Melissa Etheridge Jolie Comments Unfounded: Four Things Every Woman Should Know About Breast Cancer

Breast reconstruction expert Dr. Lisa Cassileth knows what breast cancer can mean to a woman and her family. She has called Melissa Etheridge’s comments on the matter “unfounded” and seeks to warn others to make their own choices before cancer makes those choices for them.

“My belief is that cancer comes from inside you and so much of it has to do with the environment of your body. It’s the stress that will turn that gene on or not. Plenty of people have the gene mutation and everything but it never comes to cancer so I would say to anybody faced with that, that choice is way down the line on the spectrum of what you can do and to really consider the advancements we’ve made in things like nutrition and stress levels.” – Melissa Etheridge

Yesterday, I was meeting with one of my patients who had been diagnosed with breast cancer. There she is in front of me. She is so unbelievably healthy—she is someone that when she whips out lunch you go “eeew what is that?” (It is mixed vegetables with vinegar on it, I mean wonderfully healthy food.) She is a stay at home Mom. All she does is take care of her boys, she is not a stressed out person, and she just has a wonderfully healthy approach to life.

Despite the fact that she has lived this way, she reached over and felt a 4cm lump in her breast and was then diagnosed with invasive cancer. Further examination revealed that she had the BRCA2 gene. She had to go on Chemotherapy, all of her hair fell out and she thought she was going to die. Then she underwent a bilateral reconstruction. She had weeks to months of being tearful, thinking, “I won’t be here for my boys.” She made video tapes of herself saying, “If I die, I just want to let you know that I love you.”

Yesterday, she was done with all of her treatments, and after a year of doctor’s appointments, medication, injections and feeling horrible, she has her life back. If I could turn back time and tell her two years ago that she had the BRCA gene, her response would be, “Oh my gosh, how lucky are we that we found this. Get these breasts off so that I don’t have to go through it all.” So that she could avoid the emotional, physical stress, the radiation, chemo, and thinking that she will not be there for her boys.

To say that that her decision would have been cowardly instead of brave is unbelievably disempowering to her, and to any woman that makes that decision. In my opinion, both personally and medically, I think it is an amazing thing to undergo a prophylactic mastectomy because it allows you to make your choice in life instead of cancer making the choice for you.

Four facts that everyone should know about breast cancer:

1. How common it is – About 1 in 8 women in the United States will develop breast cancer over the course of their lifetime. It is the second most commonly diagnosed form of cancer in women.

2. Early Detection – Today one in five women diagnosed with breast cancer will die from this disease. But when breast cancer is detected early enough, the survival rate is 98%. Get regular mammograms and do monthly self-exams. Don’t put it off!

3. Genetic Testing – If a member of your immediate family has had breast or ovarian cancer, you can get tested for the BRCA mutation, which indicates as much as an 80% increased risk for breast cancer.

4. One surgery, a lifetime of possibilities – Today a preventive mastectomy is not only a choice, for many it is a lifesaver. In my practice we offer a one-stage reconstruction procedure that makes it possible to remove the affected tissue, and place an implant during a single surgery. One procedure now makes it possible for a woman to lead a long, healthy cancer-free life.

Dr. Lisa Cassileth is a Board Certified Plastic Surgeon in Beverly Hills, specializing in breast reconstruction for cancer patients. Learn more at http://www.DrCassileth.com.

angelina-jolie-breast-cancerGenetic Testing and Breast Cancer

Actress, mother and director Angelina Jolie bravely announced that she opted to have a preventive double mastectomy as a proactive measure to help prevent breast cancer. This is not an easy decision, and we applaud both her courageous decision and her desire to share the details of her journey with the world.

Many of our patients have asked why she would choose to remove her breasts since she wasn’t diagnosed with breast cancer. The truth is, she made the smartest choice she could have made for her situation. Angelina’s own mother fought cancer for almost a decade and sadly lost that battle. After finding out that she herself carried the BRCA1 gene, which indicates a very high risk of future development of breast and ovarian cancer, she decided to take safe, preventive measures and address the problem before it was too late.

Although the thought of undergoing a preventative mastectomy may seem scary; Dr. Cassileth’s advanced one-stage technique results in beautiful, natural looking breasts. In fact, many of our reconstructive patients prefer their new breasts to the ones they were born with! Have a look at before and after photos by going to the One-Stage Breast Reconstruction page on our website.

Know Your Risks:
You should consider testing for hereditary breast and ovarian cancer if any of the following applies to you:

You:

  • Have had breast cancer at age 50 or younger
  • Have had ovarian cancer at any age
  • Are male and have had breast cancer at any age
  • Are of Ashkenazi Jewish descent and have a personal or family history of breast, ovarian or pancreatic cancer

Your Family:

  • Has had two breast cancers in the same person or on the same side of the family
  • Has had somebody diagnosed with triple negative breast cancer at any age
  • Has had pancreatic cancer and an Hereditary Breast and Ovarian Cancer (HBOC) – associated cancer in the same person or on the same side of the family
  • Has three or more family members with breast cancer on the same side of the family
  • Has had a previously identified BRCA1 or BRCA2 mutation in the family

We offer BRCA testing.

Call us to schedule an appointment: 888-465-5106.

Did you know that every woman has a 1 in 8 chance of getting breast cancer? It’s a scary statistic. However, breast cancer prevention and treatment and has come a long way. In my practice we have many young patients in their 20’s and 30’s with breast cancer, so it’s not just an older person’s disease. On the bright side, there are new screening tools that help increase the chance of early detection.pink-ribbon

Stay on Top of Your Breast Health:

  1. Do a breast self-exam (learn how at cancer.org)
  2. Get yearly mammograms, after the age of 40 (covered by insurance!)
  3. Know your family’s health history and share the information with your gynecologist. Having a mother, sister, or daughter with breast cancer almost doubles a woman’s risk. However, most (over 85%) of women who get breast cancer do not have a family history of this disease.

If you have a history of cancer in your family, genetic testing (in addition to mammograms) is recommended, even if you are in your 20’s.

The Genetic Link – New Screening Tests Could Save Your Life!

New advances in gene therapy have led researchers to identify the genetic codes for breast cancer genes. You may have heard or read about these genes, named BRCA1 and BRCA2.

Having one or both of these genes indicates an increased risk (as high as 4 in 5) of getting breast and ovarian cancer.

womanIf You are BRCA-Positive

Women who are BRCA-positive may opt for a mastectomy before they ever get breast cancer rather than face a lifetime of worry. Fortunately there are now new techniques for breast reconstruction that have made prophylactic mastectomy a more attractive option.

Cassileth One-Stage Breast Reconstruction technique was designed with the needs of these women in mind. This unique procedure allows women to wake up from their surgery with new, beautiful breasts.  In fact, many of our patients say they like their new breasts even better than the ones they were born with!

See the amazing before and after photos at drcassileth.com.

We want to know: if you tested positive for the BRCA gene, would you choose to have a preventative mastectomy? Or would you opt to wait and see and decide later? We’d love to hear from you. Post your response in the comments below.

Why do we associate specific plastic surgeries with specific people (or celebrities)? I have now fielded my fiftieth request (at least) that goes something like this: “make sure you put my breasts close together – I don’t want to look like Tori Spelling.”

While we’re on the subject, let’s talk about what identifies this particular celebrity with the issue at hand.  Tori has the unfortunate claim to fame of having breasts that are too far apart, producing a Grand Canyon-esque gap in her cleavage. See the photo — no amount of push-up or push-in seems to be able to close that valley!

Generally a gap like this — we’ll call it “gap-osis” — is formed by the implants being too far apart, and with some capsular contracture (explained below), it really shows off the problem.

Tori Spelling

Also, the exact shape of the implant is clearly visible because it is not submuscular (hidden under the muscle).

So, how do you fix this “gap-osis”? 

The fix can vary depending on the problem. The capsule, which is essentially the scar tissue surrounding the implant, can be released near the sternum, allowing the implant to move inward. The capsule over by the outside of the breast can be tightened. These changes together migrate the implant pocket further toward the middle, making it hard for the problem to ever come back.

If the capsule is too tight (capsular contracture), it can be released, with or without using a dermal matrix product (like Alloderm). Finally the whole shebang can be moved under the muscle, but I think the decision to do this really depends on the patient, the width of the sternum, the location of the muscle, and the previous surgery before the final decision is made to do that. Personally I am more willing to switch to a submuscular plane if implant visibility, rippling, and contracture are significant problems.

Get it right the first time! 

Avoiding implant positioning problems from the beginning is always best. Simple best practices like using an appropriate size implant (just narrower than the width of the breast), placing them submuscularly, and keeping them medial and out of the armpits — these alone can make a world of difference. Now I always minimally dissect the area laterally, which keeps it in and looking good. So before you get a breast augmentation, ask your surgeon what technique she (or he) uses in order to position your implants properly.

Copyright (C) 2011, Lisa Cassileth, M.D.

There are a many different approaches for achieving a refreshed look, without surgery.  Here are just two of them:

Botox Eyebrow Lift.

There are several ways Botox can improve one’s overall appearance.  Everyone knows it works great for frown lines. But there are tricks that most people don’t know (or won’t tell you!) that can have a fabulous effect and can do much, much more.

Small injections next to the end of the brow release the muscles that bring your brow down. A single injection of 10 units in the tail of the brow raises it as much as 5mm, depending on how strong the muscle is. This can save your upper lid from looking saggy as well as give you a beautifully arched brow.

Accent  for Lower Face, Jowls and Neck Maintenance

The Accent laser is a relatively new device that is great for tightening loose skin. It uses a radio-frequency energy that is transmitted through a handheld device. It feels like a hot rock massage, as the warming energy is transmitted to the deeper, collagen-containing layers of the skin.  This heat tightens the collagen layer, causing the skin to lift – and more importantly, it prevents sagging and horizontal neck lines from ever getting a hold of you. The Accent takes about 30 minutes for each neck treatment. I recommend a treatment every 6 months from the time you are 40 for neck maintenance, and for already sagging necks it may take 4 or more treatments to catch up.

For more Quick Tips, stay tuned…

(C) 2011 Dr. Lisa Cassileth

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