Breast Cancer

By
Yashar Hirshaut, MD, FACP
Peter I. Pressman, MD, FACS

Course Description

This lucid step-by-step guide has established itself as the indispensable book women need to make informed decisions about the care that is right for them.

Breast cancer will strike one out of every eight women in the United States. From the moment the disease is suspected, women are called upon to make numerous choices under intense stress, and none of them should go it alone. The completely revised fifth edition of this invaluable handbook, long praised for helping women manage ever stage of treatment and recovery, includes the many modifications and advances in the rapidly changing field of breast cancer diagnosis, treatment, and prevention.

About the Authors

Yashar Hirshaut is a medical oncologist specializing in the treatment of breast cancer. A graduate of the Albert Einstein College of Medicine, he completed his oncology training at the National Cancer Institute in Bethesda, Maryland, and at the Memorial Sloan-Kettering Cancer Center in New York. From 1970 to 1986 he served as an attending physician at Memorial Sloan-Kettering on the Clinical Immunology Service and as associate professor of medicine at the Cornell University Medical College. He was also head of the Laboratory for Immunodiagonsis at Sloan-Kettering. In addition to being in private practice, he is currently associate clinical professor of medicine at the Weill Medical College of Cornell University, and an attending physician at the Mount Sinai Medical Center and Beth Israel and Lenox Hill Hospitals in New York City. Dr. Hirshaut was Editor-in-Chief of the professional journal Cancer Investigation from 1981 to 2006. He is chairman of the Israel Cancer Research Fund, which provides peer-reviewed funding for basic cancer research.

Peter I. Pressman is a surgical oncologist who specializes in the treatment of breast cancer. A graduate of Columbia College and the Columbia University College of Physicians and Surgeons, he trained at Presbyterian Hospital and the Columbia Division of Bellevue Hospital in New York City. Dr. Pressman has been in private practice in New York for more than thirty-five years and is Clinical Professor of Surgery at the Weill Medical College of Cornell University and Director of the Genetics Risk Assessment Program at the Breast Center. He was attending surgeon at Beath Israel Medical Center and Lenox Hill Hospital. He has been consultant to the Guttman Breast Diagnostic Institute and president of the New York Metropolitan Breast Cancer Group, as well as a member of the Board of Directors (New York City division) and the Breast Cancer Detection and Treatment Subcommittee (national) of the American Cancer Society. He has published widely in the medical literature and has been named by American Health, Good Housekeeping, New York, and Town and Country magazines as among the best breast cancer doctors in New York City and in the nation.

Learning Objectives

After completing this course you’ll be able to:

1. State the purpose of the book.
2. State the response to the question, “Is breast cancer a death sentence?”
3. Define lumpectomy.
4. State the type of doctor you will be sent for the purpose of diagnosis.
5. Describe how to find a good cancer specialist.
6. State a major source of data when evaluating physicians.
7. List three factors to consider when evaluating a physician.
8. Define an acinus.
9. Define cancer.
10. Describe a malignant tumor.
11. Define in situ cancer and how it is detected.
12. Define fibroadenoma.
13. Discuss the old saying, “If it hurts, it’s not cancer.”
14. Discuss the age to begin breast self-exams, frequency and timing.
15. Describe digital mammography.
16. Discuss why women under thirty-five should not have routine screening mammograms.
17. Describe how sound waves react to liquid-filled cysts versus a solid mass.
18. Compare a fine-needle aspiration and core biopsy.
19. Define an incisional biopsy and an excisional biopsy.
20. Describe the role of the pathologist.
21. Describe a permanent section.
22. Define multifocal and multicentric.
23. State the length of time treatment should begin after diagnosis.
24. List three characteristics of a personal advocate
25. Define mutation and carrier.
26. Describe the “founder’s effect.”
27. Compare lumpectomy and mastectomy.
28. List blood thinners that may interfere with clotting
29. Discuss the informed consent.
30. Describe monitoring devices used during surgery.
31. Describe why lymph nodes are often removed.
32. Describe sentinel nodes and describe how they are located.
33. Define the Halstead procedure.
34. Describe the skin-sparing mastectomy.
35. List ways to prevent infection after surgery.
36. Describe treatment for phlebitis.
37. State when arm exercises should be started.
38. Describe cancer in pregnancy.
39. Define electromagnetic radiation and list side effects.
40. Define metastasis and state the first line of defense.
41. Describe the role of the radiation oncologist.
42. Define simulation.
43. Describe phase one and two of radiation.
44. List several long-term side effects of radiation.
45. List the three primary factors that are used to determine prognosis.
46. Discuss lymph node involvement in the recurrence of cancer.
47. Define oncogenes.
48. Discuss the purpose of systemic therapy and its purpose in reducing the risk of recurrence.
49. Compare chemotherapy and hormone therapy in premenopausal and postmenopausal women.
50. List qualifications you should look for in a physician to administer systemic .
51. State the most common route to administer chemotherapy.
52. List several ways to administer chemotherapy.
53. Define cytotoxic.
54. List two very important strategies in using chemotherapy.
55. Describe the five types of drugs for adjuvant therapy.
56. Describe the method of reducing hair loss by use of a tourniquet and ice pack.
57. Discuss the use of Procrit and Neupogen.
58. List several other side effects while taking chemotherapy.
59. List side effects of Prednisone, Adriamycin, Cytoxan, and Taxol.
60. Describe the Group 0 through Group 6 chart related to nodal involvement.
61. Define triple negative breast cancer.
62. List several reasons women do not want breast reconstruction.
63. Describe the trends in reconstruction after a mastectomy.
64. Define a myocutaneous flap, pedicle flap and free flap.
65. Describe several types of flaps.
66. List the major complications of flap reconstruction.
67. Define regional recurrence and distance recurrence.
68. Describe how to decide which doctor will be in charge.
69. List blood tests that are frequently done in follow-up visits.
70. State the frequency of mammograms and chest x-rays after a mastectomy.
71. Discuss how a patient should prepare for a bone scan.
72. List several things you should take with you to the first appointment with a consulting physician.
73. State where breast cancer cells often establish themselves and produce tumor recurrence.
74. Define prognosis and remission
75. Define palliative.
76. Discuss the role of heredity and the development of breast cancer.
77. List three methods of reducing fat in the American diet.
78. State the number one cancer killer of women in the United States.
79. Describe the relationship of hormones and breast cancer.
80. State the procedures that should be done prior to taking hormone replacement therapy.
81. Describe a suppressor gene.
82. Define epigenetics.
83. Define apoptosis.
84. Describe cryosurgery and radiofrequency ablation.
85. State briefly the four stages of drug testing.
86. List groups and organizations who offer practical and emotional support.
87. Discuss the possible role of environmental exposure to cancer producing agents regarding research.
88. List the most important issues facing our society.
89. State how we know about breast cancer in the United States, including SEER programs.
90. Discuss the Mammography Quality Standards Reauthorization Act of 2003.

Course Contents

Book I - From Suspicion to Diagnosis
1. How Can a Book Help Me?
2. Getting Started
3. What’s Gone Wrong
4. Diagnosis
5. Pathology
6. After the Diagnosis
Book II - Treatment
7. Genetics
8. Surgery
9. Radiation Therapy
10. Prognosis
11. Hormone Therapy and Chemotherapy
12. Breast Reconstruction
Book III - After the Treatment
13. Follow-Up
14. Recurrence
15. Prevention
16. New Directions
Book IV - Life After Cancer
17. Life After Breast Cancer
18. The Social Issues of Breast Cancer

Comments

“A definitive guidebook… in this highly regarded source, the authors— a medical oncologist and a surgical oncologist— provide both the support and every scrap of the information a woman needs to get the right treatment form the right doctor.” — New York Times

“Both timely and current…[It] discusses the most common cancer in women in a precise, clear, and positive way, providing essential information in a warm, supportive fashion in a readable and understandable format.” — Journal of the National Cancer Institute

“These experts demystify breast cancer in understandable and compassionate terms… Should help hundreds of thousands of women.” — James F. Holland, MD, Distinguished Professor of Neoplastic Diseases, The Mount Sinai Medical Center

“Comprehensive, up-to-date, and highly detailed… From selecting the best doctors to describing procedures and treatments, the authors answer all possible questions in a calm, rational manner… Highly recommended.” — Library Journal

"Thank you! Very informative course! Loved it! — S.G., RN, CA

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