Breast Cancer: What Goes Into Decisions Like Judy Blume’s

On Wednesday, September 5, young adult author Judy Blume announced on her blog that she recently underwent diagnosis and treatment for ductal carcinoma, a type of breast cancer. In weighing her treatment options, which Blume says was among the hardest decisions of her life, she admits that she wanted the treatment that would be the easiest on her physically and allow her to feel back to normal the fastest. She explains how having a single mastectomy and reconstruction (rather than a lumpectomy and radiation treatment or a double mastectomy) was right for her given her age and stage of life.

About one of every eight women will be diagnosed with breast cancer and will face decisions like Blume’s at some point in her life. Dawn Leonard, M.D., breast surgeon and medical director of the Herman & Walter Samuelson Breast Care Center at Northwest Hospital, is intimately acquainted with the process. She helps patients understand their treatment options, sometimes for hours at a time. While most breast cancer patients follow their treatment team’s recommendations, sometimes there isn’t a clear indication what option is best and the patient has to make a personal decision.

“When all treatment choices are equal, I typically advise my patients about the differences in recurrent risk associated with each option,” says Leonard. In other words, if a patient could be treated successfully with lumpectomy but she’s worried about facing a breast cancer diagnosis down the road, she may want to have a mastectomy. “If the thought of keeping the breast fills them with dread and anxiety that no amount of clear breast imaging or physical examination will help alleviate, then breast conservation is not for them. Quality of life is the key, and we want patients to undergo treatment plans that allow them to regain their trust in their health and return to healthy and happy states.”

Leonard also lets patients know that their bodies will be different after treatment and that their post-treatment breast will likely not look identical to their pre-treatment breast even after reconstruction. She doesn’t want there to be any surprises, so she’s not afraid to be honest with patients.

Of the treatment planning meetings with patients themselves, Leonard says they are more positive and uplifting than one might expect.

“These are not morgue sessions filled with long, sad faces, hand wringing and wailing. There may be some tears, but we try to emphasize that our goal is for cure: for complete eradication of the disease to the best of our abilities. Our goal for our patients is for long term disease-free survival – and we want to leave patients and their families with hope, not dread.”

We are thankful that author Blume has successfully overcome breast cancer and wish her all the best.

Have you ever faced a breast cancer diagnosis and treatment decision? What are some of the factors you considered when deciding what kind of treatment you would receive?

-Holly Hosler

To schedule an appointment with one of our highly trained physicians and find out why LifeBridge Health is Baltimore's premier health care organization, call 410-601-WELL.

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