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A doctor answers Long Island's most Googled questions about breast cancer

The American Cancer Society's Making Strides Against Breast

The American Cancer Society's Making Strides Against Breast Cancer walk at Jones Beach in Wantagh on Oct. 15, 2017. Credit: Ed Betz

October is National Breast Cancer Awareness Month, but all year long, Long Islanders have questions: At what age can you be diagnosed? How long does it take for the cancer to spread? Is there a cure?

So we asked Google to tell us the most commonly searched questions by Long Islanders when it comes to breast cancer. After that, we turned to Dr. Tiffany Troso-Sandoval, who is a board-certified oncologist with expertise in breast cancer at Memorial Sloan Kettering Cancer Center of Nassau County.

Troso-Sandoval answered the top questions from Google and also some of the most frequently asked questions she gets from her patients.

What is hormone receptor positive breast cancer?

"Breast cancer is usually defined as whether it is hormone receptor positive or hormone receptor negative," Troso-Sandoval said. "When it is hormone positive, it means that the tumor may be relying upon estrogen, the female hormone, for its growth. So in many cases these estrogen receptor positive cancers can be treated with oral anti-estrogen therapy alone, which is sometimes referred to in my field as hormone therapy, but it’s actually opposite — it’s actually anti-hormone therapy because it’s blocking the effects of estrogen. Some medications used for this purpose include tamoxifen, anastrozole and letrozole."

Is there a cure for breast cancer?

"Breast cancer is a highly treatable disease, and in many cases is curable. But that early detection is very important for the best chance of being cured. Being cured of the cancer means that it will never return, so most treatments that we currently have for breast cancer can be considered curative, especially when the tumor hasn’t spread too far, such as to the lymph nodes or other organs."

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"Even when the cancer is more advanced, there are many treatment options available that can potentially cure the disease or in some cases will prolong a patient’s life for months to years."

At what age can you get breast cancer?

"Breast cancer is commonly seen between the ages of 40 and 70 years old. The most common age of diagnosis for white women is 63, and for black women it’s 59 years old. They’re still doing research as to figure out why black women develop cancer at a seemingly younger age on average."

"Developing breast cancer before the age of 40 is rare and may be related to genetic predisposition. Breast cancers developed in later years (over 65 years old) are more frequently estrogen receptor positive and can often be treated without chemotherapy."

Is ginger good to eat if you've had breast cancer?

Troso-Sandoval said that although ginger is believed to have properties that may slow the growth of breast cancer cells, it would be best for a patient considering complementary supplements to talk to their physician and consider additional treatment.

"There are many supplements that are being explored in the treatment of breast cancer," she said. "While most herbs and supplements are considered useful as complementary therapy, they are not recommended in place of traditional chemotherapy or hormonal therapy to cure breast cancer. I feel very strongly that patients seek true medical care and look for these herbs and supplements as complementary therapy to aid their immune system, prevent recurrence, help their overall general health as opposed to a pure cancer treatment because they’re not good enough."

What part of the body does breast cancer affect?

"Breast cancer originates within breast tissue but has the ability to spread to the lymph nodes in the axilla or under arm in the earlier stages. If very aggressive or left untreated, the cancer can spread to other lymph nodes and then to other organs in the body including the liver, lung, bone, and even brain."

What does the breast cancer symbol mean?

"The pink ribbon is an international symbol of breast cancer awareness, and so it’s very prevalent this month in particular. Pink ribbons, and the color pink in general, identify the wearer or promoter with the breast cancer brand and express moral support for women with breast cancer. It’s often used by family and friends of the patients and the patients themselves to express support."

Why is a breast cancer tumor called a lump?

Troso-Sandoval said this is a very common question, and it's really just a matter of vocabulary. "Breast cancer is an abnormal growth of breast cells. The growth can form a tumor which is referred to as a lump or a mass, nodule or tumor. It is something that can sometimes be felt through the skin in the breast. Ductal breast cancers often are described as a lump. Some breast cancers, such as lobular cancers, do not form a lump and are sometimes detected as more of an area of thickening. Sometimes breast cancers are small and deep within the breast and cannot be felt on the surface."

She added, "That is why screening mammography is so important — to catch those really tiny, small ones that are deep that we can’t otherwise detect."

How long does it take for breast cancer to spread?

"Every tumor has a different growth rate and no two breast cancers are the same. Some cancers, especially if they’re estrogen receptor positive or hormone positive, they may grow very slowly over months or years and will be detected before spreading outside of the breast. Other cancers may be more aggressive and have a faster growth rate, especially in younger patients with triple negative breast cancers. They’ll come in and say, two weeks ago this wasn’t there and now it seems to be growing every other day and seems to have appeared out of nowhere. Those are obviously more aggressive, faster growing cancers. There’s another type of breast cancer called HER-2 positive breast cancer, and those tend to spread to the lymph nodes or other organs earlier in the course of its growth."

When is breast cancer prevention week?

According to the American Cancer Society website, National Breast Cancer Awareness Month is October, and National Mammography Day is Oct. 19.

Other common questions from patients

Two frequently asked questions that Troso-Sandoval gets from her patients involve diet and hair loss.

"Patients often ask me, 'What can I eat and not eat?'" she said. "A lot of patients like to control the things that they can control, which is what supplements they take or what food that they’re eating."

She said there isn't any strong evidence that anyone should take on a particularly stringent diet plan after being diagnosed, or to help prevent cancer. In general, Troso-Sandoval said she'll usually tell her patients not to eat anything they wouldn't eat if they were pregnant.

"Our general recommendation is to eat healthy and eat balanced, and drink a lot of water," she said. "Water is very good for helping to keep the system hydrated and also to help clear the system of toxins and the chemotherapy. We recommend lean meats and fish, whole grains, fruits and vegetables and to avoid processed food."

Troso-Sandoval's patients also ask her about hair loss during chemotherapy. Some hospitals now provide a cooling cap system. "We can offer patients who require chemotherapy the option to wear this cooling cap that will prevent a large amount of their hair loss," Troso-Sandoval said. "It’s becoming a big deal for a lot of young women. You’re fitted and given your own personal cap and there’s a system that’s hooked up by a pump and it keeps the cap ice cold to freeze your hair follicles, so you don’t lose as much hair."

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