in love with general surgery because of its emphasis on fixing things. In addition, my fellowship was in critical care trauma, taking care of the severely injured patients and trauma cases, perhaps because of my experience in Beirut. I eventually went into private practice in the Hudson Valley in Upstate New York, where I was the only female surgeon between Albany and Westchester. Women came in with abnormal mammogram results and/or lumps in their breasts, and this directed me to obtain additional training in mammography, ultrasound, and stereotactic biopsy. I then became a breast surgeon to serve the needs of the community.
2. How has treating patients with breast cancer impacted you?
Treating patients with breast cancer has taught me to listen to each woman. When a gall bladder or appendix is infected, it is an easy fix to take it out and be done. However, when a woman has breast cancer, it is life changing for her, including the ongoing lifetime high risk classification. I used to get mad at women who waited too long, knowing they had a lump that could be cancerous, despite their graduate degrees and education. Then each woman would tell me why she waited. Her husband has lymphoma and she is taking care of him, she didn’t have the heart to tell her children that their mother has cancer too, or she has a sick child with leukemia, who she is taking care of until remission or death, then it is her turn. I could write a book on all of the stories I have been told about “why” a woman waited to receive care. Although I don’t agree with the reasoning, I have learned to listen and understand. That is really all they are asking for, someone to just listen and help, both now and going forward.
3. How have you integrated genetic testing for hereditary breast cancer into your practice?
In the Hudson Valley, Kingston, NY where my surgical career started, there is a large community of Ashkenazi Jewish women by Woodstock who attend the same synagogue. They invited me to speak to them about breast cancer, and possible BRCA1/2 mutations in people of their descent. I had attended a breast surgical oncology meeting where BRCA1/2 and hereditary breast cancer was discussed, so I gathered information, did my research, gave my presentation and then started testing. I ordered my first genetic test in 2000.
4. If you were able to give advice to all women during this Breast Cancer Awareness month, what would it be?
Check yourselves and your families and friends. If you are at the age of needing a mammogram, get one. Go to your doctor and ask to be checked for breast cancer, including a physical exam and risk assessment. Know your risk.
1. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov)
