FRANKLIN, Tenn.—One in eight U.S. women will develop invasive breast cancer over the course of her lifetime. Those are odds breast surgeon Rebecca Baskin, M.D., knows all too well. At age 36, the Franklin provider was diagnosed with stage 2A breast cancer.
“I’d never been on the other side, and it’s a scary place to be,” Baskin said. Eleven years later, the cancer survivor uses her own experience to treat patients at Williamson Medical Group’s Breast Health Center.
An individual journey
Because every woman’s cancer experience is unique, Baskin has learned to move at her patient’s speed – not her own. “Every woman is different in how she comes to grip with her diagnosis and how proactive she is,” Baskin said. “Cancer is a journey, and everyone approaches it differently.”
Prior to her own diagnosis, breast patients comprised 60 percent of Baskin’s surgery cases. Following treatment, she made the decision to devote her entire practice to the all-too-familiar world of breast cancer, and made multiple changes to reflect her newfound level of empathy for the physical and mental health of patients. “During chemo and surgery you have this in-your-face fight you’re up against, and when it’s suddenly over you may find you still have that anxiety rather than the feeling of celebration you expected to experience,” she said. “There are a lot of transitions, and I remind patients that this is more of a marathon than a sprint.”
Advances in treatment
Baskin said breast cancer treatment has improved substantially since her own diagnosis. Once scary operating-room biopsies are now minimally invasive with tiny incisions, and often fewer lymph nodes are removed for testing. Meanwhile, MRI scans help physicians better delineate the scope of surgery beforehand. “More high risk MRI and 3D mammograms help find cancers sooner while they’re smaller, especially in dense breasts,” Baskin said. Oftentimes, 3D mammography is performed alongside biopsy to find and biopsy lumps in one day. New radiation protocols are also a plus for patients, with external beam radiation therapy still considered gold standard. The new therapy protocols often shortens radiation treatment closer to four weeks – welcome news for patients making the daily hospital pilgrimage.
Recommendations for mammography also continue to evolve, although Baskin still errs on the conservative side. “The American societies for surgeons and radiologists don’t agree with fewer mammograms,” she said. “We urge women to undergo mammograms yearly from age 40, as cancer in younger women tends to progress faster.” A woman with a first- or second-degree relative diagnosed young should begin screenings 10 years earlier than her relative was when diagnosed. Baskin also believes women with a life expectancy of 10 years or more should continue mammograms.
“If cancer’s found later in life, surgery may not be the answer, but there are now medications that can shrink tumors so grandmother doesn’t have to decrease her quality or quantity of life,” she said. “We have options today that weren’t there 20 years ago.”
Today’s high-risk screenings better identify which patients would benefit from genetic testing, which plays a key role in personalized medicine. In fact, 2018 marks a monumental change in protocol for oncologists, with cancer staging now based on tumor markers and genetic testing of the tumor, not just size of lymph node status. That means yesterday’s one-size-fits-all approach to cancer treatment is officially a thing of the past. “The genetics of each tumor is important in how it acts and reacts to treatment,” Baskin explained. “We do genomic testing after surgery to determine whether a patient only needs estrogen blocking treatment, chemo, or both, based on the genetic profile of the tumor itself.”
In addition to identifying HER2 proteins, known to promote breast cancer, oncologists now look at 20 to 60 genetic pieces of each tumor to determine aggressiveness and what it responds to. Personalized medicine ensures patients are not under- or over-treated, and continues to expand as researchers work to better understand how to teach the body to fight cancer using its own immune system instead of chemicals.
“Between imaging and treatment advances and catching cancer earlier, there’s not the need to be scared even if you do need a biopsy,” Baskin said, noting that 80 percent of biopsies prove to be benign. “Treatments have changed a lot, with overall survival rates going up. We’re seeing better outcomes, so don’t put screenings off because of fear. Take care of yourself and be proactive.”
About Rebecca Baskin, M.D.
Dr. Baskin is a board-certified breast surgeon at Williamson Medical Group’s Breast Health Center. She can be reached at (615) 595-4570.Share this Article