MONDAY, Oct. 31, 2022 (HealthDay News) — Tom Fallon, now 69, felt a lump in his left breast while taking a shower about a year ago. The Florida retiree didn’t think much of it at all — at first.

Over the course of several months, the lump became sore and enlarged, so he went to see a therapist. He quickly found out he had breast cancer and was prescribed it mastectomy almost immediately. But his family urged him to seek a second opinion.

“I didn’t even know that men could get breast cancer. I do sports, I eat right. It was a shock,” Phelan said.

Then he met Dr. Kathryn Zabicki Calvilla, a breast surgeon and founder of New England Breast & Wellness in Wellesley, Massachusetts. She spent 16 years as a breast surgeon at Boston’s Dana Farber Cancer Institute before opening her own practice earlier this year.

The Calville Clinic is one of a handful of breast health centers popping up across the country. Her practice focuses on breast health, from assessing lifetime cancer risk to organizing screening and treatment for people with breast cancer and people concerned about breast cancer risk. She performs exams, genetic testing, breast surgeries and biopsiesall of which are usually covered by insurance.

She recommended that Phelan try hormone-blocking therapy to reduce the mass so that the lump could be removed but the breast could be spared. His doctors agreed to the proposal and he is now cancer free and his left breast is intact.

Fallon also underwent genetic screening that could potentially save the lives of his siblings, sons and grandchildren if he tested positive for any cancer genes. Fortunately for everyone involved, he didn’t.

Comprehensive treatment of breast cancer

When people come to Calville, she performs a formal breast cancer risk analysis to see if genetic testing is needed. If so, she suggests testing the full panel of 77 cancer-causing genes. These genes can increase the risk of many other cancers, including colon, breast, ovarian, pancreatic, brain, and prostate.

“We’re looking for more than just two breast cancer genes,” she noted. “I also calculate each woman’s lifetime risk of breast cancer to tell us whether we need to add additional breast cancer screening and preventive medications.”

Some high-risk patients will need additional testing. Some people come for a second opinion, while others visit her more regularly for treatment and close monitoring.

“At 50 years old and in academic primary practice, I’ve never had a formal cancer risk assessment or a lifetime breast assessment,” Calvillo said. “We need to be proactive, not reactive.”

When Kathy M., 54, a self-employed retailer living outside of Boston, was diagnosed with aggressive triple negative breast cancer in January, she visited several surgeons before meeting with Calvillo. Katie underwent chemotherapy to kill the cancer cells before having a mastectomy. In the end, she chose Calville to perform a nipple-sparing mastectomy with hidden scars. She now uses fabric expanders to make room breast implants. Calvillo helped her understand the pros and cons of each procedure.

Katie’s first doctors wanted to see her every year for a follow-up, but she feels more comfortable seeing someone more often to make sure the cancer is still at bay, so she sees Calville a few times a year.

There is no one-size-fits-all solution for breast cancer surveillance, Calvillo said.

Individual treatment

The most important thing is that people with or at risk of breast cancer get the best possible care, breast cancer experts say.

“As breast cancer care becomes more and more specialized and more patients take an active role in their treatment, specialized care is a definite trend,” said Dr. Marissa Weiss. She is the chief physician and founder Breastcancer.org in Ardmore, Pennsylvania

“We believe that every person with breast cancer deserves the best care, which means the best in every specialty: radiology, surgery, pathology, radiation oncology, medical oncology, genomic and hereditary tumor genetic testing, etc.” Weiss said. “This may be available at a specialist clinic or hospital – depending on where you live, what your health insurance allows, what is culturally comfortable and where you feel listened to, understood, respected and cared for” .

Cancer centers are the best place for cancer care, said Dr. Sarah Cate, director of the Breast Surgery Quality Program and Special Breast Surveillance Program at Mount Sinai Health System in New York. “We can do same-day imaging, offer genetic counseling and testing, and have more resources than a private practice.”

However, there is a role for these niche breast health practices.

“There are patients who take a little longer to understand screening options or next steps after an abnormal disease. mammography” Kate said. “A lot of primary care doctors or OB-GYNs don’t have the time to go through all of these issues with their patients.”

Additional information

Breastcancer.org offers more detail gene analysis for breast cancer risk.

SOURCES: Tom Fallon, breast cancer patient, Bradenton, Fla.; Ekaterina Zabicki Calvila, MD, founder of New England Breast and Wellness, Wellington, MA; Cathy M., breast cancer patient, Boston; Marissa Weiss, MD, Chief Medical Officer, Founder, Breastcancer.org, Ardmore, PA; Sarah Cate, MD, Director, Breast Surgery Quality Program, Breast Care and Surveillance Program, Mount Sinai Health System, New York

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