Fact or fiction

[Phillyfish]

fact or fiction

Chemo is not as effective if started 8 weeks after diagnosis?

After lumpectomy and radiation to a breast, if cancer is found again and a mastectomy performed, breast reconstruction can not be done because of the prior radiations effect on healing.

If a fine needle biopsy is done instead of an excisional biopsy, do you risk the chance cancer cells can be released into the blood to the rest of your body during the procedure?

It is not safe to lift over 10 lbs after axillary node disection.

Is sentinal node identification compromised because a lumpectomy was performed 4 weeks earlier?  Does having the lumpectomy before having the sentinal node identification change the drainage pattern of the breast and make sentinal node identification unreliable?

If mammogram never picked up the original breast cancer (1.6cm) and because of 3 surgeries to the breast it is filled with scarring and numerouse lumps, what other testing can/should be done to scan for breast cancer recurrence? I have no confidence that mammogram will detect it.

How long after surgery/chemo/radiation has been completed can a stage I breast cancer patient be free of all side effects of treatment? (loss of energy, constipation, shortness of breath)

If no metastatic cancer is detected originally (stage I) but it does metasticise, how long after initial treatment does it most often take to have symptioms or be detected?  At what point is the magical two or five years cancer free milestone measured, date of diagnosis or date of last treatment?

[CCF-RN,MSN-rf]

1. No evidence that 8 weeks is less effective
2. In general, false.  There are situations in which the quality of the skin can present some difficulties for the plastic surgeon.
3. No
4. Immediately after surgery there may be some weight lifting restrictions but 10 lbs. after recovery is probably fine.
5. This is certainly a possibility.  It is a question that would be good to address.  The difficulty is that now that sentinel lymph node biopsy is so mainstream, most women will not enter a trial that involves axillary node dissection.
6. Mammography remains the standard in terms of breast cancer screening.  Just because one cancer did not show does not mean another cancer would not.  MRI may be useful but mammography will still be recommended.
7. There is wide variability from person to person regarding duration of side effects.  Most people recover in a matter of months but I have heard others say a year and, rarely, longer.  Some treatments can cause more permanent problems.  If you are continuing to have symptoms, you should keep your oncologist informed.
8. There is no way to predict at what point or whether a cancer will metastasize or when it could be detected.  From the point of view of oncologists counting, remission starts when therapy is complete.  There really is no magic number at which point one can erase cancer as a possibility.  The truth is that the further out you are, the lower your chances of recurrence.  Many cancers that reoccur will reoccur within the first 2 years.  Most (that will reoccur) will reoccur within the first 5 years.  But there are a few that reoccur 10, 15, and 25 years later - this is very rare but it happens.

[surgeon]

1) fiction
2) fiction: it's done all the time
3) fiction: there's no difference among any of the types of biopsy
4) fiction -- although you should ask your particular surgeon after the surgery
5) good question: as far as I know it's not been specifically studied.
6) mammograms still should be done, because the next one might be detectable. MRI is probably the best alternative
7) It varies enormously from person to person: anywhere from a few weeks to several months
8) The hard fact of the matter is that there is virtually no interval beyond which it can be said with absolute certainty that it couldn't show up again. Most recurrances occur within 2 years, and the vast majority within 5