Breast Cancer Treatments

Lyle Henry, M.D., general and vascular surgeon and chief of surgery at Columbia Hospital

Last Updated: Oct. 1, 2003

Not long ago, Dr. Lyle Henry, a general and vascular surgeon and chief of surgery at Columbia Hospital, treated a young woman who was seven months pregnant. She’d visited her doctor because of a lump on her breast. The doctor sent her to a surgeon, who wrote the lump off to pregnancy. Shortly afterward, she noticed a second lump and returned to the doctor, who sent her back to the surgeon. The surgeon’s diagnosis? Breast cancer.

“One in eight women will have breast cancer,” Dr. Henry, said. Or, putting it another way, “about twelve percent of women in the U.S. will develop breast cancer during their lifetime.”

Lyle Henry, M.D., general and vascular surgeon and chief of surgery at Columbia Hospital "Most women are pretty good observers. When you have a discrete lump in your breast, it's not normal. A lump is never normal and you have to know what that is."

Breast cancer and younger women
Dr. Henry said he and his colleagues are seeing increasing numbers of younger women with the disease. While there is no hard and fast evidence, one theory behind the spike is that women are choosing to start families later in life.

“There are certain things that lessen your risk, and one of them is having children,” he said. “We’re seeing young women who are delaying their onset of pregnancy. They’re having careers and doing other kinds of things, and they’re either getting married later or having their children later and there’s some thought that this may increase the rate of breast cancer in young women.”

Risk factors for breast cancer include age, previous breast cancer, benign breast disease, a family history of breast cancer, early onset of menstruation, late menopause, obesity after menopause, low activity rate and exposure to radiation early in life.

Although breast cancer rates may be on the rise in younger women, Dr. Henry said standard breast imaging practices aren’t as effective in detecting possible cancers as they are in those who are middle-aged and older.

“We don’t recommend that younger women have mammograms on an annual basis. It’s not common for women in their 20s and 30s. Routine mammograms are now recommended for women between the ages of 40 and 70; initially the low end of that age range was 50,” he said.

Detecting breast cancer
Mammograms look for differences in the densities between the fat in breast tissue. Younger women’s breasts tend to be denser, making the differences less distinct. Another pointer to possible cancer is calcification in the breast tissue.

“(The calcifications) look like flecks of white pepper,” Dr. Henry said, “and one of the things we look for in early breast cancer are these calcifications of the breast. We don’t know why, but it’s an associative finding.”

The most effective preventative for young women who may be concerned about breast cancer is the monthly breast self-exam. “A lump is not normal, a lump is never normal and you have to know what that is,” he said.

“It could just be a cyst, and if you stick a needle in that cyst and draw the fluid off and it goes away and stays away then it’s not a lump anymore. Or you can have an ultrasound done and if the ultrasound demonstrates that it’s what we call a simple cyst, then it can stay. Otherwise it has to be biopsied in some way.”

For most women, Dr. Henry recommends an excisional biopsy – complete removal of the lump.

“It’s easier for the woman not to have to deal with it,” he said. “There’s no anxiety, because it’s not there.”

Dr. Henry encourages young women to do breast self-exams, and he also wants medical practitioners to take breast abnormalities seriously in women of all ages. “You just cannot assume that a lump in a breast is ever normal in a young woman,” he said, “and remember that young women get breast cancer.”

For women who do turn out to have the disease, there are more options today than there were when Dr. Henry began practicing medicine. Earlier diagnosis and the realization that less invasive surgery can yield identical results has made a huge difference in treatment.

Today, it’s likely that a woman with cancer may lose a breast or portion of her breast, but often that is all.

Sentinel node biopsy
Dr. Henry is one of the first doctors in the area to perform a sentinel node biopsy, in which the portion of the lymph nodes in the armpit closest to the affected breast are removed and examined for tumor cells. In 80% of cases, the nodes are clear of cancer cells, signifying that the disease hasn’t spread, he said.

That’s a big step from past procedures in breast cancer surgery.

“At the turn of the century there was this guy named (William) Halstead who had this operation called radical mastectomy in which you removed the breasts, all the muscles of the chest wall and all the lymph nodes in the armpit.”

Learn more
Dr. Henry will team up with Dr. Patrick McWey, a diagnostic radiologist, to present the following program. Everyone is invited to attend to learn more about this important health topic:

Title: Breast Cancer Occurrence in Young Women
Event Dates: 10/16/2003
Time: 7:00 p.m. to 8:00 p.m.
Location: Columbia St. Mary’s Milwaukee Campus, Brady Hall
Cost/Fee: Free: Advance Registration Required
Description: Join us for an important program designed to increase awareness about the rising rate of breast cancer now being diagnosed and treated in younger women. Learn about the different testing techniques that are available and options for successful treatment from surgeon Dr. Lyle Henry and Dr. Patrick McWey, interventional breast radiologist. You also will have a unique opportunity to speak with Tracy, one of their patients, a remarkable young woman and breast cancer survivor who was diagnosed at an early age.

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