October is Breast Cancer Awareness Month, a time when both men and women should feel empowered to learn about the signs and symptoms of breast cancer and how to navigate a diagnosis. With flu season and COVID-19 looming, it’s important now more than ever to understand and take care of our health. We caught up with Dr. Lane Tassin, regional chief medical officer of FastMed Urgent Care, to discuss breast cancer symptoms, how to support a loved one through a diagnosis and how COVID-19 could play a factor in treatment.
Tell me about yourself and the work that you do with FastMed.
I’m the regional chief medical officer for the western region, which is Arizona and Texas. We do a lot of research on the latest and greatest thinking in certain areas. What are the most current recommendations? We’re in charge of the medical decision making, the direction and decisions that are made by the providers.
What are the main signs and symptoms that folks should look out for when it comes to breast cancer?
Either women feel a lump, their partner feels a lump, they notice some asymmetry in their breasts, they notice a change in the skin of their nipple or maybe one is larger than the other. Possibly a nipple discharge, like a bloody discharge. Those are the most common things, people trying to feel a lump. In men, it’s a bit different. In males, breast cancer is relatively quite rare, it’s less than one half of one percent in this country. There are a lot of conditions where men have what’s called gynecomastia, an enlargement of their breast tissue. It’s usually symmetrical, but asymmetrical breast masses where a male would notice a lump behind their nipple. Males can have breast cancer. It’s not just women. Just because you’re a guy, don’t think you’re immune to breast cancer.
If someone is uncertain about their symptoms, what is your best advice for going about getting diagnosed?
There are surgeons and oncologists who specialize in breast cancer. The treatment of breast cancer is a multidisciplinary team approach because there are surgeons who specialize in evaluating and treating breast cancer, radiation oncologists who are specifically involved with radiation therapy and then medical oncologists who are involved with either endocrine therapy, chemotherapy or biologic therapy. They can start with their primary care physician if they have one. That’s always a good place to start, and they can generate the appropriate referrals for someone to get further evaluated. These days, mammography remains the standard approach for diagnosis. If a mammogram indicates it, then ultrasounds and MRIs can be used to further evaluate a suspicious mass, but by and large mammography is the place to start. Family history has a lot to do with it. Ancestry has a lot to do with it. There are genetically anomalous pools of people who have high risks and then there are people who have spontaneous mutations. BRCA 1 and 2 are genetic things that increase your risk of cancer. Someone who had radiation therapy in childhood for some other problem, maybe they had lymphoma and had radiation therapy somewhere between the age of 10 and 30, then that person would be at higher risk. The first thing to do is assess a woman’s risk of breast cancer and then once you have determined that, then the approach of how to evaluate them depends on their age group.
What is the importance of early detection?
The importance of early detection is that breast cancer is prone to metastasize. It wants to go somewhere else. It metastasizes either to the chest wall or into the lymph nodes in your armpit or sometimes the lymph nodes behind your collar bones. It likes to go the bones, the lungs, the brain. Catching it early is important for reducing complications and improving long-term survival.
How can COVID-19 affect those with breast cancer?
COVID-19 has had very far-reaching effects on how people with breast cancer are treated, that goes from things that are relatively subtle to things that are very overt. Hospitals delaying surgeries was a really big thing. People don’t want to be in congregate clinic settings. That has led to things like outpatient infusions. People that were receiving drug infusions at the oncology clinic are now receiving those infusions at home, so that has tied into the home healthcare industry. People that are on chemotherapy of most kinds are immunosuppressed. Their immune system is not as strong as it would be. That increases their risk of catching COVID-19. The scheduling and the flow of oncology clinics has been affected by that. What people are balancing in their mind is what is the risk of catching COVID-19 at the oncology clinic versus what is the risk of progressive cancer disease? People have been very reluctant to seek care for a lot of things. What COVID-19 has done is increased the complexity of caring for a group of people that already have a severe underlying illness. It’s all about treatment delays versus risk of progressive disease. COVID-19 has affected the social aspects of being treated for cancer. It’s certainly thrown a wrench in people’s plans to get surgery or treatment.
What can someone do if their loved one is diagnosed with breast cancer?
One in eight women have a lifetime chance of getting breast cancer. That’s an astounding statistic. It’s all about extending social support systems. Emotional support is important for keeping people mentally healthy, and mentally healthy people seem to be more physically healthy people. Having a support system of friends and family is very important.
In honor of Breast Cancer Awareness Month, what is one thing that you want people to know about breast cancer?
How incredibly common it is and in the last 25 or 30 years, survivability has increased significantly because therapies have become better and more targeted. Genetic testing has become so much more advanced. There are all these advances: survivability, detection, therapy. Any woman that has a concern about their breasts should not ignore it. If something doesn’t seem right, maybe it’s not. They should not ignore any potential concerns. They should seek further evaluation and care for it.